Why does osteochondrosis of the lumbar spine occur?

Many of us are familiar with back pain, which disrupts normal life for a long time. Although the cause can be trauma, neurological diseases or malformations of the spine, osteochondrosis of the lumbar spine often becomes a trigger for unpleasant sensations. This degenerative disease can occur even at a young age, its initial manifestations can be detected even in adolescents and schoolchildren, but most patients are people after 40 years. Changes in the spine associated with osteochondrosis can occur anywhere from cervical to lumbar and sacrococcygeal. But the most common form that brings patients a lot of unpleasant and painful sensations is osteochondrosis of the lumbar spine. What kind of pathology is this, what is typical of it and pain in the lower back always speaks of this disease.

Osteochondrosis of the lumbar spine: what is the essence of the pathology?

Osteochondrosis is a term derived from two words: the Greek osteon, which means bone, and chondron, which is cartilage. Therefore, osteochondrosis of the lumbar spine (and all others as well) is initiated by changes in the cartilage of the discs, which are the natural "lining" between the vertebrae and the shock absorber during movement. Changes in the structure of the disc and its functionality are accompanied by a natural reaction in the vertebral body. With this disease, degenerative changes occur gradually in the body of the discs. The height of the disc decreases, so its physiological function is lost, causing instability and alterations in the vertebral joints. As the disease progresses, a reaction occurs in the end plate of the vertebral body. This reaction can be divided into three stages: edema due to malnutrition and dystrophic changes, fatty degeneration and, in the last stage, sclerosis.

Causes of osteochondrosis of the spine.

Our vertebral discs begin to deform and gradually change when we are in our 20s. The gradual decrease in fluid within the body of the disc leads to a decrease in the size of the space between the vertebrae (chondrosis). This means that the disc can no longer function as a shock absorber and the tension on the anterior and posterior longitudinal ligaments of the vertebrae changes. As a result, a much greater load is imposed on the vertebral joints, increasing from year to year. The spinal ligaments are not positioned correctly and are stretched unevenly, and the mobile segments of the spine gradually become unstable. The dorsal segment generally consists of two adjacent vertebral bodies and a disc between them. The upper and lower end plates in the vertebral body are under more stress, areas of thickening (sclerosis) and ridges at the edges (spondylophytes) gradually develop. Due to such changes, the entire clinical picture of the disease is formed in the future.

What are the symptoms of osteochondrosis of the lumbar spine?

back pain with osteochondrosis

Almost any form of the disease manifests itself as excruciating back pain, which is difficult to control and affects a specific segment of the spine (from the neck to the lower back to the sacrum). The symptoms of osteochondrosis of the lumbar spine can remain limited to the spine only (in the lumbar region) or spread to the legs if they come from the lumbar spine, or the arms if they come from the cervical spine.

Symptoms can occur during rest, exertion, or regular activity. There may be root symptoms caused by compression, irritation in the nerve root area, or pseudoradicular symptoms if the cause is in the facet joint or adjacent muscles. Often, osteochondrosis of the lumbar spine is combined with injuries in other areas, the thoracic cervical spine, then the symptoms will be more extensive. In other words, discomfort and pain cause not just one segment that is damaged, but several areas of osteochondrosis at once. The disease has a wavy course with periods of exacerbations (symptoms can seriously interfere with normal life) and temporary remissions, when the manifestations diminish or almost disappear. But any factor, physical or mental, can cause a sudden relapse.

How is spinal osteochondrosis diagnosed?

The diagnosis is based on the study of the patient's medical history and complaints, a physical examination with identification of typical symptoms, and a neurological examination. Today, doctors are increasingly inclined to carry out instrumental diagnostics, since other pathologies are often hidden under the guise of osteochondrosis.

For example, among patients with persistent back pain planning surgery to relieve pain, bone health is an important factor. If a patient is found to have low bone density before surgery, this can affect the treatment plan for osteochondrosis before, during, and after the procedure. A study from the Hospital for Special Surgery (HSS) in New York showed that CT scan of the lumbar spine before surgery showed that a significant number of patients had low bone density that had not been previously diagnosed.

Almost half of the nearly 300 patients tested were diagnosed with osteoporosis, or its precursor, osteopenia. It is especially important to take this into account from the age of 50. The prevalence of low bone mineral density in this group was 44% and osteoporosis was diagnosed at 10. 3%. Low bone density is a known risk factor for vertebral fractures and this condition can be an aggravating factor in the treatment of osteochondrosis.

Treatment of osteochondrosis of the spine.

lumbar osteochondrosis massage

Treatment options depend on the severity of your symptoms. Physiotherapy is the main method of pain relief in the early stages. Ultrasound, electrotherapy, heat treatment are used. Treatment is supplemented with appropriate pain management such as NSAIDs, muscle relaxants, and steroids. Injection practices can be used: blockages, trigger point injections. Manual therapy, osteopathy, exercise therapy are shown.

Surgical treatment is always the last resort. There are situations when surgery is needed. An example would be paralysis of the bladder or rectum caused by narrowing of the spinal canal or a prolapsed disc, a large herniated disc. Options for the operation are selected together with the doctor. But after surgical treatment, the problem is not completely eliminated, long-term rehabilitation and lifelong supportive treatment is required. This is due to the fact that osteochondrosis does not go away anywhere, it can progress in other departments.