- reasons spondyloarthrosis
- Symptoms Diagnosis and treatment
Under spondyloarthrosis lumbar spine (lyumboartroz) refers to a chronic disease of the spine, which is due to degenerative processes in the joints of the spine.It should be noted that in most cases (90%) of the disease in patients registered age, whereas 10% of cases, this diagnosis is young people aged 20-35 years.
In this disease degenerative processes begin with cartilage gradually loses its elasticity, after which the process extends to the joint capsule.In the latter stages of the bone affected areas, located near the joints.As a result of degenerative changes produced spinous bony outgrowths.
as causes of the development of the lumbar spine spondyloarthrosis can act:
- congenital anomalies of the spine;
- various spinal injuries;
- spondilolizis or spondylolisthesis;
- instability or hypermobility of the vertebrae;
- simultaneous degenerative intervertebral disc lesions that develop in osteochondrosis;
- metabolic disorder;
- low physical activity.
Moreover, decided to allocate aggravating and predisposing factors:
- gender (women are more likely registered a similar pathology, than men);
- age (it is characteristic for the elderly);
- professional activity (bad posture, or increased loads on the spine);
- long athletic exercises;
- increased or overweight;
- lyumbalizatsiya (at the expense of the first sacral vertebra, an additional 6 in the lumbar spine);
- sacralization (fusion of the sacrum and the fifth lumbar vertebra);
- violations formation of vertebral arches;
- violations emanating from the fusion of the vertebral bodies and arches;
- violation articular tropism (asymmetric position dugootroschatyh joints).
should be noted that in most cases the ultimate reason for the development is not possible to find out spondyloarthrosis.However, according to current research refers to the pathology multifactorial category under which combined several reasons, in particular environmental influences and genetic predisposition of the organism.
to main symptom spondyloarthrosis lumbar spine include chronic pain in the spine.The pains are aching in nature, and periodically aggravated, while the pain may radiate to the thighs and buttocks.In contrast, osteochondrosis in spondyloarthrosis usually not observed neurological symptoms of numbness of extremities, weakness therein.In addition, minor pain after a workout pass.
should be noted that emit several types of pain:
- mechanical pain that occurs during prolonged stress on the joints of the vertebrae;
- blockade pain due to compression of the nerve roots due to overgrown osteophytes;
- start of pain arising from the sharp change in body position;
- joint pain which is sometimes quite strong.
for the disease and is characterized by morning stiffness, the duration of which can range from 20 to 60 minutes.to the content ↑
Diagnosis and treatment
For diagnosis spondyloarthrosis lumbar spine doctor is mandatory:
- holds spine palpation and muscles, during which the celebrated muscle tension (in some cases possible to establish palpation fusion of the sacral and lumbar vertebrae);
- conducts diagnostic blockade;
- appoint MRI, CT, and radionuclide scan of the spine, at which it is possible to identify an inflammation of the facet joints.
Today, for the treatment of lumbar spine spondyloarthrosis highly developed treatment strategy, which allows to achieve remission, depending on the age and general condition of the patient and stage of the disease.
Treatment means itself:
- drug therapy;
- traction therapy, suggesting spinal traction;
today of great importance in the treatment of this pathology is given physical therapy, which should be sparing in the elderly patient.The course is 10-12 sessions, session duration of 5-50 minutes.
main objectives of physical therapy:
- decrease in lumbar lordosis;
- pelvis position correction;
- strengthening muscular frame.
In addition to physical therapy appointed massage and swimming.
- ionogalvanizatsiya with analgesic drugs (lidocaine and procaine);
- phonophoresis with hydrocortisone;
- sinusoidal modulated currents.
should be noted that the procedure of acupuncture is to deal only with the specialist who is fluent in this methodology.Otherwise, damage from treatment will be greater than the positive effect.
in drug therapy are of paramount importance so-called chondroprotectors, which include glyukozaminosulfat and chondroitin sulfate.The drugs stimulate the regeneration of cartilage, preventing them from degeneration.
for pain relief and to reduce inflammatory responses in the spine are used NSAIDs, among which quite often prescribed nimesulide, diclofenac, ketorol, ibuprofen and piroxicam.
With the ineffectiveness of NSAIDs appointed steroids - prednisone and methylprednisolone.The drugs have a more pronounced anti-inflammatory and analgesic effect than the group of NSAIDs.Sometimes therapy supplemented relaxants (baclofen and sirdalud) as pain in spondyloarthrosis arise as a result of muscle spasm.
In addition, to improve the trophism of the affected tissues appointed vascular drugs and vitamins of group B. The warming ointment (Fastum gel and finangel) used as a diversionary therapy.
At strongly expressed painful syndrome, beyond the relief of NSAID used therapeutic blockade using a mixture of analgesics and steroids.
In rare cases, the ineffectiveness of drug therapy, resort to surgical methods of treatment, including the widely used hemilaminectomy and radiofrequency destruction of painful endings on the affected area of the spine.