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Spondylarthrosis of the lumbosacral spine, what is it?

The musculoskeletal system of a person undergoes various static and dynamic loads. At the same time, various diseases can develop, which are the result of the reaction of the spine to this load.

Thus, the effect on intervertebral discs consisting of cartilage tissue leads to the development of osteochondrosis of intervertebral discs in various departments. So called dystrophic-degenerative process that occurs in cartilage.

What will happen if this process occurs not in the cartilage tissue, but in the ligamentous apparatus of the intervertebral joints? - Spondyloarthrosis will develop.

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What is the lumbosacral spondyloarthrosis?

Spondyloarthrosis of the lumbosacral spine

It is known that the mobility of the spine in all its sections mainly depends on the elasticity of the intervertebral discs. This is true. But between the vertebrae there are other joints that are not equipped with discs. They are called faceted.

They received their name from the small size of the articular surfaces, which are quite a few, and the ligaments in the spine are strong. Therefore, they are sedentary, and may be subject to degeneration. Now we are close to answering the question "What is it?"

In essence, the lumbosacral spondyloarthrosis is a common arthrosis that only develops in the small joints of the spine, is chronic, and leads to a restriction of mobility, in this case in the lumbosacral spine.

In addition to the term "spondyloarthrosis," such a name as spondylosis can occur. The difference between these concepts lies in the fact that during spondylosis, the anterior longitudinal ligament is affected, which undergoes calcification, and the spinal joints are less affected, and degeneration is less pronounced.

A feature of the lumbosacral are more massive vertebrae, a high load on them, greater mobility, as well as the presence of a single sacral bone, in which five vertebrae have grown together.

Therefore, all manifestations of osteoarthritis (the appearance of osteophytes, the development of stiffness) is possible only in the overlying department, or in the lumbar.

It is clear that only moving surfaces can experience pressure on each other, and in the sacral bone these phenomena are absent. Only arthrosis of the sacroiliac joints is possible, as well as their inflammation - sacroiliitis.

Causes of spondyloarthrosis

Causes of spondyloarthrosis Spondyloarthrosis, like any involutional disease, depends on age and metabolic disorders. It has much in common with other causes of arthrosis, which are localized in other places, such as the knee or shoulder joints. The most common causes of spondyloarthrosis are as follows:

  • Violation of phosphorus-calcium metabolism;
  • Osteoporosis , especially in postmenopausal women;
  • Diabetes and thyroid disease;
  • Spinal injuries and the effects of fractures;
  • Sacralization of the lumbar vertebra or lumbarization of the sacral. So called congenital anomalies, in which either the last, fifth lumbar vertebra "grows" to the sacral bone, or the first sacral vertebra is separated from the sacral bone. In this case, 6 vertebrae appear in the lumbar spine, and their excessive mobility provokes the development of the load;
  • Professional sports, leading to increased load;
  • Office work and a sedentary lifestyle;
  • Violation of posture and spinal deformity (kyphosis, kyphoscoliosis of the overlying departments);

But, of course, the main reason for the development of spondyloarthrosis is osteochondrosis of the lumbar spine . The intervertebral discs lacking elasticity become thinner, and the articular surfaces, together with the ligamentous apparatus of the bowed process joints, begin to experience significant loads.

Symptoms of spondyloarthrosis of the lumbosacral spine

Symptoms of spondyloarthrosis of the lumbosacral spine Since this is a chronic disease of the joints, back pain will be the main symptom.

As a rule, it is an aching pain of low intensity, which is given (radiating) from the waist to the pelvis or to the leg. Irradiation never drops below the knee, and pain can only give up to mid-thigh or higher.

Characterized by increased pain and discomfort during prolonged sitting and immobility, and, conversely, with severe physical exertion on the lumbar spine, for example, when carrying a heavy backpack.

If the disease continues to progress, then soon the pain of spondylarthrosis, as stiffness, joins the pain. Most often, it appears in the morning, and lasts for a few minutes to an hour. Then she passes. Then stiffness can last several hours, and become a constant companion.

This symptom of spondyloarthrosis of the lumbosacral spine indicates a significant decrease in the elasticity of the ligamentous apparatus and pronounced osteophytes in the vertebrae.

In addition, stiffness can be secondary in nature, when muscle tone increases due to the development of subluxations in small joints. In this case, the distance between the articular surfaces increases, and the muscles experience strong stretching. This causes painful reflex spasm with the accumulation of lactic acid.

The result is increased pain. In addition, muscle spasm can cause secondary disorders, as there is compression of the nerve roots, increased joint pain.

On the diagnosis of spondyloarthrosis

Since both osteochondrosis and spondylarthrosis are very interconnected with both anatomical localization and risk factors, these processes can occur simultaneously. Differences between them can only be established using imaging techniques, for example, x-ray examination.

In the event that an MRI scan is performed afterwards, this makes it possible to examine the long ligaments of the spine, which are often involved in the pathological process.

Treatment of spondyloarthrosis of the lumbosacral spine

The disease, like any chronic, long-term ongoing process, has exacerbations that alternate with periods of remission. As a rule, exacerbations occur twice a year - in spring and autumn, and are often associated with hypothermia and exercise.

Spondylarthrosis can be treated by a rheumatologist, a spine specialist (a specialist in spinal diseases), or a neurologist.

Treatment of spondyloarthrosis of the lumbosacral spine in the period of exacerbation is reduced to drug relief of pain, possible signs of inflammation, improvement in motor activity. Standard drugs are used for this:

  • Non-steroidal anti-inflammatory drugs, both inside and injections, as well as for topical application to the lumbar region: ketoprofen, meloxicam, lornoxicam, ibuprofen. The commercial names of these drugs are “Ketonal”, “Movalis”, “Ksefokam”, “Nalgezin”. To improve portability, these drugs are taken along with the proton pump blocker - omeprazole. It is the use of omeprazole to minimize the manifestations of ulceration in the gastrointestinal tract, which are called the "ulcerogenic effect of NSAIDs."
  • Muscle relaxants centrally acting. Spondyloarthrosis of the lumbosacral spine: treatment, injections will be effective in reducing muscle tone. This will release the nerve endings from the condensed muscles, as well as reduce stiffness in the back. These drugs include tolperisone ("Mydocalm") and tizanidine ("Sirdalud").
  • Topical treatment consists of rubbing ointments, gels and creams containing anti-inflammatory components (“Ketonal - cream”, “Fastum - gel”), or snake and bee venom derivatives (“Nayatox”, “Viprosal”, “Apizartron”) into the loins. Warming and irritating ointments, which are based on cayenne pepper extract, have a good effect, for example, capsicum ointment containing capsaicin.
  • Chondroporotectors have some effect. These drugs are the "donor" of chondroitin sulfate and mucopolysaccharides (glucosamine), which form cartilage tissue. These drugs can be used as in the tablet form "Artra", "Teraflex", and in the form of solutions for the intramuscular administration of "Alflutop".
  • Reception of multivitamins and mineral complexes enriched with calcium and magnesium.
  • Wearing a semi-rigid corset.
  • Using the hipplikator Kuznetsov or Lyapko (applying to the lumbar region 2 to 3 times a day for 15 to 20 minutes.
  • Use orthopedic mattress and pillows. Moreover, this should be the norm for every person, even in the absence of back problems. It must be remembered that in a dream we spend a third of life, and the state of stress on the spine caused by improper selection of the sofa and mattress can cause pain and various disorders.

After stopping the acute stage of spondylarthrosis, treatment begins, which largely depends on non-drug factors. The most sought-after species are:

  • Exercise therapy in the presence of an instructor.
  • Swimming. The load on the back muscles in a horizontal state allows you to increase blood flow in the back muscles, normalize the outflow of metabolites from the muscles into the venous bed and prevent exacerbation.
  • Physiotherapy procedures. In case of spondyloarthrosis, hardware techniques such as SMT (sinusoidally modulated currents), magnetic therapy, galvanization, electrophoresis on the lumbar region with vitamins (thiamine), and hormones (hydrocortisone) are shown. The first sessions show electrophoresis with local anesthetics (novocaine) for the relief of pain.
  • Sessions of osteopathy and manual therapy.
  • Acupuncture.
  • Hand massage. It allows you to reduce the level of muscle tone, normalize blood circulation in the deep back muscles.

Prevention of spondyloarthrosis

In the treatment of spondyloarthrosis and osteochondrosis, prevention plays a very large role. With age, you need to monitor your weight, hormone levels, try to keep an active lifestyle, do gymnastics.

It must be remembered that the small joints of the spine, due to its multiplicity, can be a source of severe back pain, even if the intervertebral disc is intact.

In that case, if the problem of small joints is not given due attention, then, as a result, not only stiffness in the back, but also ankylosis of the spine, in which all movements in the lower back will be impossible, because the spine simply “stiffens” can develop.

In addition to this factor of disability, patients suffer from constant pain, significantly reducing the quality of life.

  • In order not to miss the changes in the small joints of the vertebrae, it is necessary, when pain in the lower back occurs, it is necessary to perform a radiography of the lumbar spine in 2 projections, and consult a specialist.
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