L'osteocondrosi lombare è una delle forme più comuni della malattia di base, l'osteocondrosi stessa.Lumbar osteochondrosis, the symptoms of which are equally defined in both men and women, manifests itself in the form of pain concentrated in the sacral region, which is reflected in symptoms in the lower extremities, which is often independently defined by patients as "pinching of the lumbar nerve".
General description
Molto spesso, la forma di osteocondrosi in esame si sviluppa sullo sfondo di lesioni alla schiena e di uno stile di vita sedentario;consequently, people whose particular professional activities involve loads that weigh on the back are automatically at risk of developing this disease.And it's not just office workers, who, obviously, belong to this group, but also loaders, builders, service workers (waiters, for example), drivers, etc.
An important role is also played by the hereditary factor in the context of consideration of thoracic osteochondrosis.Here not much, not a little, but about 60% of the probability is present if the disease is present in close relatives.The rest is influenced by environmental factors that, in one way or another, affect the spine.
Lumbar osteochondrosis, like its other forms, is characterized by pain of varying degrees of severity, which can be aching, occurring after sleep or after remaining in the same position for a long time (during prolonged sitting, standing), as well as stabbing and sharp.In this last version, they arise following the prolonged adoption of an uncomfortable posture with the simultaneous impossibility in this situation to implement actions aimed at straightening up, thus eliminating this posture together with the load it provides.The same painful sensations arise from pinching under the corresponding influence of the nerve roots, as well as irritation of the nerves in the spine, irritation of the ligaments and muscles (concentrated in the area of innervation, that is, the actual location of the nerves of the affected region that control it) and swelling.
It is important to note that in an isolated form this type of osteochondrosis is extremely rare, and therefore very often the course of the disease is combined with the symptoms inherent in cervical osteochondrosis, which we will talk about in our next article.
The general and early symptom, relevant for all forms of osteochondrosis, as we have already noted, is the manifestation of pain, which in this case is determined by a specific localization, that is, pain in the lower back.Spread (radiation) of pain can be noted to the thighs and buttocks, as well as to the legs (from their outer surface).
The term used to define osteochondrosis in its most extensive version (degenerative-dystrophic lesion), relevant to the intervertebral disc, actually implies a significant, in its diversity, complex of pathological conditions directly related to various types of structures of the spinal column (spine), namely discs, joints and osteophytes.The same problems directly related to disc damage are its protrusion and discogenic pain.Types of osteochondrosis and areas of concentration.
Protrusions in lumbar osteochondrosis
Protrusions in this area of our interest develop more often;Furthermore, it is the protrusions that cause pain in the lower back.The lumbar region itself, given its position and characteristics, is the most susceptible to the onset of some functional problems.
That is, considering this statement on the one hand, we can highlight that our center of gravity is directly related to the lumbar region in particular and, accordingly, bears a significant part of the loads.When viewed from the other side, you can see that a significant range of motion, once again, falls right into this lumbar region.Taking this into account, the greatest tendency for damage (as well as for the protrusions that interest us) occurs precisely on the discs concentrated in the lumbar region.Also, we must not forget that changes in the discs in this and, of course, also in other areas occur against the background of age-related degenerative processes.
Let us remind our readers what ledges really are.The mutual connection of the discs in the spine is ensured by discs based on cartilaginous tissue.The main components of the intervertebral disc are the nucleus pulposus and the fibrous ring, through which fixation within the vertebral disc is ensured.The influence of certain factors and conditions causes the possibility of rupture of this ring, against the background of which, in turn, protrusion of the core occurs.As a result of this process, a hernia develops.As for the protrusion, it is already developing as a result of a similar process, but without the resulting rupture of the ring - in this case it is simply subject to thinning and not rupture, because the core protrudes directly through the ring.In fact, this protrusion is called a ledge.
As for the symptoms of protrusion, it manifests itself as follows:
- feeling of stiffness in the lower back;
- pain in the lumbar region;
- chronic low back pain;
- lumbosacral radiculitis;
- numbness, pain, tingling in toes, feet;
- urination dysfunction (in rare cases of the pathology in question).
Conservative treatment is mainly used for lumbar disc protrusion.Meanwhile, protrusions that exhibit significant development are often accompanied by severe symptoms that are resistant to treatment;in this case surgery is no longer possible.
Lumbar osteochondrosis: symptoms
Pain in this form of osteochondrosis manifests itself in various variations in intensity.So, these can be aching pains that appear mainly after sleep or after a long period of sitting, or there can also be excruciating pains that are sharp in their manifestation.Furthermore, the manifestation of the latter is often noticed when one assumes an uncomfortable position without the possibility of straightening up.Any type of pain is directly related to the effect on the nerve endings, muscle swelling, irritation and pinching that the nerve roots are exposed to.The pain is also associated with irritation of the lumbar ligaments in the area of innervation of its nerve endings.
Increased pain in the lower back in this form of osteochondrosis is observed when coughing and sneezing, including during body movements (especially when bending forward).
Lumbar osteochondrosis can manifest itself, in addition to lower back pain, also in the form of sensory disturbances found in some areas (skin, lower half of the body, leg muscles).It is also possible that the tendon reflexes in the legs weaken or disappear completely.As a rule, it is osteochondrosis that causes the development of curvature in the lumbar spine.
According to the specific plane of effective curvature, osteochondrosis is divided into the following types:
- kyphosis: in this case there is a flattening of the lumbar region and often an arching of the back;
- lordosis: the spine bends forward;
- scoliosis: the spine is curved to the left or right.
Pinching of the roots belonging to the spinal cord as a result of the development of osteochondrosis in the lumbar region is often determined in the form of a number of specific disorders, namely disorders of defecation or urination, disorders associated with sensitivity in the genital or perineal area.
As a rule, pain appears (and even worsens) due to the impact produced during physical activity.A painful reaction in this case can be observed both after this load and after some time from the moment of its impact.Basically, patients' complaints in this regard are reduced to the appearance of dull, aching pain in the lumbar region, and in some cases radiating to the leg, which is called lumbago.Also, complaints of pain in the leg with its intensification when trying to lift something heavy (low back pain) may occur.The same applies to sneezing and coughing, driving with tremor, changing body position and staying in the same body position for a long time.
As a result of an exacerbation of the disease in question, constant and pronounced tension occurs in the back muscles, which manifests itself in the inability to perform actions aimed at straightening or moving.Any movement is accompanied by increased pain.Furthermore, even if the patient spends little time in the cold, he experiences acute lower back pain (also called “low back pain”).
Symptoms of lumbar osteochondrosis also appear in the following cases:
- reduced sensation in the thighs, buttocks, legs and feet (which is noticed a little less frequently);
- spasm of the arteries of the feet, increased cold in the legs;
- tingling sensation in the legs, “goosebumps”;
- flaking and dry skin in an area where you usually experience loss of sensation or pain;
- sweating disorders.
The most unpleasant complication that occurs against the background of osteochondrosis is vertebral instability, in which the disc ceases to properly fix the vertebra.This, in turn, causes a “slipping” under the influence of gravity of the lumbar region from the sacrum when the load is placed on the lumbar region.As a result, not only unpleasant disorders can develop, but also dangerous disorders that affect the functioning of internal organs.The genitourinary system "suffers" in particular;this manifests itself in men as potency problems and in women as problems relating to the appendages, uterus and ovaries.
Manifestations of lumbar osteochondrosis
According to the most comprehensive classification, a number of specific syndromes relevant to lumbar osteochondrosis are identified.In particular, these are the following syndromes:
- reflex syndromes: include lumbar ischalgia, lumbago and low back pain;
- radicular syndromes – vertebrogenic (or discogenic) sacrolumbar radiculitis, the course of which is mainly accompanied by damage to the first sacral root or the fifth lumbar root;
- radiculovascular syndromes - radiculoischemia manifests itself as a process of vascular compression (in particular, veins or arteries are subjected to compression), while compression is performed simultaneously with the root.
We briefly describe the syndromes listed.
Lumboniain particular we mean chronic pain that gradually manifests itself after having assumed an uncomfortable position with the body for a long period or after a prolonged session, as well as after the impact exerted on the body and on a specific area after physical activity.
Low back painmanifests itself in the form of acute lumbar pain, characterized as "low back pain";Low back pain mainly occurs when lifting heavy objects or when a movement fails.Sometimes low back pain is also observed after coughing or sneezing.
Diseases accompanying lumbar osteochondrosis
Lumbar osteochondrosis occurs not only in combination with pain and other listed symptoms, but also in combination with some characteristic diseases of internal organs.
Therefore, approximately more than 30% of patients with clinical symptoms relevant to lumbar osteochondrosis note the presence of some problems associated with the liver or gastrointestinal tract functions.The fact is that the presence of a particular disease of the gastrointestinal tract, pancreas or liver causes, along with painful impulses, tension in the blood vessels and muscles and spasms, causing a state of oxygen deficiency with the simultaneous development of a degenerative process in some areas of the body.The process is aggravated by the metabolic disorders inherent in this type of disease.
Also, as we noted earlier, low back pain can provoke the development of diseases in the pelvic organs.Women can encounter such a disease as inflammation of the appendages (which is called adnexitis), and men, in turn, experience all the "delights" of prostatitis, that is, inflammation of the prostate gland.
Manifestations of lumbar osteochondrosis are also accompanied by phenomena of congestion in the pelvic area, which develop as a result of the above diseases, including chronic colitis, hemorrhoids and constipation.
Treatment
Mostly, the treatment of osteochondrosis is multicomponent and rather complex in its implementation.Mostly all therapeutic measures boil down to the following points:
- pharmacological treatment;
- if necessary, surgical treatment;
- diet;
- physical therapy.
An exacerbation of the disease requires, first of all, the patient to remain in bed.The main recommendation for this part is a place to sleep hard/hard.Extremely pronounced attacks require minimal physical activity and prompt consultation with an appropriate specialist.The appearance of symptoms indicating the possible relevance of lumbar osteochondrosis requires contact with a neurologist.