About 80% of people over 55 experience manifestations of various diseases of the back; they should not be neglected also for persons of younger age categories. So, one of the most common diseases of the spinal column – chondrosis of the lumbar spine – is currently found in patients 25-45 years old. Even young people aged 16–25 years are increasingly suffering from the symptoms and causes of this ailment. The logical question is whether it is possible to stop the growth trend in the number of patients as a whole, and what should each person do as a preventative measure so as not to become a victim of this pathology?
Features of development
Understanding the mechanism of progression of chondrosis of the lumbar allows you to take a set of preventive measures. The pathology under consideration is the primary form of another disease that is dangerous for posture and the health of all organs of the disease – osteochondrosis.
Chondrosis is characterized by degenerative-dystrophic disorders in the skeleton of the spinal column. At the same time, destructive changes occur, as a result of which both the anatomy of the articular elements of the spine and their physiology change.
The problem of developing such disorders in the lower back is a particular health hazard for the likely consequences of the disease. After all, it is the lumbar region that takes on the bulk of the loads – the weight of the entire upper part of the human body, dynamic loads during movement, training or any physical activity.
In the process of developing pathology in the back, a number of changes occur:
- The axis of the spinal column is distorted;
- Posture assumes an unnatural position;
- The bones of the skeleton of the body press on the internal organs. Especially – on the heart and lungs. This provokes secondary respiratory diseases and diseases of the cardiovascular system;
- Shakiness is manifested when walking;
- Coordination is disturbed due to infringement of nerve receptors;
- Irreversible processes occur in the structure of the spinal column;
- Cartilage is thinning;
- The intervertebral fissure is reduced in size;
- The structure of the synovial fluid is filled with third-party components.
The vertebrae also undergo changes – they wear out faster and the distance between them decreases. Most of the clinical symptoms described below arise against the background of this particular phenomenon – when the vertebrae touch and rub, the nerves get pinched, which causes acute pain. And structural disorders and protective mechanisms of the body stimulate the development of bone tumors – osteophytes. They press on soft tissues and create a pain sensation.
This disease is considered one of the most dangerous, as it deprives the patient of his usual activity and limits his mobility. But the most unpleasant prospect is to allow the intensive development of the disease, leading the patient to disability.
- Representatives of manual professions, who have to work with a heavy tool, face exposure to vibrational vibrations and other manufacturing costs, are more often prone to chondrosis of the lumbar.
- Athletes, as well as people leading an excessively active lifestyle, also belong to the risk group. Children with increased hyperactivity are prone to this pathology at a more mature age, although some of them experience the first symptoms in their teens.
- Representatives of professions involving a sedentary image of the working process also create an increased load on the lumbar, staying in one unchanged position for several hours.
How and where does it start?
Considered among orthopedists, surgeons and representatives of other medical specialties, the basis for the development of chondrosis of the lumbar spine is usually an incorrectly distributed mechanical load on the back.
As a result of this, abnormal bends are created in different parts of the spine, which only increases pressure on the lower back.
A variety of direct and indirect etiological factors can provoke this circumstance:
- Weak muscle corset, flabby structure of the lumbar muscles;
- Long stay in one position;
- The influence of gravity when they are raised;
- Stooped posture;
- Congenital curvature of the vertebrae;
- Reinforced and too frequent workouts;
- Falls and injuries;
- Age-related reasons;
The primary factor in the development of chondrosis of the lumbar are often joint pathologies, regardless of their location. Inflammatory processes, infections, neoplasms in the joints inevitably lead to a redistribution of static and dynamic load on the axis of the spine. Since the main volume of pressure falls on the lumbar region, lumbar chondrosis is manifested there even in the initial stages of arthrosis, arthritis, bursitis, osteoporosis, and other pathological phenomena.
According to many orthopedists and vertebrologists, genetic dependence plays a role in the formation of incorrect posture. As a result of this, distortions occur in the vertebral axis, creating an excessive load on the lumbar region.
This pathology is actively developing against the background of frequent hypothermia, in case of non-compliance with water quenching conditions, as well as in cases where feet often get wet or when shoes are worn out of season in the cold season.
Internal problems in the body are also able to affect the spine and provoke chondropatic changes in it. For example, a lack of calcium and calcium phosphorus compounds leads to the destruction of bone tissue. Those, in turn, create pressure on the cartilage, narrowing the intervertebral space.
Chondrosis of the lumbar spine can develop if a person prefers high or too dense pillows for a night’s rest – in this case, there is a forced change in the axis in the cervical region. As a result, this load is transmitted to the lower back.
With insufficient attention to this disease, untimely diagnosis, its treatment is complicated by the fact that secondary diseases or complications arise. As a natural continuation of the pathology, osteochondrosis begins to progress. Its treatment is not always effective, and if you delay or incorrectly prescribed therapeutic course, there is a risk of disability.
Another characteristic problem is the appearance of intervertebral hernias, which is accompanied by unbearable pain. Every day the chances of an irrevocable disposal of a hernia are becoming less and less.
Other consequences in case of untimely identified symptoms of lumbar chondrosis are neuroses, nerve receptor dysfunctions, decreased finger mobility, formation of bone growths, decreased or absent reflexes of the knee or Achilles tendon.
The characteristic clinical symptoms help to recognize the disease in the early stages and avoid these sad consequences:
- Sharp pain after a night’s sleep;
- Shooting pains during sharp turns of the body or lifting of heavy things;
- The body becomes inactive;
- Signs of scoliosis appear;
- Sleep becomes restless;
- Depressive moods arise;
- Frequent urination is noted.
Self-assessment of these symptoms may not be correct, since most of them have a common similarity with signs of other diseases in the spine or joints. Therefore, only a rheumatologist or orthopedist has the competence to talk about the presence of developing lumbar chondrosis.
To conduct differential diagnosis in order to correctly identify the disease, distinguish it from identical pathologies and determine the treatment course, the classification of the stages of this disease helps:
- Stage 1 – at this time, the structure of the cartilage is just beginning to undergo changes. But now, the pathological processes affect the roots of nerve endings. As a result, soreness is given in the legs. At the same time, blood flow worsens and inflammation begins. The pains are acute or dull in nature, and appear mainly only after increased loads on the back axis;
- Stage 2 begins with the destruction of the fibrous ring in the spine, while the cartilage becomes thinner, and the vertebral elements reduce the distance between themselves. The pains in the second stage are sharp and sharp, sometimes causeless. During this period, mobility of the spine along its entire axis increases, nerves get pinched, pressure is created on the soft tissues of the muscle corset;
- Stage 3 is characterized by strong compression of muscle fibers and nerve roots. Unbearable spasms and soreness with a burning character occur. In the affected area feels numb. With the intensive development of the disease, signs of paresis and paralysis are manifested;
- Stage 4 – the period of growth of already formed osteophytes (neoplasms with a bone structure). At this stage, changes of a degenerative nature are activated, arthrosis appears in the spine and joints. The back becomes inactive, and in the absence of the correct treatment – completely motionless.
Methods of diagnosis
Since even perfect knowledge of the clinic and the classification of chondrosis of the lumbar spine do not give a complete picture of the pathological processes provoked by him, an additional diagnostic examination should be prescribed by a vertebrologist or orthopedist:
- X-ray in the frontal and lateral projection – makes it possible to identify axis distortions, the formation of osteophytes, anatomical anomalies of the vertebrae;
- Magnetic resonance imaging – determines the condition of the entire affected area of the back, detects fragments of destroyed vertebrae, cartilage and foci of inflammation;
- Computed tomography gives an idea of the state of soft tissues, vertebral bones, fibrinous ring and blood circulation in the area of the disease.
At the same time, the patient passes tests for a rheumatoid test, general blood counts, and the content of biochemical components. The total results of the examination allow you to accurately establish the diagnosis and identify the stage of development of lumbar chondrosis.
Throughout the treatment course, the patient will have to follow the normalization of metabolic processes, the restoration of tissues and cells of the spine, and the improvement of local blood flow.
For this purpose, a vertebrologist prescribes physiotherapy:
- Electrophoresis using painkillers, anti-inflammatory drugs and corticosteroids;
- Magnetic therapy to relieve inflammation;
- Hirudotherapy – leeches improve microcirculation and metabolism of beneficial components in the tissues of the back;
- Reflexotherapy to relieve pain and cramping.
At the same time, daily exercise therapy for the spine and joints is recommended. Acupuncture, manual therapy and massage are prescribed.
In intensive mode, treatment of chondrosis of the lumbar, especially – starting from stage 2 and 3, is impossible without pharmacological agents.
- To relieve spasms and neurosis – Sirdalud, Cycllobenzaprine, Baclofen, Midokalm;
- To localize the focus of inflammation – Diclofenac, Ibuprofen, Fastum-gel, Ketorolac;
- To normalize the structure of tissues – Finalgon, Apizartron.
Preventing lumbar chondrosis is much easier than fighting it, and for this it’s enough to follow simple recommendations:
- Choose a comfortable bed, if possible – with orthopedic properties;
- Wear comfortable shoes in size;
- Avoid the effects of low temperatures;
- Balance your diet, especially in terms of phosphorus and calcium.
But the main conditions are visiting doctors for an examination – an orthopedist, vertebrologist or rheumatologist. It is advisable to do this 1-2 times a year. And when you discover the very first signs of the disease, do not rush to the advice of traditional medicine for salvation, do not plunge into uncoordinated self-medication methods. Only the competence of qualified doctors will help to put an end to the development of this ailment.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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