Treatment of spondylarthrosis of the lumbosacral spine

Spondylarthrosis of the lumbosacral spine refers to degenerative progressive pathologies. It is characterized by a gradual destruction of the cartilaginous tissues of the vertebrae, over time affecting the connective tissue and bone structures. In the absence of medical intervention, pathology can cause disability and disability. Spondylarthrosis is manifested in the morning swelling of the lumbar spine, stiffness of movements, the development of neurological disorders.

The causes of its occurrence can be injuries, endocrine and systemic joint diseases, excessive physical exertion, osteochondrosis. Diagnose the disease with the help of the results of x-ray examination, CT, MRI. The treatment uses conservative methods, but surgical operations are performed to identify severe vertebral lesions.

The mechanism of development and causes of the disease

Intervertebral discs can be damaged as a result of various pathologies, including inflammatory ones, which often complicates the diagnosis of spondylarthrosis. For example, similar symptoms are characteristic of deforming spondylosis, accompanied by proliferation of bone tissue, the formation of osteophytes, and damage to discs. With spondylarthrosis, not only bone and cartilage tissues of the discs are gradually damaged, but also all structural units of small intervertebral joints.

The disease begins to develop due to destructive changes in cartilage. They lose their density, smoothness, elasticity, are no longer able to soften shock and shock during movement. The wear of the cartilage tissue causes thinning, flattening, and destruction of the intervertebral discs in the lumbosacral spine. An internal and external adverse factors can provoke a pathological process:

  • back injuries resulting from a strong blow or prolonged squeezing. Such damage affects the nutrition of tissues and leads to their destruction;
  • structural features of cartilage, tendons of ligaments, transmitted to the child from parents. Violation of the synthesis of collagen, fibrinogen, proteoglycans provokes a slowdown in recovery processes;
  • congenital and acquired abnormalities of the lumbosacral spine. With a violated anatomical structure of the articular structures, rapid vertebral wear occurs;
  • low physical activity. A sedentary lifestyle is one of the causes of a weakened muscle corset and frequent back injury.

Mesvertebral discs can be destroyed in people with systemic articular pathologies. For example, in severe rheumatoid or psoriatic arthritis, destructive changes affect all small and large joints, including the spine.

One of the specific reasons for the development of spondylarthrosis, characteristic only for the lumbosacral spine, is flat feet. In case of improper gait, excess back loads are distributed irrationally, causing rapid thinning of the discs.

clinical picture

At the initial stage of the disease, weak, aching pain occurs, the intensity of which increases during walking or when lifting weights. Uncomfortable sensations intensify with active sports, prolonged stay on the legs according to the type of service (hairdressers, sellers, pharmacists). In the morning, the lumbar region slightly swells, and the first movements are difficult. By dinnertime, the swelling and stiffness of the movements disappear. This body, in response to pain, begins to produce hormone-like compounds with analgesic activity. But as the disease progresses, the severity of clinical manifestations increases. For spondylarthrosis of the 2nd degree, the following symptoms and signs of disc destruction are characteristic:

  • pains become intense, do not subside throughout the day;
  • often there are subluxations of the vertebrae, accompanied by clicks;
  • pain occurs not only when moving, but also at rest – when trying to change the position of the body, throw one leg over the other;
  • while walking, when turning or tilting the body, a crunch is heard when the vertebrae are displaced;
  • stiffness of movements forces a person to make adjustments to their usual lifestyle, to avoid stress;
  • gait changes over time as a result of curvature of the spine;
  • at night there is a “gnawing” pain that does not subside for a long time.

Often, formed osteophytes pinch sensitive nerve roots, disrupting the transmission of impulses. The arising pains are so strong that they radiate to the hips, lower legs, stomach, and subscapular region.

With spondylosis of the 3rd degree, the lumbosacral can completely lose mobility. The patient is not able to make inclinations, turns and even be in an upright position. Irreversible destruction of the intervertebral discs causes disability.

Diagnostics

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The diagnosis is made on the basis of the patient’s complaints, symptoms, symptoms, history. During the examination, differentiation of spondylarthrosis from spondylosis, lumbar osteochondrosis, rheumatoid arthritis, gout is carried out. Confirm the primary diagnosis will help the results of instrumental studies:

  • radiography;
  • tomography – computer or magnetic resonance;
  • ultrasound examination.

In the diagnosis of spondylarthrosis, the use of radioisotope scanning with the introduction of a contrast medium is practiced. If the drug is unevenly distributed in the spinal column, then this indicates the development of the inflammatory process.

The main methods of therapy

How to treat spondylarthrosis, only doctors of specialization know – orthopedists, traumatologists. To eliminate pain and swelling, they prescribe non-steroidal anti-inflammatory drugs to patients in the form of ointments, tablets, injections. The best NSAIDs in the treatment of spondylarthrosis are:

The simultaneous use of external agents helps to strengthen and prolong the action of systemic drugs: Fastum, Voltaren, Diklovit, Dolobene, Arthrosilen. If NSAIDs are ineffective, glucocorticosteroids – Triamcinolone, Prednisolone, Dexamethasone, Kenalog, Hydrocortisone are included in the therapeutic regimen.

Underwater hood with any form of spondylarthrosis has proven itself well. This method of treatment can reduce the load on the lumbosacral region by increasing the distance between the discs. An extract under water helps reduce the frequency of painful subluxations of the vertebrae.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Physiotherapeutic procedures

Physiotherapy is recommended for patients with spondylarthrosis of any degree. Therapeutic procedures not only improve the well-being of a person, but also prevent further destruction of the lumbosacral vertebrae. Here are the most effective methods:

  • electrophoresis. Its principle of action is the penetration of pharmacological preparations into the vertebrae under the influence of a weak electric current. The most commonly used are solutions of analgesics, non-steroidal anti-inflammatory drugs, chondroprotectors;
  • UHF therapy. The lumbosacral region is affected by electromagnetic fields of ultrahigh frequency. In affected tissues, temperature rises, metabolic rate and regeneration processes are accelerated;
  • magnetotherapy. Under the influence of a static magnetic field, nutrient and biologically active substances, as well as molecular oxygen, begin to flow into the vertebrae affected by spondylarthrosis;
  • laser therapy. The lumbar region is affected by low-frequency laser radiation. The state of blood vessels improves, an analgesic effect occurs, and indiscriminate resistance of the body increases.

In the treatment of spondylarthrosis of the lumbosacral spine, massage is actively used, useful mud and mineral water are used. Applications with ozokerite, paraffin, compresses with blue and green clay help to stop the progression of pathology.

Therapeutic gymnastics and physical education

With spondylarthrosis of the 1st and 2nd degree, the patient is recommended regular gymnastics in the absence of stress on the spine. First, training is conducted under the supervision of a specialist who selects a set of exercises individually for each patient. Then you can train at home 1-3 times a day. Therapeutically most effective exercises are:

  • lie on your back and relax. Bend your legs slowly, resting your feet on the floor. Then, alternately clasping his knees with his hands, pull them to the torso;
  • sit on a chair or stool. Lean forward, trying to touch first one, then another foot;
  • leaning back against the wall. Bring your knees together, and then socks from side to side. When performing this exercise, you can not tear your back from a vertical surface.

You can not immediately actively begin training – the muscle corset strengthens gradually. If pain occurs during training, then exercises should not be performed at full strength.

The main types of treatment for spondylarthrosis of the lumbosacral spinePharmacological preparations, physiotherapeutic procedures, strengthening methods
Medicinal productsNonsteroidal anti-inflammatory drugs, glucocorticosteroids, muscle relaxants, warming ointments, vitamin and microelement complexes
Physiotherapeutic proceduresUHF-therapy, laser therapy, magnetotherapy, phonophoresis, electrophoresis
Non-drug therapyPhysical therapy and gymnastics classes, massage, underwater hood

Pathology at the initial stage is successfully treated with 5-10 sessions of physiotherapeutic procedures. Therefore, rheumatologists recommend that you seek medical attention if you experience the first back pain. This will stop the pathology, prevent its progression, and avoid disability.

Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles

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