Symptoms of lumbosacral osteochondrosis

Lumbar osteochondrosis is characterized by painful symptoms of varying intensity and localization. At the initial stages, the osteochondrosis is usually asymptomatic; the pain appears only at the second stage of disease. We suggest you to familiarize yourself with the most frequent options of spine pathology behaviour.

The clinical findings of the lumbar osteochondrosis are determined by the following syndromes:

• vertebral (change of the lumbar spine statics and dynamics);
• extravertebral, which means dysfunction of neurological and vascular structures in the lumbosacral spine area

The vertebral syndrome is characterized by the following complex of symptoms:

• applanation or aggravation of lordosis (physiological bending in the lower back);
• scoliosis or lordoscoliosis (sideward curvatures);
• limitation of mobility in the lumbar area;
• movement volume contraction;
• muscular-tonic imbalance;
• local pain and soreness at active and passive movements;
• palpatory tenderness of bone and ligament structures in the affected area.

Extravertebral syndromes are divided into two large groups:

1. Reflex
2. Compression

Reflex syndromes include:

• lumbago
• lumbodynia
• lumboishialgia

The lumbago is an acute pain in the lumbar area, which usually arises suddenly after an awkward movement or lifting weights. An attack of pain may occur after hypothermia. The clinical findings develop during several hours (acutely). Pain in the lumbar area is usually noted from two sides; it has considerable intensity, especially in the first hours, irradiates to the buttocks, sometimes to the lower abdomen, sharply increases with any movement, so the patient with the lumbago syndrome spares the lower back; careful movements and forced postures are characteristic of him.

In lumbalgia the pain gradually intensifies, it has a dull, aching character and usually accrues for several days. The disease is accompanied by the restriction of the trunk bending due to pain. The pain is mostly one-sided. With a long course of disease, accompanied with a local muscle tone increase, dense nodes (myogeloses) are formed in the paravertebral muscles, which are determined by palpation.

The lumboishialgia is characterized by pain of a diverse origin in the lumbosacral area; it can be acute, blunt, aching, firing, compressive, etc., and quite often irradiates along the posterior or lateral surface of the lower limbs. Pain is accompanied by skin sensation disorders, most often in the form of an exacerbation of pain sensitivity. Numbness or feeling of “running goosebumps” may also occur.

Compression syndromes are syndromes resulting from squeezing, pinching nerves, blood vessels and the spinal cord in the lumbar vertebral motor segments area. Compression syndromes in osteochondrosis of the lumbosacral division are divided into:

Compression syndromes are syndromes resulting from compression, pinching of nerves, vessels and spinal cord in the lumbar spine-motor segments.

Compression syndromes at the osteochondrosis of the lumbosacral spine are divided into:

• radicular
• vasculo-radicular
• spinal

Radicular syndromes (radiculopathy) are caused by pinching of spinal radices. The resulting radicular symptoms correspond to the level of the affected vertebral segment.

Most often, the radices of the last lumbar area segments (L5-S1) are affected. The lesion of the L5 radix leads to a sensitivity decrease, expressed lightning pain in the lower back and its irradiation to the foot thumb; in some cases the force of the thumb extensor decreases.

The lesion of the S1 radix is characterized by lightning pain and the following subsequent sensitivity decrease of the external hip and lower leg surface, as well as the feet to the baby finger and the fourth finger.

The vasculo-radicular neurologic disorders are caused by compression of the radix and the passing radicular artery.

In such cases, the appearance of motor disorders is accompanied by the disappearance of pain syndrome and sensitivity disorders in certain myotomes and dermatomes.

Compression of the radicular artery, passing into the spinal canal together with the L5 spinal nerve, is accompanied by the development of paralytic sciatica syndrome. Paralytic sciatica syndrome is manifested by paresis or paralysis of the foot and toes extensors on the affected side. The patient, while walking, lifts the leg high, throws it forward and at the same time slaps the forefoot (toe) on the floor.

Spinal syndromes (compression of the spinal cord) can be manifested by compression-vascular myeloischemia or compression myelopathy.

The myeloischemia occurs at the compression of the radicular-spinal artery, which can enter the vertebral canal together with the fifth lumbar spinal nerve. It depends on the blood supply to the caudal spinal cord and cauda equina.

Chronic blood flow disorders are characterized by weakness and numbness of the legs that occur during walking, which can disappear after a short rest (the so-called myelogenous “intermittent claudication”).

The compression myelopathy is a spinal cord lesion caused by the narrowing of the spinal canal for any reason. The severity of the lesion and its symptoms depend on the lesion localization.

There exist epiconicum syndrome (pain in the lumbar area, at posterior hip and shin surface; legs weakness, gluteus and calf muscles weakness, foot paresis, sensory decrement of shin and foot posteroexternal surface) and cones syndrome (pelvic organs dysfunction, decrease or sensitivity loss in the anogenital area).

At the present time, neurodystrophic disorders with pathological changes of the spinal column have been rather fully studied. Among neurodystrophic disorders, osteofibrosis, periarthrosis, coxarthrosis, and neuro-osteofibrosis of the sacroiliac joint are noted, which, along with the limitation of function, cause pain reactions. Pathology of the root of L4 can cause periarthrosis of the knee joint, L5 – ankle, L1 — L2 – coxarthrosis or osteofibrosis of the sacroiliac joint.

The pathological impulse from the S1 radix can cause the pain in the heel and lead to the development of calcaneal spurs, calcification of the calcaneal tendon. In this case, the realization of pathological influences is carried out through vegetative nervous formations and, first of all, through a sympathetic chain.

As you can see, such a common disease as lumbosacral spine osteochondrosis can lead to quite serious complications and disorders. Therefore, this disease treatment should be done in a timely and competent manner. If you feel pain in the lower back – contact a neurologist, so that the pathology won’t become a chronic one and won’t have the serious consequences.