Signs of initial degenerative changes in the lumbar spine. Degenerative-dystrophic changes in the lumbar spine: symptoms, causes, treatment. Features of the treatment of such pathologies

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With a modern sedentary lifestyle, with constant sudden movements, injuries, when the spine takes on a large load, temporary changes and deformation of the cartilaginous tissues may occur.

Often, doctors make patients such diagnoses as spondylosis, osteochondrosis, spondylarthrosis. The degenerative process in the intervertebral discs of the spine develops in 4 stages, and the symptoms vary depending on the case.

If you are experiencing any of the symptoms listed below, then you need to see a doctor and start treatment.

What are degenerative-dystrophic changes in the lumbosacral spine?

Take any person: everyone has suffered from back pain at least once in their life. Medical statistics says: 20% complain of lumbar pain constantly, and 1-3% need surgical treatment. The lumbosacral region is the center of gravity of the body, it takes on all the loads that accompany any movement human body.

Sometimes these loads exceed the permissible limits, temporary changes and deformation of cartilaginous tissues occur in the spine. Under the influence of pressure on the damaged area of ​​the spine, salts present in the bloodstream and plasma begin to actively penetrate into its structure.

There is a beginning of calcification of a certain area cartilage tissue. This is degenerative dystrophic changes spine.

Degenerative-dystrophic changes in the lumbosacral spine is a syndrome in which the pathology of the intervertebral disc provokes the appearance of pain in the lower back.

Although there is a slight genetic predisposition to the occurrence of this disease, the true cause of degenerative changes in the spine appears to be multifactorial.

Degenerative changes may be due to natural process aging of the body or have a traumatic nature. However, they are rarely the result of major trauma, such as a car accident.

Most often, we will talk about a slow traumatic process, leading to damage to the intervertebral disc, which progresses over time.

The intervertebral disc itself is not provided with a blood supply, so if it is damaged, it cannot recover in the same way that other tissues of the body recover. Therefore, even minor damage to the disk can lead to the so-called. "degenerative cascade", due to which the intervertebral disc begins to collapse.

Despite the relative severity of the disease, it is very common, and current estimates suggest that at least 30% of people aged 30-50 have some degree of disc space degeneration, although not all experience pain or are diagnosed with it.

In fact, in patients over 60 years of age, some level of intervertebral disc degeneration detected by MRI is the rule rather than the exception.

Disease pathogenesis

The spine in the lumbar region and the sacrum is subject to the greatest loads in comparison with its other departments. Therefore, degenerative and dystrophic changes in it develop more often. The incidence is high - up to 30% of the population older than 35 years.

Degenerative-dystrophic changes in the lumbar sacral department of the spine are a multifactorial pathology, their development provokes many reasons.
The main links of the process are the same, regardless of the cause:

• malnutrition (dystrophy) of the cartilage of the discs between the vertebrae, which leads to their destruction (degeneration);
• cartilage degeneration causes height change intervertebral discs,
• the appearance of protrusions in them with the destruction of the fibrous membrane (hernia) or without (protrusion).

All these factors cause a violation of the proportional ratio of the vertebrae, with subsequent infringement of the spinal roots; the development of inflammation in the area of ​​degenerative changes in cartilage - cells of the immune system, due to destruction processes, produce substances that induce the inflammatory process (prostaglandins), which cause pain, increased blood supply (hyperemia) and tissue edema.

The pathological process takes a long time, tends to gradual progression and chronic course. The main disease in degenerative changes in the lower back and sacrum is osteochondrosis, which may be accompanied by hernias or protrusions of discs between the vertebrae.

In the case of a predominance of damage to the cartilage of the joints of the vertebrae, spondylosis develops. In order for degenerative changes to pass into an irreversible phase, a lot of time must pass. And this time the disease wins back in a person, due to the fact that the disease does not manifest itself immediately.

Expressed symptoms show themselves when time is lost, and the degenerative changes themselves have become large-scale and irreversible. medical term"degenerative-dystrophic changes in the spine" summarizes several diseases.

A type of spinal degeneration

Those few who seek help from a doctor with the firm intention of curing (or at least getting rid of pain) an ailment, most often receive such diagnoses:

• Spondylosis. Atypical bone growths form along the edges of the vertebrae. The disease is characterized by marginal bony growths that look like vertical spines on x-ray. Experts consider this disease clinically insignificant. Doctors around the world believe that osteophytes (marginal growths) and thickening of the ligaments lead to immobilization (immobilis - motionless) of the spinal segment prone to problems;
• Osteocondritis of the spine. There is a visible thinning of the intervertebral disc, which proceeds without inflammation. Simply put, this is a decrease in the height of the disc located between the vertebrae. As a rule, the disease appears due to the processes of dystrophy of vertebral tissues; osteochondrosis is characterized by the absence inflammatory phenomena. During osteochondrosis, there is a convergence of the vertebrae and articular processes, as a result of which their frequent friction is inevitable - it will inevitably lead to local spondylarthrosis in the future;
• Spondylarthrosis. This disease is a consequence of osteochondrosis. It is arthrosis of the intervertebral joints. In simple terms, spondylarthrosis is a type of osteoarthritis.

There are many more similar diseases, the consequences of each of which are reduced to a violation of the spine, and in some cases even to the loss of a person's ability to work.

Reasons for the development of the disease

The human body is a delicate and precise mechanism. It is determined by nature itself - the load on the human spine should be distributed evenly. A healthy spinal column can withstand both jumping and lifting weights.

But, all this works only when a person follows his posture, has a strong muscle corset. Modern look life is immobile. And this leads to a weakening of the muscular corset, weight gain.

The appearance of degenerative changes in the spine contributes to sedentary work. Due to degenerative changes, the intervertebral discs lose moisture, cracks and all kinds of ruptures form in them. This contributes to the appearance of intervertebral hernias.

The vertebrae, when the load changes, try to increase their area, grow, thicken intensely, pinching the adjacent nerves.

Causes that provoke pathological changes:

• constant or sudden loads;
• active sports with heavy loads;
• trauma; including generic;
• natural aging of the body;
• inflammatory diseases of the spine;
• malnutrition.

Degenerative-dystrophic changes in the lumbosacral spine are usually provoked by one or both of the two following reasons:

• Inflammation that occurs when proteins in the disc space irritate the nerve roots during the formation of an intervertebral hernia.
• Pathological instability of micromovements when outer shell The disk (annulus fibrosus) wears out and cannot effectively support the load on the spine, resulting in excessive mobility in the affected spinal segment.

The combination of both factors can lead to persistent low back pain. The combination of both factors is most common in the formation of an intervertebral hernia, which is a complication of the degenerative-dystrophic process in the intervertebral discs.

When a disc herniation occurs, mechanical compression of the neurovascular bundle passing into spinal canal, as a result of which the pain in the lower back increases significantly and becomes permanent.

Symptoms of diseases appear as degenerative-dystrophic lesions develop, but on early stages pass without pronounced external signs. As the pathological process develops, the patient may feel stiffness and heaviness in the lower back.

But, the main symptom of all degenerative changes in the spine is pain. Pain in the lumbar region occurs during a long walk and during physical exertion, prolonged sitting in one position, during bending. The pain syndrome is undulating: it arises, then decreases, disappears.

A progressive degenerative process in the intervertebral discs of the spine can lead to serious and dangerous complications. Degenerative changes develop in stages.

initial stage
The first symptom, "screaming" about the presence of pathological changes in the lumbar spine, is a pronounced pain syndrome in the lower back.

The pain sensations are so palpable that the patient is forced to limit his movements, and this significantly reduces normal level life and performance. Complaints of pain directly depend on the place where the lesion is localized.

Second stage
Further progression of degenerative changes is characterized by the presence of:

At the second stage of the disease, radicular syndrome develops - compression of the nerve roots occurs.

Third stage
At the third stage, blood circulation is disturbed due to compression of the radicular vessel, which leads to the development of ischemia. In addition to increasing pain, the third stage is noted:

• partial or temporary numbness in the lower extremity girdle;
• convulsions.

Fourth stage
Degenerative pathological processes of the spine that have not received proper treatment are fraught with paralysis and paresis at the fourth stage of development. These complications arise as a result of a complete violation of the blood circulation of the spinal cord.

• severe mobility restrictions;
• "lumbago" that occurs in the lower back;
• tingling and "goosebumps" in the limbs and buttocks.

Most patients with degenerative-dystrophic changes in the lumbosacral spine experience constant but tolerable pain, which from time to time increases for several days or more. Symptoms may vary depending on the individual case, but the main symptoms in this disease are as follows:

• Pain localized in the lower back, which may radiate to the hips and legs;
• Prolonged pain in the lower back (lasting more than 6 weeks);
• Low back pain is usually described as dull or aching, as opposed to burning pain where it radiates;
• The pain is usually aggravated in a sitting position, when the discs are under more pronounced load compared to that which is placed on the spine when the patient is standing, walking or lying down. Prolonged standing can also make the pain worse, as can bending forward and lifting objects;
• The pain is exacerbated by certain movements, especially when bending over, turning the torso and lifting weights;
• If a herniated disc develops, symptoms may include numbness and tingling in the legs, and difficulty walking;
• With a medium or large herniated disc, the nerve root exiting the spinal cord at the affected level can be compressed (foraminal stenosis), which in turn can lead to pain in the legs (sciatica);
• Neurological symptoms (eg, weakness in the lower extremities) or pelvic organ dysfunction (various urination and defecation disorders) may result from the development of cauda equina syndrome. With cauda equina syndrome, immediate action is required to provide qualified medical care.
• In addition to lower back pain, the patient may also experience leg pain, numbness, or tingling. Even in the absence of nerve root compression, other spinal structures can cause pain to radiate to the buttocks and legs. The nerves become more sensitive due to the inflammation triggered by proteins within the disc space, causing numbness and tingling sensations. Usually in such cases the pain does not go below the knee;

In addition to degenerative changes in the intervertebral discs, pain can be caused by:

• Stenosis (narrowing) of the spinal canal and / or osteoarthritis, as well as other progressive diseases of the spine, the occurrence of which contributes to the degeneration of the intervertebral discs;
• Intervertebral hernia, a consequence of degeneration of the intervertebral disc.

Diagnostics

• x-ray;
• CT (computed tomography);
• MRI (magnetic resonance imaging).

The first of these methods is the most accessible, but at the same time the most uninformative. X-rays provide information about the location of the bones and the deformity of the spine. He is able to determine the disease in the later stages. CT and MRI are more modern methods.

MRI allows you to see the destruction of the disc space, dehydration of the disc, erosion of the cartilaginous end plate of the vertebral body, the presence of an intervertebral hernia, a rupture in the fibrous ring. But such procedures are usually expensive.

Diagnosis of the presence of degenerative-dystrophic changes in the lumbosacral spine, as a rule, is carried out in three steps:

• Compilation of a patient history, including when the pain began, a description of pain sensations and other symptoms, as well as actions, positions and methods of treatment (if treatment was carried out), which weaken or, conversely, increase pain;
• A medical examination, during which the doctor checks the patient for signs of degeneration of the intervertebral disc. This examination may include checking the patient's range of motion, muscle strength, looking for painful areas, etc.
• An MRI scan, which is used to confirm the suspicion of degenerative changes in the spine, as well as to identify other potential causes that led to the patient's painful symptoms.

The results of MRI, most likely indicating the presence of degenerative changes as the cause of pain symptoms:

• Disk space destroyed by more than 50%;
• The initial signs of disc degeneration, such as dehydration of the disc (on an MRI, such a disc will look darker because it will contain less water than in a healthy disc);
• Rupture in the fibrous ring;
• The presence of protrusion or intervertebral hernia;
• There are signs of erosion of the cartilaginous end plate of the vertebral body. The disk does not have its own blood supply system, but, nevertheless, living cells are located inside the disk space. These cells are nourished by diffusion across the end plate. Pathological changes in the end plate as a result of degeneration lead to malnutrition of the cells.

These changes are best seen on T2-weighted images taken in the sagittal plane. Usually, the end plate appears as a black line on MRI. If this black line is not visible, this indicates an erosion of the end plate.

Treatment of the disease

Degenerative-dystrophic changes lumbar of the spine, alas, are observed in a large number of people, and therefore the question of how to treat these pathologies is very relevant.

After all, if degenerative changes are not treated, they will progress, and the consequences can be the most deplorable, up to disability due to impaired motor activity.

There are two methods of treatment of degenerative-dystrophic changes in the spine - conservative and surgical. A conservative method of treatment includes the following actions: Restriction of the mobility of the spine (carried out with the help of orthopedic bandages or prescribed bed rest).

• Medical treatment. Drugs are used to combat inflammatory and degradation processes, improve vascular patency. Also prescribed sedatives and vitamin complexes group B.
• Novocaine blockade.
• Physiotherapy (laser therapy, diadynamic currents, inductothermy, electrophoresis).
• Therapeutic methods (traction on the plane, underwater traction). Traction is considered the most dangerous method of treating degenerative-dystrophic diseases.
• Physiotherapy.
• Manual therapy.
• Acupuncture, acupuncture.

The vast majority of cases of intervertebral disc degeneration do not require surgery and are treated with conservative methods, which include special therapeutic gymnastics, physiotherapy, various types of massages.

In addition, spinal traction helps a lot with degeneration of the discs, as it increases the distance between the vertebrae, allows the intervertebral disc to receive the water and nutrients it needs, which contributes to its recovery.

Separately, it is worth highlighting percutaneous nucleotomy. This method is a boundary method between conservative and surgical treatment. This type of treatment involves needle biopsy, the purpose of which is to reduce the volume of the affected intervertebral disc.

This type has a large list of contraindications. Surgical intervention is required only in cases of a rapidly progressive course of neurological symptoms of the disease, persistent long-term pain syndrome, and ineffectiveness of conservative treatment.

Treatment of diseases of the lumbar region is considered complete and promotes recovery if after its implementation there is:

• reduction or disappearance of pain syndrome;
• relieving tension in the muscles of the lumbar, pelvis and lower extremities, strengthening muscles;
• improvement of blood flow and supply of tissues with nutrients and oxygen, normalization of metabolic processes;
• removal or reduction of inflammation;
• normalization of the sensitivity of the lumbar;

Load-free traction of the spine is ideal for the treatment of degenerative lesions of the intervertebral discs (osteochondrosis of the spine) and its complications - spondylosis, spondylarthrosis, intervertebral hernias and protrusions. Traction takes place with the preservation of all physiological curves of the spine and is safe, since no force is applied during traction.

With an increase in the intervertebral distance, there is an improvement in the nutrition of all intervertebral discs, the restoration of their structure and the removal of pain.
By using complex treatment it is possible to achieve a complete recovery of the patient, and not just pain relief for a limited period.

Complication

Degenerative-dystophic changes do not occur at once, however, a person is able to feel the symptoms of the disease even at the earliest stages. First of all, nerve damage caused by infringement due to narrowed intervertebral canals makes themselves felt. This position causes the nerve endings to swell, reduces their conductivity.

The patient feels this as numbness of the limbs, a feeling of fatigue in the shoulders, neck, and back. The vertebrae change the pattern of tissue growth. To reduce the load, the vertebra expands, which subsequently leads to osteochondrosis and even more pinched nerves. People suffering similar ailments, noted increased fatigue, changes in gait, persistent back pain.

And if bacteria and / or fungi are added to these lesions, then arthrosis, arthritis and osteochondropathy cannot be avoided. Subsequently, these ailments are transformed into herniated discs. Also, degenerative changes in muscles lead to scoliosis or even displacement of the vertebrae.

In more severe stages disease, ischemia, impaired blood supply, paresis, paralysis of the limbs are observed.

Prevention

In connection with the scale of the spread of degenerative-dystrophic changes in the spine, it is worth taking care to follow preventive recommendations.

These rules will protect against disability in youth and extend the years of activity until old age:

• Keep your back dry and warm. Humidity and hypothermia are the primary enemies of the spine.
• Excessive, sudden physical exertion should be avoided. Exercises aimed at developing the muscles of the back will also protect against degenerative-dystrophic changes in the spine.
• When working, requiring a static posture, it is necessary to change the position of the body as often as possible. For office workers, it is recommended to lean back in your chair every half an hour. Every hour and a half, you need to get up from your chair and make small passes for 5-10 minutes.

The minimum measures for the prevention of back diseases include:

• daily strengthening of the back muscles. This can be done by doing elementary physical exercises every day (for example, exercises);
• getting out of bed, "land" on both legs (this will avoid a sharp load on the spine);
• under no circumstances keep your back in an arched position (try to keep your back straight even while brushing your teeth);
• serious approach to choosing a mattress. Since ancient times, we have been repeating the truth that sleep is health, since during sleep the muscles of the body relax: if this process is accompanied by an uncomfortable bed that is unable to provide sufficient support to the back, this will lead to the fact that you will wake up with the syndrome "hard back".

Aging is the main cause of spinal changes

Degenerative changes are a process of destruction of the cartilage and bone tissue of the segments of the spine. At the same time, the elasticity of the intervertebral discs is lost, the bone structure of the vertebrae weakens, and structural changes occur. spinal column.

If we consider the degenerative process in the lumbar spine, then it is worth noting here that main reason are age-related changes.

Throughout life, the lumbar region bears the greatest load, and as a result of the natural aging of the body, all processes responsible for maintaining the normal state of cartilage and bone tissue slow down.

That is why most often in people after 30 years of age, adverse changes begin to occur, which in medical practice are called degenerative.

The main causes of occurrence

Degenerative processes gradually destroy the bone and cartilage tissue of all segments of the spine. Therefore, it is very important to identify problems at an early stage of their development. But this is very difficult to do, because the first symptoms appear after certain negative changes.

But what factors are provocateurs of degenerative processes?

The most important cause of pathological changes is an unhealthy lifestyle.

This can include malnutrition, bad habits, lack of physical activity, sedentary image life and many other indicators.

Immobility leads to degenerative changes in the spine

But besides this, there are other annoying factors, which include:

Prolonged stay in the wrong position impairs blood circulation in the spine, disrupting metabolic processes in the tissues. As a result of insufficient nutrition with useful substances, cartilage and bone tissue weakens, any movements lead to microscopic injuries. It is at this moment that degenerative changes in the structure of the spine begin to develop. Large physical exercise on the lumbar spine also adversely affect the normal condition of the segments of the spine. Most often, people whose work is associated with heavy work fall into the risk group. physical labor or professional heavyweight athletes. Injuries of the lumbar spine often cause disturbances in metabolic processes in tissues, which also leads to degenerative changes in the future. Job disruption muscle tissue. The back muscles maintain the correct position of the vertebrae. Therefore, after inflammation or during a spasm, the coordinated work of muscle fibers is disrupted, which as a result negatively affects the condition of the spine. Infectious and endocrine diseases often affect segments of the lumbar spine.

There can be many reasons for degenerative changes in the lumbar spine. But the most important thing is to identify them in time and start treatment.. Therefore, in order to prevent serious pathologies, it is necessary to undergo annual full examination at the doctor's.

Consequences of pathological processes

Osteochondrosis - the scourge of modern man

Any degenerative changes entail many different complications.

The most common of these is the disease of osteochondrosis. It is a destruction of the anatomical structure of the spine, resulting in serious problems with the musculoskeletal system. Indeed, with such a disease, the intervertebral spaces narrow, the vertebrae shift, and the compression of the intervertebral discs increases.

At the second or third stage of the development of osteochondrosis, patients begin to develop not only back pain, but also other neurological symptoms.

Another disease of a degenerative nature is chondrosis, which precedes osteochondrosis. As a result of the development of the disease, microcracks appear in the bodies of the vertebrae and other segments of the spine. Most often, such a degenerative process occurs at an early age or in professional athletes involved in weightlifting. This is due to heavy loads on the lumbar region, which puts enormous pressure on the segments of the spinal column.

Intervertebral hernia is also a disease associated with degenerative processes in the spine. It is these pathological changes that destroy the shell of the fibrous ring, which, as a result of a strong load on the lumbar region, leads to a protrusion of the nucleus pulposus. Such a neoplasm compresses the nerve roots extending from the spinal cord, and limits the movement of a person. After all, neurological symptoms at the first stage are expressed in pain, and then in disorders of the musculoskeletal system.

Bone growths - osteophytes

Another form of degenerative-dystrophic changes is spondylosis. This is a disease in which bone growths appear on the bodies of the vertebrae. Ossification of segments of the lumbar spine occurs slowly. Such gradual increase the size of the bone growths is accompanied by severe pain when turning, tilting or other body movements.

Spondylarthrosis is a process of degenerative-dystrophic changes in the joints of the spine. Affecting the cartilaginous tissue, the disease spreads to neighboring areas of the bone tissue of the vertebrae, forming bone processes on them. They limit the mobility of the lumbar, and every movement is accompanied by a sharp pain. Without timely treatment, a person can not only disrupt the work of the musculoskeletal system, but there is a possibility of a disability group.

At the first stage of development, the degenerative-dystrophic process practically does not manifest itself, but its further spread is always accompanied by pain. They can be sharp, dull, aching or pulling, constant and periodic.

Diagnosis and treatment

Degenerative dystrophic changes in the lumbar region lead to the destruction of the anatomical structure of the spine. Therefore, in order to determine the specific location of the lesion, special instrumental methods diagnostics.

Physical education is the main method of prevention and treatment of degenerative changes in the lumbar region

First of all, radiography is prescribed. It allows you to see on the x-ray all the changes in the correct position of the segments, determine the exact location of the disease and the degree of damage.

Also in medical practice, computed or magnetic resonance imaging of the spine is used. These two methods make it possible to more accurately establish degenerative changes in the structure and determine the causes of their development.

Treatment of degenerative changes always depends on the type of disease.. But in any case, it is primarily aimed at stopping its development and eliminating pain in the affected area of ​​the back. For this, painkillers and anti-inflammatory drugs can be prescribed, as well as for tissue repair - chondroprotectors.

Physiotherapy treatment often consists of a back massage. Manual therapy makes it possible to restore the correct position of the vertebrae, and physiotherapy procedures such as UHF, electrophoresis and phonophoresis speed up the healing process.

And the most important method of both slowing down and preventing such processes is therapeutic exercises.

Thanks to a specially designed set of exercises, patients not only improve blood circulation, improve metabolic processes, but also maintain the mobility of the spine and the elasticity of all its segments.

Degenerative changes in the lumbar spine are one of the leading social problems: the pathology of the spine affects not only the elderly, but also young and middle-aged people, that is, the able-bodied population. In addition, the diagnosis of degenerative changes in the spine, in particular, displacements of the lumbar vertebrae, is a poorly studied issue in radiology.

Interest in the issue of degenerative changes in the lumbar spine is not accidental also because the displacement of the vertebrae, their instability causes pain and subsequent neurological disorders. And, taking into account the costs of treatment, diagnostics, costs of compensation for disability, disability, we can say that such a disease of the spine is the third most expensive disease after oncology and cardiovascular diseases.

Such significance of the problem of osteochondrosis (which is a form of degenerative changes in the spine) is due to a number of reasons. One of them is the high prevalence of morbidity: according to WHO data in 2003, up to 87% of the entire working-age population suffer from osteochondrosis of the spine. Morbidity rates in Russia are growing, while in most patients the disease is accompanied by a lesion of the lumbar spine. Lumbar osteochondrosis in the structure of the incidence of the adult population in our country is approximately 50%, while occupying the first place (including the time of disability).

What determines the health of the spine?

Mobility and health of the spine are possible due to the elasticity of the apparatus of the vertebral bodies, intervertebral discs and arches. Under normal static conditions, the function of absorbing vertical pressure forces (for example, the heaviness of the torso, head) is carried out by the intervertebral discs. In those cases when the articular processes are forced to perform a support function unusual for them, anterior displacements of the vertebrae and local arthrosis develop in the true joints. With a significant and increasing vertical load, neoarthrosis of the articular processes with the bases of the arches develops. Moreover, the entire spine and the musculo-ligamentous apparatus of the entire body resist the applied force, adapting to the external load. It is under the influence of cumulative microtraumas as a result of acute and chronic overloads that degenerative-dystrophic changes develop in the segments of the spine and in the lumbar region as well.

What to do?

The problem of instability of the spinal motion segment, which occurs under the influence of various factors, is far from being resolved. General principle therapy of exacerbations of pain syndrome of osteochondrosis - elimination of manifestations of the disease - restrictions in movement and pain itself. This includes the exclusion of static-dynamic unfavorable loads on the diseased spine, ensuring rest, especially at the very beginning of an exacerbation. Next, you need to take care of strengthening the muscles of the spine to ensure the protective function of the spinal segment, that is, special gymnastics and an active lifestyle.

Pathologies of the intervertebral discs can lead to the appearance of degenerative-dystrophic changes in the lumbosacral spine, which will be accompanied by pain and discomfort. In middle-aged people - from 30 years old - deviations occur in about 30% of cases, and at retirement age, changes are almost inevitable. However, sometimes the disease can appear in younger people, so at any age it is important to start treatment before complications appear.

Causes of degenerative-dystrophic changes in the lumbosacral region

There are several factors that can contribute to the development of the disease, while they can act together or separately:

• The presence of an intervertebral hernia can provoke inflammation. It appears due to irritated nerve roots.
• Wear of the annulus fibrosus. Deformation leads to the fact that the spine ceases to cope with the load, especially heavy. As a result, pathologically unstable micromotions are formed in the spinal segment.

Most often, degenerative changes in the lumbosacral spine are the result of a disease such as intervertebral hernia.

Symptoms of the disease

Questioning the patient and external examination may show the following signs:

• Pain of a dull nature, described as aching. At some stages of the disease, it can "give" to the buttocks, followed by movement to the lower extremities.
• Abnormal sensations in the legs different intensity: weakness in the limbs, tingling, numbness.

Earlier we wrote about the symptoms of lumbar radicular syndrome, we advise you to read the article.

Advice: Degenerative changes reach an irreversible form for a long time, however, given the fact that a long period of the disease can pass almost imperceptibly for a person, you should consult a doctor immediately after the onset of symptoms.

• Violation of urination and defecation, problems with reproductive function.
• The need to “disperse” in the morning before fully starting to move. Stiffness can also be felt throughout the day.
• An increase in temperature in the affected area of ​​the back.
• The appearance of redness and swelling on the lower back.
• Asymmetry of the buttocks.

A characteristic sign of the first stage of degenerative changes in the lumbar spine is pronounced pain in the lower back, which forces you to limit movement.

Diagnosis of degenerative changes

Only a doctor can make a correct diagnosis. Diagnosis is carried out, as a rule, in three stages:

• A patient history is being compiled. Information should be collected about the time of onset of pain and their nature, the presence or absence of other signs and concomitant diseases, attempts to cure the disease on their own. Positions and movements are also recognized when the pain syndrome subsides and intensifies.
• A medical examination is being carried out. It involves determining the signs of degenerative changes in the spine.
• Making an MRI picture of degenerative-dystrophic changes in the lumbosacral region using MRI. The study not only confirms the diagnosis, but also reveals possible reasons occurrence of the disease.

During an external examination, the amplitude of movements, muscle strength, causes of pain, etc. are checked.

Important: If you start the disease to the last stage, the blood circulation of the spinal cord will be disturbed, which can contribute to the formation of paralysis or paresis.

Problems detected by MRI

The study can show the following MR signs of degenerative-dystrophic changes in the lumbar:

• half and more destroyed disk space;
• rupture observed in the disc shell;
• a critical decrease in the amount of water in the disk, reflecting the initial stage of the disease;
• destruction of the cartilaginous end plate of the vertebra;
• confirmation of the patient's intervertebral hernia or protrusion.

In contact with

Spinal dystrophy is a metabolic disorder in the cells of the spine, which leads to insufficient nutrition of the tissues. Dystrophy, as a rule, leads to degenerative changes, so these two phenomena are inextricably linked.

Degenerative-dystrophic diseases of the spine (DDSD) proceed according to the following scheme:

1. The content of the intervertebral discs (nucleus pulposus) gradually loses moisture, as a result of which pressure on the disc increases, blood flow and the supply of nutrients to the disc worsen - this is dystrophy.
2. As a result of dystrophy, degeneration of the intervertebral discs develops: cracks, ruptures, hernias form. The discs either thin out from the pressure of the vertebrae or take on an abnormal shape.
3. Changing the shape of the intervertebral disc disrupts the balance between the vertebrae, pinching the spinal roots.
4. Inflammation develops at the site of degeneration - this is the immune system tries to protect the spine from destruction and signals trouble in the body.

Degenerative-dystrophic changes in the spine lead to serious consequences. It is necessary to diagnose them in time, treat them and take preventive measures.

Degenerative-dystrophic changes in the lumbar: the main symptoms

The waist is the center of gravity of the human body which bears the main burden. Therefore, degenerative-dystrophic processes in it begin earlier than in other parts of the spine.

If there wasn't serious injury, the disease develops gradually, several years and often unnoticed by the patient. At first, stiffness and heaviness in the back area may be felt. But over time, pain will definitely appear, because. pain is the main syndrome of all degenerative changes in the spine.

This pain has a certain character:

• Occurs in the lumbar region and the sacrum with long walking, sitting / standing in one position, atypical physical exertion, with bending.
• Strengthens and decreases in waves, sometimes disappears altogether.
• The pain is aching.
• Subsides after lying down.
• It spreads to the nearest areas, most often gives to the back of the thigh. The movements of the limbs may be constrained, they feel numbness or "crawling".

About read here.

How do degenerative changes in the lumbar spine develop?

Only when the symptoms become pronounced, and the pain is regular, can the changes be considered large-scale and irreversible. The degenerative process does not have a retroactive effect; over time, the condition worsens or is preserved in a chronic form.

Development stages:

1. Initial stage. Constant pain in the lower back. Over time, the pain bothers more and more, the efficiency and quality of life decrease.
2. Second stage. The spinal nerves are compressed (radicular syndrome), mobility is seriously limited. Periodically, “lumbago” occurs in the lower back, tingling and “goosebumps” are felt in the legs and buttocks.
3. Third stage. Radicular syndrome leads to vasoconstriction and circulatory disorders of the spine, ischemia develops. The pain intensifies, periodically there may be numbness in the legs, convulsions.
4. Fourth stage. If the patient has not received proper treatment in the previous stages, the circulation of the spinal cord may be completely impaired. As a result, a serious weakening or loss of motor activity (paresis and paralysis).

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Causes of degenerative-dystrophic changes in the spine

• Age changes. After 30 years, the nutrition of the cartilage of the spinal column is disturbed in the body. Sooner or later, it depends individual features person.
• genetic predisposition. If parents had serious degenerative changes in the spine, then their children are also at risk. The disease can begin at a very early age.
• Congenital pathologies. Deviations from the norm in the structure of the skeleton, incl. flat feet, improper muscle development pinch the spine in muscle spasm, which again worsens the nutrition of tissues and clamps the nerve endings.
• Large load on the lower back and sacrum. This is already due to the way of life and work of a person: standing for a long time or carrying heavy loads is fraught with microtraumas of the intervertebral discs. Detrimental to the spine and excessive effort in professional sports.
• Physical inactivity. As a result of a long stay in one position, cartilage and bone tissue do not receive the right nutrition weaken, and any movement can lead to microtrauma.
• Violation of the muscles of the back. They support the correct position of the vertebrae. If the muscles are inflamed, tight, or vice versa without tone, this adversely affects the functionality of the spine.
• Spinal injury. Any impacts, falls, can lead to displacement of the vertebrae, microcracks or subluxations of the joints.
• Inflammatory diseases of the spine. Infections that enter the body can affect cartilage and bone tissue.
• Hormonal diseases. Disorders of the endocrine system reduce the elasticity of the cartilaginous tissues of the spine.
• Wrong way of life. This includes malnutrition, bad habits, disturbed daily routine. All this causes a malfunction in the body, metabolic disorders, including spinal dystrophy.
• Overweight. All extra pounds increase the load on the spine, especially in the lumbar region. If a ? - read the answer to the question here.

About read here.

Types of diagnostics

For correct diagnosis degenerative-dystrophic disease of the spine, it is necessary to draw up a complete clinical picture: identify local symptoms, understand the location of the process, obtain X-ray diagnostics and laboratory data.

At the initial medical examination, it is highly likely that the diagnosis of ADSD can be made with the following symptoms:

• Sharp pains in the neck, spreading to the head, in the back, in the extremities, in the chest. Especially pain occurs during physical exertion, awkward movements, hypothermia.
• Acute pain in the lumbar region and lower extremities, the big toe is poorly extended, low sensitivity in the shins and feet.
• Pain in the neck, shoulder girdle, arm, weakness in the muscles of the hands, decreased sensitivity.
• Bilateral back pain which is aggravated by extension and rotation of the body, and decreases at rest.
• Constant aching pain in the back, arms and legs, chest.
• Pain in one or both legs while walking above or below the knee or distributed throughout the limb. The pain is relieved by bending forward.
• There is no pain in the back or neck, but there is a stable radicular syndrome(pain in the arm or leg, decreased sensitivity of the limbs, muscle weakness and hypotrophy, decreased reflexes). The pain appears either with a vertical load on the spine or with an inclination to the affected side.

Up to 95% of cases, pain in the back and limbs is caused by physical activity against the background of degenerative lesions of the spine. Therefore, when diagnosing, first of all, it is necessary to exclude more than serious reasons pain that requires rapid intervention (injuries of the spine, tumors of the spine and spinal cord, inflammation, diseases bone marrow and etc).

To clarify the localization of the degenerative process and find out how seriously the intervertebral discs and vertebrae are affected, apply instrumental diagnostics. The most informative methods - x-ray, computed tomography and magnetic resonance imaging. Electroneuromyography helps to understand where and how the nerve is affected.

It is also necessary to carry out patient's blood test to identify possible infections in the body and endocrine disorders.

About read here.

Pain and crunch in the back over time can lead to dire consequences - local or complete restriction of movement, up to disability.

People, taught by bitter experience, use a natural remedy recommended by orthopedists to cure their back and joints...

Treatment Methods

The initial stages of degenerative changes in the spine can be successfully treated with non-surgical methods. After passing the course of procedures selected by the doctor, pain partially or completely disappears, the affected area of ​​the spine is restored, blood flow improves, processes in the intervertebral disc are artificially normalized.

The work of a surgeon in the treatment of DDSD is required as a last resort, when the disease begins to adversely affect the functioning of the internal organs of a person. But even then it's better to try everything conservative methods treatment before lying down on the operating table, since spinal surgery is very risky even in our time.

The primary goal of treatment is relieve inflammation and pain. For this patient, they are transferred to bed rest and prescribed analgesics, anti-inflammatory drugs, chondroprotectors (with joint damage) or muscle relaxants (with muscle spasms). A positive effect is observed from the use of drugs, but the doctor must clearly measure the benefits for the treatment of the spine with side effects(First of all, they affect the work of the digestive tract).

After the pain has gone or lessened, it is necessary to restore the work of muscles and ligaments. For this, physiotherapy, massage and therapeutic exercises are used. Massage for a sore spine should be trusted only by a qualified specialist, and the exercise therapy complex is selected by the doctor individually.

About read here.

Prevention of diseases of the spinal column

Prevention of degenerative-dystrophic diseases of the spine does not require much effort, but it will allow you to maintain his health and mobility for as long as possible. We cannot completely eliminate the load on the spine and stop the aging of bones and cartilage. But everyone can slow down the process of degeneration of the spine and the entire musculoskeletal system.

The development of degenerative dystrophic changes in the lumbosacral region is associated with complex impact on the cartilaginous intervertebral and bone tissues of the vertebrae of various age, metabolic, inflammatory, traumatic, behavioral factors. Pathology refers to progressive changes - without adequate treatment, not only painful symptoms, but dangerous complications join. Therefore, it is important for patients to know whether the progress of pathology can be prevented, and how to deal with already formed changes.

general characteristics

Quite often, doctors explain the appearance of pain, backache, numbness and weakness, cramps in the lower extremities, and even malfunctions of the pelvic organs with degenerative changes in the spine. To understand this relationship, let's try to figure out what it is - dystrophic changes in the lumbar spine.

To prevent friction and provide shock absorption, the vertebrae, which protect the spinal cord from external influences and provide support and movement of the body, are separated by layers of fibrous cartilage - intervertebral discs. Movement and flexibility depend on the state of the vertebral processes that form the joints, which are lined with cartilage.

Under the influence of various factors, the intervertebral and articular cartilages lose their functionality: they dry out, crack, lose their elasticity, which entails a number of physiological changes.

Doctors do not consider DDSD to be a disease of the lumbar spine degeneratively dystrophic character. Usually, cartilage is destroyed simultaneously in other departments. Degenerative processes also affect the joints of the hands and feet.

But if, with the defeat of the joints of the limbs, we are talking about diseases of arthritis, arthrosis, bursitis, then with the destruction of the vertebral cartilage, it develops:

• osteochondrosis - a decrease in the height of discs with coracoid growth of the vertebrae and the formation vertebral hernias, protrusion;
• spondylosis in the form of marginal bone growths covering the disc;
• spondylarthrosis - destruction of the intervertebral joints.

The mechanism of development of such diseases is directly related to dystrophic changes in the discs, cartilage of the joints, which are dehydrated, dry out and thicken, which leads to subsidence of the fibrous ring, proliferation of bone tissues.

Video

Video - changes in the lumbosacral region

Causes of the disease and risk group

The state of cartilage is affected various factors, therefore, it is almost impossible to single out a single cause of dystrophic changes.

Among the most common are:

1. Cartilaginous tissue malnutrition. Associated with the aging of the body, inadequate intake nutrients with food, metabolic disorders against the background of hormonal disruptions and endocrine diseases.
2. Overload on the spine. Risk factors - playing sports, stress on the lower back associated with professional and labor activity, excess weight.
3. Lack of physical activity. A passive lifestyle, a long stay in an immobilized state due to other diseases, being in weightlessness lead to dehydration of cartilage tissues and their destruction.
4. Spinal injuries, including birth. For a young or growing body traumatic conditions become an impetus for the development of tissue dystrophy.
5. Inflammatory diseases autoimmune, infectious, etc. character.

The most common cause of dystrophy is still called age. On the MR picture, degenerative and dystrophic changes in the lumbosacral spine of varying degrees are observed in 80% of elderly people.

Symptoms and signs

Clinical picture pathology directly depends on the degree of destruction. A degenerative dystrophic change develops in the lumbar spine for quite a long time. That's why characteristics at the initial stages of development, pathologies may be completely absent.

1. Cartilaginous degeneration in the initial stages of degenerative changes in the lumbosacral spine can be manifested by aching pain, heaviness in the lower back after exertion or a long stay in a static position.
2. With the progress of the pathology, a violation of the mobility of the spine joins. In addition to aching and stupid pain symptoms of a periodic nature, “lumbago” can be observed with irradiation to the buttocks, legs, and to the sacrum. Patients are concerned about numbness of the skin, goosebumps, cramps of the lower extremities. The development of scoliosis is observed.
3. At the third stage, it joins, manifested by sharp, piercing pains with a concentration at the site of the pathology and the spread of soreness along the damaged nerve. When the blood vessels are squeezed, soft tissue ischemia develops. There are malfunctions in the work of internal organs, primarily the bladder, genital organs, and rectum.
4. Symptoms and signs of degenerative-dystrophic changes in the lumbar region of the advanced 4th stage are manifested by the addition of complications in the form of paresis, paralysis of the lower extremities. The mobility of the spine itself is practically absent, the pain becomes chronic.

Diagnostic methods

Physicians use various direct and differential methods diagnostics, allowing not only to detect changes, but also to exclude the presence of diseases similar in symptoms.

The examination begins with the study of the anamnesis, external examination, palpation, and motor neurological tests.

But such methods are not enough to assess the picture of dystrophic changes in the lumbosacral spine. It is possible to confirm a preliminary diagnosis only after instrumental examinations:

1. An x-ray will show subsidence of discs, the presence of bone growths, displacement of the vertebrae.
2. CT reveals the pathological picture in more detail in a 3-dimensional image, allows indirect signs to diagnose the presence of hernias, protrusions.
3. To study the condition of soft tissues, damaged nerves and blood vessels, doctors prescribe an MRI. This method is considered the most informative and safe. A significant disadvantage is the cost of such an examination.

Computer images show ruptures (hernias) and protrusions (protrusions) of the fibrous ring.

Treatment

For diseases associated with pathological changes in the spine, the alternation of periods of exacerbations with temporary remissions against the background of the progress of dystrophy is characteristic. Therefore, for each period and stage, its own tactics for the treatment of degenerative dystrophic changes are chosen:

1. At the initial acute stages and during remission, preventive and behavioral treatments predominate.
2. During periods of exacerbations, conservative medical and physiotherapeutic methods come to the fore.
3. On the advanced stages when changes affect the nerves, the spinal cord, accompanied by loss of mobility, other complications, they resort to operations.

Preparations

Medicines for dystrophic changes in the lumbar spine of degenerative origin are selected individually, taking into account the stage, intensity of pain, and the presence of complications.

Pain relief may include:

1. Non-steroidal drugs that not only relieve pain, but also relieve inflammation in the form of Diclofenac, Movalis, Meloxicam, Ortofen, Ketanov, Ibuprofen. Most often, infusions of nonsteroidal drugs are prescribed, which accelerates the analgesic effect. During the recovery period and with non-intense pain, the use of external agents is allowed: ointments, gels, patches.
2. Analgesics: Dexamezaton, Analgin, Spazgan are administered drip for quick relief of pain.
3. Steroid drugs Betamethasone, Triamcinolone, Prednisolone in short courses as injections.

At radicular syndrome paravertebral or epidural blockade is performed with the introduction of anesthetics: Lidocaine, Novacaine or combinations of drugs.

• muscle relaxants;
• B vitamins;
• chondroprotectors;
• means for restoring nerve conduction;
• vasodilators.

Physiotherapy

Exercise therapy is an excellent way to restore mobility of the spine and strengthen the muscular corset. Adequate physical activity helps to stop the progress of changes and even relieve pain during recovery period.

But you need to be careful when choosing exercises.. Intense loads, jumping, twisting are prohibited, especially with exacerbation and the presence of hernias.

The complex should be developed individually and include exercises for:

• traction of the spine;
• strengthening the muscle corset from both the back and the press.

In diseases of the back, other exercise therapy exercises can aggravate the condition or lead to complications.

Water aerobics, swimming, traction on the crossbar, on an inclined board are considered safe and effective for such patients.

Massage

Some patients see salvation in massage, without thinking that the mechanical effect on the vertebrae even harms healthy spine. Only massaging soft tissues and exclusively by a professional massage therapist will give a positive effect in the initial stages of the pathology.

When degenerative changes in the lumbosacral spine are accompanied by the formation intervertebral hernia, protrusions, the spinal cord is affected, the nerves are blocked, massage, especially manual, is strictly prohibited.

It is impossible to massage the back during the acute period of the disease. The blood flow under the influence of massage will provoke increased swelling, inflammation and pain.

Diet

special regime nutrition for patients with on the list therapeutic diets does not exist. Doctors recommend that patients adhere to a balanced diet that can provide the body with all the necessary nutrients, vitamins and minerals, which in turn will contribute to good nutrition cartilage tissue.

To a greater extent, diet is important for people with overweight body, since obesity is one of the risk factors for the development of dystrophic changes.

Prevention

It is rather difficult to avoid age-related dystrophic processes, but it is possible to prolong an active life, despite age.

This will help simple preventive measures.

Degenerative-dystrophic changes in the lumbosacral region - a set of pathologies in the intervertebral disc or, alternatively, in the lumbar vertebrae. Mostly, such a disease can be recognized by back pain.

In most cases, able-bodied people suffer from such problems, and gender does not play a role here. Statistics say the following: there are now an extremely large number of people with such a diagnosis, and this number is growing, not intending to slow down the pace of development, which cannot please.

The body of any person is an extremely delicate and well-oiled system. And it is not surprising that changes in the activity of at least one of its components inevitably entail disruptions in the work of all other parts of the body. In recent years, the incidence of diseases in the population has greatly increased musculoskeletal system. As a result, people's ability to meet their needs has decreased.

The spine is a component of the human skeleton. This body plays a certain number of vital functions:

• support;
• participation in the movement;
• giving the body flexibility;
• distribution of nerve fibers throughout the body.

Due to the high complexity of the structure of the body, its organs and tissues are not so rare to age earlier than the time allotted by nature. Degenerative dystrophic changes begin to appear in the spine, which necessarily cause osteochondrosis, coupled with extremely powerful pains.

Without such changes in the spine, none of its known diseases. Any osteochondrosis, spondylarthrosis, herniated disc and the like are precisely the results of degenerative dystrophic pathologies of the intervertebral disc that have not been cured in time, which can be detected by making necessary examination at a specialist. However, an examination is not so necessary, when the most common symptoms of pathology that can be detected during the first examination can indicate the disease.

Despite the fact that a person may not have a very great propensity for this pathology, transmitted to him by inheritance, in reality its root lies in the totality of many genes. Degenerative processes are also possible due to the aging process or due to any injuries. And yet, this is not often the result of extensive injuries like the same car accident. In most cases, they occur due to a slow traumatic process, from which the intervertebral disc is damaged. Moreover, this damage gradually becomes more pronounced, which leads to the disease.

The intervertebral disc does not receive blood, and therefore, in case of damage, it will not be able to “patch” them in the same way as other organs and tissues. For this reason, any, even the slightest damage to this tissue can lead to the most serious consequences, starting the so-called "degenerative cascade". That inevitably leads to the destruction of the intervertebral disc. And this severe pathology has a very high "popularity". According to modern statistics, almost a third of the world's population, who has reached the fourth or sixth decade, has such a problem, at least in the very small degree. This means that almost every elderly patient has such a diagnosis or pain, if not both.

Why the disease begins

In more than half of the cases, the occurrence of such a problem has at least one of the following reasons:

• inflammatory processes that begin due to the fact that the nerve roots are irritated by a protein located in the disk space during the appearance of a hernia;
• microscopic damage that occurs if the fibrous ring wears out, completely losing any ability to bear the load. The consequence is an excess of mobility in the diseased area.

Most often, the combination of these two factors occurs when an intervertebral hernia begins to develop, which is a complication of the pathological process in the intervertebral discs. When it appears, the neurovascular bundle passing through the spinal canal is compressed by mechanical action. Because of this factor, lower back pain becomes much stronger and does not stop anymore.

In general, degenerative-dystrophic pathologies most often cannot occur without wrong image life. This is characterized by a lack of moderate physical education, an unbalanced diet, as well as insufficient sleep and, of course, bad habits like addiction to tobacco and alcohol. Other reasons why dystrophy of the lumbar spine may begin:

• harmful effect heavy loads on the spine, due to which the lumbar segments become less elastic. Because of this circumstance, people who constantly expose themselves to heavy physical exertion are most at risk of catching one or another disease of the lower back, especially if this is required at work;
• a long stay in a sitting position, and with an incorrect posture, which also leads to impaired blood supply. And this affects both the lumbar region and the rest of the body. This entails a metabolic disorder in the bones and muscles. Violation of metabolism spoils the structure of tissues. And because of all this, microtrauma can easily appear in the spine from any movement. On this occasion, pathology may begin to develop;
• infectious diseases, as well as diseases associated with endocrine system. Because of them, harmful processes in the lower back can also easily begin;
• one or the other mechanical injury spine. They cause injuries to bones and muscles;
• back muscle injury. This, of course, is also perniciously affects the spine in general, and its lumbar region in particular;
• often the cause of the pathology can be described with just one simple word: “old age”. Then the disease can hardly be cured. In this case, they do not try to cure a person, but only carry out supporting therapeutic procedures for him to prevent the aggravation of the disease.

What can happen due to this pathology

One has only to start dystrophic changes in the spine, and serious complications are not excluded in the lumbar region:

• hernia;
• osteochondropathy;
• numbness and partial paralysis of the lower extremities;
• complete paralysis of the legs;
• difficulty going to the toilet;
• decrease/loss of libido.

In order to avoid such problems, one should choose in time and correctly what and how to cure the pathology. So you can effectively keep the intervertebral discs intact.

How to recognize the disease

More than half of the patients who have degenerative-dystrophic pathologies in the lower back complain of incessant pain, which, however, can be tolerated. But sometimes they get stronger for a long time. For the most part, each patient has their own symptoms of the disease, but there are several of its common signs:

• back pain, with possible pain in the hips and legs;
• pain in the lumbar region lasting over one and a half months;
• in the lower back pain is dull / aching, and in the hips and legs - burning;
• when the patient sits, the pain becomes worse. Standing, walking or lying down, he feels the pain less. Standing too long, bending forward, or lifting something heavy causes the patient to experience more "bright" pain;
• if a person has become the owner of a disc herniation, his legs may go numb, their tingling is not excluded. In addition, he may have trouble walking;
• if the hernia turned out to be medium in size, it is possible that the nerve root that comes out of the spinal cord at the affected level will be compressed (foraminal stenosis), and this will already provoke pain in the legs ();

• symptoms of neuralgia, like weakened legs, and various problems in the functioning of the organs in the pelvic area (difficulties with going to the toilet) can quite eloquently “hint” at the appearance of the cauda equina syndrome. Then you need to urgently consult a doctor;
• inflammation caused by proteins trapped in the disc causes the nerves to become more responsive to stimuli. It is from this that the legs become numb and tingling is felt. And in most cases, such sensations are localized in the knee or above.

If you want to learn more about how to treat, as well as consider symptoms, diagnosis and alternative treatments, you can read an article about this on our portal.

Lower back pain can easily appear not only due to pathological processes in disks, but also from the following:

• narrowing (stenosis) of the spinal canal, osteoarthritis, any other pathology of the spine that worsens over time, caused by a deterioration in the condition of the discs. However, this does not mean that such diseases cannot be combined;
• herniation caused by disc pathology.

Moreover, with the development of the disease, as well as the transition from one stage to another caused by it, its symptoms become more and more severe:

• stage№1 . The disease rarely manifests itself in any way. Except after physical work dull pain can be felt, but in most cases it is mistaken for normal fatigue;
• stage№2 . It is possible to accurately distinguish symptoms from normal phenomena. From time to time in the back "shoots". It's also hard to bend sometimes. The reason lies in the nerve endings: they are compressed, and therefore the pelvic area "tingles";
• stage№3 . Spicy. At this time, the metabolism in the lower back is disturbed, since the blood vessels. There is ischemia, convulsions, numbness of the legs. Pain becomes stronger;
• stage№4 . Due to the deformation of the spinal cord, the legs may be paralyzed. This pathology has exacerbations - the time of the greatest severity of symptoms. If the dystrophy becomes chronic, the symptoms subside to a state of tolerable discomfort.

Diagnostics

It is very important that the disease be diagnosed before the first complications appear. For this purpose, diagnostics are done using a variety of methods so that they capture many types of stimuli. However, the patient must first be examined by a neurologist. After examination, the specialist must prescribe additional examinations to make the diagnosis more accurate.

In most cases, they use following methods: x-ray, computed tomography(CT) and MRI.

X-ray is the most accessible, but at the same time it is the least useful. This technique allows diagnosing pathology when it has already moved to one of the rather late stages. Much better than MRI and CT. With the help of these methods, it is possible to more reliably find out both where the focus of the disease is and how much it has developed.

Moreover, in information about the presence / absence of changes, it is best to rely on MRI.

What can an MRI show for disc dystrophy:

• destruction of the disk, if they exceed half of it;
• disk dehydration. MRI shows this tissue as darker;
• the presence of hernias, as well as protrusions;
• erosion of the cartilage plate, which allows the disc to receive nutrients.

Sometimes electroneuromyography is needed, which allows you to recognize where and how the nerve is damaged. Of course, doctors take blood tests. They need this to detect infections and endocrine pathologies.

If you want to know in more detail, as well as consider when magnetic resonance imaging is indicated, you can read an article about this on our portal.

How to treat

First of all, conservative therapy procedures are carried out. Among them are the use of painkillers, warming ointments, therapeutic exercises, massage, physiotherapy. In the absence of benefit from these methods of treatment, an operation is performed.

Medications

First of all, you need to put down pain so that the patient can walk normally. To this end, the doctor prescribes the necessary painkillers (for example, Ketanov and Ketonal), as well as anti-inflammatory drugs (Movalis and Diclofenac).

Further, already to relax the muscles of the lower back, muscle relaxants are used ("Mydocalm" and "Sirdalud"). These drugs are not used constantly, but with periodic breaks, because otherwise they do muscular system less strong.

Chondroprotectors are also used in the treatment. With their help, you can quickly restore cartilage and joints.

But with all the miraculousness of the complex of drugs, it must be remembered that they can easily cause an unpleasant “side effect”, disrupting the functioning of the gastrointestinal tract.

exercise therapy

Of course, therapeutic exercises should be done both during treatment and rehabilitation. Properly selected and planned exercises are very useful for any symptoms of degenerative-dystrophic pathologies in the lower back. When selecting and planning exercises, it is necessary to look at the causes, severity and main signs of the disease.

If the pathology is acute, of course, it is recommended to refrain from exercise therapy. Before it is necessary to use other methods to alleviate pain: NSAIDs, a state of complete rest, local cooling, blockade.

If the symptoms are severe, low-amplitude static exercises will be very useful. But it should be done very carefully, and haste here can only do harm. During the rehabilitation period, it is much better to use dynamic exercises.

As the patient's condition improves, it is possible to complicate, and also begin to use weighting agents in it.

Massage and physiotherapy

Doctors still cannot come to a consensus about the appropriateness and safety of massage for dystrophic changes in the lumbar spine. Even for a spine that is not affected by a disease, it is harmful when it is mechanically affected. If there is absolutely no way without a massage, only a true professional should carry out such a procedure. And only while the pathology is at the first stage of development.

In the acute period, the back is not massaged. This is because, due to such an action, blood rushes to it, and after that, the sore spot begins to become more inflamed and swell.

With remission, that is, the temporary absence of inflammation and acute pain, physiological procedures can be used. Thanks to electrophoresis, acupuncture, and magnetotherapy, the patient can quickly recover from the disease. And with the help of manual therapy, the vertebrae can stand where they are supposed to by nature.

Surgery

Surgical intervention is carried out in case of revealed futility of massage, therapeutic exercises, as well as medication, and further progression of the disease. This method is also used in the diagnosis of "intervertebral hernia". During the operation, the doctor installs devices in the patient's body to support the diseased part of the spine. This allows you to reduce pressure on the spine to avoid further development diseases.

Table. Types of spinal surgery

The likelihood of complications

Running this pathology, it is possible to allow the appearance of a hernia. This term hides the displacement of a deformed disc. This rarely can be cured without surgery. Also, with running dystrophic processes, it can become inflamed sciatic nerve and start malfunctioning genitourinary system. Moreover, there are usually problems in order to go to the toilet "for small needs."

Prevention

Warn similar pathologies in the spine can be following simple rules. First of all, a lot of physical activity is needed. Morning should start with charging. And it is worth choosing exactly such exercises that would help make the back muscles stronger. Those who have to sit for long periods of time during their work should occasionally take breaks to stretch their muscles.

Also, to maintain the health of the spine, it is useful to be able to choose a mattress: it should be firm, but in moderation. It is also best to use orthopedic pillows. It is important that the width of such a pillow is suitable for the distance of the shoulders. In case of obesity, you should lose weight: it once again loads the spine.

Outcome

Regular back pain is a reason to see a doctor. Alas, any organism is not eternal, and with aging, the spine suffers first. If a person begins to feel the first signs of the disease, you should immediately be examined by a doctor. Many severe illness at first they signal themselves with a completely insignificant discomfort, but having missed the moment, you can forget about normal life for a long time. It is not always possible to cure degenerative-dystrophic pathologies, but it is quite possible to stop their development and maintain a state of health.

Video - What are degenerative-dystrophic changes in the lumbosacral region?

Traumatologist-orthopedist of the highest category. Adult and children's specialist, Mgmu, 1998

Different parts of the spine take on the load of varying degrees of complexity. And a sedentary or hyperactive lifestyle can aggravate the situation and lead to the destruction of bone and cartilage tissue. Very often, such changes occur in the sacral and lumbar region, which leads to the appearance of a stable pain syndrome and limited skeletal mobility.

Degenerative-dystrophic changes in the lumbosacral region are understood as the result of prolonged mechanical destruction of the bone and cartilage tissues of the spinal column. Destructive changes are accompanied by deformation, loss of cartilage elasticity. Degenerative processes are accompanied by systematic pain in the event of complications in the form of pinched nerves and blood vessels.

The complexity of diagnosing the problem lies in the slow progression, due to which it is not always possible to identify the initial degenerative changes in the lumbosacral spine.

All destructive disorders have common signs, symptoms and causes. However, they can also be divided into the following types:

Similar pathologies are also diagnosed in other parts of the spine. However, due to the peculiarities of the mobility of the skeleton, it is the lumbosacral that is most often affected.

Risk factors and causes of destruction

Women suffer from diseases of this group much more often than men, since their muscular corset in the lumbar region is somewhat less developed. Because of this, the spinal column lacks support and experiences a lot of stress.

In addition, the spine is a complex element of the skeleton, consisting of many vertebrae, vertebral discs and joints. The cartilage here plays the role of a shock absorber and, with a significant loss of moisture, wears out and becomes thinner, and can also protrude.

Among the main risk factors and prerequisites for the development of degenerative changes in the lumbar spine:

• Increased physical activity with uneven distribution along the spinal column;
• Sedentary lifestyle and weakness of the muscular frame;
• Traumatic injuries of the spine, muscles and ligaments;
• Overweight, obesity;
• Hormonal disorders in the body;
• Infectious pathologies;
• Age-related changes in the skeleton, ligaments and muscles;
• Bad habits;
• Poor diet and lack of vitamins and minerals;
• Poor environmental situation;

An important role in degenerative-dystrophic changes in the lumbar spine is played by the hereditary factor. The presence of a genetic predisposition significantly increases the risk of diseases of the spine and its components. In addition, the basis of the problem can be laid back in childhood especially with poor nutrition.

Symptoms

In the early stages of the progression of the disease, they practically do not manifest themselves in any way, in some cases it is possible fast fatiguability. Therefore, patients turn to doctors only when visible symptoms occur.

The following pronounced signs of degenerative-dystrophic changes in the lumbar spine are distinguished:

1. pain different type(stabbing, aching, burning);
2. Cold surface of the skin in the lumbar region;
3. Weakness in the lower limbs;
4. Difficulties in tilting and turning the body, the occurrence of pain;
5. Body asymmetry;
6. Significant mobility of the body, mainly in the morning;
7. The occurrence of pain syndrome with a long stay of the body in one position;
8. Difficulties in urination, stool disorders.

Symptoms of degenerative-dystrophic changes in the lumbar and sacral spine appear gradually, depending on the stage of development of the disease.

There are four main stages:

The sooner dystrophic changes in the lumbosacral spine are detected, the greater the patient's chances of recovery. Significant tissue destruction and pinching is practically untreatable.

Other signs also help to identify diseases in the early stages:

• Dryness and peeling of the skin;
• chilliness;
• Increased susceptibility to cold.

Modern diagnostic methods

Diagnosis of the disease takes place in several stages. First of all, the doctor forms an anamnesis, studies the patient's medical history and makes an initial conclusion. AT without fail an external examination is carried out for visible changes, mobility, muscle strength. Palpation of the affected area is also used.

At the second stage, the following types of diagnostic studies are required:

Consultations of specialists and other areas may also be needed to exclude other possible pathologies of the body.

Treatment methods for disorders

In practice, three main types of treatment of the lumbar spine are used: conservative, physiotherapy, surgery. In some cases, it is possible to use combinations of methods in therapy.

Medical treatment

The use of medicines in the form of tablets, injections, ointments and gels is necessary to reduce inflammation and relieve pain. For this, appoint:

Vitamin and mineral complexes are also additionally prescribed for the restoration and maintenance of cartilage and bone tissue.

Massage and therapeutic gymnastics

These measures are aimed at solving the following tasks:

In addition, to improve the condition with degenerative-dystrophic changes in the lumbar, swimming, acupuncture, acupressure, physiotherapy (laser and electrophoresis) are used.

Surgical intervention

In the last stages of the progression of degenerative-dystrophic changes in the lumbosacral region, conservative methods help only slightly alleviate the patient's well-being. As a rule, in such situations, surgery is chosen as the main method of treatment. The course of intervention depends on the specific type of destruction.

Treatment usually includes the following measures:

After the operation, the patient is shown good rest and sleep, a specialized diet, wearing a corset, taking prophylactic drugs, physiotherapy exercises (in the last stages of recovery).

Folk remedies

At acute diseases of the spine to relieve pain and reduce inflammation help recipes traditional medicine:

It is highly discouraged to use traditional medicine recipes as an alternative to professional treatment. Before use, you must consult a doctor.

Possible Complications

In the absence of proper treatment, serious complications are possible in the form of disc protrusion, growth of osteophytes to a significant limitation of mobility, paralysis of the limbs, hernias.

Elimination and alleviation of the course of these pathologies is much more difficult and does not always bring positive results. Therefore, it is important to start the therapy of destructive disorders of the spinal column at the early stages of their appearance.

Prevention

Preventive measures against degenerative changes in the lumbar spine should be carried out with young age especially if there is a genetic predisposition. For this are used:

It is important to monitor your posture and correctly distribute the load on the spine. When discomfort in the back, you need to contact an orthopedist or surgeon as soon as possible.

Conclusion

Degenerative-dystrophic changes in the lumbar spine are a complex of various diseases affecting cartilage and bone tissues, joints, muscles and ligaments. The occurrence of these pathologies is most often associated with improper distribution of loads on the skeleton or a sedentary lifestyle, in which the supporting muscles atrophy.

That is why it is important not to go to extremes, to apply therapeutic exercises in practice, and if the first signs of discomfort occur, consult a doctor for professional help.