Osteochondrosis is the most serious form of degenerative injury -Dystrophic of the vertebral column, which is based on the defeat of the core of the intervertebral disc core, with subsequent deformations of the bodies of the adjacent vertebrae, of the intervertebral joints, of the articulations of the compromised Ligamic and the path of the patimero system and the EMOCHING system.
One of the most common forms of osteochondrosis is osteochondrosis of the lumbar region or, more precisely, the lumbosacral column.For a long time - both men and women - are familiar with back pain in the lower back, sacred, lower end, caused by various types of lumbar osteochondrosis and its complications.Among the reasons for disability and temporary disabilities, this disease occupies one of the first places.
The course of the disease is chronic, usually with periods of exacerbations.Very often, the exacerbations of the osteochondosis of Linema lumbar lift and the transfer of weights, hypothermia, stress and injuries are aroused.
Osteochondosis of the lumbar column - causes, mechanism of occurrence and development
There was no unequivocal cause of osteochondrosis, the disease is considered polyphaast.The Most Popular Theory Is, According to Which the Cause of Osteochondrosis of the Spine is the Constant Overwhelming of the muscles or hyPotenSion of muscles, nonphysiological muscle tension, which leads to overloading the vertebral segments, the deterioration of their blood supply and, ultimotely, last.to the degeneration of the intervertebral discs and joints, The result of which is the result of which is the result osteochondrosis.
The cause of the premature aging of the intervertebral discs can also be endocrine and metabolic disorders, a hereditary predisposition to the development of osteochondrosis, autoimmune disorders and microtrauma.The negative role of the visceral has also been demonstrated, that is, related to the internal organs, in the development of the osteochondosis of the spine.A significant role in the development of the disease belongs to the adverse inheritance.The contribution of hereditary factors to the appearance of the lumbar osteochondrosis is about 60%, the rest refers to the factors of the external influence adverse on the spine.
The factors that contribute to the development of osteocondrosis both in the lumbar and other parts of the spine are very numerous.The main of them: improper posture, hypodynamia, muscle overvoltage in the lumbar region due to the constant weighing or an excessive acute load, hormonal renovation, endocrine and somatic diseases, violation of the normal blood supply to the tissue of the plug, emotional stress, reduced changes by age, poor nutrition.Under the influence of these factors in the structures of the spine, the processes of dehydration and circulatory disorders, arthrosis and subluxation in small joints, bone growths and disks - the hernias are gradually increasing.
The most obvious causes of lumbar osteocondrosis are often considered a sedentary lifestyle and back injury.Therefore, the risk group mainly includes those people whose profession is directly related to loads on the back.This is a wide range of professions - seller and waiters, surgeons and teachers - all those who are forced to spend most of the work time standing.The risk group includes manufacturers and removals, as well as athletes who, in the nature of the activity, are large loads on the spine.In addition, drivers, various employees, programmers, that is, those who have mostly sedentary work and suffering from hypodynamia, suffer from osteochondosis of the lumbar.
Symptoms of osteochondosis of the lumbar column
TOLumbar osteochondrosisPainful sensations of various nature are possible.This can be a painful pain that occurs with a prolonged seat or after sleep, as well as acute shots, causing the most uncomfortable pose and not allowing the opportunity to straighten.The pain is pinched by the nerve roots, by the irritation of the nerves of the spinal column, by the edema and the irritation of the muscles and ligaments located in the area of innervation of the lumbar column.
Pain syndrome can be caused by the compression of the root structures (radicolopathy), compression of the spinal cord (compression myelopathy), damage to the spinal cord due to an alteration of the blood due to push, restriction (stenosis) of the power arteries (veins (vascular myeloemia compression).
The reason for the compression can be: protrusion and hernia of the intervertebral discs, spondilolistz (which slip the vertebra forward compared to the underlying), the growth of osteophytes and the cartilage tissue in the vertebral segment.ConsequentiallyOsteochondrosis of the lumbar regionThe vertebral column leads to a narrowing of the canal through which the cerebrospinal nerves or the vascular structures pass and under certain conditions (embarrassing movement, physical activity, an without success of the body, etc.), compression (crushing).The compression of the nerve structures leads to various pain syndromes, muscle spasms.The compression of the blood vessels causes a violation of the blood intake: the organ of the organ that feeds on this ship or artery begins.
Clinical syndromes of osteochondosis of the lumbar column
The clinical picture for lumbar osteochondrosis is determined by a complex of vertebral symptoms (a change in the static and dynamics of the lumbar column) and of the symptoms escorted, which are understood as a violation of the function of the neurological and vascular structures in the lumbosacral region of the plug.
Vertebral syndromes of lumbar osteochondosis
With lumbar osteochondrosis, vertebral syndrome is characterized by the following symptom complex:
- Violation of the configuration of the Spinal Functional Anatomical Segment: an increase in flattening or (less often) of lordosis, scoliosis or lordostulus is observed;
- Violation of mobility in the lumbar region, a decrease in the volume of movements, the muscle-syry imbalance caused by the tension of the multi-human muscles both deep and superficial;
- Local pain and pain with active and passive movements, which cause reflected tonic muscle tension;
- violation of spring motor functions both of the intervertebral disc and, in general, of the vertebral-motor segment;
- Local pain (increase in sensitivity) of bone structures related to the spine in the affected area (pain during palpation, the vertebral and/or local vertebrosonal pain syndrome).
It is important to note that with the osteochondosis of the lumbar department, vertebral pathologies are always observed.The presence of signs of myelopathy, radicolopathy and myeloradicolopathy without evident clinical and morphological signs of the vertebral syndrome requires, as a rule, an examination in depth of the patient for the primary damage ("non soreter") to the nervous system.
Extroverse syndromes (reflections and compressions) for osteochondosis of the lumbar column
Estrovertebral syndromes are divided into two large groups: reflection and compression.
Reflex syndromesThey precede the compression and are caused by the irritation of the receptors of the roots of the nerves that emerge from the spinal canal through the intervertebral holes.Irritation can be caused by intervertebral hernia, bone growths and vascular disorders (edema, worsening of blood circulation) and inflammation.In some cases, this leads to intensive pain, which occurs not only at the local level, but also during the nerve at a distance from the place of irritation: the thus called "reflected pains", the reflected pain can be short and acute ("move") or stupid long term.In the area of innervation of the damaged nerve, vegetative disorders are possible (burning, goose skin, altered sensitivity).Myofascial pains are possible: muscle spasm, which leads to limiting movements.
Reflex syndromes include lumbago ("shift") in the acute development of the disease and lumballo with a subacute or chronic path.
The compression syndromes are syndromes that occur following compression, violation of the nerves, blood vessels, spinal cord in the area of the leap of lumbar segments.Compression syndromes for osteochondosis of the lumbosacral department are divided into root and vascular brown.A special case of compression syndrome is myelopathy - violation of the spinal cord.
The remedies syndromes (Radicolopathy) are generally due to the protrusion of the disc, causing violation of the cerebrospalous roots.The root symptoms deriving in this case correspond to the level of the vertebral segment concerned.Very often, the L4-S1 roots are interested.
Vascular brown neurological disorders are caused by the compression of the Arnia on the spine and the radical artery that pass with it.At the same time, "Ischia Paralytic" can develop catastrophicly characterized by peripheral paresis or paralysis of the muscle of the foot extensors.In such cases, the aspect of motor disorders is accompanied by the disappearance of pain.
The even more serious neurological manifestations are caused by a violation of the blood supply to the spinal cord due to the damage to the root-spinal arteries.At the same time, mylopathy in chronic disco is developed, usually at the level of lumbar thickening of the spinal cord.
The most unfavorable version of the vertical lumbar root syndromes is the compression of the "horse tail" - the caudal syndrome so called.Very often, it is caused by the fall of Ernia Medinal of the disc, which holds all the roots at the level of the segment concerned.
What is osteochondrosis of the lumbar column?What are its symptoms?How to treat osteochondosis of the lumbar?
Clinical classification of osteochondosis of the lumbar region.Degree of osteochondrosis
The classification of lumbar osteochondrosis based on the degrees is used for the systematic characteristics of the clinical manifestations of the disease.This classification systematically describes the symptoms of the disease and begins from the moment the patient has pain.
1 degree of osteochondrosis
It occurs when the intervertebral disc occurs caused by a strong movement or overvoltage.It manifests itself from a sudden pain, in the spine arises a feeling of passage of the electric current, the muscles are reflected tense.
2 degrees of osteochondrosis
The second degree can manifest itself in the form of intervertebral protruding symptoms and instability of the spine.Chronic pain that increases loads.The remission and exacerbations intervals alternate.The cervical region is characterized by neck pain, increasing after a long living room in a position, headache, pain in hand, shoulder pain, periodic discomfort or numbness between the fingers.For the lumbar region - back pain, pain in the gluteal region, periodic pain in the sacred, frequent fatigue in the legs.
3 degrees of osteochondrosis
It manifests itself in the form of symptoms of the intervertebral disc (pain along the interested nerve, numbness of the arms or legs, a change in the pace, headache) or distant symptoms of the intervertebral resistance: the violation of the cervical spine violation of the heart rhythm, difficulty breathing;
4 degrees of osteochondrosis
It is generally accepted that the fourth degree of osteochondrosis begins from the moment in which the hernia no longer manifests itself, the manifestations of the disease can decrease, but the symptoms of spinal instability, slide or torch the vertebrae or their complete fixation are still related to the other.The manifestations of the outcrops of the vertebral bodies (osteophytes) can join, which can also squeeze the spinal nerves or superimpose the spinal canal (secondary stenosis of the spinal canal) and squeeze the spinal cord (ischemia of the spinal cord).In addition, the fourth degree includes the consequences of the surgical intervention if the hernia has been promptly removed (various types of innervation, paresis, inflammation).
Treatment of the osteocondrosis of the lumbar column
With the first acute back pain, it is necessary to consult a doctor to establish a diagnosis in order to exclude an attack on kidney colic, appendicitis or any other disease that requires emergency medical treatment.
If the cause of back pain is known and this exacerbation of the osteochondosis of the lumbar column, first of all, it is necessary to maximize the load on the spine.It is necessary to observe the rest in bed for 3-7 days - sometimes only this can significantly reduce pain.But in order to accelerate recovery, it is necessary, that is, effective, treatment.He should stimulate his own protective and health processes in the human body.The treatment should take into account the location of the lesion, the stage of the disease, the functional state of the body and its individual systems.The surgical treatment of this disease is indicated only in very serious cases.Very often various methods of conservative treatment of osteochondrosis are used.
Conservative treatment of lumbar osteochondosis
The conservative treatment methods are, first of all, the pharmacological treatment.In order to reduce pain, as well as reduce inflammation, which is often the cause of vertebral syndrome, non -pounded anti -inflammatory drugs (NSAIDs) are prescribed in the form of tablets or - in acute cases - in the form of injections.Sometimes, after injection, an analgesic, the pain calms and does not recover even when the duration of the medicinal substance ends.This means that it was possible to break the vicious circle in which pain leads to muscle cramps and, in turn, muscle tension improves pain.However, if pain lasts for a long time, it is important to remember that fans usually have various side effects and with prolonged use it can cause unwanted complications - a decrease in the number of leukocytes in the blood, complications from the gastrointestinal tract.
Sedative agents (soothing) are often prescribed to improve the general condition of patients within 1-3 weeks, as well as small doses of antidepressants.With osteochondrosis of the lumbar column, if necessary, the block of novocaine is produced.Recently, the drugs of the anticonvulsants have started to be successfully used to relieve pain.
To reduce compression syndromes, manual therapy, traction treatment (spinal traction) and in special cases they are used - surgery.
When weakening the fixation properties of the binding system and consistency of the spine, it is recommended to use fixing devices: corsets, collars, medications, etc.However, only limited time can be used, since when they are used, weakening of the muscles is observed.And patients with spinal osteochondrosis are extremely important in the future to strengthen their muscle corset.
After removing acute symptoms, the task of creating muscle fixation comes first and therefore stimulate the regeneration processes of damaged structures.To do this, use therapeutic gymnastics, reflexology, massage.To do this, use chondroprotectors (drugs to restore the cartilage tissue).In addition to drugs that improve the condition of blood vessels (angioprotectors), vitamins, mainly of group B, calcium preparations that improve the condition of bone tissue.
For the treatment of osteochondosis of the spine, physiotherapy procedures are widely used.They reduce tissue pain and edema, improve blood circulation and stimulate muscle fixation.The procedures can be combined, alternative.Such methods of physiotherapy treatment such as:
- Darsonvalization of the Having Area of Back and Taping Rimbi;
- electrophoresis;
- low energy laser radiation;
- ultrasound;
- exposure to the magnetic field;
- Thermal procedures.
In the conditions of Sanatorium, mud, Ozokeritico, paraffin, radon, sulphide, hydrogen sulfur, terrible and other bathrooms are successfully used;
It should be remembered that for the development of full regeneration, it takes a fairly long period of time, in favorable circumstances it occurs in the sixth month.Therefore, the treatment should be long.It should be performed with a combined way, i.e. combined drugs with physiotherapy and physiotherapy exercises.