Despite the spread of opinions, osteochondrosis of the spine is not seen as part of the aging process. Like shock absorbers, the elastic discs between the vertebrae are responsible for the flexion and extension of the back. Over time, they wear out and no longer offer full freedom of movement. As you age, daily stresses on the spine and accidental injuries, including minor ones, can damage the discs in the back and lead to lumbar spine osteochondrosis.
Who Does This Lower Back Disorder Affect?
In most cases, the first symptoms of osteochondrosis of the lumbar spine appear between the ages of 11 and 12 years. The disease manifests itself vigorously by the age of 16, but the most severe course and most common complications occur between the ages of 15 and 20.
Children under the age of 15 rarely have severe forms of osteochondrosis, which is in some way related to the excellent condition of their musculoskeletal system in general and the spine in particular. In addition, the disease takes time to develop, and on average, it takes five years.
Fortunately, these diseases are much easier to treat in children than in adults.
Symptoms
Reflex Syndromes
- Cervicalgia- differently manifested pain in the neck (pulling, tingling, shooting), a feeling of "crawling" in the cervical muscles as well as reduced mobility and flexibility of the neck.
- Lumbagois a sharp, sharp pain in the lumbar region that can be accompanied by numbness or swelling. Instead of the word "lumbago" the words "lumbodynia" or "lumboischialgia" can be used.
- Thoracalgia- Pain of various types in the chest, shoulder blades and ribs that is constant or occurs when the body moves.
Compression syndromes
The occurrence of a pain syndrome in osteochondrosis of the lumbar spine is due to:
- Compression of root structures (radiculopathy).
- Spinal cord compression (myelopathy).
- Spinal cord injury due to disturbed blood supply.
- Narrowing (stenosis) of arteries and veins (vascular compression myeloid ischemia).
Methods for detecting diseases
differential diagnosis
Not every disorder can be diagnosed with a simple laboratory test. Many diseases cause similar symptoms. For example, many infections cause fever, headache, and fatigue.
Many mental disorders are caused by:
- sadness;
- concerns;
- Sleep problems.
The differential diagnosis identifies possible disorders that are causing symptoms. Usually this diagnosis is based on several tests. These tests can rule out conditions and / or determine if you need additional testing.
Differential diagnosis is used to diagnose physical or mental health problems that are causing similar symptoms.
The differential diagnosis is also often used in the field of psychiatry / psychology, where two different diagnoses can be made for a patient who has symptoms of several diseases. For example, a patient diagnosed with bipolar disorder may also have a differential diagnosis of borderline personality disorder based on the similarity of symptoms in both conditions.
Who is diagnosed more often?
If the disease was diagnosed earlier in sick people after 45 years, today about 27% of adolescents suffer from osteochondrosis of one degree or another.
Such a widespread spread of the disease is understandable - children spent a lot of time in a sitting position, also because of the computer and the Internet. Is it bad? Time will tell, but the fact remains - the pay for a sedentary lifestyle is high, and osteochondrosis is far from the worst disease that can occur in such a lifestyle, but it is the most common (after obesity).
How do I define a disease and its degree?
First
In the normal state, the intervertebral discs are constantly regenerating, but it happens that the process slows down and a disease such as first-degree osteochondrosis appears.
There are many reasons for this:
- obese;
- metabolic disorders;
- immunocompromised and so on.
Unfortunately, the instability of pain in a certain degree of disease is influenced by the fact that many people neglect diagnosis and treatment and try to heal pain themselves. For this purpose, ointments and various tinctures are used. However, this is the biggest mistake.
First-degree lumbar spine osteochondrosis can be cured quite simply by turning to a good specialist and following a series of simple measures.
Grade 1 osteochondrosis is a knot of the intervertebral cartilage. The main symptom at this stage is slight pain when twisting or bending. Sometimes symptoms are more acute and short-lived due to sudden movement or significant exertion.
Second
A pronounced symptom of the disease is pain in the lumbar region, which increases with every movement. The pain can radiate higher up the spine.
With osteochondrosis, pain can radiate to the lower extremities.
The second stage of osteochondrosis is characterized by pain so severe that it also manifests itself when you cough.
Additional symptoms are associated with pinched nerve endings:
- The sensitivity in the lower limbs changes. The main signs: pain, numbness of the legs, high or low sensitivity of the skin of the lower extremities.
- Limited mobility. A person with osteochondrosis (Grade 2) notices that as the disease progresses it becomes very difficult to move.
- Increased tiredness and constant sleepiness. The patient has chronic fatigue, accompanied by irritability. This symptom is explained by the pain syndrome, which is constantly bothering the person.
- Problematic urination and pain in the kidney area.
Third
When the patient reaches stage 3, his posture has changed significantly. In more advanced cases, bone deformation occurs. At this stage of osteochondrosis of the lumbar spine, there is also an obvious deterioration in the general physical and / or mental condition of the patient and a deep loss of energy.
The third stage is characterized by the appearance of a narrowing of the intervertebral foramen against the background of previous changes. Hernias of intervertebral discs are formed, the vessels of the neck and muscles are damaged. The patient has dizziness, pain in the back of the head.
Fourth
The terminal stage occurs when the disc degenerates and the disc space is destroyed. At this stage, disc thinning reaches its maximum or, worse, completely disappears. Postural imbalance is acute and movement and flexibility are extremely limited.
Stage 4 of lumbar spine osteochondrosis is often characterized by severe pain and a greater degree of physical and / or mental deterioration. There is also a permanent loss of growth and energy. Level 4 is usually considered irreversible.
Consultation with the doctor
Which doctor should I contact?
When independent methods of treatment no longer have an analgesic effect, the patient begins to ask the question: which doctor treats osteochondrosis? The first person to turn to for treatment of lumbar spine osteochondria is your local therapist. However, in this situation he plays the role of dispatcher, as he cannot prescribe full treatment - this is not his specialization.
Most likely he will send you to a neurologist. It is this specialist who does the necessary research and helps set up a treatment program. The therapist can also refer you to a vertebrate. This doctor deals directly with diseases of the spine.
Scales and tests
Assessment of the quality of life
Such a generalized property as quality of life is particularly important for a group of patients with comorbid conditions as it can influence the effectiveness of the treatment. This is especially important in order to compare the results of multiple studies, conduct economic analysis, and understand the problem as a whole.
Methods for assessing quality of life include:
- Questionnaire on the quality of life in Oswestry.
- Roland Morris questionnaire.
- Stratford scale.
- Quebec Back Pain Scale - A questionnaire about how back pain affects your daily life.
Pain scales
Pain is an uncomfortable sensation and emotional experience that is associated with tissue damage. Its purpose is to enable the body to respond and prevent further tissue damage.
Methods for assessing pain syndrome include:
- Korf rating scale for chronic pain obtained.
- McGill pain questionnaire.
- Verbal pain scale.
Evaluation of the treatment result
- McNab's subjective rating scale.
- patient satisfaction scale.
- Prolo functional and economic result scale.
- Lumbo-sacral result scale.
- Nurik scale.
Hardware test
X-ray
X-rays provide detailed bone structures in the spine and are used to rule out back pain caused by:
- Spondylolisthesis.
- tumors.
- cracks.
Calcium in the bone blocks the penetration of the X-ray beam and the image of the bones is perceived as a shadow on the film. X-rays provide excellent visibility of all details as the bone is mainly made up of calcium. However, intervertebral discs and nerve roots do not contain calcium, so X-rays do not capture images of these structures. Therefore, X-rays cannot be used to diagnose a herniated disc or any other cause of a pinched nerve.
X-rays should not be taken in pregnant women.
Complications and possible consequences
Complications and possible consequences of osteochondrosis of the lumbar spine are:
- Radiculopathy is a disease characterized by a disease of the nerve roots.
- Muscle weakness - Common symptoms include fever, fatigue, flu-like symptoms, paresthesia, weight loss, and changes in consciousness.
- Neurogenic Bladder - Problems with the nerves that control the bladder and urination
- Damage to the lower motor neurons.
- Raynaud's phenomenon is a condition in which cramps occur and the capillaries of the fingers and toes narrow.
- Pain in the neck, back, leg.
Treatment
Treatment may vary depending on the severity of your symptoms and how limited your daily activities are.
Here are some of the treatments your doctor may prescribe depending on your pain level:
- Non-surgical treatment- Not all patients with osteochondrosis require surgical intervention. For mild to moderate pain, more conservative treatments.
- Spondylodesis- surgical intervention in the treatment of osteochondrosis.
Prevention
Prevention of osteochondrosis of the lumbar vertebral segment is aimed at eliminating the risk factors that lead to this disease. Eliminating factors is the most important preventive measure.
Physical activity is normalized, back muscles are strengthened, the maximum load on the lower back is prevented, the development of diseases that lead to lower back pain is prevented. All of these are prophylaxis to prevent the symptoms of lumbar osteochondrosis.
Moderate exercise, lifestyle changes, and eating well can all help avoid painful and debilitating symptoms.
If you experience symptoms of osteochondrosis of the lumbar spine, do not tighten them and seek medical advice immediately. A disease recognized in time is easier to treat and has no consequences.