Degenerative-dystrophic changes in the lumbar spine: symptoms, causes, treatment. Degenerative-dystrophic changes in the lumbosacral spine Degenerative-dystrophic changes in the lumbar spine

The spinal column is part of the musculoskeletal system of the human body. She is responsible for several basic functions. Among them we can distinguish supporting, motor, innervation and providing flexibility of the body. The complex structure often leads to premature aging of tissues. Degenerative dystrophic changes in the spine appear, invariably leading to the development of osteochondrosis and severe pain.

You need to understand that it is degenerative-dystrophic changes in the spine that underlie all known pathologies of this structural part of the musculoskeletal system. Osteochondrosis, spondyloarthrosis, spondylolisthesis, protrusion and disc herniation - all these are consequences of neglected and not promptly treated degenerative dystrophic changes in the intervertebral disc, identified on the MRI picture of the examination. However, even without a special examination, it is possible to reliably make a diagnosis using typical clinical symptoms after the initial examination.

If you have an MR picture of degenerative-dystrophic changes in the cartilage tissue of the spine, we recommend that you immediately make an appointment with a vertebrologist. In our manual therapy clinic, the first doctor's appointment is free. During the consultation, the patient receives comprehensive information about the prospects and possibilities of the treatment.

What are degenerative-dystrophic changes?

The MR picture of degenerative-dystrophic changes in the spine is the result of an examination using a magnetic resonance tomogram. In the resulting images, the diagnostician sees characteristic structural changes in the tissues of the spinal column. They can affect the vertebral bodies, cartilaginous intervertebral discs, ligaments and muscles. A detailed indication of the localization of degeneration is usually included in the image description.

First, let’s clarify what degeneration and dystrophy are from a medical point of view. So, tissue degeneration begins with a violation of their nutrition (supply of fluid, oxygen, nutrients, vitamins and minerals). Regarding intervertebral discs, we can say that they do not have their own vascular network. Therefore, the supply of fluid and nutrients to them can only be achieved through diffuse exchange between the fibrous ring and the surrounding muscle tissue.

In order for the diffuse exchange to be constant, regular load on the muscular frame of the back is necessary. If there is no physical activity, then the muscles lose their ability to transfer fluid and nutrients dissolved in it to the structures of cartilage tissue.

Dystrophy is an organic change in structure with dehydration and loss of functional ability. Intervertebral discs become deformed and lose their shock-absorbing ability. The bone structure of the vertebral bodies and their spinous processes becomes porous and can become covered with growths (osteophytes). Muscles lose their myocyte volume and become unable to fully conduct nerve impulses, contract or relax.

Degeneration is the replacement of the normal tissue structure with connective fibers (scars) and salt deposits. In this process, a complete loss of typical functions characteristic of certain tissues occurs. Thus, the cartilage tissue of the intervertebral disc is capable of absorbing fluid and releasing it into the surrounding space. Due to this, elasticity and shock-absorbing ability are maintained. With degenerative changes, the fibrous ring of the intervertebral disc becomes rigid and loses its ability to absorb fluid. They fill with lime deposits, calcify and become very brittle and brittle.

Causes of degeneration and dystrophy

Now let’s look at the most common causes of degeneration and dystrophy of spinal tissue. First of all, it is worth noting that recently this condition has ceased to be associated with age and associated with the aging of the body. Nowadays, osteochondrosis is first diagnosed in people under 25 years of age. Residents of megacities and representatives of professions whose daily work is associated with static long-term tension of individual parts of the body suffer especially often.

Among the probable causes of the development of degenerative dystrophic changes in the spine, doctors name the following factors of pathogenic influence:

a sedentary lifestyle without regular physical activity on the muscular frame of the back, torso and abdominals;
excess body weight, leading to endocrine disorders and metabolic pathologies;
incorrect posture (among modern youth, curvature of the spine is detected in 85% of cases);
injuries, bruises, falls, improper distribution of physical activity;
improper organization of work and sleeping space in violation of hygiene and ergonomic rules;
staying in a static position for a long time;
poor nutrition and lack of clean drinking water;
smoking, drinking alcohol and many other bad habits.

Despite the widespread carcinophobia in modern society, tumor processes cause pain in the back, neck and lower back in only 0.5% of cases. And tuberculosis, syphilis and other dangerous infections are even less common.

A healthy lifestyle, active physical education, the fight against excess weight and compliance with hygiene standards for organizing personal space are the most effective ways to prevent the development of degenerative-dystrophic changes in the spine.

What do initial, moderate and severe degenerative-dystrophic changes mean?

You need to be able to correctly understand the doctor’s conclusion given after an MRI examination. Let’s try to figure out what these or other terms mean further.

So, most often with intermittent back pain, in conclusion you can see that there is an MR picture of initial degenerative-dystrophic changes in the spine, in practice this is the absence of visible structural changes that could significantly disrupt the function of the musculoskeletal system. The doctor sees that some areas of cartilage, bone or ligament tissue do not receive sufficient blood supply and slight trophic changes have already occurred.

If effective treatment is not started at this time, then moderate degenerative changes in the spine will appear in the future, manifested by fairly severe and prolonged pain. This is an already developed stage of osteochondrosis with protrusion of the fibrous ring and partial loss of its shock-absorbing ability. Most likely, at this stage, independent physical exercise is already very difficult, and the patient experiences serious stiffness of movements, a decrease in their amplitude and limited flexibility of the spinal column. The help of a specialist in kinesitherapy, therapeutic exercises, massage and osteopathy is needed.

Pronounced degenerative changes in the spine indicate that the disease is already at an advanced stage. It can manifest itself not only as severe chronic pain in one or another part of the spinal column. Here signs of neurological damage to the radicular nerves may appear. This is numbness of certain parts of the body, weakening of muscle effort, muscle cramps and clonic hypertonicity.

Degenerative-dystrophic changes in the cervical spine

Very often, degenerative changes in the cervical spine are detected, associated with constant static tension of the muscles of the collar zone. Office employees who are forced to work in one position at a computer for a long time suffer from this pathology.

Degenerative-dystrophic changes in the cervical spine lead to the following clinical manifestations of diseases:

feeling of tension in the neck and collar area;
pain in the neck and its spread to the upper extremities;
tension headaches, dizziness, decreased mental performance, drowsiness and depressed mood;
increased blood pressure and other symptoms of vegetative-vascular dystonia;
numbness of the upper extremities (often starting with the little fingers).

In the absence of treatment, spondyloarthrosis quickly develops with loss of usual mobility, vertebral artery syndrome, leading to impaired cerebral circulation, etc.

Degenerative-dystrophic changes in the thoracic spine

MRI examinations rarely reveal degenerative-dystrophic changes in the thoracic spine, this is due to the special anatomical structure. The thoracic vertebrae are responsible for forming the frame of the chest. Paired costal arches are attached to them; in front they are balanced by the sternum. Rigid fixation limits mobility and does not create prerequisites for rapid wear of the cartilaginous intervertebral discs. Degenerative changes in the thoracic spine usually occur as a result of traumatic impact, for example, after falling on your back. They may be associated with deformities and changes in posture, for example, scoliosis.

Degenerative-dystrophic changes in the discs of the lumbar spine

Degenerative-dystrophic changes in the lumbar spine, caused by excessive physical activity, incorrect posture and other negative factors, occur very often in people over the age of 30. But cases of manifestation of degenerative changes in the lumbar spine in patients at an earlier age are not uncommon. Those who suffer mainly are representatives of professions associated with heavy physical labor (loaders, lumberjacks, painters, finishers, builders, etc.).

Degenerative changes in the discs of the lumbar spine cause pain. There may be a striped spread of pain along the inner and outer surfaces of the thigh and lower leg. This is a sign of a pinched sciatic nerve. Very often in the morning, immediately after waking up, you feel some stiffness in your movements. It goes away completely within a day. In the evening, before going to bed, severe tension in the muscles of the lower extremities bothers you, and a mild convulsive syndrome or restless legs may develop.

Degenerative-dystrophic changes in the lumbosacral spine

Severe degenerative-dystrophic changes in the sacral spine can only be diagnosed in persons under 25 years of age. After reaching this age limit, the intervertebral cartilaginous tissues of the sacrum atrophy naturally and all vertebrae fuse together. Even if a young person develops degenerative changes in the sacral spine, they will be leveled out during the fusion process.

But degenerative-dystrophic changes in the lumbosacral spine, localized in the L5-S1 articulation, pose a particular danger. Here is the hypothetical center of gravity of the human body. This accounts for the maximum physical, mechanical and static load. Therefore, the disk is destroyed very quickly. The result is severe pain, hernial protrusion and pinching of the sciatic nerve.

Any degenerative changes in the lumbosacral spine require immediate treatment. They often cause a person's disability. This is worth remembering.

Possibilities for treating degenerative changes in the spine

Current options for effective treatment of degenerative changes in the spine are extremely limited. Special medications (chondroprotectors) have been invented that can restore the structure of damaged cartilage. But the difficulty lies in the fact that if the diffuse exchange between muscles and cartilage discs is disrupted (which is the cause of degeneration), it is impossible to deliver these substances to the site of pathology. There is no point in spending huge sums of money and injecting chondroprotectors until normal diffuse nutrition is restored.

And manual therapy with its comprehensive approach can really help with this. Our clinic has a huge number of practical cases of complete recovery. There is documentary evidence of the complete elimination of diffuse degenerative and dystrophic changes in the tissues of the spinal column after courses of therapy.

An individual approach is used. Depending on the existing problem, the patient is recommended reflexology, osteopathy, massage, kinesitherapy, spinal traction and therapeutic exercises. Significant relief is achieved after 2-3 sessions.

We invite you to sign up for a free consultation with our specialist. During the appointment, the doctor will conduct an examination, review the results of the MRI examination and talk about all the prospects for treatment.

Degenerative-dystrophic changes in the lumbosacral spine are the slow destruction of the tissues of the intervertebral discs of the lower back. They stop receiving nutrition, become dehydrated, become dry and lose elasticity. Excess weight and sedentary work lead to weakened back muscles and excess weight. As a result, the spine puts pressure on the intervertebral discs, and their structure becomes deformed.

Disc pathologies are dangerous because, as a rule, they can only be detected at critical moments. Preventive measures will no longer be able to help, and the patient will have to take medications and attend various medical procedures. But treatment alone may not be enough. After all, in order to improve the condition of the spine and prevent the development of serious complications, you need to reconsider your daily life as a whole.

What are degenerative-dystrophic changes in the lumbosacral region? To understand, let’s understand how intervertebral discs are structured. These peculiar springs of the spine consist of cartilage tissue. On top they are covered with a denser fibrous ring, and inside there is a nucleus pulposus. Discs are normally quite soft and elastic - because they ensure the mobility of the spine.

When the muscles can no longer withstand the load, they transfer it to the vertebrae. The spine is compressed, the discs experience pressure that they were not designed to withstand. The cells of their soft cartilage tissue begin to die.

Intervertebral discs can also weaken and become deformed because the nutrition of their cartilage tissue is impaired. This can happen due to the fact that the vertebrae reduce the distance between themselves and compress the blood vessels and capillaries. Or an inflammatory process or lower back injury led to the same consequences.

The risk factors are as follows:

Sudden movements, heavy lifting;
Inflammatory processes;
Sedentary work;
Cold and drafts;
Unhealthy food;
Professional sports;
Disturbed hormonal levels;
Elderly age;
Pathologies of metabolic processes;
Traumatic injuries of the vertebrae.

Most often, people who move very little and are overweight suffer from problems in the lumbar spine. Usually the spine stabilizes the muscles, but if the muscles are weakened and excess weight constantly burdens the back, even light household loads cause deformation of the discs. Modern lifestyle, as we see, increases the risk of developing dystrophic changes in the lumbar region.

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Progression of pathology

It is in the lumbosacral region that the lion's share of tension occurs; it is here that the intervertebral discs are most often deprived of the necessary nutrition. Cartilage tissue loses nutrients, regenerates worse, and ceases to be elastic.

The fibrous ring becomes fragile, the nucleus pulposus sharply loses moisture and dries out. As a rule, more and more loads are placed on the lower back at the same time, and the space between the vertebrae narrows even more. Excess tissue of the lumbar discs protrudes from the boundaries of the spinal column - this is called protrusion. And when the fibrous ring around the disc breaks its structure and ruptures, the result will be first the pulp coming out of the disc, and then the disc itself from its place in the spine. This is called a herniated lumbar spine.

Protrusions and hernias pinch, compress the nerves, and severe pain occurs. The body turns on the immune system to protect itself from the source of pain. As a result of this protection, inflammation and swelling form in the lumbar region, preventing the patient from living a normal life.

Degenerative-dystrophic changes in the lumbar spine develop unnoticed, and when it is too late to engage in prevention, they strike the patient. Even if you are lucky and no protrusion or hernia has formed, a person can suffer consequences such as osteochondrosis or radiculitis.

Symptoms

Unfortunately, until the lower back disease puts the patient’s performance at risk, the person is basically unaware of the disease. It is not the degenerative process itself that has symptoms, but its complications and consequences.

You should respond to the following sensations by visiting a neurologist or vertebrologist:

Stitching, burning or dull pain in the lower back;
The appearance of pain after exercise;
Pain after being in one position for a long time;
Difficulty performing certain movements, such as bending or turning;
Weakness in the legs;
Difficulty urinating, constipation;
Cold skin of the lumbar region;
Loss of mobility, especially in the morning;
Violation of body symmetry;
Swelling and red skin in the lumbar region.

There are four stages in the development of this pathology of the lumbosacral region:

At first, symptoms appear very rarely. True, often after physical activity people experience dull pain and stiffness in the lumbar region. But this is almost always attributed to fatigue;
In the second stage, symptoms appear. It is much more difficult to move the back; it is difficult for the patient to bend or turn. It “shoots” in the back, that is, radiculitis is talking about itself. Compressed nerves may cause tingling in the pelvis and legs. A feeling of “goosebumps” appears;
The third stage is acute. Blood vessels are pinched, the metabolism of the lower back muscles is sharply disrupted, which leads to their ischemia. The pain is getting worse. The legs go numb, they are pierced by cramps;
The fourth stage is diagnosed if the spinal cord and its nerve roots are deformed. This can cause your legs to become paralyzed.

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Diagnostics

Diagnosis of degenerative-dystrophic changes in the lumbosacral region is carried out in three stages:

A medical history is compiled, symptoms and usual conditions for the onset of a painful attack are indicated;
The doctor examines the patient for signs of tissue degeneration of the lumbosacral region - studies the level of mobility, muscle strength, areas of localization of pain;
An MRI is performed. She will find evidence that the patient is experiencing dystrophic changes in the lumbosacral region of the spine. Find physiological reasons that ultimately led to the development of pathology.

If a degenerative process in the lower back is indeed observed, then an MRI will certainly show that the symptoms are making themselves felt for one of the following reasons:

The intervertebral discs were deformed by more than half;
The discs are just beginning to deform, for example, the level of moisture in them is reduced;
The fibrous ring is already beginning to collapse, cartilage tissue cells are dying;
The annulus fibrosus is ruptured and the nucleus pulposus begins to leave the disc. That is, a hernia of the lumbosacral region has developed.

You may also need:

Blood tests;
X-ray examination;
CT scan.

However, an x-ray will not show signs of a pathological process at an early stage. CT scans and MRIs look much deeper into the spine. But unfortunately, these diagnostic methods are usually resorted to only when the problem has already made itself felt.

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Treatment

First, doctors prescribe conservative treatment: various painkillers, warming ointments, physical therapy and massage, manual therapy, acupuncture. And only if these methods do not help, do they decide on surgical intervention.

Drugs

First of all, it is necessary to relieve pain, allow the patient to move and regain functionality. For these purposes, non-steroidal anti-inflammatory drugs (Diclofenac, Movalis, Nise) and painkillers (Ketonal, Ketanov) are used. Medicines are used orally, externally, or by injection. In particularly difficult situations it is possible.

To relax tense muscles of the lumbosacral region, muscle relaxants (Sirdalud, Mydocalm) are prescribed.

They need to be consumed intermittently, as over time they weaken the muscles. Chondroprotectors activate the regeneration of cartilage tissue and joints. Vitamin and mineral complexes will also help the body recover. B vitamins work best.

Exercise therapy and massage

Massage and physiotherapeutic procedures will improve blood circulation in the problematic lower back, relax the muscles, and provide nutrition to depleted tissues. Therapeutic exercise will improve metabolism and pump blood into the lower back, helping to lose excess weight. Properly planned physical activity strengthens the lumbar muscles. They will again have enough strength to take the load off the spine. The main thing is that stretching exercises will increase the distance between the vertebrae of the lower back and release compressed nerves. The inflammatory process and pain syndrome will disappear. Swimming is especially beneficial. Exercises in the pool not only strengthen the muscles, but also smoothly stretch the lumbosacral spine. This way you will treat not only the pain, but also its causes.

Losing weight will remove constant excess stress from the lower back. But you can’t just lose weight - you must make sure that the patient’s diet contains the B vitamins and calcium he needs.

Operation

Fortunately, in most cases, the patient's condition will be alleviated by conservative treatment. Surgery is necessary only if the disease continues to progress, ignoring all attempts by doctors and the patient to stop it. During the operation, devices that support the lumbar spine will be installed. This will help relieve pressure from the spine and prevent the intervertebral discs of the lower back from deforming further. Another case requiring surgical intervention is a severe lumbar hernia with a disc protruding from the boundaries of the spine. The pulp that has left the disc is pulled out, like fat during liposuction, or burned off with a laser.

Chiropractor, traumatologist-orthopedist, ozone therapist. Methods of influence: osteopathy, post-isometric relaxation, intra-articular injections, soft manual technique, deep tissue massage, analgesic technique, craniotherapy, acupuncture, intra-articular administration of drugs.

Degenerative-dystrophic changes in the spine are observed in 80% of the adult population of the planet. They worsen the quality of life and lead to the development of serious complications. How to avoid pathologies?

Take any person: everyone has suffered from lower back pain at least once in their life. Medical statistics say: 20% constantly complain of lumbar pain, and 1-3% require surgical treatment.

The lumbosacral region is the center of gravity of the body; it takes on all the loads accompanying any movement of the human body. Sometimes these loads exceed permissible limits, temporary changes and deformation of cartilage tissue 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. Calcification of a certain area of cartilage tissue begins. These are degenerative-dystrophic changes in the spine.

For degenerative changes to move into an irreversible phase, a lot of time must pass. And this time the disease plays out in a person, due to the fact that the disease does not manifest itself immediately.

Pronounced symptoms show themselves when time is lost, and the degenerative changes themselves have become large-scale and irreversible.

The medical term “degenerative-dystrophic changes in the spine” summarizes several diseases:

The clinical picture of changes may vary, depending on which spinal structures are damaged and how serious the damage is.

Symptoms of the disease appear as degenerative-dystrophic lesions develop, but in 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 long walking and physical activity, prolonged sitting in one position, and bending. The pain syndrome is wave-like: it arises, then decreases, and disappears.

The progressive degenerative process in the intervertebral discs of the spine can lead to serious and dangerous complications.

Degenerative changes develop in stages:

The first symptom that “screams” about the presence of pathological changes in the lumbar spine is a pronounced pain syndrome in the lower back. The pain is so noticeable that the patient is forced to limit his movements, and this significantly reduces the normal standard of living and performance.

Complaints of pain directly depend on the location of the lesion.

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

severe mobility limitations; “lumbago” that occurs in the lower back; tingling and goosebumps in the limbs and buttocks.

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

At the third stage, blood circulation is disrupted 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 extremities; convulsions.

Degenerative pathological processes of the spine that have not received proper treatment at the fourth stage of development are fraught with paralysis and paresis. These complications arise due to complete disruption of the blood circulation of the spinal cord.

The human body is a delicate and calibrated mechanism. It is determined by nature itself that the load on the human spine should be distributed evenly. A healthy spinal column can withstand both jumping and heavy lifting. But all this works only when a person watches his posture and has a strong muscle corset. The modern lifestyle is sedentary. And this leads to weakening of the muscle corset and weight gain.

Sedentary work contributes to the appearance of degenerative changes in the spine.

According to research, the human spine is in a bent position 75-80% of the time: the intervertebral discs become less elastic, and the vertebrae become deformed.

Due to degenerative changes, intervertebral discs lose moisture, cracks and all kinds of ruptures form in them. This contributes to the appearance of intervertebral hernias. When the load changes, the vertebrae try to increase their area, grow, and become increasingly thick, pinching the adjacent nerves.

Reasons that provoke pathological changes:

constant or sudden loads; active sports with heavy loads; injuries; natural aging; inflammatory diseases of the spine; poor nutrition.

Degenerative-dystrophic changes in the lumbar 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 very dire, including disability due to impaired motor activity.

Treatment of diseases of the lumbar region is considered complete and promotes recovery if after treatment the following is observed:

reduction or disappearance of pain; relieving muscle tension in the lumbar region, 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 lumbar sensitivity;

To achieve the above results, proper treatment is necessary. Specialists prescribe complex therapy using the latest achievements of modern medicine. For the treatment of degenerative changes in the lumbosacral spine, the following is prescribed:

drug therapy; physiotherapy; massage, therapeutic exercises, manual therapy; acupuncture, acupuncture; in extremely severe cases - surgical intervention.

From all of the above, it follows that diseases of the lumbosacral region can be overcome in several ways. But it is better not to allow irreversible pathological processes to occur. You should consult a doctor on time, monitor your health, and lead a correct lifestyle.

To understand the nature of the development of degenerative-dystrophic changes in intervertebral discs, it is very important to understand the reasons for the appearance of such processes. The fact is that the human body is a proven mechanism that can withstand colossal loads, but under the influence of various kinds of unfavorable factors, a weakening of the natural defense mechanisms is observed, which leads to a rapid breakdown of the integrity of cartilaginous structures. Modern lifestyle plays an important role in disrupting the trophism of intervertebral discs. Thus, the following triggers contribute to the development of degenerative changes in the spine:

sudden loads; inflammatory diseases; passive lifestyle; hypothermia; poor nutrition; active sports; hormonal disorders; diseases of the endocrine system; normal aging process; metabolic disorders; old and recent spinal injuries.

Most often, degenerative-dystrophic changes in the spine are observed in people who lead an extremely sedentary lifestyle and at the same time have an unhealthy diet. The fact is that normally the load on the spinal column is distributed evenly, and a developed muscular frame provides significant support to it. People who lead a sedentary lifestyle and have excess fat deposits, as a rule, have poorly developed muscles, so even the slightest strength exercises lead to serious overload of the intervertebral discs. In this case, the muscular frame can no longer take on part of the load during movement, which contributes to the rapid appearance of degenerative-dystrophic changes.

The influence of other unfavorable factors and their combinations also affects the condition of the spinal column, so in most cases it is extremely difficult to determine what exactly was the impetus for the appearance of such disorders in the cartilage tissue of the intervertebral discs. At the same time, understanding the cause of the appearance of such a pathological condition as degenerative-dystrophic changes in the spine allows us to take effective preventive measures.

It is now well known how degenerative-dystrophic changes in the lumbar spine develop. The spinal column in the sacrum and lower back bears the greatest load during any movement and even while sitting. Due to the influence of overloads, as well as other unfavorable factors, in the area of the intervertebral discs of this department, a disruption of the nutrition of cartilaginous tissue is primarily observed. There are no blood vessels directly in the intervertebral discs that could feed it directly, so often the first appearance of nutritional disturbances in the soft tissues surrounding the spinal column is observed. In the absence of the proper level of nutrition of the intervertebral discs, cartilage tissue begins to gradually deteriorate, losing elasticity.

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The second stage in the development of degenerative-dystrophic changes is the thinning and weakening of cartilage tissue. At this time, there is a gradual drying out of the cartilage, which leads to a slow decrease in the height of the intervertebral discs. Due to the destruction of the fibrous membrane, various protrusions, that is, disc protrusions, can occur. With critical destruction of the tissue of the fibrous ring, its rupture may occur, which in the vast majority of cases leads to the exit of the corpus pulposus beyond the intervertebral disc and the appearance of a hernial formation. Such protrusions inevitably entail changes in the proportions of the vertebrae and pinching of the nerve roots extending from the spinal cord.

In response to a violation of cartilage tissue, activation of the immune system is observed, the cat’s cells begin to produce prostaglandins, that is, substances that are inducers of the inflammatory process. Due to the production of these substances, there is an increase in blood supply and swelling of the soft tissues surrounding the spinal column, which is often accompanied by the appearance of even greater stiffness of the lumbar spine and pain in the affected area. Degenerative-dystrophic changes in the lumbosacral spine, as a rule, are characterized by slow progression and chronic course. In the future, dystrophic changes in the lumbar spine can become a springboard for the development of a number of dangerous diseases and complications, including osteochondrosis, radiculitis, etc.

In the vast majority of cases, patients cannot independently determine the onset of the development of degenerative-dystrophic changes, since at the initial stages of this pathological process there are usually no pronounced symptoms. In fact, there are 4 main stages of development of degenerative-dystrophic changes, each of which has its own characteristic features. At the initial stage, obvious symptoms that may indicate to a person without medical education that there are spinal problems may not be observed.

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However, often at this stage of the process severe dull pain in the lower back may occur after increased physical activity. In addition, some people report some stiffness in the lower back.

At the 2nd stage of the disease, severe symptoms may be observed. First of all, in people with this stage there is a serious restriction in the mobility of the spine; with any flexion, so-called “lumbago” may appear, that is, attacks of radiculitis. Patients may complain of tingling and pins and needles sensations in the buttocks and lower extremities.

At the 3rd stage of development of degenerative-dystrophic processes, the disease passes into the acute stage, since at this time there is compression of the radicular blood vessel and disruption of the nutrition of the soft tissues surrounding the spinal column, which leads to their ischemia. The physical manifestations of this stage include increasing pain, frequent cases of numbness of the lower extremities and cramps.

When degenerative-dystrophic processes of the spine enter stage 4, damage to the spinal cord and its branching roots may occur, which can lead to paresis and paralysis of the lower extremities. As a rule, such complications are a consequence of compression damage to the spinal cord or disruption of its nutrition.

In most cases, patients with degenerative-dystrophic processes in the lumbar spine come to the doctor in the later stages, when the symptoms manifest themselves quite intensely, preventing the person from leading a full daily life. Diagnosis of this pathological condition begins with a detailed analysis, examination of the lumbosacral spine and palpation.

As a rule, an external examination is not enough to assess the presence of pathological changes in the intervertebral discs and their extent. To confirm the diagnosis, a number of studies using modern medical equipment are required. Such studies include:

general blood analysis; radiography; computed tomography: magnetic resonance imaging.

Despite the fact that radiography is a publicly available diagnostic method, it is at the same time considered the least accurate and informative, since in the early stages of pathology development it does not allow identifying existing degenerative changes in the lumbosacral spine. CT and MRI are more reliable and modern imaging tools, so they can detect existing abnormalities even in the early stages. With MR, the picture allows us to notice the existing degenerative-dystrophic changes in the thoracic or lumbar spine, even if they are extremely weakly expressed. Thus, MRI is the most accurate modern diagnostic method.

Due to the fact that most people lead a sedentary lifestyle, dystrophic changes in the lumbosacral spine are one of the most common pathologies. The complexity of the phenomenon lies in the fact that the intervertebral discs do not have a direct blood supply, and, as a result, are not capable of independent regeneration. This pathology occurs in almost every 3rd person over the age of 30 years. Moreover, almost all people over 60 years of age have this phenomenon.

A significant role in the process of deformation is played by the fact that it is extremely difficult to detect the development of pathology at the initial stage.

Such a pathology as dystrophic degenerative changes in the lumbosacral spine is a process characterized by the gradual destruction of intervertebral discs in the lumbar region. The main destruction occurs due to loss of elasticity and dehydration of tissues, against the background of a deficiency of nutrition of these elements.

A significant role in the process of deformation is played by the fact that it is extremely difficult to detect the development of pathology at the initial stage. The phenomenon noticeably makes itself felt already at the stage of serious destruction, most often not amenable to simple conservative treatment.

Reasons for the development of pathology

Degenerative changes in the lumbosacral spine can occur due to a number of reasons. The main ones are:

Sedentary lifestyle. The almost complete absence of regular loads on the lumbar spine leads to a gradual weakening of the muscles located around. As a result, they become unable to withstand even minor loads.
Intense sports with excessive stress on the body. Quite often, the onset of destructive changes in the lumbosacral region comes from lifting significant weights and as a result of sudden movements with insufficiently warmed muscles.
Various mechanical injuries, including birth injuries.
An incorrect principle of nutrition, as a result of which the body does not receive a sufficient amount of elements useful for metabolism. Often the patient is obese, which also has an extremely negative effect on the condition of the spine.
The presence of inflammatory processes in the spine. These include many diseases such as ankylosing spondylitis and arthritis.
Severe hypothermia.
Age-related aging of the body, during which there is a persistent leaching of beneficial components from bone and cartilage tissues. With this type of pathology, surgical intervention is not performed, and the general condition of the patient is maintained with the help of special medications and physical therapy methods.

During the manifestation of dystrophic changes in the lumbosacral spine, pain always occurs. Its appearance in this case is a consequence of excessive mobility of individual vertebrae, and also occurs when the hernia puts pressure on the nerve processes located in the interdisc space.

Symptoms

The development of pathology in the sacral spine is accompanied by fairly clear symptoms that appear during the period of exacerbation. When degenerative processes become chronic, signs of the disease often take on the character of muted discomfort.

The main symptoms of destructive-dystrophic manifestations in the lumbosacral spine are:

pain manifested in the lumbar region. In this case, there may be a transition of painful sensations to the buttocks and legs. The pain itself is aching and dull;
complete or partial decrease in the sensitivity of the skin in the area of the damage;
tingling sensation in the legs;
persistent disruption of the pelvic organs, accompanied by urinary incontinence, problems with defecation, as well as reproductive function and potency in men;
feeling of weakness in the legs;
severe limitation in the mobility of joints and individual parts of the body;
redness of the skin in the area of spinal injury, accompanied by a local increase in body temperature;
swelling.

Diagnostics

One of the most characteristic symptoms that manifests itself with dystrophic changes in the lumbosacral spine is a slight change in gait and asymmetry of the gluteal muscles.

It is extremely difficult to determine the initial process of degenerative dystrophic changes in the lumbosacral spine. Most often, it is detected during a comprehensive examination using a magnetic resonance imaging device. To make and confirm the diagnosis, the patient must consult a neurologist.

The process of diagnosing pathology includes two stages. The first is an examination by a doctor, as well as an analysis of complaints and palpation of the disturbing area of the back. The second stage includes the collection of general tests and examination with diagnostic equipment. So to confirm the diagnosis it is necessary:

take a general blood and urine test to determine the condition of the patient’s body as a whole;
donating blood for biochemistry. The procedure allows you to identify special markers indicating inflammatory processes inside the body;
taking an x-ray that can demonstrate obvious destructive disorders of the spine;
CT examination;
MRI diagnostics.

Although the use of X-rays allows one to see degenerative changes in the lumbosacral spine, this pathology can only be clearly seen at an extremely late stage. That is why CT and MRI examinations, despite the high cost of the procedures, are a higher priority. It is these devices that allow us to examine in detail the extent and location of damage.

Treatment

The selection of treatment is based on the degree of destruction of the intervertebral discs during dystrophic changes in the lumbosacral spine. Therapy can be conservative or using surgical methods.

Conservative treatment of pathology involves:

prompt relief of symptoms of pain and elimination of inflammation using medications based on ketoprofen, ibuprofen, diclofenac and indomethacin;
restoration of damaged tissues with the help of chondroprotectors, muscle relaxants and B vitamins;
the use of physiotherapy methods, including therapeutic massage, visiting a physical therapy room.

The process of treating dystrophic changes in the lumbosacral spine also requires maximum unloading of the body with adequate nutrition. That is why, with this type of pathology, it is very important to follow a diet.

The surgical method of treatment is used strictly in the absence of the desired effect from the conservative technique. The operation is also performed in cases of serious damage to the disc or vertebrae that cannot be restored naturally.

Since such a phenomenon as dystrophic changes in the lumbosacral spine is an extremely serious pathology, its analysis and the prescription of effective and safe treatment are carried out strictly by the attending physician.

Degenerative-dystrophic changes in the lumbosacral spine are the result of a complex effect of negative factors on the body. In most cases, degenerative-dystrophic changes are a consequence of inflammatory pathologies and previous injuries. Degenerative changes are a whole complex of various diseases that are connected by a common pathological mechanism affecting cartilage tissue. As a result, the spine suffers significantly, the patient experiences constant pain, which can ultimately lead to disability.

Degenerative-dystrophic changes in the spinal-sacral area are not a specific diagnosis, but a whole group of different pathologies that provoke the syndrome. During traumatic effects and inflammatory processes, bone tissue is rebuilt. Destructive changes in bone begin slowly and tend to progress. Only when exposed to a traumatic factor, changes appear rapidly and are associated primarily with disruption of tissue trophism as a result of damage.

In some cases, pathological changes in the spine in the lumbar and sacral areas occur under the influence of a hereditary factor, and also arise due to improper work and rest regimes. The real scourge of the 21st century is physical inactivity and excess body weight. All these factors negatively affect the spine and disrupt the structure of the intervertebral discs.

Appearance mechanism

The intervertebral disc is a key figure and an important structural element of the spinal column. It is the disc that serves as a shock absorber, a kind of elastic pad between the vertebrae, allowing them to maintain a physiological distance between themselves to ensure the normal functioning of the body.

REFERENCE! The disc has a complex structure; in the center of the disc there is a nucleus pulposus, and around its circumference it is limited and protected by a fibrous membrane.

With strong pressure on the spinal column, its elements - the vertebrae - begin to diverge, shifting relative to each other. In this case, the intervertebral disc feels the greatest pressure from the vertebrae from all sides - below and above. The pressure of the bone tissue is so great that the disc cannot withstand such pressure and begins to collapse; changes occur both in the pulp and in the fibrous membrane itself.

Pathological effects lead to changes in biochemical processes and a significant reduction in the volume of blood circulating in the spinal zone. This situation not only leads to destruction of the vertebrae in the lumbosacral region, but also generally negatively affects the condition of the body. As a result of research, doctors have identified several names of diseases that are included in the group of degenerative-dystrophic changes:

osteochondrosis;
spondylosis;
protrusion;
intervertebral hernia.

All these diseases, one way or another, are associated with disc pathology. In the lumbosacral region, intervertebral discs often suffer, since a large load is distributed over these sections. Intervertebral discs are deprived of blood supply, so they are restored from their own connective tissue cells. Nutrition here occurs indirectly, so degenerative changes occur much more slowly.

Causes

There are several reasons why degenerative-dystrophic changes can develop in the lumbosacral region. The first reason is inflammatory pathologies of the spine. Usually this is a non-septic inflammation that appears due to the irritating effect on the nerve endings of the substance from the destroyed disc.

Hypermobility of the vertebrae can also provoke initial pathological changes in the spinal column. With excessive dynamism, the surface of the vertebrae shifts relative to each other, abrasion of the cartilage tissue and the surface of the intervertebral disc occurs. They shrink and become unable to cushion the vertebrae. All this leads to subsidence of the vertebrae and squeezing of the intervertebral disc from its anatomical position.

Both causes are related to the movement of the vertebrae and damage to the nerve endings. In this case, patients suffer severe pain in the lumbar region, and if the pain is endured and no measures are taken for treatment, complete paralysis can occur.

With degenerative-dystrophic changes in the late stage, the intervertebral disc may completely disappear.

In addition to the reasons that directly lead to the appearance of degenerative-dystrophic changes, it is worth pointing out a number of factors that provoke damage to the spinal column. Among the reasons we note:

lifting weights;
active sports with increased load on the lumbosacral region;
excess weight;
sedentary lifestyle;
age factor (pathology usually manifests itself in patients over 60 years of age, mainly in women);
sudden power loads with a weak muscle corset;
sedentary work;
stoop and other curvatures of the spinal column;
spinal injury;
problems with the functioning of the gastrointestinal tract, as a result of which calcium is poorly absorbed and its deficiency provokes problems with bone tissue, leading to its destruction;
calcium deficiency in the diet;
hypothermia of the back;
hormonal changes;
thyroid dysfunction;
inflammatory pathologies.

Symptoms

Typically, a negative factor leads to the onset of destructive changes in the spine by about 30–50 years of age. At this age, patients do not yet experience alarming symptoms, since compensatory mechanisms play a role. But in the process of aging of the body over the age of 50, more than 60 percent of patients experience symptoms of degenerative changes.

Not all degenerative-dystrophic changes in the lumbar region give early symptoms - this is the main problem that doctors face when diagnosing and treating such pathologies. That fertile time is missed when the disease has just begun to develop and the patient can be helped in a conservative way.

IMPORTANT! The latent stage of the disease creates an imaginary appearance of relative health, and the patient does not even suspect that he is already suffering from similar disorders.

As the pathological processes worsen, patients begin to experience sudden feelings of anxiety in the back. Pain in the lower back and coccyx area is the most common and most disturbing sign of pathological changes in the spine. Pain may appear in the lower back or radiate to the buttock or thigh.

At the initial stage, discomfort appears from time to time, but as the disease progresses, pain constantly accompanies the person. At first, the pain is well relieved with medications, but after a while the drugs lose their ability to help patients. The nature of the pain also changes - usually at the initial stage the pain is mild, aching in nature. At the same time, as the pathology intensifies, stabbing and shooting pains appear.

Pain in the spine first appears when the intervertebral disc is compressed; the severity of the pain depends on the time factor - the longer the disc is compressed, the stronger the discomfort will be. For example, discomfort occurs when standing for a long time or sitting in an uncomfortable position. Then the aching pain becomes acute: when you try to turn or bend over, you can feel a sharp stabbing in the back. There will also be discomfort when lifting some objects.

If the cause of dystrophic changes is an intervertebral hernia, then the pain in the back becomes more pronounced: the back in the lower back begins to burn, multiple tingling, numbness, and coldness in the legs may appear. Even walking can cause lower back pain in patients. If the nerve endings are compressed, doctors will diagnose sciatica.

In addition to immediate signs in the back, degenerative-dystrophic changes also provoke disturbances in urination and problems with defecation. This can include both urinary incontinence and constipation. If the nerve endings are damaged, pain can be felt along the entire length of the spine, rushing from the lower back to the neck.

An irresponsible attitude towards your health can lead to serious complications. One of the most common is spinal canal stenosis, as well as the formation of hernial protrusion and protrusion. If you do not seek medical help promptly, such complications can seriously deteriorate a person’s health.

Diagnostics

Diagnostics for identifying degenerative-dystrophic changes in the lumbar and coccyx areas is complex. Along with the simplest techniques, modern technologies are also used to help more accurately determine the nature of the lesion. At the first visit, the doctor listens to the patient’s complaints and conducts a visual examination. It is important to know whether the pain was associated with previous injuries or surgical interventions.

And the doctor will also palpate the painful area, pay attention to the position of the vertebrae and various types of protrusions. Then an x-ray examination is prescribed. The patient is photographed in two projections - front and side to see degenerative changes in the spine. Usually an x-ray is sufficient to make the initial diagnosis. For a more detailed diagnosis, a magnetic resonance imaging study is recommended.

MRI

Magnetic resonance imaging is performed absolutely painlessly; it is a non-invasive study that allows using magnetic waves to obtain a three-dimensional image of the area of interest.

The most accurate diagnostic results can be obtained using MRI.

In terms of the value of the data obtained, an MRI image is much superior to an X-ray, since it allows one to obtain the most accurate results. This is extremely important for degenerative-dystrophic changes in the lumbosacral region.

Thanks to a high level of detail, you can see the cause of the pathology, identify the degree of its development and plan a course of therapy. And magnetic resonance imaging also gives an overall picture, allowing you to see how the pathology affected the surrounding tissues. Degenerative-dystrophic changes in the spine in the lumbar region are diagnosed if the following signs are present:

destruction of half or more of the fibrous ring and pulp of the intervertebral disc;
loss of moisture from the disc substance (on MRI, areas with the greatest loss of moisture appear darker);
if there is destruction of the end plate of the intervertebral disc (looks like a dark stripe);
disc ruptures or cracks;
intervertebral hernia, as a result of which the disc seems to be squeezed out by the vertebrae, squeezing it from above and below;
protrusion - subsidence of the vertebrae, pathological rapprochement.

Typically, dystrophy is observed mainly in the area of the vertebral region; in the coccygeal region such changes are rarely diagnosed. The lumbar region suffers mainly from overload, but the tailbone is usually injured when falling, for example, during icy conditions.

Treatment

For degenerative-dystrophic changes in the lumbosacral region, therapy is carried out predominantly conservatively. According to statistics, only five percent of patients require surgical treatment. First of all, doctors recommend medications designed to relieve the inflammatory process and eliminate pain.

Another task of medications is to establish nutrition for the tissues of the lumbosacral region and restore trophism in the damaged area. And physiotherapy and exercise therapy are also expected.

The following medications are used for therapy:

muscle relaxants - drugs for relieving muscle spasms, which help relax muscles, activate blood circulation and eliminate pain;
non-steroidal anti-inflammatory drugs - drugs to block the inflammatory process and relieve pain;
B vitamins – means for activating blood circulation and tissue nutrition;
chondroprotectors - chondroitin, collagen and glucosamine, which are building elements for cartilage cells - chondrocytes;
sedatives – used to relieve pain when the above remedies are ineffective.

REFERENCE! Medicines are predominantly in tablet form, but injections or topical medications may be offered.

The most effective injections, but when using gels and ointments, an average of 10 to 25 percent of the product is absorbed. To relieve severe pain, patients can be given novocaine blockades.

Physiotherapeutic treatment and massage have a significant positive effect. During treatment, it is recommended to wear a special corset to support the back. All procedures prescribed by the doctor also affect the site of pain, but only mechanically - using an electromagnetic field and currents. Among the physiotherapeutic techniques that most effectively relieve symptoms of pathology:

electrophoresis;
laser therapy;
magnetic therapy;

In parallel, patients are recommended detensor therapy and physical therapy. Detensor therapy is done using a special device - a detensor. Outwardly, it looks like a mattress with stiffeners that bend under the weight of the human body.

In turn, the protruding ribs of the detensor help restore the normal position of the vertebrae. As doctors note, during a session of detensor therapy, patients “grow” by 0.5–1 cm, and consequently, the distance between the vertebrae increases and compression is relieved from the intervertebral disc.

Therapeutic physical education is developed individually depending on the patient’s age and the ability to perform certain exercises. When performing a set of exercises, you can strengthen the muscle corset, stabilize the position of the vertebrae and counteract their increased mobility. Exercises can be performed both in a clinic under the supervision of a doctor, and at home, having mastered a complete treatment course.

Prevention

Degenerative changes in the lumbar region are easier to prevent than to treat, so doctors insist on early prevention of spinal pathologies.

In order not to become hostage to dystrophic changes, you need to follow a few simple rules:

monitor body weight and avoid excess weight;
give the body a daily feasible load, and if it is impossible to do gymnastics, at least take walks for 20–30 minutes a day;
swim more often, since during swimming all muscle groups are involved, and there is no load on the spine in the water;
When working with heavy objects, follow safety precautions and use safety belts;
avoid increased stress on the back, for example, in sports;
If you have back pain, consult a doctor in a timely manner;
patients with sedentary work once every six months (or more often - on the doctor’s recommendation) undergo courses of massage and manual therapy;
avoid hypothermia;
Eat a balanced diet and include enough foods containing calcium in your diet.

During the cold season, it is necessary to protect yourself from falls in many places on the road. Women are recommended to take hormonal medications during menopause, since when hormone levels change, the condition of bone tissue sharply worsens. And it is also necessary to promptly treat all inflammatory diseases.

The most important

Degenerative-dystrophic changes in the lumbosacral region of the spinal column occur gradually and do not make themselves felt for a long time. The cause of the pathology is predominantly inflammatory diseases or traumatic injuries. In most cases, pathologies are manifested by diseases such as osteochondrosis, spondylosis, spondylarthrosis, protrusion, etc.

Diagnosis is made using x-rays, but MRI is crucial. Based on the research results, treatment is prescribed - drug therapy, physiotherapy and exercise therapy. Prevention of violations plays an important role.