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Spondylosis of the lumbar spine
Last reviewed: 23.04.2024
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Such a pathology as spondylosis of the lumbar spine may be caused by degenerative and dystrophic disorders in the fibrous ring of the intervertebral disc, as well as in the anterior longitudinal ligament of the spine, as a consequence of prolonged overloads, frequent traumatizations or age-related changes.
Causes of spondylosis of the lumbar spine
With age, under the influence of physical exertion, other biological and external causes, the development of moderate osteoporosis of the vertebrae can gradually develop: they become lower, the discs between them become flattened. Such violations are very typical for signs of aging.
The aging of discs is relatively early: discs do not have the property of self-healing, and the vertical position of the human body provokes a lack of tissue supply and increased strain on the spine. With the passage of time, the hyaline cartilage is destroyed, the tissue of which is replaced by a connective cartilage. This degeneration significantly reduces the resistance of the cartilage to various overloads and mechanical impacts, even insignificant. In addition, depreciation of the gelatin-like nucleus worsens: the intervertebral disc becomes rigid and does not perform its functions properly.
Against the background of the changes described, the process involves a fibrous ring. There are also unfavorable changes in it: they are cracks in the fibrous tissue at the sites adjacent to the bone edges of the adjacent vertebrae (laterally, posteriorly or in the front). Cracks can appear due to minor traumatic injuries, increased functional loads, prolonged permanent standing in an upright position. In the area of cracks, a weakened fibrous tissue can be displaced, which can lead to traumatization of the anterior and posterior longitudinal ligaments. The gelatinous nucleus does not change its position in such a situation, displacement does not occur.
The constant trauma of the ligament gradually leads to its detachment, which provokes the formation of bony proliferation, typical of spondylosis. Over time, they increase in size, merging, and forming the so-called "blocks" that prevent normal mobility of the vertebrae.
Symptoms of spondylosis of the lumbar spine
The disease is more common in men, and the prevalence of spondylosis increases with age, after 30-40 years.
Deformation of the fibrous ring and its effect on the vertebral canal or vertebral aperture can cause the corresponding neurological symptoms: leg vitality, crawling sensation, pain.
The disease can be manifested by limited motor capacity of the spine, stiffness, a sense of discomfort. Later stages are characterized by local soreness and impaired innervation of the nerves (sensitivity disorder).
The majority of patients can observe the changes inherent in the age-specific features: fast fatigue of the back, restriction of motor activity, periodic pain both after exercise and during rest.
The initial stages of the disease are usually characterized by an asymptomatic course.
If the pathology is localized in the lumbar spine, then this is usually the fourth and fifth lumbar vertebra.
Spondylosis of the lumbosacral spine
Spinal pathology of the spine with spondylosis can occur in isolation, when 1-2 vertebrae are involved in the process, common (2-3 or more vertebrae) and totally (almost all vertebrae damage).
With the development of pathology in the lumbosacral region, the third, fourth and fifth lumbar vertebra most often suffer. This is a characteristic difference from the manifestations of osteochondrosis, when the fifth lumbar and first sacral vertebrae are involved in the process more often. By the way, when spondylosis (in contrast to osteochondrosis), you can observe obvious soreness when pressing on the bone processes of pathologically damaged vertebrae.
Complaints of the patient with lesion of the lumbosacral area indicate, as a rule, pain in the lumbar region, giving to the buttock and lower limb, a feeling of weakness in the leg. Painful sensations can subside when the body tilts anteriorly or when walking up stairs. Sometimes the pain that gives in the foot causes the person to limp, or to lean on anything when walking.
Deforming spondylosis of the lumbar spine
The deforming form of spondylosis can develop after a traumatic lesion of the lumbosacral apparatus or a significant load on the spine. This form of the disease can be considered as a protective response of the organism, which strives to stabilize the area of the spine damaged by overloads.
The deforming form of spondylosis is characterized by pain when turning the trunk and walking down the stairs. Lumbar pain can radiate to the lower limb, which can cause a claudication attack, and also increase in the evening and after physical exertion.
The deforming form of the disease is more difficult to treat, however, it is possible: a therapy aimed at eliminating soreness, suppressing the inflammatory focus, improving blood supply, strengthening the ligamentous-muscular system.
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Diagnosis of spondylosis of the lumbar spine
In the diagnosis of the disease using the history of the patient, carry out an objective study: if this can be observed restriction of the mobility of the spine, or determine the soreness when pressed on the spinous processes.
X-ray examination helps to detect spondylosis, to track the scale and extent of pathological changes. X-rays of the spinal column are drawn from different angles to compare the state of several parts of the vertebrae.
The main radiographic symptom of the disease is the detection of osteophytes: they are usually located symmetrically and are mutually directed towards each other. Osteophytes are prone to growth beyond the limb edges towards the bodies of the vertebrae.
Sometimes X-rays are carried out in atypical projections (oblique, three-quarter), or use computerized tomography.
The most informative diagnostic method is magnetic resonance imaging (MRI). This method of tomography provides complete information on the state of soft tissues (disks, nerve fibers, ligaments), diagnoses compression effects.
As an additional diagnostic method, electroneuromyography can be used to assess the degree of neuromuscular damage.
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Treatment of spondylosis of the lumbar spine
The cardinal way of treatment of spondylosis, unfortunately, has not yet been invented. However, to improve the condition of the spine, reduce manifestations, alleviate the symptoms can, and even quite successfully.
Conservative therapy. To stop the pain, non-steroidal anti-inflammatory drugs (diclofenac, movalis, ibuprofen, naproxen) and muscle relaxants can be used to relieve muscle spasm (tizanidine, flexeryl). Symptomatic therapy also provides for the use of vitamin complexes, tranquilizers, antidepressants.
Method of physiotherapy. Improves blood circulation and trophism in the affected tissues, relieves painful sensations. Procedures are carried out on a specific site of the spine, or in a paravertebral way: ultrasound, phonophoresis, DMV therapy, mud therapy.
The composition of the treatment complex must include exercises LFK, manual therapy, massage.
A special role in the therapy of spondylosis is played by extensive treatment - the use of static and dynamic orthotracing, extraction of the spinal column with immersion in mineral water. Special indications include the use of dynamic semiautomatic orthotracking: in addition to removing compression, such therapy has a strengthening effect on the spine and spine muscles, strengthens the corset, and activates the locomotor properties of the joint apparatus.
Therapeutic physical exercises can be offered to the patient in the form of individual complex exercises, gymnastics of yoga or qigong, on special simulators and without them.
Acupuncture (reflexotherapy) - improves nerve conduction, relieves pain.
In cases where the apparent effect of conservative treatment is not observed, the use of the surgical method is recommended.
Gymnastics with spondylosis of the lumbar spine
During the recurrence of spondylosis, patients are advised to avoid soft beds, preferring a semi-rigid mattress. In this period, the spine needs rest and lack of muscle corset tension. Observance of such measures will accelerate the healing of microcracks and lesions of the fibrous ring.
To find the right therapeutic gymnastic exercises should the doctor, taking into account injuries of the spine and the presence of concomitant diseases. However, there are conditions that must be observed when choosing the loads:
- exercises should not be performed while standing. For the best effect of the exercises, you need to unload the spine, and for this you should lie on your back or on your stomach, or squat;
- in the intervals between exercises, it is recommended to relax muscles of the body, arms and legs as much as possible;
- in the period of relapse should not perform exercises in general, and especially on the extension of the waist, so as not to increase the squeezing of nerve endings;
- The exercises using the spine axis extract are the most effective. Such exercises reduce the compression of nerve endings and vascular networks.
During the practice of therapeutic gymnastics, it is recommended to fix the lower back with the help of an orthopedic corset or belt. This corset can reduce the pressure inside the discs, so it is advised to wear it as often as possible.
- Exercise 1. Lie on your back, hands are straight. We bend our legs in our lap, raise them to our chests, we return. Conduct up to 6 repetitions;
- Exercise 2. We are on our knees, leaning on the palm of our hands. We lift our head, bend, return to the previous position. Repeat up to 6 times;
- Exercise 3. We are on our knees, leaning on the palms of our hands. We stretch one leg to the back, while straightening our back and lifting our head. We return. We alternate with the participation of the other leg. Repeat up to 6 times.
- Exercise 4. We stand on our knees, leaning on the palm of our hands. We bend our hands, we try to get our forearms to the floor, we come back. The tempo is arbitrary, repeat 6 times;
- Exercise 5. Lie on your back, hands behind your head. Legs are bent at the knees and are pulled to the stomach. We grab our knees and press our head to them, we come back. Repeat up to 6 times.
Exercises can be effective with daily regular lessons.
Prevention of spondylosis of the lumbar spine
Preventive measures to prevent the development of spondylosis should be aimed at protecting the spine from unfavorable factors.
- It is necessary to protect your back from hypothermia, drafts, you should dress in the weather, do not lean against cold walls, do not lie on the cold floor;
- It is necessary to establish food, not to eat a lot of salty, spicy, roasted. Preference should be given to fruit, greens, drink a sufficient amount of liquid;
- Morning exercise is a necessary and useful habit for the health of the spine and joints;
- It is necessary to avoid increased stress on the spine;
- It is necessary to watch the weight of your body. Excess weight increases the compression and increases the load on the spine.
Try to move more - a sedentary lifestyle is also a factor in the development of the disease of the spine. However, at the same time, avoid active sports that contribute to back and joint trauma: weightlifting, gymnastics, extreme sports.
Periodically it is recommended to visit a massage therapist or a chiropractor: a well and correctly performed massage improves blood circulation in the spine and improves trophic tissue.
Prognosis of spondylosis of the lumbar spine
In the absence of necessary treatment, the disease can lead to the growth of bone formations on the vertebrae: this process contributes to the emergence of constant pain and development of disability. Also, one of the frequent complications of spondylosis is the narrowing of the spinal canal to the critical state.
Therapeutic measures to fight the disease should be started as soon as possible. Fulfilling all the prescriptions of the doctor, it is possible to achieve a stable remission and slow down the development of pathology.
Spondylosis of the lumbar spine is a chronic disease. Cure it is very difficult, but not to allow negative consequences - it is possible and necessary.