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Lumbale osteochondrosis

The causes of osteochondrosis of the lumbar spine

The osteochondrosis lumbar is a chronic disease that develops from a degenerative-dystrophic process in intervertebral discs between hurricane.The disease is widespread and has an impact from 25 to 40 years in most cases.

According to the statistics of back pain, every second adult experiences at least once in his life, while in 95% of the osteochondrosis of the spine.

Patients with a severe course of lumbar osteochondrosis with persistent pain and other manifestations are recognized as temporarily disabled.If your condition does not improve within four months, the problem of setting up a group of disabled people will be solved.

The osteochondrosis lumbar is a serious medical and social problem, since the disease mainly affects people in work and can also cause the hernia of the intervertebral disc without treatment.

Causes and risk factors

The factors that are predisposed to the development of a lumbar osteochondrosis are:

  • Anomalies of the structure of the spine;
  • The lumbarization is a congenital pathology of the spine, which is characterized by the separation from the sacrum of the first vertebra and its transformation in the sixth (additional) lumbar vertebrae;
  • Sacralization is a congenital pathology in which the fifth lumbar vertebrae is fed with the sacrum;
  • the asymmetrical location of the joint crissop of the band fire joints;
  • Pathological narrowing of the spine canal;
  • Reflected spondiogenic pain (somatic and muscle);
  • Obesity;
  • sitting lifestyle;
  • longer vibration exposure;
  • systematic physical stress;
  • Smoke.

Side effects of the statodynamic loads in combination with one or more risk factors lead to a change in the physiological properties of the mantle core of a fiber disc, plays a shock -absorbing role and offer the mobility of the spine.The basis of this process is the depolymerization of polysaccharides, which leads to the loss of moisture with a fabric of the jet core.As a result, the jacket kernel and thus the fibrous disc lose its elastic properties.Other mechanical stress provokes the lead of the fiber ring, which has lost elasticity.This phenomenon is called a lead.Cracks occur in the fibrous core due to the fragments of the jacket core (Prolapse, hernia of the intervertebral disc).

A long compression of the nerve roots, the certain organs of the abdominal cavity in the course of time, leads to a deterioration of its functioning.

The instability of the spine segment is developed by reactive changes in the bodies of neighboring vertebrae, intervertebral joints and the simultaneous spondylarthrosis.A significant muscle contraction, for example, against the background of physical activity, leads to a shift in the vertebral body and a violation of nerve roots with the development of radicular syndrome.

Osteophytes can be another cause of pain and neurological symptoms with lumbar osteochondrosis - bone growth in processes and bodies of vertebrae that cause roysold syndrome or compression myelopathy (compression of the spinal cord).

Forms of the disease

Depending on which structures are drawn into the pathological process, the lumbar osteochondrosis is clinically based on the following syndromes:

  • reflex- Lumbalgia, Lumboichachalia, Lumbago;Develop yourself against the background of the reflex tension of the muscles of the back;
  • Compression (spinal, vascular, radicular)- Their development leads to compression (compression) of the spinal cord, blood vessels or nerve roots.Examples are lumbosacral radiculitis, radiculoichemia.

Symptoms of lumbar osteochondrosis

In the case of lumbar osteochondrosis, the symptoms are determined through which structures are drawn into the pathological process.

Lumbago occurs under the influence of hypothermia or physical overvoltage and sometimes for no apparent reason.The pain suddenly appears and shoots.It exacerbates when sneezing, coughing, turning, physical exertion, seat, standing.In the lying position, the pain weakens considerably.Sensitivity and reflexes are preserved, the volume of the movements in the lumbar region is reduced.

At Palpation you observe:

  • Pain in the lumbar region;
  • Cramp of paravertebral muscles;
  • The flattening of the lumbar lordosis, which is combined with scoliosis in many cases.

The voltage syndrome of nerve roots with lumbar is negative.When increasing a straight leg, the patients notice the increase in pain in the lower back and not in their appearance in an elongated lower limb.

Often there are repeated occurrence of pain attacks with lumbar osteochondrosis, which are becoming more and more intense and long every time.

At Lumbalia, the clinical image is similar to a lumbago, but within a few days there is an increase in pain intensity.

In lumbar -colored, patients complain about pain in the lower back, which shine on one or both lower limbs.The pain spreads over the buttocks and the back of the thigh and never reaches the feet.

Vasomotor diseases are characteristic of lumbar spine:

  • Changes in the temperature and color of the skin of the lower extremities;
  • Feeling of heat or cold;
  • Violation of blood supply.

The development of lumbar vertebral compression syndromes is clinical on the basis of the following symptoms:

  • Dermatomical Gipalgesia;
  • Shoot pain;
  • weaker or complete loss of deep reflexes;
  • Peripheral parese.

In compression syndromes, the pain increases when the body tilts, sneezing and coughing.

Diagnosis

The diagnosis of lumbar osteochondrosis is carried out on the basis of the clinical image of the diseases, the laboratory and instrumental research methods.

In blood tests against the background of lumbar osteochondrosis, it can be determined:

  • Acceptance of the calcium concentration;
  • Increase in the ESR;
  • Increasing the level of alkaline phosphatase.

When diagnosing lumbar osteochondrosis, the radiological examination of the spine is of great importance.

A long compression of the nerve roots, the certain organs of the abdominal cavity in the course of time, leads to a deterioration of its functioning.

X -ray functions that confirm the diagnosis are:

  • Change of configuration of the affected segment;
  • Pseudo -pondylastez (shift of related vertebral body);
  • Deformation of locking plates;
  • Flattening of the intervertebral disc;
  • The unequal height of the intervertebral disc (symptom of the spacer), which is connected to the asymmetrical muscle tone.
How to recognize the presence of osteochondrosis of the lumbar spine

The diagnosis of lumbar osteochondrosis in the presence of indications are also used:

  • Myelography, calculated or magnetic rejection imaging - are required for persistent symptoms, the development of a neurological defect;
  • Scintigraphy (examination of the accumulation of a bone system of phosphorus, a melted technology-99), is carried out if a tumor or an infectious process, an vertebral violation, is carried out.

The differential diagnosis of lumbar osteochondrosis is carried out with the following diseases:

  • Spondylolistz;
  • Disglormon spondylopathy;
  • Ankylosions spondylitis (ankylosions spondes);
  • Infectious processes (inflammation of the diskettes, osteomyelitis of the spine);
  • non -plastic processes (primary tumor of the spine or its metastatic lesions);
  • Rheumatoid arthritis;
  • Deforming osteoarthritis of the hip joint;
  • Reflected pain (diseases of internal organs and large blood vessels).

Treatment of lumbar osteochondrosis

In the case of lumbar osteochondrosis, you usually record the following treatment tactics:

  • Bed rest for 2-3 days;
  • the traction of the affected segment of the spine;
  • Strengthening the muscles of the back and abdominal press (the creation of the so-called sore muscles);
  • Effects on pathological myofascial and myotonic processes.

Lumbago occurs under the influence of hypothermia or physical overvoltage and sometimes for no apparent reason.

In most cases, conservative treatment of lumbar osteochondrosis is carried out, including the following measures:

  • Muscle infiltration with a solution of local anesthetics;
  • Take not steroidal anti -inflammatory medication;
  • Reception of desensitization agents;
  • Vitamin therapy;
  • Reception of sedatives and antidepressants;
  • Manual therapy, massage;
  • Physiotherapy sports lessons;
  • Acupuncture;
  • Postisometric relaxation.

Absolute indications for the surgical treatment of lumbar osteochondrosis are:

  • Acute or subacute compression of the spinal cord;
  • The development of the Horse Tail syndrome, characterized by impaired function of the pelvic organs, sensitive and motor disorders.

Medical gymnastics for lumbar balosteochondrosis

Physical exercises for lumbar balosteochondrosis

With the complex treatment of lumbar osteochondrosis, a significant role is part of physiotherapy exercises.Regular classes make it possible to normalize the muscle tone of the paravertebral muscles, which improve metabolic processes in the tissue affected by the pathological processes and also form a well -developed muscle corset that can maintain the spine in the correct position, remove excess static loads.

So that gymnastics with lumbar osteochondrosis achieve the greatest effect to comply with the following principles:

  • Regularity of the classes;
  • gradual increase in the intensity of physical exertion;
  • Avoid revision during the lesson.

Sports lessons should be involved in the management of an experienced instructor who selects the most effective exercises for a specific patient and controls the accuracy of their implementation.

According to the statistics of back pain, every second adult experiences at least once in his life, while in 95% of the osteochondrosis of the spine.

In addition to classes with an instructor, you should carry out a complex of morning exercises every day, which includes special exercises with lumbar osteochondrosis.

  1. Relaxation and contractions of the abdominal muscles.The starting position is available, the legs are shoulder -wide apart, the hands of the body are lowered.Breathe a smooth breath and relax the muscles of the front abdominal wall.Draw as far as possible during exhalation and put a strain on the muscles of the press.The exercise should be repeated before light fatigue occurs.
  2. Movement of the head with the bend of the spine.The output position of the knees that rests from the back on the floor is the back straight.Slowly lift your head and bend your back.To linger in this position for a few seconds in this position, and then return smoothly to its original position.Repeat at least 10-12 times.
  3. "Pendula".The starting position on the back, arms along the body, the legs are bent in the knee and hip joints at right angles.Turn your legs to the right and left with fluctuating, pendulum -shaped movements and try to get the floor.At the same time, the shoulder blades cannot be torn from the ground.
  4. "Boat".The starting position of the stomach, the hands are extended to the front.Cut the upper body and legs off the floor and bend your back.Linger in this position for 5-6 seconds and slowly return to the starting position.Perform 10 times.

Possible consequences and complications

The main complications of lumbar osteochondrosis are:

  • the formation of Swandromeries;
  • Vegetovascular dystonia;
  • Spondylolis, spondylolistz;
  • Osteophytosis;
  • Spondylarthrosis;
  • Stenosis of the spine canal, which leads to the compression of the spinal cord and is able to cause continuing loss of work capacity and reduce the quality of life.

A long compression of the nerve roots, the certain organs of the abdominal cavity in the course of time, leads to a deterioration of its functioning.As a result, patients have intestinal functions (constipation, diarrhea, flatulence) and pelvic organs (urine disorders, erectile dysfunction, frigidity, infertility).

forecast

Pain syndrome for lumbar osteochondrosis is carried out in the form of remissions and tightening.Lumbago takes 10-15 days, according to which the patient's condition improves, the pain subsides.Spricularly secondary diseases can affect a favorable result.Often there are repeated occurrence of pain attacks with lumbar osteochondrosis, which are becoming more and more intense and long every time.

With the complex treatment of lumbar osteochondrosis, a significant role is part of physiotherapy exercises.

Patients with a severe course of lumbar osteochondrosis with persistent pain and other manifestations are recognized as temporarily disabled.If your condition does not improve within four months, the problem of setting up a group of disabled people will be solved.

prevention

Preventing the development of osteochondrosis of the spine is the following measures:

  • Rejection of smoking;
  • Normalization of body weight;
  • Improvement of general physical condition, active lifestyle;
  • Avoid provocative conditions (weight lifting, sharp movements, curves, tendencies).