Degenerative-dystrophic changes in the lumbar spine: symptoms, causes, treatment. Degenerative changes in the lumbar spine Mr signs of degenerative changes in the lumbar spine

Alexander:

MR picture of degenerative-dystrophic changes in the lumbosacral spine, complicated by herniation at the level of L5-S1.
Disk protrusions L1-L2, L2-L3, L4-L5. Deforming spondylarthrosis at the level of L4-L5. What does this mean?

Alexander, the letter L denotes the lumbar vertebrae, the letter S denotes the sacral, and the number next to it is the number of the vertebra. In your case, there are intervertebral hernias at the level of the 5th lumbar vertebra and 1 sacral vertebrae.

A hernia is a displacement of the nucleus pulposus of the intervertebral disc with a rupture of the fibrous ring.

Protrusion is considered one of the preliminary stages in the development of disc herniation, in which rupture of the fibrous ring is not observed.

In both cases, this is a consequence of degenerative-dystrophic changes in the spine.

MR picture of degenerative-dystrophic changes in the lumbosacral region according to

Doctor Stupin said:

Six lines without swear marks.

Strange, but I read it with difficulty.

Let's go in order:

Do you have data from the examination of the neurologist?

Show pictures.

Describe the treatment in detail.

The situation is standard, most have it by 48.

We need to improve the situation and learn to live with it.

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A local neurologist advised me to pierce movalis, I didn’t hear anything new from him again. Movalis I pricked repeatedly together with medocalm. In December I went to the manualist. Treatment was carried out: Manual massage twice a day, magnetotherapy, laser therapy 2 times a day, spinal stretching.

From injections: IV panticeufelin 200, Reopolinoglukin 200 every day No. 10 intramuscular prozerin, ketonal, lidase, a nicotinic acid Aflutop with novocaine and vitamin B12 intra-articular all according to No. 10.

After the treatment, the legs became freer in movement, and in shoes on the left leg, the fingers cramp when walking. Please let me know if there is anything else that needs to be done. We don't care about good doctors in the provinces. No offense is said - it's actually true. Therefore, I turn to you. Please advise, thank you in advance.

How can you send pictures? Thanks a lot. Sorry if it's written wrong!

Degenerative-dystrophic changes in the spine are a group of diseases in which the vertebrae change their shape, and the elasticity of the intervertebral discs decreases.

Osteochondrosis is a pathology in which the elasticity and strength of the intervertebral discs is reduced.

Varieties

There are three types of degenerative-dystrophic changes in the vertebrae and intervertebral discs:

spondylosis; osteochondrosis; spondyloarthrosis.

Depending on the localization, the following types of the disease are distinguished:

degenerative-dystrophic changes cervical region spine; degenerative-dystrophic changes thoracic spine; degenerative-dystrophic changes lumbar spine; degenerative-dystrophic changes in the sacral region.

In spondylosis, bone tissue grows at the edges. Such neoplasms - osteophytes - look like vertical spikes on the x-ray.
Osteochondrosis is a pathology in which the elasticity and strength of the intervertebral discs is reduced. It also reduces their height.
Spondylarthrosis often occurs as a complication of osteochondrosis. This is a pathology of the facet joints, with the help of which the vertebrae are attached to each other. With spondyloarthrosis, the cartilaginous tissue of the facets becomes thinner and becomes loose.

For the prevention and treatment of DISEASES OF THE JOINTS, our regular reader uses the method of non-surgical treatment, which is gaining popularity, recommended by leading German and Israeli orthopedists. After carefully reviewing it, we decided to offer it to your attention.

Degenerative-dystrophic changes in the cervical spine: causes and symptoms

The development of this disease is provoked by such factors:

hypodynamia; incorrect posture; genetic predisposition; bad habits; age-related changes in the body.

Many symptoms of the disease are associated not only with a malfunction of the spine, but also with compression of the vertebral artery, which is responsible for the blood supply to the brain. There are such signs:

pain in the neck; restriction of its mobility; tinnitus; dizziness; headache; nausea; decreased visual acuity; hypertension; frequent trembling of arms and legs.

This diagnosis can be accurately made after X-ray examination and MRI.

Degenerative-dystrophic changes in the thoracic spine: causes and signs

This disease occurs due to such factors;

congenital and acquired curvature of the spine; sedentary work; spinal injuries; carrying weights on the back; lack of sleep, due to which the innervation of the vessels that feed the spine is disturbed; smoking and alcoholism; age-related changes in the body.

Initial signs of the disease:

drawing or aching pain in the spine; feeling of stiffness in the upper back.

Over time, the following symptoms appear:

the pain spreads to the ribs; the sensitivity of the skin on the back is disturbed (tingling, numbness occurs); pathologies of the organs of the chest cavity arising from a violation of their blood supply.

Diagnose this disease with the help of MRI and X-ray examination.

Degenerative-dystrophic changes in the lumbar spine: causes and symptoms

Factors provoking the development of the disease:

too heavy physical activity; inflammatory diseases of the spine; age-related changes in the body; hypodynamia; bad habits; injuries.

This disease is characterized by the following symptoms:

pain in the lower back, which is aggravated by coughing, sneezing, physical exertion; restriction of mobility; tingling and "goosebumps" in the buttocks and legs; numbness of the extremities; convulsions.

In addition, symptoms from this list may occur:

pain when lifting a leg that is not bent at the knee;

X-ray and MRI are used for diagnosis.
Degenerative-dystrophic changes in the sacral region are accompanied by the same symptoms. Very often, this disease affects both the lumbar and sacral regions at the same time.

Diagnostic methods

If the patient complained of pain in the spine, then the following manipulations will be carried out:

examination by a doctor, during which painful areas are identified, the level of mobility is checked; X-ray; MRI of the spine.

The latter diagnostic method is the most effective and allows you to make an accurate diagnosis.
Radiological signs of the disease:

shortened disc height; deformed articular and uncovertebral processes; subluxations of the vertebral bodies; presence of marginal osteophytes.

MRI picture of degenerative-dystrophic changes:

intervertebral discs look darker than healthy ones (due to dehydration); the cartilaginous end plate of the vertebral body is erased; there are gaps in the fibrous ring; there are protrusions; there may be intervertebral hernias.

If the patient was given the conclusion "MRI picture of degenerative-dystrophic changes in the spine", it is necessary to urgently start treatment. If the disease is not taken seriously, it will progress, which can even lead to disability.

Treatment

It is aimed at:

elimination of pain; removal of inflammation; restoration of intervertebral discs; rehabilitation of cartilage tissue.

In most cases, degenerative-dystrophic changes in the spine are amenable to conservative treatment. It may include:

taking medications; wearing special orthopedic bandages; physiotherapeutic procedures; massage; therapeutic exercises; traction of the spine (this method is considered the most dangerous).

If the patient was given the conclusion “MR-picture of degenerative-dystrophic changes in the spine”, then he is prescribed the following drugs:

anti-inflammatory drugs (Diclofenac, Ketanov); drugs to improve blood circulation (Trental); drugs that restore the structure of cartilage (Chondroitin, Teraflex); group B vitamins; painkillers; sometimes sedative drugs.

In addition, patients with the conclusion "MRI picture of degenerative-dystrophic changes in the spine" are shown physiotherapy:

electrophoresis; ultrasound therapy; inductothermy; laser therapy.

Electrophoresis is a procedure in which the patient's body is exposed to electrical impulses. It can also be administered through the skin medicines. To relieve pain in diseases of the vertebrae and intervertebral discs, electrophoresis with novocaine is used.
Ultrasound therapy is aimed at improving blood circulation in tissues. It also helps relieve pain and relieve inflammation.
Inductothermy is a treatment method in which the patient's body is exposed to a high-frequency magnetic field. Such a physiotherapeutic procedure allows you to warm up the tissues well, which helps to normalize blood circulation and relieve pain.
Laser therapy helps to improve the condition of intervertebral discs and eliminate compression of nerve fibers and blood vessels.
To monitor the effectiveness of therapy in the process, x-ray examination and MRI may be prescribed several times.

Prevention

Degenerative-dystrophic changes in the spine will not appear if the following rules are observed:

perform morning exercises every day; monitor your posture; give up smoking and drinking alcohol; sleep on an orthopedic mattress; choose the right table and chair for work according to your height; go in for sports (it will be enough to go for a run or go to a fitness club 2-3 times a week).

Also, to prevent the disease, you should eat right. It is necessary to ensure that the body receives a sufficient amount of vitamin D, calcium, phosphorus and magnesium.
Vitamin D is found in the following foods:

cod; salmon; seaweed; fish oil; caviar; butter; egg yolk; cheese; chanterelle mushrooms.

calcium in in large numbers present in:

cheese; cottage cheese; hazelnuts; almonds; walnuts; legumes; sour cream; cream; pistachios; oatmeal.

Rich in phosphorus

sea fish; squid; shrimp; crabs; cottage cheese; cheese.

Magnesium is found in the following foods:

buckwheat; nuts (hazelnuts, peanuts, cashews, pistachios, walnuts, almonds); kelp; oatmeal; buckwheat; legumes; mustard.

Salt intake should be limited.

Complications

If a person was given the conclusion “MR-picture of degenerative-dystrophic changes in the spine”, then you should take this seriously and immediately begin physical and drug therapy.
If you do not start treatment in time, then the following complications may occur:

arthrosis; scoliosis; osteochondropathy; intervertebral hernia; paresis.

The advanced stage of the disease can even lead to paralysis.

Do you often experience back or joint pain?

Do you have a sedentary lifestyle? You can’t boast of a royal posture and try to hide your stoop under your clothes? any opportunity that will give you the long-awaited good health!

Degenerative-dystrophic changes in the lumbosacral spine - a slow destruction of tissue structures related to the discs. All this happens for the simple reason that the tissues are no longer supplied with sufficient nutrition, and this leads to their dryness and loss of elasticity.

Dystrophic changes in the lumbosacral spine dangerous disease. It is almost impossible to detect pathology immediately. In such situations, there is nothing left to do but take various medications and go to the hospital for procedures. The situation is aggravated by the fact that in order to bring the spine back to normal, you may have to change some habits, and not rely only on the power of medicine.

DDZP include in their group several pathological conditions. They are united by some generalized signs and features. In practice, the following types of changes are traditionally encountered:

- problems associated with the broken integrity of the disks, their thinning, deformation;
spondylosis - a manifestation of growths of a pathological nature in the region of the vertebrae, these elements limit the patient's motor capabilities;
spondylarthrosis is a phenomenon in which there is a violation of the joints, which entails strong pain when moving.

These are the types of these states. In order for the clinical picture to be revealed as clearly and clearly as possible, a detailed diagnosis is necessary.

Causes of the disease

There are several causal factors of degenerative-dystrophic changes in the lumbosacral region:

Leading a sedentary lifestyle. If the body is healthy, there is a uniform distribution of the load along the spine. But lack of mobility leads to excessive weakness of the muscular corset and weakening of the muscles. Therefore, even a minimal load factor can lead to displacement of the vertebrae.
Excessive physical activity. Lead to pathology, maybe the opposite state of affairs, when a person is intensively involved in sports, not sparing his own muscles. Statistics show that joint diseases occur in 90% of athletes.
traumatic events. If we are talking about young patients, then such pathologies (arthrosis, nerve infringement, hernia) are most often caused by injuries, including birth processes.
Aging is another process that causes irreversible changes. In the treatment process, there can be no talk of surgery, since dystrophy is natural. Only supportive therapy is considered acceptable.
Irrational nutrition. Due to problems with metabolic reactions, body cells do not receive the proper quality of nutrition. This has a negative impact on the state of the whole organism and creates an extra load.
inflammatory processes. Changes can occur against the background of inflammation. For example, the most common causative agents of such conditions are arthritis, ankylosing spondylitis.

Thus, degenerative changes in the lumbar spine can manifest themselves in various ways. causal factors. For their exact establishment, it is necessary to pay a visit to the attending specialist.

The course of development of pathology

The spinal column, especially the sacral region, is an object of increased load during any body movements. Because of this, there are violations of the supply of nutrients to cells and tissues. The discs lack blood vessels that could hypothetically provide direct nutrition. Therefore, there is a gradual loss of tissue elasticity and its slow destruction. In the next step, the tissue becomes thinner and more loose.

The cartilage shrinks, the discs lose their height. In response to these processes, active work comes immune function. Its cellular structures begin to produce inflammation inducers. As a result, the tissues swell, pain appears. Usually, the course of degenerative-dystrophic changes in the lumbosacral spine is slow and chronic. In the future, against their background, the development of other dangerous conditions may occur.

Stages of progression and main symptoms

In the lion's share of clinical situations, there are problems in self-determination of the onset of the development of the disease. The fact is that at first there are no pronounced signs. As the practical side of the issue shows, there are 4 stages of progression of pathology. And each of them is accompanied by special signs.

First stage. Man without medical education may not notice any changes in health, since in fact there are no signs of degenerative-dystrophic changes. Some patients note that they have experienced excessive stiffness in the lumbar region.
Second stage. In this process, more severe symptoms may come into play. First of all, we are talking about limiting movements in the lumbar spine. Even with the slightest bending, shooting pain and attacks of initial sciatica can make themselves felt.
Third stage. There are problems with the nutrition of the soft tissues that surround the spinal column. As for the physical manifestations, there is increasing pain, numbness of the limbs and a convulsive state.
Fourth stage. This is the most neglected condition in which obvious damage can progress. spinal cord and roots. This state entails the formation of paresis and paralysis.

As you can see, there is a direct relationship between the stage at which the pathological process has passed and the characteristic manifestations of the disease. Thus, DDSD of the lumbar spine proceeds within several stages and is a dangerous condition. It is important to determine the condition as early as possible in order to start the treatment process in a timely manner.

Diagnostic measures

The complex of surveys is quite simple and is carried out within the framework of three common stages.

Drawing up a general history of the disease. In this case, attention is paid to the symptoms of the disease and the general conditions under which the attack began.
Examination of the patient. At this stage, the specialist checks characteristics degeneration, examines the degree of mobility, determines muscle strength and the area in which the lesion is localized.
Holding. This event serves to reveal the evidence base for dystrophic changes and causal factors in the development of pathology.

Other measures can be used as additional tests to determine dystrophic changes in the spine. This is a blood test. But not all of these activities are able to demonstrate the symptoms of pathology at an early stage. The most in-depth examination methods are measures such as CT, MRI. But patients resort to them in the case when the lesion of the lumbar region has already begun to actively develop.

Complex of therapeutic measures

The list of methods of therapy is quite wide, most often it involves a complex of medical, physical and surgical treatment. The desired method of therapy is selected by a medical specialist.

Drugs for the treatment of the disease

First, doctors prescribe conservative treatment. It involves the use of drugs for pain relief, warming action. They allow you to relieve pain and ensure free movement and normal performance. Most often, preference is given to representatives of the group of non-steroidal anti-inflammatory compounds:

Diclofenac.
Nise.
Meloxicam.
Ibuprofen.
Movalis.

They are effective, but are accompanied by quite dangerous side effects for the intestines, up to the formation of ulcers.

To improve overall well-being, degenerative-dystrophic change involves the use of simple medicinal formulations - Ketonal, Ketanov. The principle of action of drugs is to eliminate pain and alleviate general well-being.

In order to relax tense muscles, Sirdalud, Mydocalm are prescribed. These drugs are indicated for use only intermittently, since they have a serious effect on the condition of the muscles.

In addition to these remedies, doctors prescribe regular use, which are aimed at activating the regeneration of joints and tissues.

Complexes of special vitamins and minerals are often used to restore the body. Group B drugs have the greatest effect (6, 12).

If the pain sensation is strong enough and cannot be suppressed with popular medications, novocaine blockade is used. The procedure involves the introduction of a drug directly into the area of the spinal cord.

It is quite simple to cure dystrophic changes in the lumbar region if you follow all the rules for the use of drugs and follow the dosages.

Therapeutic exercise and massage

This set of procedures usually contributes to the normalization of the blood circulation option in the problem area. And also it is aimed at muscle relaxation and providing thinned tissues with the necessary nutrition. Exercise therapy for degenerative lesions improves metabolic processes and brings blood to the lumbar region. In addition, the event will be useful for obese people, as it helps to eliminate excess weight.

It is important to correctly plan a set of physical activities, and as a result, it will be possible to achieve muscle strengthening, which will subsequently be able to take on moderate loads.

The main nuance of these activities is the possibility of increasing the distance between the vertebrae of the lower back, as well as the ability to release nerves that have been compressed. So, with degenerative-dystrophic changes in the lumbosacral spine, it will be possible to get rid of the pain syndrome and relieve inflammation.

And it is also advisable to sign up for a pool, because high-quality classes will help strengthen the muscles and ensure their smooth stretching. Through weight loss, you can achieve the removal of excess stress. But at this time it is important to correctly think over and plan the diet so that the body receives a sufficient amount of vitamin and mineral substances.

Surgery

Fortunately, in a huge number of clinical cases, the use of medications and therapeutic physical exercises comes to the rescue. The operation is needed only in case of active progression of the disease, even with timely and regularly taken therapy measures. At the same time, the doctor looks at the MR picture of degenerative-dystrophic changes. During the event, devices are installed that help maintain the lumbar spine. This approach allows you to remove excess pressure and prevent further process of deformation of the intervertebral discs.

Another common case is the formation of a serious lumbar herniation, involving the protrusion of the disc from the vertebral borders. The pulp that has left the disc is then cauterized with a laser or pulled out.

The operation process implies the possibility of solving several clinical problems at the same time:

decompression in the region of the nerves of the spinal type;
elimination of an object that leads to compression of nerve fibers;
removal of stenosis that has developed in the spinal cord.

If the phenomenon of degenerative change is acute, emergency intervention is indicated. It is intended to prevent neurological disorders. Through this measure, specialists can eliminate brain compression and restore the options of the pelvic organs.

Preventive actions

Due to the vast scope in which these changes are propagated, some preventive measures must be observed. They will help protect against disability at a young age, as well as extend the time of activity until old age. To improve the MR picture of degenerative-dystrophic changes in the lumbosacral region and improve general well-being in the present and future, certain actions should be taken.

In contact with

Classmates

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 low back 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 of cartilage tissue. This is degenerative-dystrophic changes in the 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 can be caused by the natural aging process of the body or be traumatic in 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 this disease, it is very common, and, according to modern estimates, at least 30% of people aged 30-50 have some degree of disc space degeneration, although not all of them 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 lumbosacral 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 the 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 is long time, tends to gradually progress 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 the vertebral tissues; osteochondrosis is characterized by the absence of 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 come down to disruption 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 the posture, has a strong muscular corset. Modern look life is immobile. And this leads to a weakening of the muscular corset, weight gain.

Sedentary work contributes to the appearance of degenerative changes in the spine. 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 micromotions, when the outer shell of the disc (annulus fibrosus) wears out and cannot effectively withstand the load on the spine, which leads to 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 through the spinal canal is also added, as a result of which the pain in the lower back increases significantly and becomes permanent.

Symptoms of the diseases appear as degenerative-dystrophic lesions develop, but at the initial stages they 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.

The 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, at the fourth stage of development are fraught with paralysis, paresis. 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 lower limbs) or dysfunction of the pelvic organs (various disorders of urination and defecation) may be a consequence of 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) 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:

Compiling 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%;
Initial signs of disc degeneration, such as disc dehydration (such a disc will appear darker on an MRI because it contains less water than 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 through the end plate. Pathological changes in the end plate as a result of degeneration lead to malnutrition of the cells.

Such 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

Unfortunately, degenerative-dystrophic changes in the lumbar spine 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. Sedative drugs and vitamin complexes of group B are also prescribed.
Novocaine blockade.
Physiotherapy (laser therapy, diadynamic currents, inductothermy, electrophoresis).
Therapeutic methods (traction on the plane, underwater traction). Stretching is considered the most dangerous method treatment of 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 exercises, physiotherapy, different kinds massages.

In addition, spinal traction helps 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 a puncture 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 from such ailments note increased fatigue, changes in gait, and constant 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 of the disease, ischemia, impaired blood supply, paresis, and 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);
a 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 changes in the structure of the spinal column occur.

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, a sedentary lifestyle 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 malnutrition 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 loads on the lumbar spine also adversely affect the normal condition of the spinal segments. Most often, people whose work is associated with hard physical labor or professional heavyweight athletes fall into the risk group. Injuries of the lumbar spine often cause disturbances in metabolic processes in tissues, which also leads to degenerative changes in the future. Violation of the work of muscle tissue. The back muscles maintain the correct position of the vertebrae. Therefore, after inflammation or during spasm, the harmonious work muscle fibers, 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 experience not only back pain, but also others. 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 in early age or in professional weightlifters. 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. This gradual increase in 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 destruction anatomical structure 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 physiotherapy.

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 cost of treatment, diagnosis, the cost 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 damping function of vertical pressure forces (for example, the heaviness of the torso, head) is carried out 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 in retirement age change is 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 an 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 restrict 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.
Held medical checkup. 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

The spine is most susceptible to various pathological changes in the structure, since it has a huge load every day - after all, the spinal column serves as a support for the whole body.

Under the influence of certain factors, degenerative-dystrophic changes begin to occur in the spine, characterized by pathological changes in the vertebrae or intervertebral discs that begin to collapse.

Features of the pathology

Most of all, the lumbosacral region is subject to such changes, since it is located at the very bottom of the spinal column and is more vulnerable.

Dystrophic changes can be caused by the following diseases (the main ones are listed below):

Osteochondrosis- with this disease, the intervertebral discs are affected, which gradually become harder and reduce the effect of depreciation. At the first stage of the disease, discs with cartilaginous tissue are replaced by bone tissue; in the last stages, deformation and destruction of the disc occurs.
Arthrosis- a disease similar to osteochondrosis in terms of symptoms and other signs. With arthrosis, the vertebrae themselves are affected, on which bone outgrowths - osteophytes - are gradually formed, causing severe discomfort in the lower back.
Spondylosis- This disease also affects the intervertebral discs, leading to their deformation and destruction.

Causes

All dystrophic pathologies of the lumbosacral spine can be caused by the following factors:

Weight lifting.
Excessive sports.
Sedentary lifestyle.
Inflammatory diseases - arthritis, bursitis, synovitis.
Violations in the structure of the spinal column.
Posture disorders.
Scoliosis.
Elderly age.
Cold and constant exposure to drafts.
genetic predisposition.
Hormonal failures.
Diseases associated with metabolism.
Wrong nutrition.

Degenerative changes in the lower back are most often found in people whose professional work or lifestyle is associated with heavy loads on the lower back - movers, builders, office workers.

Symptoms

The main symptom of degenerative-dystrophic processes in the lower back is pain, which increases with movement, bending over, standing up, etc. Painful sensations can be dull, sharp, burning. Pain can also radiate to the buttocks and thighs.

In addition to pain, the disease is accompanied by the following symptoms:

Restriction of lumbar mobility.
Decreased sensitivity in the affected area, buttocks and legs.
Tingling sensation in buttocks and legs.
Weakness in the legs.
Rapid fatigue after walking.
Impotence in men.
Gynecological problems in women.
Urinary incontinence.
Problems with bowel movements.

If a person has degenerative - dystrophic changes in the lumbosacral region, then he has a change in gait - this is caused by painful sensations when walking. You can also notice some asymmetry of the gluteal muscles.

Diagnostics

Diagnosis of pathological processes begins with the fact that the doctor examines the patient's lower back and listens to his complaints. The doctor must be aware of all the symptoms, as well as past diseases, injuries, the patient's lifestyle, in order to find out the cause of the pathologies in the lower back.

For a more accurate diagnosis, the following types of diagnostics will be required:

Radiography- will show the presence of osteophytes on the intervertebral discs, deformation of the anatomical structures and disorders in the structure of the spine.
- a type of diagnostics with high accuracy of the results of the study. Shows the presence of osteophytes, deformation of the intervertebral discs, pathologies that led to the formation of degenerative processes in the lower back.

Treatment

Treatment of all degenerative diseases of the spine is carried out comprehensively and is aimed at:

Eliminate pain.
Restoration of lumbar mobility.
Cartilage regeneration.
Treatment of complications.

The patient is prescribed painkillers, which not only quickly eliminate pain, but also stop inflammatory process. It is also mandatory to assign chondroprotectors- special preparations intended for the treatment of degenerative - dystrophic changes. They start the process of regeneration in the cartilage, improve the metabolism in the cartilage tissue. In addition, vitamins and drugs are prescribed to treat complications.

In order to restore the mobility of the lumbar, eliminate pain and improve the blood supply to this area, massage is prescribed. As a result of the procedures, the tissues are saturated with oxygen, which contributes to the elimination of many discomfort, improve nutrition of intervertebral discs.

It is also mandatory to assign physical therapy course, which can be practiced in a clinic or at home, having previously learned the technique of performing exercises from a doctor or instructor. It is recommended to conduct several classes in the clinic under the supervision of an instructor, and after that, do gymnastics on your own at home. With the help of exercise therapy, you can improve the mobility of the entire back, strengthen the muscular frame, improve sensitivity in the buttocks and legs. After exercise therapy, the patient should feel relief in the lumbar region, pain and stiffness should disappear.

Not a single therapy for devastating diseases of the spine can do without physiotherapy. Effective procedures are:

Electrophoresis.
Magnetotherapy.
laser therapy.
Impact of ultrasound.

With the help of physiotherapy, it is possible to eliminate pain and stiffness, normalize blood circulation in the affected area, start recovery processes in cartilage and intervertebral discs.

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:

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.
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.
Changing the shape of the intervertebral disc disrupts the balance between the vertebrae, pinching the spinal roots.
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 were no serious injuries, 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".

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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:

Initial stage. Constant pain in the lower back. Over time, the pain bothers more and more, the efficiency and quality of life decrease.
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.
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.
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).

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, 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 tissue nutrition and pinches 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.
Hypodynamia. As a result of a long stay in one position, cartilage and bone tissue do not receive the necessary 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. Violations 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.

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Types of diagnostics

For the correct diagnosis of 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, badly extended big toe, low sensitivity in the legs 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 back and limb pain is caused by physical activity on the background of degenerative lesions of the spine. Therefore, when diagnosing, first of all, it is necessary to exclude more serious causes of pain that require 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, instrumental diagnostics are used. 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 reveal possible infections in the body and endocrine disorders.

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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 work internal organs person. But even then, it is better to try all conservative treatments before going to the operating table, because spinal surgeries are 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 treating the spine with side effects (first of all, they affect the work of the gastrointestinal 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 sick spine should be trusted only by a qualified specialist, and the exercise therapy complex is selected by the doctor individually.

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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.

Minimum preventive measures:

Be active! Without movement, unused muscles atrophy and ligaments lose elasticity. Daily exercise is necessary condition for a healthy back.
Strengthen your back muscles. In addition to general activity, it is necessary to purposefully develop the muscular corset. Strength exercises in the gym and swimming will help here.
Avoid sudden stress on the spine: do not lift weights, do not jump from a great height without grouping, even from the bed it is recommended to stand on both legs so that there is no sharp blow.
Keep your back always straight, watch your posture.
Choose a good mattress to simultaneously provide the back you need support and let it relax.

Conclusion

If your back starts to hurt on a regular basis, this is cause for concern. Remember that sooner or later our body will begin to age, and the spine often takes the first blow of this. natural process. It is not recommended to delay the visit to the doctor because harmless symptoms can develop into serious illnesses.

Degenerative-dystrophic changes are irreversible, but timely medical attention can slow down or stop the process and allow you to enjoy flexibility and mobility for many years.