Treatment of lumbar osteoarthritis

Osteochondrosis (disc) in the lumbar or lower back is caused by invasive changes in the disc, leading to lower back pain.

The discs are hard, hard structures such as ligaments between vertebrae, stroke absorption and providing shock absorption of the spine.The disks are elastic, but strong enough to facilitate the movement, such as the tilt of the body, progress, back or to the sides.

Although the name, Osteochondrosis is not considered a disease and symptoms actually over time, as prescribed, not worse.Disc, as well as all the structures of the body, recession and degeneration of discs developed in everyone, as part of the invasion process.

A characteristic feature of osteoarthritis is that the symptoms of the spine begins to stabilize.Treatment of osteoarthritis of the lumbar spine focuses on reducing pain, stabilizing the spine and improving or maintaining the ability to move.

Symptom

Most cases of manifestations of osteoarthritis of the lumbar spine will have mild back pain, constant, over time to increase for a few days or more.

Symptoms may vary, but the most characteristics include:

• Moderate back pain, continuous.Pain in damaged disk is the most common symptom of disc degeneration.The pain may spread to the buttocks, groin and upper thighs.This pain is often felt as stupid, and the intensity may vary from light to serious.
• Periodic acute stages of pain.Back pain can be strengthened for several days or weeks, and then return to a moderate level.The outbreak of pain occurs when degenerating and decreasing when the spine is gradually stabilizing.The outbreak of pain can occur suddenly and pain manifestations often lead to reduced movement.
• Local pain.The lower part of the back around the degenerative plate may be sensitive when touching.Local pain is caused by inflammation and muscle tension in the area of the plate damaged by degeneration.
• Foot pain.Mental symptoms, including numbness, weakness or throbbing pain in the buttocks, thighs and/or back of the leg, may appear if the height of the disc decreases significantly and occurs nerve root compression.Pain in the legs when degenerated lumbar vertebra usually does not go down to the knee.
• The sudden weakness or instability may occur when the disc is significantly weakened and the patient feels as if the lower back does not work normally.

In addition, the pain may increase or decrease when a certain movement or posture, such as:

• Pain when sitting.Sitting for a long time often makes back pain and stiffness worse and will be relieved when standing up or changing positions.
• The pain increases when bent or rotated.Turn the spine and bend forward, back or to one side that can cause severe pain in the damaged disc area.
• Relieve pain when walking or changing posture.When the spine changes the position, the pressure on the disc will decrease or be allocated from the disc to the muscles and joints.Changing posture regularly, alternating between standing and sitting, walking short can help reduce stiffness and minimize pain.

Degeneration of disc does not cause symptoms of intestinal/bladder dysfunction, fever accompanied by back pain, weight loss quickly and unknown cause or severe abdominal pain.These symptoms show more seriousness and often need surgery.

Related symptoms

When degenerative lumbar vertebrae, in addition to lumbar pain, other symptoms related to the degenerative disc may occur.For example:

• The proteins contained inside the plate can cause significant inflammation if they are exposed to the surrounding spine structures, and this inflammation can lead to spasms of lower back muscles, as well as piercing pain, with radiation in the hips and on the back surface of the lower limbs (also called ISHIAS).
• The degeneration of the lumbar disc may contribute to the development of lumbar stenosis and / or lumbar osteoarthritis, as well as other conditions on the lower back.
• A degenerative disk can also lead to the appearance of herniated disc.Neurological symptoms with a hernia of a plate can be acute and intense.
• Symptoms caused by the degeneration of the lumbar spine may vary widely depending on the rapid or complete degree of the disc, which has degenerated and how it affects the surrounding spine structures.
• Pain for osteoarthritis is often caused by deformation of spinal support muscles and inflammation around the structures nearby to the disc.

Causes of lumbar osteoarthritis

Osteochondrosis occurs due to age wear and disorder of discs, and degenerative processes can accelerate due to injury, general condition, health and lifestyle, and, maybe, a genetic tendency for the development of pathological processes in the skeletal muscle system.

Osteochondrosis rarely starts with a serious injury, such as a car accident.It is likely that the beginning of degenerative processes is associated with low disk lesions.

Pain related to lumbar osteoarthritis is usually created by one or more pathological processes:

• Inflammation, protein from disks are stimulated by surrounding nerves - both small nerves in the disc and large nerves are capable of going to the foot (sciatica).
• The abnormal instability of the microphone, when the outer ring of the plate, is called the yarn ring, worn and cannot effectively absorb energy vectors on the spine, leading to movement along the vertebra.
• For a long time, the pain of osteoarthritis in the lumbar spine will eventually be reduced instead of worse.This analgesic occurs due to the degenerative disc completely no more inflammatory protein (can cause pain) and the collapse will move into a stable position, removing painful micro -movements.

Risk factor

Lifestyle factors that affect the overall health may affect the disc.The risk factors for degenerative disc (Osteochondrosis) include:

• Family history with back pain or musculoskeletal disorders
• Excessive stress on the lower back due to sports or work nature
• Prolonged static load on the disc due to prolonged sitting and/or poor posture
• Lack of disc support due to weak back muscles
• Obese
• Smoking or any form of nicotine consumption

Degenerative disc is part of the aging body, but not everyone has pain or any specific symptoms.Symptoms tend to occur when there is instability, muscle tension and may be stimulating nerve roots.

Diagnose

• The history includes a detailed study of patients' symptoms, their intensity and the relationship of pain with exercise or body posture.Information about regular physical activity, sleep habits and past injuries are also necessary.
• Physical examination is necessary to check the range of motion and muscle condition.The presence of painful areas when touching or physical abnormalities is also determined.In addition, neurological tests are performed to identify neurological defects.
• The above diagnostic methods are often enough to diagnose bone and joints, but the accurate diagnosis requires visual methods.
• CT
• X -ray
• MSCT
• Pat
• MRI - This diagnostic method allows you to clarify the degree of degeneration, the presence of fractures, hernias of narrow disks.Usually a MRI study is necessary to prepare surgical treatment to determine the exact location of the degenerated disk and plan for operation.

Studies have shown that the results of MRI with medium or significant degeneration are found when scanning the patient, both severe pain and minimum or lack of pain.In addition, many painful conditions may not appear on MRI.For this reason, the diagnosis cannot be performed exclusively based on the results of visualization and verification of diagnostics that can only be based on the sum of all clinical and tools.

Treatment

The initial methods to treat osteoarthritis of the lumbar spine and painful manifestations include the following combinations:

• Excessive painkillers They can reduce inflammation, contributing to discomfort, stiffness and irritation of nerve roots.
• Prescription painkillers.In severe pain, muscle relaxants or addictive painkillers may be prescribed.These drugs are often used to treat painful pain, acute pain, expected to last for more than a few days or weeks.These drugs can be addictive and cause serious side effects, so they should be used carefully.
• Heat and ice.The use of heat on the lower back improves blood circulation, reduces muscle cramps and stress and improves movement ability.Ice bags can reduce inflammation and relieve moderate pain.Very useful when using heat before physical exercises to relax muscles and use tape after physical activity to minimize inflammation.
• Craft therapy. The operation performed by an expert is a common pain control method in lower back pain.Practice doctors, manual therapists, use their hands to affect the different areas of the body to reduce stress in the muscles and joints.It has been found that operations are an effective measure to temporarily relieve pain, and in some cases, it is as effective as drug treatment.
• Massage.Exposure by massage methods can reduce stress and cramps in the lower back muscles, reduce pressure on the spine and relieve pain.In addition, massage can improve blood circulation, ensuring the supply of nutrients and oxygen for stress muscles.
• Steroid epidural injection.Putting steroids into the space around the spine can reduce pain pulses, as well as inflammation.Steroid injections can be used in combination with physical therapy programs to relieve pain in physical exercises and rehabilitate.As a rule, epidural steroid injection allows analgesic to relieve pain over a period of a few weeks to a year.

In many cases, for effective anesthesia, a combination of treatment methods is required.The process of trial and error, as a rule, is necessary to choose a treatment method that turns out to be the most effective.

Do not rest in a long bed, and, as prescribed, may be motionless with intense pain in a short time, because lack of physical activity can lead to muscle weakening and normal support of the spine.

Exercise therapy and modification of activity

To maintain the healthy movement of the spine, physical exercises are necessary.An effective exercise program for lumbar spine should include:

• Exercises to extend the muscles of the lower back, hips and pelvis, as well as the muscles of harm.The seal of these muscles increases the pressure on the lumbar spine and contributes to the development of lower back pain.
• The strength of the muscles of the lower back and abdomen allows you to maintain a good and better posture than maintain the spine.The exercise program to enhance muscles may include a personal exercise therapy program, stabilizing the dynamic of the lumbar spine, ear-chi, pilates or others.
• Aerobic exercises with low loads, increase the frequency of heart contractions, improve blood circulation and supply nutrients and oxygen, necessary to restore body tissues.For example, it can be walking, swimming and water aerobics.

The programs of physical exercises are often adjusted in each case, depending on the general health condition, the severity of pain and personal interests.

In addition, small adjustments to daily activities (modification of lifestyle) can reduce the effectiveness of pain.For example, wearing corset when lifting weight or avoiding torsion when lifting weight, can prevent pain increased due to excessive load on the disc.The use of a Thai academic chair and orthopedic mattress can also improve posture and reduce the load on the disk.

Surgical treatment

Treatment of osteoarthritis surgery of the lumbar spine is necessary in the case of conservation treatment for 6 months is ineffective.Surgical treatment for osteoarthritis is always selected, which means that the patient himself decides whether surgery should go through.

You should take into account all factors before deciding on surgery for osteoarthritis, including the time of recovery, treatment of pain during the recovery and restoration of the spine.

The union of the vertebra

Treatment of standard surgery for osteoarthritis of the lumbar spine is a merger surgery in which two vertebrae are used together.The purpose of the merger (Spondylodeza) is to relieve pain and eliminate the instability in the movement of the spine.

All activities consolidate the spine as follows:

• The broken disk is completely removed from the Intervertebral space.
• Stability is made using bone graft and / or tools (implants, sheets, bars and / or screws).
• After that, the vertebrae fuse, forming a solid, motionless structure.Fighting occurs within a few months after the procedure, and not in the operation process.

After surgery, wear a corset, take prescribed pain medication.The exercises are connected very carefully, taking into account the individual characteristics of the patient and the degree of tissue regeneration.Full recovery after fusion can take up to a year until the vertebrae grow together.

Surgery to replace an artificial plate

Replacing damaged disks by artificial implants has been developed in recent years as an alternative to the merger.The alternative activity includes completely removing the damaged disk due to degeneration (cutting), restoring the disc spatial to natural height and artificial disk transplant.

This process is designed to maintain motion in the spine similar to natural motion, reducing the ability to increase pressure on the segment of the spine (quite common complications of the spinal synthesis reaction).

Recovery after replacement activity usually lasts up to 6 months.