We are sure you have read and heard that low back osteochondrosis often affects bank employees and office workers, programmers and representatives of heavy physical labor. This is true, but the whole truth is that today it is hardly possible to find at least one type of activity that is not associated with the risk of developing this disease.
Why is that? Low back osteochondrosis is a kind of "tax on upright walking", a tribute that each of us has to pay to nature. The reason for the degenerative changes in the cartilaginous tissue of the intervertebral disc lies not so much in the increased loads on its nucleus pulposus, but in the peculiarities of the blood supply to these structures.
By about the twentieth year of life, the arteries that feed the fibrocartilaginous tissues of the IVD in adolescence are obliterated, and for all the remaining years the nucleus pulposus and annulus fibrosus receive nutrients exclusively through diffusion, and this is clearly not enough! Trace elements, polysaccharides, amino acids and other structural components enter chondrocytes (cells that synthesize the interstitial substance of the disc) in extremely limited quantities, which creates a fertile ground for the development of dystrophic processes.
In the course of our professional activities, we regularly throw seeds into this fertile soil. We sit in the wrong position, lift weights incorrectly, move a little and spend a lot of time behind the wheel or behind a computer monitor. All other things being equal, such a form of physical activity "would get away with us", but in conditions of a limited supply of cartilaginous structures in the IVD, degenerative processes inevitably develop.
How is low back osteochondrosis manifested?
The first manifestation of osteochondrosis of the lumbar region is pain syndrome. As a rule, for the first time a "lucky man" is struck by a sharp pain in his back, which pierces his body with a dagger. The pain occurs after an inadvertent twist of the torso, tilt, or after hypothermia. There is no way to endure such pain - it literally knits a person by the hands of his legs and fetters him to bed.
What changes occur in the spinal column against the background of pain syndrome? To reduce pain, the nervous system sends stimulating signals to the deep muscles of the back. Strengthening muscle tone helps to reduce mobility in the affected segment of the spine, which for some time reduces the severity of pain. In the future, myofixation ceases to perform a compensatory function, and such a muscle-tonic imbalance only intensifies the pain.
When examining such a patient, the neuropathologist will detect signs of fixation syndrome, or objective symptoms of the disease - changes in statics and dynamics. By changes in statics in low back osteochondrosis, we mean a flattening or strengthening of physiological curvature (lordosis) and the appearance of pathological curvature towards pain (scoliosis). The dynamic symptoms of the disease are a sharp limitation of mobility (up to complete immobilization) in the affected segment.
All these changes can be confirmed using spondylography (X-ray of the spine) and more modern research methods such as computed tomography and MRI. The images also show a decrease in the height of the disc in the area of clinically significant PDS, hernial protrusion, osteophytes.
Low back osteochondrosis, treatment
Fixation and pain syndrome in combination with morphological signs on diagnostic images form a complete picture of vertebral syndrome, which is caused by low back osteochondrosis. The next question we ask the doctor after completing the diagnostic stage is how to treat the disease?
Of course, it is always not the disease that needs to be cured, but the patient, but we will not get away from philosophical discussions. And we will solve more pressing problems - first we will have to overcome the pain syndrome. To do this, we need medications of systemic and local action, such as NSAIDs, corticosteroid hormones, muscle relaxants, and possibly even antidepressants. After the relief of pain syndrome comes the turn of conservative treatment methods.
If you have been diagnosed with low back osteochondrosis, the treatment will be long, and you should be prepared for this both morally and financially. De facto and de jure, it is impossible to completely overcome the disease, so with a certain frequency you will have to visit doctors until the end of your days.
The treatment algorithm is always individual, and it is developed by the attending physician who knows the history of the disease, we will only list the possible directions of therapy. Reflexology has a positive effect, among the methods of which acupuncture is in the first place. Some specialists advocate traction therapy, although other schools of vertebrology deny this technique. It is worth trying massage therapy, you definitely need to include back exercises (LFK) in your rehabilitation program, you can also resort to the help of qualified chiropractors.
In 90 cases out of 100 methods of conservative therapy are sufficient to bring the disease under control, the remaining ten patients are indicated for surgical treatment. In the absence of absolute indications for surgery (severe spondylolisthesis, spinal stenosis), treatment with minimally invasive surgery is possible. If the degree of morphological changes in the spine has reached a critical level, modern methods of disc reconstruction using implants are used.