Many of us are familiar with back pain, which can disrupt normal life for a long time. Although the cause may be trauma, neurological disease or spinal deformity, lumbar osteochondrosis usually causes discomfort. This degenerative disease may occur even at a very young age, and its initial manifestations can be found even in teenagers and school children, but most patients are people after the age of 40. The changes in the spine associated with osteochondrosis can occur anywhere from the cervical spine to the lumbar spine and the coccyx. However, the most common form that brings a lot of unpleasantness and pain to patients is lumbar osteochondrosis. What pathology is this, what is typical, and pain in the lower back is always talking about this disease.
Lumbar osteochondrosis: what is the nature of the pathology?
Osteochondrosis is a term derived from two words: the Greek "bone" (meaning bone) and "chondron" which means cartilage. Therefore, rickets of the lumbar spine (and all other diseases) are caused by changes in the cartilage of the intervertebral disc, which is the natural "lining" between the vertebrae and the shock absorber during exercise. Changes in the structure and function of the intervertebral disc are accompanied by natural reactions in the vertebral body. For this disease, the body of the intervertebral disc gradually undergoes degenerative changes. The height of the intervertebral disc is reduced, thereby losing its physiological function, resulting in instability and changes in the vertebral joints. As the disease progresses, a reaction occurs in the endplates of the vertebral body. The reaction can be divided into three stages: edema caused by malnutrition and malnutrition changes, steatosis, and hardening in the last stage.
Causes of spinal osteochondrosis
When we are about 20 years old, our intervertebral discs begin to deform and change gradually. The gradual decrease of fluid in the intervertebral disc leads to a decrease in the space between the vertebrae (chondropathy). This means that the intervertebral disc can no longer be used as a shock absorber, and the tension in the anterior and posterior longitudinal ligaments of the vertebrae will change. As a result, a greater load is applied to the vertebral joints, and the load increases year by year. The ligaments of the spine are placed incorrectly, the extension is uneven, and the movable segments of the spine gradually become unstable. The dorsal segment usually consists of two adjacent vertebral bodies and an intervertebral disc between them. The upper and lower end plates in the vertebral body bear greater stress, thickening areas (hardening), and ridges (spinal plants) at the boundary gradually form. Due to this change, the entire clinical picture of the disease will be formed in the future.
What are the symptoms of lumbar osteochondrosis?
Almost any form of disease manifests as severe back pain, which is difficult to control and affects specific parts of the spine (from the neck to the lower back and the spine). The symptoms of lumbar osteochondrosis may be limited to the spine (in the lumbar region), or spread to the legs if they originate from the lumbar spine, or spread to the legs if they originate from the cervical spine.
Symptoms may appear during rest, exercise, or habitual activity. It may be due to compression, nerve root symptoms caused by stimulation of the nerve root area, or if it is caused by false nerve root symptoms in small joints or adjacent muscles. Usually, lumbar osteochondrosis is combined with other parts of the disease (thoracic spine, cervical spine), then the symptoms will be more extensive. In other words, the discomfort and pain not only cause the damaged part, but also immediately cause multiple osteochondrosis areas. The disease fluctuates, its condition aggravates (symptoms may seriously interfere with normal life) and temporarily relieved, and the symptoms gradually alleviate or almost disappear. However, any factors, physical or mental, may cause a sudden relapse.
How is spinal osteochondrosis diagnosed?
The diagnosis is based on the study of the patient’s medical history and chief complaint, physical examination with identification of typical symptoms, and neurological examination. Nowadays, doctors are more and more inclined to perform instrumented diagnosis, because other pathologies are usually hidden under the guise of osteochondrosis.
For example, bone health is an important factor in patients who suffer from persistent back pain and plan to undergo surgery to relieve the pain. If the patient's bone density is found to be low before the operation, it may affect the treatment plan for osteochondrosis before and after the operation, during the operation. A study by the New York Special Surgery Hospital (HSS) showed that preoperative computed tomography scans of the lumbar spine showed that a large number of patients had low bone density and had not been previously diagnosed.
Of the nearly 300 patients tested, almost half were diagnosed with osteoporosis or osteoporosis. This is especially important to consider among people over 50. The prevalence of low bone mineral density in this group was 44%, and the ratio of diagnosed osteoporosis was 10. 3%. Low bone density is a known risk factor for vertebral fractures, which may aggravate the condition in the treatment of osteochondrosis.
Treatment of spine osteochondrosis
The treatment plan depends on the severity of the symptoms. Physical therapy is the main method of early pain relief. Use ultrasound, electrotherapy, and heat treatment. Complement treatment with appropriately matched pain management (such as NSAIDs, muscle relaxants, and steroids). Can use injection method-blockade, trigger point injection. Shown are manual therapy, osteopathy, exercise therapy.
Surgical treatment is always the last resort. In some cases, surgery is required. An example is bladder or rectal paralysis caused by the narrowing of the spinal canal or herniated disc (large herniated disc). This operation option is selected together with the doctor. However, after surgical treatment, the problem has not been completely eliminated, and long-term rehabilitation and life-long supportive treatment are required. This is due to the fact that osteochondrosis does not disappear anywhere, but can progress in other departments.