What is lumbar spine osteoarthritis?

Lumbar spondylosis is a disease of the musculoskeletal system, accompanied by degenerative-dystrophic changes in bone tissue and functional impairment of the lower 5 vertebrae (from 20 to 24). The disease causes discomfort for the patient and is characterized by specific symptoms such as pain and stiffness during movement. Chondrolysis in the lower back occurs episodically, with periods of exacerbation and remission. According to statistics, this form is one of the most popular. Unattended medical conditions often lead to irreversible changes and a significant decline in quality of life. However, with an effective integrative approach, osteoarthritis can be treated successfully.

Main cause of pathology

There is no exact data on the reasons for degenerative-dystrophic changes in the spine. It is believed that the initiating mechanism for the development of the pathology is early age-related changes in the joints. They can be genetically determined - transmitted through heredity, but most often they initially manifest themselves under the influence of adverse factors.

The main reason among them is considered to be the improper distribution of loads on the spine. Osteonecrosis of the lumbosacral spine may develop with:

• wear high heels;
• carry bag or backpack on one shoulder without shifting;
• sleeping or resting for long periods in an uncomfortable position;
• sedentary work;
• lift weights.

People at risk of developing osteonecrosis include elderly people characterized by natural changes in cartilage and bone tissue, professional athletes who practice daily and intense training, pregnant women, people whose center of gravity changes as the fetus grows and the load on the lower back increases significantly, office workers, are forced to spend a lot of time in a sitting position.

In addition to external risk factors, doctors also call them internal risk factors. These include:

• previous trauma to the musculoskeletal system;
• curvature of the spine;
• flat feet;
• Congenital dislocation or dislocation of the hip;
• autoimmune disorders;
• joint tissue inflammation;
• pathology of the circulatory system;
• endocrine diseases;
• obesity.

Osteonecrosis of the lower back can also be provoked by prolonged intoxication and dehydration, bad habits, calcium deficiency and any mechanical impact on the lower back - bruises, blows, falls.

Lumbar spondylosis: symptoms

Pathology affects not only bone tissue, but also the entire moving segment of the spine - vertebrae, intervertebral discs, ligaments, surrounding soft tissues, blood vessels and nerve endings. Lumbar spondylosis develops, symptoms become apparent with a significant degree of damage, gradually and slowly. In the early stages it is moderate discomfort during exercise, in the later stages it is acute unbearable pain. Clinical signs are pronounced in the acute stage. During remission, they disappear, and in the early stages this happens even without treatment.

Lumbar spondylosis - symptoms:

• pain in the affected area of the spine;
• pain spreads to the shoulder blades or down to the pelvis and hip joints;
• persistent feeling of tension in the lower back;
• difficulty bending and rotating the body;
• limping;
• limp;
• muscle weakness or, conversely, increased tone;
• tingling sensation.

Not all the symptoms described appear at the same time. Pain may be related to limited mobility, but is not due to muscle weakness or numbness. Any of the signs discussed above should be a reason to consult a doctor.

Stages of the disease

The intensity of symptoms accompanying osteoarthritis of the lumbar spine depends directly on the degree of development of the pathology. There are four of them in total.

1. First stage. The first structural and functional changes begin. The disc dries out and can crack. Symptoms at this stage are minor. Many patients mistakenly think they are fatigue after a day of work, wearing uncomfortable shoes, or exercising. The main signs of early osteochondrosis are mild discomfort in the lower back, which increases when bending and turning. There may be mild pain, which will subside after rest.
2. Second stage. The height of the intervertebral discs gradually decreases, the bone structures move closer together. This causes a new set of symptoms – stiffness when moving and pain. The pain becomes prolonged and intense, and can spread to the pelvis and legs.
3. Third stage. At this stage, the vertebrae are deformed. Convex appearance - the discs bulge into the spinal canal area, but the annulus fibrosus remains intact. The main symptoms are severe pain, discomfort even at rest, decreased sensitivity, crunching and crunching when moving, tingling and numbness in the lumbar region.
4. Fourth stage. Pathological changes continue to progress. The functions of the vertebrae are lost. Hernia type. Osteoporosis—bone growth—is formed. Blood vessels can be compressed and nerve fibers compressed. Against the background of poor blood circulation, the functioning of the pelvic organs is disrupted. In men, the risk of erectile dysfunction increases, in women, the menstrual cycle is disrupted. Progressive osteonecrosis is manifested by severe pain in the lower back, limping, impaired mobility to complete immobility, and elevated temperature.

If you are worried about lumbar osteoarthritis, treatment will depend directly on the stage of diagnosis of the disease. In the early stages, the doctor has more recovery methods and techniques in his arsenal. Detection of degenerative-dystrophic changes at an early stage helps treat the pathology conservatively without resorting to surgical intervention.

Types of pathology

The division into types is based on the characteristics of the pain syndrome that always accompanies osteoarthritis in the lumbar spine. There are three in total:

1. Low back pain. This is an acute pain that prevents you from moving. The cause of pain may be nerve compression or muscle spasm.
2. Lumbodynia. This is a long-lasting pain. That is characteristic of the stage of formation of protrusions and hernias. Additionally, discomfort may be related to sprained ligaments.
3. Sciatica. This is severe pain that radiates down to the pelvic area. Patients complain of pain when walking, sitting or changing positions.

Two more forms of pathology are distinguished depending on the accompanying symptoms. Patients may be diagnosed with:

1. Radiculopathy. Accompanied by compression of nerve endings due to spinal deformity. With this form of the disease, sensitivity decreases and the affected area becomes numb. Pain and tingling sensations are expressed. There may be decreased muscle tone, impaired reflexes, and tingling in the legs.
2. Lumbar osteoarthritis causes intervertebral discs. This is a serious condition that causes patients to have limited mobility. His lower back and limbs were numb. Other symptoms are general weakness, fever, urinary incontinence and, if the disease persists, weight loss.

Risk of spinal disease

If left untreated, osteoarthritis not only causes unbearable pain and stiff movements, but is also accompanied by a number of pathologies that can develop against its background. The most common complications:

• intervertebral hernia;
• sciatic nerve inflammation;
• radiculitis;
• paralysis.

To prevent accompanying diseases, it is necessary to begin treatment of osteoarthritis right from the time of detection. With the right therapeutic approach, it is possible to stop or significantly slow down the process of destruction of bone and cartilage tissue.

Pathological diagnostic methods

Lumbar spondylosis must be distinguished from other pathologies of the musculoskeletal system, which may occur with similar symptoms. The main stage is consultation with a neurologist, orthopedist or surgeon. The doctor clarifies complaints, collects anamnesis, conducts a physical examination, pays attention to the patient's posture and posture characteristics, the nature of work activity, bad habits and accompanying diseases.

For the most accurate diagnosis, instrumental techniques are used:

• MRI;
• X-ray;
• myelogram with contrast agent;
• Multi-slice CT.

Each diagnostic procedure allows the doctor to evaluate the condition of the lumbar spine and sacrum at the present time. The images clearly show structural changes in the vertebrae, indicating the stage of osteoarthritis. Based on the data obtained, the specialist makes decisions on tactics for further patient management.

Laboratory diagnosis is not paramount, however, studies may be recommended if indicated. In particular, if diagnosed with lumbar osteoarthritis, treatment may be prescribed based on blood test results. They are needed to clarify the intensity of the inflammatory process in muscle fibers near the spine.

Lumbar osteoarthritis: treatment

The fight against pathology is carried out under the supervision of a neurologist and begins after a comprehensive diagnosis, when the extent and extent of tissue damage is determined. Modern medicine offers a number of effective conservative treatments. If their use does not bring expected results, doctors will have to operate.

Lumbar spondylosis: treatment with physical therapy

All physical therapy techniques are good because they work comprehensively on the sacral and lumbar spine. This approach allows you to cope with pain, reduce inflammation and restore normal blood circulation.

As lumbar osteoarthritis progresses, treatment needs to be comprehensive. Patients with complaints are prescribed:

• electrophoresis - exposure of the problem area with continuous electrical pulses with the possibility of using the drug for external use;
• diadynamic therapy - a variation of electrotherapy using pulsed currents;
• magnetotherapy – treatment with alternating or static magnetic fields;
• Ultrasound therapy - the effect of high-frequency sound waves;
• shock wave therapy - exposure to low-frequency sound pulses;

It is important to consider two nuances. Firstly, the effectiveness of physical therapy treatment is only evident after one course of treatment, the duration of treatment is selected individually for each patient. Second, physical therapy as an independent method is effective for osteoarthritis at the initial level. For large-scale lesions, it is recommended to be used as an auxiliary technique in addition to medical and surgical treatment.

Lumbar osteoarthritis: treatment with medication

Pharmacological treatment of lesions in the lumbar spine and sacrum is aimed at reducing acute pain and inhibiting the inflammatory process. This method is suitable in the acute stage, when symptoms interfere with a full life.

How to treat lumbar spondylosis with medication is always decided individually. A neurologist can prescribe medications from different pharmacological groups. Foundation:

• NSAIDs (systemic and local) to suppress inflammation in the vertebrae and adjacent tissues;
• muscle relaxants to reduce muscle spasms;
• Vasoprotective drugs to improve blood circulation;
• chondroprotective agent to protect the cartilage tissue of the intervertebral disc from destruction;
• Vitamin B to improve nerve conduction;
• pain relievers for sharp pain that limits mobility.

Exercise therapy as a method of treating pathologies of the sacrum and lumbar region

Intense training for osteoarthritis is strictly prohibited, but you cannot completely abandon physical activity. On the contrary, exercises of moderate strength and duration help restore blood circulation and reduce pain.

How to treat lumbar spondylosis with exercise therapy:

1. Practice with an instructor. The trainer will show you which exercises are permissible in a particular situation and ensure they are performed correctly. Even the smallest flaws in technology can significantly reduce training effectiveness or even cause harm.
2. Prepare carefully for the lesson. Before exercising, it is recommended to warm up the muscles - you can gently massage the lower back and sacrum.  
3. Strict loading dose. The lower back is a vulnerable area. To avoid overexertion, you need to monitor the duration of classes. Their optimal duration is no more than 20 minutes.
4. Gradually increase exercise intensity. For inexperienced beginners, simple exercises and short programs are suitable. For those who have been doing exercise therapy for a while, you can move on to more complex options.
5. Remember to be regular. A one-time workout will not bring noticeable improvement. Pain in the lumbar and sacral spine is reduced if the patient performs regular exercise therapy - optimally twice a week.
6. Consider contraindications. Physical therapy has been shown to be a safe method of treating osteoarthritis, but there are limitations. You should stop exercising if you feel unwell: fever, weakness or high temperature.

Lumbar osteoarthritis, the treatment of which should take into account the period of the disease, will not bother you if all the rules are strictly followed.

1. During the acute phase. Only smooth and slow movements are allowed. If pain increases during exercise, you need to stop and give your joint a rest.
2. In the subacute stage. Pain syndrome is reduced, mobility is restored, so you can slightly increase the intensity of exercise and increase the duration of exercise. However, to avoid deterioration, you need to carefully monitor your health.
3. In remission. We allow a full range of exercises for pathologies of the lumbar spine, but it is important to remember that overtraining will lead to a new exacerbation of the disease.

If lumbar osteoarthritis is diagnosed as mild or moderate, treatment with physical education can also be carried out at home. After perfecting the exercise technique under the supervision of an instructor, it is not allowed to repeat the exercises at home. To practice, you will need a gym mat, a roller and a ball.

Modern therapeutic and rehabilitation gyms are equipped not only with traditional accessories, but also with special medical simulators. They help you recover gently and safely, while also making activities more fun and interactive. For example, the neuromuscular rehabilitation system turns rehabilitation into an exciting competition with yourself. The patient stands on a moving platform and performs exercises presented on a screen. Another important advantage of the simulator is the ability to monitor even the slightest progress in the patient's condition. The system evaluates the results of each exercise performed and the physician can see progress from one workout to the next. Knowing their success also motivates patients to try harder and not give up.

Manual therapy

Good results can be achieved if you supplement exercise therapy and medications for lumbar pathology with manual therapy. This method allows:

• eliminates increased tone of muscle fibers;
• pain relief;
• restore blood supply in the lumbar and sacral regions;
• improve metabolism.

Manual therapy is an effective way to properly redistribute the load on the spine and protect you from further harmful changes. The good thing about this method is that it not only helps reduce pain but also prevents neurological disorders that often develop due to lumbar osteoarthritis.  

Today, chiropractors combine massage and physical therapy methods, such as tecartherapy. Electromagnetic waves penetrate deep bone tissue and allow you to relieve pain and quickly restore mobility.  

Surgical method

Osteoarthritis of the lumbar spine, treatment with drugs, physiotherapy and exercise is not always effective, significantly complicating the patient's life. In some cases, only surgical intervention can be used to eliminate pain and restore back mobility. Modern technological methods and equipment make it possible to perform minimally invasive operations with shortened recovery times.

For osteonecrosis, the following intervention methods are relevant:

• endoscopic excision of intervertebral hernia - using microsurgical instruments and integrated cameras;
• surgical excision of intervertebral hernia - using neurosurgical tube dilators;
• surgical excision – surgical removal of pathologically altered bone processes;
• microdiscectomy – removal of the protruding part of the hernia.

Direct indications for surgical intervention are recurrent hernias, spinal stenosis when the spinal canal is narrowed, and spondylosis, a disease in which the vertebrae are displaced relative to each other. In all other cases, if lumbar osteoarthritis is confirmed, doctors will try to proceed with treatment using conservative methods.

Disease prevention

Symptoms of osteonecrosis cause inconvenience, and treatment of the pathology can take a long time. It will be much more effective to protect the vulnerable lumbar area from overuse in advance. For prevention purposes, it is recommended to:

1. Streamline your workplace during office hours. The back of the chair must support the lower back, and the table must be appropriate for the height.
2. Avoid uncomfortable shoes. The optimal heel height for women is up to 5 cm. Flat soles should also be excluded because they contribute to foot deformation and flat feet - one of the factors.
3. risk of osteonecrosis.
4. Exercise. Avoid lifting heavy objects. Swimming, walking and cardiovascular training are useful if there are no contraindications.
5. Eat a balanced diet. The diet must include foods that provide calcium, phosphorus and B vitamins. These are fish, dairy products, green vegetables and cereals. These substances are needed to strengthen all elements of the joints and support the nervous system.
6. Make sure you get enough sleep. It is better to sleep on an orthopedic mattress of moderate firmness. It will provide an anatomically correct position for the body to rest from daily stress.
7. Control body weight. Obesity is one of the stimulating factors. If your weight is at a normal level, the load on the spine will be properly distributed and the risk of circulatory disorders will be minimized.

The prognosis for patients with osteoarthritis directly depends on the degree of vertebral damage. That's why timely diagnosis is extremely important. If you are worried about lower back pain and the picture shows destructive processes in the early stages, you need to start treatment. In the early stages, medication and physical therapy are effective. In these latter cases, it is rarely possible to do without surgery. Exercise therapy can be used as an additional support in any form and at any stage.