Despite the prevalence of opinion, spinal osteochondrosis is not considered to be part of the aging process. The elastic discs between the vertebrae are responsible for flexing and extending the back, like the shock absorbers. Over time, they wear out and no longer provide full range of motion. With age, daily stress on the spine and accidental injuries, including minor ones, can damage the back discs and lead to osteochondrosis of the lumbar spine.
Who is affected by this lower back disease?
In most cases, the first symptoms of osteochondrosis of the lumbar spine occur at the age of 11-12 years. The disease manifests itself vividly at the age of sixteen, but the most serious course and frequent complications occur between the ages of 15 and 20.
Children under the age of 15 rarely have severe forms of osteochondrosis, which is somewhat related to the excellent condition of their musculoskeletal system in general, and the spine in particular. In addition, the disease takes a long time to develop and on average five years.
Fortunately, these conditions are much easier to treat in children than in adults.
Symptoms
Reflex syndromes
- Neck pain- pain manifested differently in the neck (tightness, tingling, shooting), a feeling of "crawling" in the cervical muscles, as well as reduced mobility and flexibility of the neck. neck.
- Lumbagois a sharp, sharp pain in the lower back area, which may be accompanied by numbness or swelling. Instead of the word "lumbago", the words "lumbodynia" or "lumboischialgia" may be used.
- Thoracalgia- pains of a different nature in the chest, shoulder blades and ribs, which are constantly present or occur during body movements.
Compression syndromes
The occurrence of pain syndrome in osteochondrosis of the lumbar spine is due to:
- Compression of root structures (radiculopathy).
- Compression of the spinal cord (myelopathy).
- Spinal cord injury due to insufficient blood.
- Narrowing (stenosis) of the arteries and veins (vascular myeloischemia by compression).
Disease detection methods
Differential diagnostics
Not all disorders can be diagnosed with a simple lab test. Many conditions cause similar symptoms. For example, many infections cause fever, headaches, and fatigue.
Many mental disorders are caused by:
- sadness;
- concern;
- sleeping problems.
Differential diagnosis identifies possible disorders that cause symptoms. As a rule, this diagnosis is based on several tests. These tests may rule out conditions and / or determine if you need additional testing.
Differential diagnosis is used to diagnose physical or mental health problems that cause similar symptoms.
Differential diagnosis is also commonly used in the field of psychiatry / psychology, where two different diagnoses can be made for a patient who is showing symptoms of more than one disease. For example, a patient diagnosed with bipolar disorder may also be diagnosed differently with borderline personality disorder, given the similarity in symptoms of the two conditions.
Who is diagnosed most often?
While the disease was diagnosed earlier in people who were sick after 45 years of age, today around 27% of adolescents have osteochondrosis to one degree or another.
Such a spread of the disease is understandable - children began to spend a lot of time sitting down, especially because of the computer and the Internet. Is it bad? Time will tell, but the fact remains - the payment for a sedentary lifestyle is high, and osteochondrosis is far from the worst disease that can arise with such a lifestyle, but it is the most common. (after obesity).
How to define a disease and its degree?
First
In a normal state, the intervertebral discs constantly regenerate, but it happens that the process slows down and a disease such as osteochondrosis of the 1st degree occurs.
There are several reasons for this:
- obese;
- metabolic disorders;
- immunocompromised and so on.
Unfortunately, the instability of pain at this stage of the disease is influenced by the fact that many people neglect diagnosis and treatment and try to cure the pain on their own. To do this, use ointments and various tinctures. But this is the biggest mistake.
Osteochondrosis of the first degree lumbar spine can be cured quite easily by contacting a good specialist and performing a number of simple actions.
Grade 1 osteochondrosis is a compaction of the intervertebral cartilage in the lumbar region. The main symptom at this stage is slight pain when rotating or bending. Sometimes the symptoms are more acute and short-lived due to sudden movements or heavy exertion.
Second
A pronounced symptom of the disease is pain in the lumbar region, which increases with any movement. The pain may radiate higher up the spine.
With osteochondrosis, the pain can radiate to the lower limbs.
The second stage of osteochondrosis is characterized by pain so severe that it manifests itself even when coughing.
Additional symptoms are associated with pinched nerve endings:
- The sensitivity of the lower limbs changes. The main signs are: pain, numbness in the legs, high or too low sensitivity of the skin of the lower limbs.
- Limited mobility. A person with osteochondrosis (grade 2) notices that as the disease progresses, it becomes very difficult to move.
- Increased fatigue and constant drowsiness. The patient has chronic fatigue, accompanied by irritability. This symptom is explained by the pain syndrome that constantly bothers the person.
- Problematic urination and pain in the kidney area.
Third
By the time the patient reaches stage 3, his posture has changed markedly. In more advanced cases, bone deformity occurs. At this stage of osteochondrosis of the lumbar spine, there is also an obvious deterioration in the general physical and / or mental state of the patient and a profound loss of energy.
The third stage is characterized by the appearance of a narrowing of the intervertebral foramen against the background of the previous changes. Hernias of intervertebral discs form, the vessels of the neck and muscles are damaged. The patient has dizziness, pain in the back of the head.
Fourth
The terminal stage occurs when the intervertebral disc degenerates and the disk space is destroyed. At this point, disc thinning peaks or, worse yet, disappears completely. The postural imbalance is acute and movement and flexibility are extremely limited.
Stage 4 osteochondrosis of the lumbar spine is often characterized by severe pain and greater deterioration in physical and / or mental condition. There is also a permanent loss of growth and energy levels. Stage 4 is generally considered irreversible.
Medical consultation
Which doctor should I contact?
When independent methods of treatment cease to provide an analgesic effect, the patient begins to ask the question: which doctor treats osteochondrosis? The first person you can contact to treat osteochondria in the lumbar spine is your local therapist. But in this situation, he plays the role of a dispatcher, because he will not be able to prescribe a full course of treatment - this is not his specialization.
Most likely, he'll send you to a neurologist. It is this specialist who will conduct the necessary research and help build a treatment program. The therapist may also refer you to a vertebrologist. This doctor directly treats diseases of the spine.
Scales and tests
Quality of life assessment
A characteristic as pervasive as quality of life is particularly important for a group of patients with co-morbidities, as they can influence the effectiveness of treatment. This is particularly important for comparing the results of several studies, economic analyzes and for understanding the problem as a whole.
Methods of assessing quality of life include:
- Oswestry Quality of Life Questionnaire.
- Roland-Morris Questionnaire.
- Stratford Scale.
- Quebec Back Pain Scale - a questionnaire on how back pain affects your daily life).
Pain scales
Pain is an unpleasant sensation and emotional experience associated with tissue damage. Its purpose is to allow the body to react and prevent further tissue damage.
Methods of assessing pain syndrome include:
- Won Korf Chronic Pain Assessment Scale.
- McGill Pain Questionnaire.
- Verbal Pain Scale.
Evaluation of treatment results
- McNab's subjective rating scale.
- Patient Satisfaction Scale.
- Prolo Functional and Economic Results Scale.
- Lumbosacral results scale.
- Nurik's Scale.
Hardware test
Radiography
X-rays provide detailed bone structures in the spine and are used to eliminate back pain resulting from:
- Spondylolisthesis.
- Tumors.
- Cracks.
Calcium in bone blocks X-ray penetration and the bone image is seen as a shadow on the film. X-rays provide excellent visibility of all details because bone is mostly made up of calcium. However, discs and nerve roots do not contain calcium, so x-rays do not capture images of these structures. X-rays therefore cannot be used to diagnose a lumbar disc herniation or other causes of a pinched nerve.
X-rays should not be taken on pregnant women.
Complications and possible consequences
Complications and possible consequences of osteochondrosis of the lumbar spine include:
- Radiculopathy is a condition characterized by disease of the nerve roots.
- Muscle Weakness - Common symptoms include fever, fatigue, flu-like symptoms, paresthesias, weight loss, and changes in consciousness.
- Neurogenic bladder - problems with the nerves that control the bladder and urination
- Damage to lower motor neurons.
- Raynaud's phenomenon is a condition in which spasms occur, narrowing of the capillaries in the fingers and toes.
- Pain in neck, back, leg.
Processing
Treatment may vary depending on the severity of your symptoms and the extent to which they limit your daily activities.
Here are some of the treatments your doctor may prescribe based on your pain level:
- Non-surgical treatment- not all patients with osteochondrosis require surgery. For mild to moderate pain, more conservative treatments.
- Spondylodesis- surgical intervention in the treatment of osteochondrosis.
Prevention
Prevention of osteochondrosis of the lumbar segment consists of eliminating the risk factors leading to this disease. The elimination of factors is the main preventive measure.
Physical activity is normalized, the back muscles are strengthened, the maximum load on the lower back is avoided, the development of diseases leading to lower back pain is avoided, all of this is prophylaxis for the prevention of symptomsof lumbar osteochondrosis.
Moderate exercise, lifestyle changes, and good nutrition can help prevent painful and disabling symptoms.
If you notice any symptoms of osteochondrosis of the lumbar spine, do not squeeze and see a doctor immediately. A disease detected in a timely manner is easier to treat and proceeds without consequences.