We are sure that you have read and heard that lumbar osteochondrosis often affects bank employees and clerks, programmers and representatives of heavy physical labor. This is true, but the truth is that nowadays it is hardly possible to find at least one type of activity that is not associated with the risk of developing this disease.
Why is that? Lumbar osteochondrosis is a kind of "tax on upright walking", a tribute that each of us must pay to nature. The reason for the degenerative changes in the cartilaginous tissue of the intervertebral disc lies not so much in the increased loads on its nucleus pulposus, but in the peculiarities of the blood supply to these structures.
Around twenty years of life, the arteries that feed the fibrocartilaginous tissues of IVD in adolescence are obliterated and for all the remaining years the nucleus pulposus and annulus fibrosus receive nutrients exclusively through diffusion, and this is clearly not! enough! Trace elements, polysaccharides, amino acids, and other structural components enter chondrocytes (cells that synthesize the interstitial substance of the disc) in extremely limited quantities, creating fertile ground for the development of dystrophic processes.
In the course of our professional activities, we regularly shed seeds on this fertile soil. We sit in the wrong position, lift weights incorrectly, move around a bit, and spend a lot of time behind the wheel or behind a computer monitor. All other things being equal, such a form of physical activity would "get away with us, " but under conditions of a limited supply of cartilaginous structures in the IVD, degenerative processes inevitably develop.
How is lumbar osteochondrosis manifested?
The first manifestation of osteochondrosis of the lumbar region is pain syndrome. As a general rule, for the first time a "lucky man" is struck by a sharp pain in the back, which pierces his body with a dagger. The pain occurs after an inadvertent twist of the trunk, a tilt, or after hypothermia. There is no way to bear such pain: he literally weaves a person with his hands from his legs and chains him to the bed.
What changes occur in the spine in the context of pain syndrome? To reduce pain, the nervous system sends stimulating signals to the deep back muscles. Strengthening muscle tone helps reduce mobility in the affected segment of the spine, which for some time reduces the severity of pain. In the future, myofixation ceases to perform a compensatory function, and such a tonic muscle imbalance only intensifies the pain.
When examining such a patient, the neuropathologist will detect signs of the fixation syndrome or objective symptoms of the disease - changes in statics and dynamics. By changes in statics in lumbar osteochondrosis, we understand a flattening or intensification of the physiological curvature (lordosis) and the appearance of a pathological curvature towards pain (scoliosis). The dynamic symptoms of the disease are a severe limitation of mobility (up to complete immobilization) in the affected segment.
All of these changes can be confirmed by spondylography (spinal x-ray) and more modern research methods such as computed tomography and magnetic resonance imaging. The images also show a decrease in disc height in the area of clinically significant PDS, hernial protrusion, osteophytes.
Lumbar osteochondrosis, treatment
The fixation and pain syndrome in combination with the morphological signs on the diagnostic images form a complete picture of the vertebral syndrome, which is caused by lumbar osteochondrosis. The next question we ask the doctor after completing the diagnosis stage is how to treat the disease?
Of course, it is not always the disease that needs to be cured, but the patient, but we will not shy away from philosophical discussions. And we will solve more urgent problems: first we will have to overcome the pain syndrome. To do this, we need both systemic and local-acting drugs, such as NSAIDs, corticosteroid hormones, muscle relaxants, and possibly even antidepressants. After pain syndrome relief, it is the turn of conservative treatment methods.
If you have been diagnosed with lumbar osteochondrosis, the treatment will be long and you must be prepared for this both morally and financially. De facto and de jure, it is impossible to completely overcome the disease, so with some frequency you will have to go to the doctor until the end of your days.
The treatment algorithm is always individual and is developed by the attending physician who knows the history of the disease, we will only list the possible directions of therapy. Reflexology has a positive effect, among the methods of which acupuncture is in the first place. Some specialists advocate traction therapy, although other schools of vertebrology deny this technique. Massage therapy is worth trying, you should definitely include back exercises (LFK) in your rehabilitation program, you can also enlist the help of qualified chiropractors.
In 90 cases out of 100 conservative therapy methods are sufficient to control the disease, the remaining ten patients are indicated for surgical treatment. In the absence of absolute indications for surgery (severe spondylolisthesis, spinal stenosis), treatment with minimally invasive surgery is possible. If the degree of morphological changes in the spine has reached a critical level, modern methods of disc reconstruction using implants are used.