What is lumbar osteoarthritis?

Cartilage degeneration in the lumbar region occurs due to deformation and destruction of cartilage tissue of the intervertebral discs.Without cartilage, the vertebrae will lose elasticity and shift, causing pain.According to WHO, the disease mainly affects people over 30 years old.Women get sick three times more often, which is also associated with age-related changes and a decrease in calcium in the body.

Osteonecrosis of the lower back

Among all diseases of the peripheral nervous system, spinal cartilage degeneration accounts for 80%, of which 60-80% affect the lumbar region, including 5 vertebrae.In 40% of people, the first signs of the disease appear at the age of 30-35.In old age, osteoarthritis of the spine is diagnosed in 90% of people.7 out of 10 people experience pain, an attack that can last from 6 to 16 months.

Stages of development

• First – the onset of degenerative disorders, affecting nerve endings and disrupting blood supply.The inflammatory process causes pain that radiates down the leg.Patients occasionally feel tingling in the back and buttocks.Appears after heavy exertion.
• Second – the outer shell of the disc (annulus fibrosus) is destroyed.The distance between vertebrae is reduced, nerve endings are compressed, causing severe, acute pain.Symptoms are especially pronounced when walking.
• Third – due to excessive movement of the vertebrae, muscle fibers and nerve endings are compressed.Spasms, numbness, burning pain, herniation occur - displacement of the intervertebral disc into the spinal cord.
• Fourth – the growth of pathological cells on the bone structure.The spine literally means “turning to stone.”Progressive arthritis and lack of treatment leave the patient immobile.

Reasons for development

The disease develops slowly, subject to a combination of many circumstances, that is, the development of the disease does not depend on the influence of one, but on many factors:

• Sedentary lifestyle (physical inactivity), sedentary job, low level of physical activity.At first glance, they are not dangerous.However, with prolonged exposure, muscle tone, or “muscle corset”, will weaken.It supports the spine and internal organs.Therefore, physical inactivity causes disruption of the functioning of several systems - blood circulation, respiration, digestion.
• Overweight.With a BMI (Quetelet body mass index) above 25 kg/m2, excess weight puts additional stress on the body: it puts pressure on the spine, overloads the joints and impairs blood supply.
• Endocrine pathological process.Hormonal imbalance, dysfunction of the adrenal and thyroid glands "slow down" the body's metabolism.Frequent hormonal changes will "wash" calcium from bone tissue, causing bones to become weak and brittle.
• Unbalanced diet.Popular and affordable fast food fully satisfies the body's energy needs, while in terms of saturating the body with the necessary vitamins and trace elements, it is completely useless.
• Pathology and genetic predisposition to diseases of the musculoskeletal system.
• Age-related degeneration.Under the influence of time, natural wear and tear of the support system occurs.

In men whose occupation involves significant physical activity, lumbar osteoarthritis occurs many times more often.

Symptoms of lumbar osteoarthritis

Pain is the main sign of the onset of the disease and its location.Based on the nature of the occurrence, frequency and duration, a preliminary diagnosis can be made.Normally, patients with lumbar osteoarthritis will feel pain spreading to the legs, groin and tailbone.In a horizontal position, the feeling of discomfort disappears.

Spinal nerves extend from the spinal body to different parts of the body.Each nerve is responsible for a specific area.This is called "segmental preservation."It is for this reason that the affected nerve “reacts” in a specific area: this is how “nerve root syndrome” manifests.

Spinal nerve mapping allows you to identify pain in a specific area of the spine: C1-C8 - 8 cervical, T1-T12 - 12 thoracic, L1-L5 - 5 lumbar, S1-S5 - 5 sacral, C0 - 2 coccygeal.Signs of cartilage degeneration depend on the preservation of each segment:

• L3-L4 – weak knee reflexes, partial numbness, intermittent loss of sensation along the anterior surface of the thigh;
• L4-L5 – muscle weakness, the patient cannot stabilize the body when standing on the heels, pain and tenderness disorders extend to the area from the lower back to the buttocks, as well as along the entire lateral surface of the thigh (from top to bottom).
• L5–S1 – tremor in calf muscles, inability to stand on toes, pain in back of thigh.

In rare cases, the radicular arteries are also involved in the destructive process, causing spinal stroke - a dangerous pathology that leaves the patient paralyzed and paralyzed as well as dysfunction of the pelvic organs.

Pain reflex symptoms

• Low back pain or lumbago (in this case not sciatica!) – acute pain.Any awkward movement, even sneezing and coughing, causes spasms.The patient automatically changes body position, moves to the side.Trying to maintain an upright position will cause new low back pain.
• Lumbodynia is a dull, aching pain that occurs on one side.After a period of remission, the condition gets worse, gradually developing into severe pain.
• Low back pain - painful sensations appear in the legs.

Secondary signs of the disease are not so typical and can easily be mistaken for symptoms of another problem: decreased sweating (hypohidrosis), pale skin in the affected area due to poor blood circulation, severe dryness and peeling.

Diagnose

In the early stages, a complete medical history of the patient will be obtained.The overall picture needs to be supplemented by the opinions of surgeons, orthopedists, neurologists, and rheumatologists.Experts ask patients to perform a visual examination to evaluate changes in posture, muscle tone, and skin sensitivity.

X-rays are performed for the primary diagnosis of grade 1 lumbar osteoarthritis;It is used to check the condition of the intervertebral discs, diseases of the spinal cord, and evaluate the general condition of the spine.However, this type of diagnosis does not provide complete information about the affected tissues.

Computed tomography (CT) is a highly sensitive examination method that uses ionizing beams.A CT scan records the degree of deformation of the disc, inflammation in the spinal membrane and nerve endings in layer-by-layer images.

Magnetic resonance imaging (MRI) shows the general condition of muscles, blood vessels and ligaments in a comprehensive manner.Detect tumors and inflammatory processes.

Myelography is one of the ways to visually assess the condition of the spinal cord and nerve roots by using a needle to inject contrast material into the space between the pia mater and arachnoid membrane of the spinal cord filled with cerebrospinal fluid.Similar to CT, MTP and X-ray, this procedure is performed in real time.

Neurological testing of sensitivity and reflexes for pathologies is a research complex that includes screening methods for studying the symmetry of the limbs, testing vibration sensitivity and assessment of Babinsky, Chaddock and Oppenheiman reflexes.

Treatment of lumbar osteoarthritis

The effectiveness of conservative treatment is achieved through a combination of drugs of various groups, massage and manual therapy.However, in stage 3, lumbar osteoarthritis can no longer be cured with conservative methods;surgical intervention is required.One of the surgical methods to treat osteoarthritis is microsurgical resection.This is a neurosurgery to remove the hernia without damaging the nerve structures.It is performed under general anesthesia.Patients can walk on the 3rd day.

Drug treatment (for stages 1-2)

• Pain relievers: topical (ointment, gel), oral (tablets, suspension), intramuscular (injection solution).
• Nonsteroidal anti-inflammatory drugs to prevent the development of the inflammatory process.Reduces temperature, eliminates swelling.Most often, gels and tablets are used, in more severe cases (sciatica neuritis) - injections.Beginner course - 7-14 days.
• Muscle relaxants.Prescribed during the acute period for muscle spasms, as well as during periods of remission to consolidate the effect.
• Chondroprotectors.Prevents destruction of intervertebral discs, promotes regeneration, and improves metabolism in cartilage tissue.
• Vascular medicine.Helps normalize blood supply to the musculoskeletal system.
• Vitamin B complex. Improves nerve conduction.
• Diuretics.Reduce swelling.

As an emergency aid at the moment of exacerbation, strong injections are used - paravertebral blockade, causing temporary loss of sensitivity.

It is also recommended to undergo a course of manual therapy twice a year, which helps relieve muscle tension and spasms, restore blood circulation, improve lymph circulation and increase mobility of the musculoskeletal system.

prevent

• Active lifestyle combined with moderate physical activity;
• Choose comfortable shoes or, if indicated, orthopedic shoes;
• Good nutrition;
• Control body weight;
• Sleep only on mattresses and orthopedic pillows;
• Office furniture only has a flat back;
• Refuse heavy loads on the back and spine.When carrying heavy objects, the load must be evenly distributed in both hands.