Spondylosis of the lumbar spine

A pathology such as lumbar spondylosis can 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 result of prolonged overloads, frequent injuries or age-related changes.

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Causes of lumbar spondylosis

With age, under the influence of physical activity, other biological and external causes, moderate osteoporosis of the vertebrae can gradually develop: they become lower, the discs between them become flatter. Such disorders are extremely typical for signs of aging of the body.

Disc aging occurs relatively early: discs do not have the ability to self-heal, and the vertical position of the human body provokes a lack of tissue nutrition and increased stress on the spine. Over time, the hyaline cartilage is destroyed, the tissue of which is replaced by connective tissue. Such degeneration significantly reduces the resistance of cartilage to various overloads and mechanical impacts, even minor ones. In addition, the cushioning of the gelatin-like nucleus worsens: the intervertebral disc becomes rigid and does not perform its functions properly.

Against the background of the described changes, the fibrous ring also becomes involved in the process. Unfavorable changes also occur in it: these are cracks in the fibrous tissue in the areas of adjoining the bone edges of the adjacent vertebrae (laterally, behind or in front). Cracks can appear as a result of minor traumatic injuries, increased functional loads, prolonged constant stay in a vertical position. Weakened fibrous tissue can shift into the area of cracks, which can lead to traumatization of the anterior and posterior longitudinal ligaments. In such a situation, the gelatinous nucleus does not change its position, and no displacement occurs.

Constant trauma to the ligament gradually leads to its detachment, which provokes the formation of bone growths typical of spondylosis. Over time, they increase in size, merging, and forming so-called "blocks" that prevent normal mobility of the vertebrae.

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Symptoms of lumbar spondylosis

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 impact on the spinal canal or vertebral openings can cause corresponding neurological symptoms: tingling in the legs, a crawling sensation, pain.

The disease may manifest itself as limited mobility of the spine, stiffness, and a feeling of discomfort. Later stages are characterized by local pain and disturbances in the innervation of nerves (sensitivity disorders).

Most patients may notice changes typical of age: rapid back fatigue, limited physical activity, periodic pain both after physical exertion and during rest.

The initial stages of the disease are usually asymptomatic.

If the pathology is localized in the lumbar spine, then this is, as a rule, the fourth and fifth lumbar vertebrae.

Spondylosis of the lumbosacral spine

Pathological damage to the spine by spondylosis can occur in isolation, when 1-2 vertebrae are involved in the process, widespread (2-3 or more vertebrae) and total (damage to almost all vertebrae).

When pathology develops in the lumbosacral region, the third, fourth and fifth lumbar vertebrae are most often affected. This is a characteristic difference from the manifestations of osteochondrosis, when the fifth lumbar and first sacral vertebrae are more often involved in the process. By the way, with spondylosis (unlike osteochondrosis), one can observe obvious pain when pressing on the bone processes of pathologically damaged vertebrae.

Complaints of a patient with a lesion of the lumbosacral region usually indicate pain in the lumbar region, radiating to the buttock and lower limb, a feeling of weakness in the leg. Painful sensations may subside when bending the body forward or when walking up the stairs. Sometimes pain radiating to the leg makes a person limp or lean on something when walking.

Deforming spondylosis of the lumbar spine

The deforming form of spondylosis can develop after a traumatic lesion of the ligamentous-muscular apparatus or a significant load on the spine. This form of the disease can be considered as a protective response of the body, seeking to stabilize the area of the spine damaged by overloads.

The deforming form of spondylosis is characterized by pain when turning the body and walking down the stairs. Lumbar pain can radiate to the lower limb, which can cause an attack of lameness, and also intensify in the evening and after physical exertion.

The deforming form of the disease is more difficult to treat, but it is possible: therapy is carried out aimed at eliminating pain, suppressing the inflammatory focus, improving blood supply, and strengthening the ligamentous-muscular system.

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Diagnosis of lumbar spondylosis

In diagnosing the disease, the patient's medical history is used, and an objective examination is conducted: with this, limited mobility of the spine may be observed, or pain may be determined when pressing on the spinous processes.

X-ray examination helps to detect spondylosis, track the scale and degree of pathological changes. X-rays of the spine are taken from different angles to compare the condition of several sections of the vertebrae.

The main radiological symptom of the disease is the detection of osteophytes: they are usually located symmetrically and mutually directed towards each other. Osteophytes tend to grow beyond the edges of the limbus towards the vertebral bodies.

Sometimes radiographs are taken in atypical projections (oblique, three-quarter), or computed tomography is used.

The most informative diagnostic method is magnetic resonance imaging (MRI). This tomography method provides complete information about the condition of soft tissues (discs, nerve fibers, ligaments), and diagnoses compression effects.

Electroneuromyography can be used as an additional diagnostic method, allowing one to assess the degree of damage to the neuromuscular system.

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Treatment of lumbar spondylosis

Unfortunately, a radical method of treating spondylosis has not yet been invented. However, it is possible to improve the condition of the spine, reduce manifestations, and alleviate symptoms, and even quite successfully.

Conservative therapy. To relieve pain, nonsteroidal anti-inflammatory drugs (diclofenac, movalis, ibuprofen, naproxen) and muscle relaxants that relieve muscle spasms (tizanidine, flexeril) can be used. Symptomatic therapy also includes the use of vitamin complexes, tranquilizers, and antidepressants.

A method of physiotherapy. Improves blood circulation and trophism in the affected tissues, relieves pain. The procedures are carried out on a specific section of the spine, or paravertebrally: ultrasound, phonophoresis, UHF therapy, mud therapy.

The treatment complex must include exercise therapy, manual therapy, and massage.

Extension therapy plays a special role in the treatment of spondylosis – the use of static and dynamic orthotraction, traction of the spinal column with immersion in mineral water. Special indications include the use of dynamic semi-automatic orthotraction: in addition to relieving compression, such therapy has a strengthening effect on the system of ligaments and muscles of the spine, 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 classes, yoga or qigong gymnastics, on special exercise machines or without them.

Acupuncture (reflexotherapy) – improves nerve conduction, relieves pain.

In cases where there is no visible effect from conservative treatment, the use of a surgical method is recommended.

Gymnastics for lumbar spondylosis

During a relapse of spondylosis, patients are advised to avoid soft beds, giving preference to a semi-rigid mattress. During this period, the spine needs rest and no tension in the muscle corset. Following these measures will speed up the healing of microcracks and damage to the fibrous ring.

The correct therapeutic gymnastic exercises should be selected by a doctor, taking into account the damage to the spine and the presence of concomitant diseases. However, there are conditions that must be observed when choosing loads:

• exercises should not be performed standing. For the best effect from the exercises, it is necessary to relieve the spine, and for this you should lie on your back or stomach, or squat;
• between exercises, it is recommended to relax the muscles of the body, arms and legs as much as possible;
• During a relapse, you should not perform exercises at all, and especially those that extend the lumbar region, so as not to increase the compression of the nerve endings;
• The most effective exercises are those that use spinal axis extension. Such exercises reduce compression of nerve endings and vascular network.

During therapeutic exercises, it is recommended to fix the lower back with an orthopedic corset or belt. Such a corset can reduce the pressure inside the discs, so it is recommended to wear it as often as possible.

• Exercise 1. Lie on your back, arms straight. Bend your legs at the knees, lift them to your chest, and return. Do up to 6 repetitions;
• Exercise 2. We are on our knees, resting on our palms. We raise our head, bend, return to the previous position. Repeat up to 6 times;
• Exercise 3. We are kneeling, resting on our palms. We stretch one leg back, simultaneously straightening our back and raising our head. We return. We alternate with the other leg. We repeat up to 6 times.
• Exercise 4. We are on our knees, resting on our palms. We bend our arms, try to reach the floor with our forearms, and return. The tempo is arbitrary, repeat 6 times;
• Exercise 5. Lie on your back, hands behind your head. Legs bent at the knees and pulled to your stomach. Grab your knees with your hands and press your head to them, return. Repeat up to 6 times.

Exercises can be effective if done consistently on a daily basis.

Prevention of lumbar spondylosis

Preventive measures to prevent the development of spondylosis should be aimed at protecting the spine from adverse factors.

• It is necessary to protect your back from hypothermia and drafts; you should dress according to the weather, do not lean against cold walls, and do not lie on a cold floor;
• You should improve your diet, do not eat a lot of salty, spicy, fried foods. Preference should be given to fruits, greens, drink enough liquid;
• Morning exercises are a necessary and useful habit for the health of the spine and joints;
• It is necessary to avoid excessive stress on the spine;
• You should monitor your body weight. Excess weight increases compression and increases the load on the spine.

Try to move more – a sedentary lifestyle is also a factor in the development of spinal diseases. However, at the same time, avoid active sports that contribute to back and joint injuries: weightlifting, gymnastics, extreme sports.

It is recommended to visit a massage therapist or chiropractor periodically: a well-done and correctly performed massage improves blood circulation in the spine area and improves tissue trophism.

Lumbar Spondylosis Prognosis

Without the necessary treatment, the disease can lead to the growth of bone formations on the vertebrae: this process contributes to the appearance of constant pain and the development of disability. One of the frequent complications of spondylosis is also known - narrowing of the spinal canal to a critical state.

Therapeutic measures to combat the disease should be started as early as possible. By following all the doctor's instructions, it is quite possible to achieve stable remission and slow down the development of the pathology.

Lumbar spondylosis is a chronic disease. It is very difficult to cure, but it is possible and necessary to prevent negative consequences.