Spondylosis is a chronic degenerative disease that affects the vertebrae, intervertebral discs, facet joints, ligaments and other tissues that form the musculoskeletal system. Many people believe that only adults and the elderly are susceptible to the disease. But in recent years, this diagnosis is increasingly applied in young people and even children. If osteochondrosis is not treated, serious complications can develop.
Treatment of lumbosacral osteoarthritis is carried out in clinics, where conservative methods are used to help relieve pain and stop the progression of the disease without surgery.
Osteochondrosis can occur in any part of the spine: cervical, thoracic, lumbosacral and multiple parts at the same time. But most often it affects the lumbosacral region. This is because the lower back bears the heaviest load when performing even simple daily activities: lifting heavy objects, walking, running, sitting. The lumbar vertebrae are the largest, so the discs that separate them are also the largest. The lumbar region, along with the cervical region, is the most mobile part of the spine. This fact, coupled with the heaviest loads, makes it a favorite "target" for osteoarthritis.
Initially, the pathology involves the intervertebral discs losing elasticity, becoming "dry" and losing height. Their shock absorption function is disrupted, causing the vertebrae to move closer together. The inner part of the disc, called the nucleus pulposus, is soft and begins to bulge, pushing the ring of fibers around it aside. This is how protrusions and hernias form. They can compress the spinal ligaments and spinal nerve roots, causing pain.
reason
The exact cause of osteonecrosis is unknown. But the fact that this disease is often diagnosed in representatives of certain groups shows that lifestyle has a great influence on the development of the disease. First of all, this affects people who lack physical activity and work sedentarily. An inactive lifestyle weakens the muscle layer and reduces the mobility of the spine. As a result, the muscles lose their ability to hold the spine in the correct physiological position, leading to rapid wear and tear of the neck.
Major risk factors for the development of osteonecrosis include:
- frequently lift heavy objects;
- overweight, obesity;
- endocrine diseases, hormonal imbalance;
- poor nutrition, insufficient vitamins, proteins and minerals;
- genetic burden;
- excessive physical activity;
- back injury;
- Postural disorders;
- Arthritis: arthritis, arthritis;
- congenital malformations of the spine;
- flat feet;
- pregnancy, especially multiple pregnancy.
Symptom
The danger of osteonecrosis is that it can be asymptomatic for many years. At first, there is a feeling of mild pain and discomfort in the lower back area, which will go away on its own after a short period of rest. Usually, patients do not pay attention to these signs and do not consult a doctor. But gradually the intensity of the unpleasant sensations increases and to relieve them, it is necessary to rest more or take painkillers.
Lower back pain due to osteoarthritis is the main symptom of the disease. Its nature, severity and location can vary greatly - it depends on the exact cause of the pain. Most often, patients complain of pain, which intensifies with physical activity, standing still for a long time, sneezing and coughing. Sometimes the pain radiates to the legs, sacrum, and buttocks. The feeling of discomfort disappears in the supine position. Acute and sharp pain is often described by patients as a "shot in the back".
Other common complaints:
- stiffness and tension in back muscles;
- impaired sensitivity in the lower limbs of varying severity, crawling sensation of "goosebumps" in the legs;
- limited mobility of the spine;
- gait changes, limping due to back pain or severe leg pain;
- muscle weakness in the legs;
- rachiocampsis;
- crunching in the back when bending or turning;
- Urinary and fecal incontinence or conversely, constipation and urinary retention.
Symptoms of lumbar osteoarthritis in women can be supplemented by certain gynecological diseases and infertility, and in men - infertility and erectile dysfunction.
Diagnose
Diagnosing lumbar osteoarthritis begins with a consultation with your doctor. In addition, laboratory and instrumental examination methods are performed to evaluate the condition of the spine and the body as a whole.
At the initial consultation, the doctor conducts:
- Survey.The specialist clarifies the complaints, time of appearance and presence of association with provoking factors: physical activity, prolonged static posture, sudden movements, hypothermia. He also studied medical documents - doctors' reports and previous examination results.
- Investigate. The doctor checks the skin and spine for obvious wounds, damage, and deformities. He evaluates gait and limb symmetry.
- Palpation. When palpating the spine, pain is detected, the presence of tumors or deformities is detected.
- Neurological examination. Consultation with a neurologist must necessarily include assessment of muscle strength of the limbs, sensitivity in them, as well as symmetry of tendon reflexes.
The patient will then be referred for a more detailed diagnostic examination. To evaluate the condition of the body, laboratory tests are prescribed:
- general and biochemical blood tests, including assessment of inflammatory indicators - ESR and C-reactive protein;
- General urinalysis.
Osteoarthritis in the lumbar region is confirmed by instrumental diagnostic methods:
- X-ray in two projections. X-ray images help evaluate the condition of the bones, identify abnormalities in the development of the spine, detect bone spurs and pathological changes in the joints.
- CT. Layer-by-layer CT images help study the spine in more detail. It visualizes the vertebrae, bone growth, and other important defects. CT scan with intravenous contrast shows the condition of blood vessels and blood circulation in tissues.
- MRI. The diagnostic method is preferred because it allows you to obtain a large amount of accurate information quickly and without radiation. MRI images show the condition of cartilage, ligaments, intervertebral discs, spinal nerve roots, spinal cord and other soft tissues.
Which doctor should I contact?
Diagnosis and treatment of osteoarthritis is carried out by doctors of several specialties: neurologists, vertebrologists, orthopedic traumatologists. For therapeutic procedures, a physiotherapist, massage therapist, acupuncturist and physiotherapist are involved. Doctors of all these specialties work in clinics. Qualified specialists conduct a comprehensive examination and prescribe effective treatment individually for each patient.
It is important not to self-medicate but to immediately seek help from specialists. Many people do not know why lumbar osteoarthritis is dangerous and how it affects daily life. If this disease is ignored, serious and often irreparable health consequences can occur. Therefore, do not delay seeing a doctor and register for consultation at the clinic at the first signs of the disease.
Treatment
What to do with lumbar osteoarthritis in men and women, only a qualified doctor can know. Self-medication is strictly contraindicated - this can aggravate the course of the disease. The doctor chooses treatment tactics strictly, taking into account the characteristics of each patient:
- year old,
- stage of osteoarthritis,
- current health,
- presence of comorbidities,
- pregnancy and lactation period.
Treatment methods for lumbar spondylosis:
- Treatment with medication.
The type of medication, dosage, frequency and duration of medication are chosen by your doctor. Depending on each clinical case, the indications are as follows:
- Nonsteroidal anti-inflammatory drugs.They have anti-inflammatory and analgesic effects. They are prescribed taking into account the severity of pain and accompanying pathologies, especially from the gastrointestinal tract and cardiovascular system.
- Muscle relaxants.Eliminate back strain and relieve pain.
- Glucocorticosteroids.Sometimes used to relieve severe pain and inflammation.
In case of severe pain, blockers may be prescribed. This procedure involves injecting pain relievers and anti-inflammatory drugs directly into the source of pain - at a point located next to the compressed nerve. This allows you to quickly relieve pain, improve the mobility of spinal joints and the general well-being of the patient.
- Physical therapy.
Physiotherapeutic procedures improve health, enhance the effect of prescribed drugs and accelerate tissue regeneration. For osteonecrosis, the following are recommended:
- shock wave therapy,
- magnetic,
- laser therapy.
To achieve maximum treatment results, it is necessary to undergo a course of physiotherapy treatment that includes several procedures. The doctor determines the duration and frequency of physical therapy individually.
- Massage therapy.
Massage is indicated outside of periods of exacerbation. It is performed by a qualified massage therapist who chooses the tactics of action on the body taking into account the medical history. You may feel better after the first session, but several procedures are required for lasting results. One of the main advantages of therapeutic massage is its additional impact on the psycho-emotional state. During massage, endorphins are released - hormones that create a feeling of pleasure and joy.
- Acupuncture.
The essence of acupuncture is that the doctor inserts special sterile needles into certain points on the body. They act on active points in the projection of nerve endings leading to the source of inflammation and pain. The method helps relieve pain, relax muscles and improve spinal mobility.
- Physical education therapy (physical therapy).
Exercise therapy is indicated during remission, that is, when acute pain is no longer present. Exercises are aimed at stretching and relaxing the muscles of the spine, strengthening and increasing the mobility of the spinal joints. Gymnastics increases blood circulation and stimulates metabolism - this helps improve tissue nutrition.
Regular and proper physical therapy, even at home, will prevent the condition from worsening and the onset of pain. And even during acute pain, bed rest is contraindicated, movement is required.
Consequence
The most common consequence of lumbar spondylosis is due to the herniation forming and compressing the spinal nerve roots. As a result, the following neurological symptoms occur:
- paralysis or paresis of the lower extremities, usually the feet;
- numbness and crawling sensation in the lower limbs;
- disruption of the genitourinary and intestinal systems.
Large herniations can compress the spinal cord, which is called discogenic myelopathy. In this case, persistent neurological symptoms develop, sometimes leading to disability. . . In addition, among the complications of osteoarthritis, it is necessary to highlight spondylosis - this is stiffness between the vertebral arches. This disease leads to marked limitation of movements in the spine.
Another unpleasant complication is chronic pain syndrome, which lasts more than 12 weeks and disrupts the patient's psycho-emotional state.
Prevent
The following will help prevent the development and progression of lumbar osteoarthritis:
- regular physical activity, gymnastics;
- control body weight;
- Warm up every hour when working sedentary and in a stationary position for long periods of time;
- proper nutrition;
- swimming pool tour;
- yoga and pilates classes;
- quit smoking and alcohol abuse;
- Avoid strenuous physical activity, especially lifting heavy objects;
- minimize stress.
Coming to the clinic promptly can prevent dangerous complications of osteoarthritis. Prescribing treatment at the early stages of the disease has a favorable prognosis for recovery. Early treatment will stop the degenerative process and make the patient's life painless and comfortable.