Lumbar discopathy, also known as the hernia of the nucleus pulposus, is a symptom complex resulting from degenerative changes in the intervertebral discs (discs) of the spine. Then they dehydrate (dehydrate) and reduce their height. The causes of this disease are associated primarily with a sedentary lifestyle, as well as excessive stress on the structures of the spine. Symptoms of lumbar discopathy include lower back pain, numbness in the lower limbs, sensory disturbances in the leg, and even paresis and problems with keeping urine or stools.
Lumbar discopathy – characteristics
Lumbar discopathy is a disease of the spine caused by degenerative changes in intervertebral discs and pathologies related to adjacent structures – ligaments, muscles and their attachments. Currently, it is a very common medical and social problem – discopathy is one of the most common diseases of civilization.
Degenerative changes in the structure of the discs cause a number of unpleasant symptoms, incl. back pain in the lumbar region, numbness in the lower limbs, stiffness, sensory disturbance. A very dangerous consequence of this condition is pressure on the spinal cord or the roots of the spinal nerves, which can lead to paresis.
In addition to limb symptoms, a hernia of the lumbar spine can lead to reduced urination, faeces, and sexual dysfunction.
Lumbar discopathy – causes
The lumbar section is considered to be one of the most common places where there is overload in the human musculoskeletal system. This is because it is the biomechanical center of the spine.
Among the factors predisposing to the appearance of a lumbar hernia are: obesity, excessive use of the musculoskeletal system by carrying heavy objects, carrying disproportionately heavy loads, rotating the spine while bending it at the same time.
Work in a forced position, such as prolonged sitting, exposure to vibration, or the need to bend down while keeping the knee joints straight, is also potentially conducive to discopathy. The specific, individually variable anatomical structure that may favor the development of L5 / S1 discopathy should also be taken into account. People with osteoporotic changes or endocrine disorders are also more likely to have herniated discs.
Lumbar discopathy – symptoms
Damage to the intervertebral disc in the lumbar region can cause a number of very different ailments. Usually, the severity of symptoms and their topography depend on the severity of discopathy. The most characteristic symptoms of lumbar discopathy include:
- lumbar (lower back) pain originating from the nerve root,
- neurological symptoms accompanying lumbar discopathy in the form of numbness, tingling in the lower limb,
- increased tension in the paraspinal muscles, painful muscle spasms,
- in some cases, sensory disturbances in the lower limb are possible,
- bladder and bowel dysfunction,
- difficulty climbing on toes.
Such symptoms may intensify after prolonged standing, sitting or attempts to load the spine, e.g. when lifting or moving furniture. Additionally, ailments may be favored by abnormal anatomical conditions and posture defects. This role is played, among others, by reduction of lumbar lordosis.
Lumbar discopathy – diagnosis and treatment
Treatment of discopathy begins with a thorough diagnosis. The basis is an interview with the patient and diagnostic tests provoking ailments characteristic of a lumbar hernia.
An example of such a test can be the Lasequa test. It consists in the fact that the patient, lying on his back, is asked to raise the lower limb. If we are dealing with lumbar spine discopathy, the need to move will generate pain, preventing the leg from being raised. It is then necessary to bend it at the knee joint.
Imaging tests are then performed. Depending on the severity of symptoms and the need to differentiate from other diseases, the doctor may recommend X-ray of the lumbar spine, computed tomography or magnetic resonance imaging of the spine. The most accurate is, of course, resonance, which very precisely determines the degree and stage of damage, often colloquially referred to as a prolapse of the lumbar disc, which in fact means its displacement (only a fragment or a few fragments of the disc can be translocated). When undergoing diagnostic procedures, it may be necessary to perform an EMG test, which is recommended in the situation of the presented sensory disorders.
In the first place, the treatment of lumbar discopathy is carried out conservatively – mainly pharmacological agents from the group of non-steroidal anti-inflammatory drugs are used. Vitamin D supplementation is often recommended. Sometimes drugs from the benzodiazepine group are also used. In the case of very severe pain, a decision may be made to perform an epidural injection, i.e. an epidural block (commonly known as a spine block). If this procedure is not effective, surgical treatment of lumbar discopathy with the use of surgical methods such as laminectomy, discectomy and microdiscectomy is considered.
Lumbar discopathy – rehabilitation
Physiotherapy most often plays a major role in regenerating the damaged structure of the intervertebral disc. It is very important to implement a few basic rules. Important are: education in the field of daily activities so as not to overload the spine, reduction of excessive body weight, systematic individual therapy and following the recommendations of a physiotherapist.
In the treatment of lumbar discopathy, applications of Kinesiology Taping (kinesiotaping), mechanical diagnosis and therapy using the McKenzie method, deep tissue massage, TENS stimulation, and spine traction are used. In acute conditions, posture positions, such as the chair position, are used to alleviate the symptoms.
After the symptoms disappear, it is recommended to train the core muscles and promote the activity that maintains the spine in the best condition. Running should only take place on shock-absorbing surfaces and in properly selected footwear. However, whether you can play sports should be decided by the doctor in cooperation with the therapist.
Lumbar discopathy – exercises
Exercises for the lumbar spine to reduce the risk of discopathy include:
Position: lying on your back, arms along the body, legs bent at the hip and knee joints. The movement consists in lifting the hips to the height of the line joining the knee joints and shoulders. In the end position, keep your hips for 3-5 seconds while breathing. We perform the exercise in 3 series of 7-8 repetitions.
Position: hip-width apart, hands on hips. The movement consists in extending the lumbar section while exhaling at the top of the movement. We repeat the exercise 10-15 times.
Position: sit down kneeling, arms extended on the floor. The movement consists in moving the hands forward on the ground so as to elongate the spine. We perform the exercise in 2 series of 10 repetitions.
Exercises for lumbar discopathy should be an integral part of home treatment. It is worth remembering that their use must be consulted with a physiotherapist. If you want to relieve ailments in the form of inflammation and increased muscle tension, you can use Echinacea infusion and bath in water with Epsom salt.