What are degenerative-dystrophic changes in the lumbosacral region. Degenerative-dystrophic changes in the lumbar spine Moderately degenerative-dystrophic changes in the lumbar spine

Degenerative-dystrophic changes in the lumbosacral region are a set of pathologies in the intervertebral disc or, alternatively, in the lumbar vertebrae. This disease can mainly be recognized by lower back pain.

In most cases, able-bodied people suffer from such problems, and gender does not play a role here. Statistics say the following: there are now an extremely large number of people with this diagnosis, and this number is growing, with no intention of slowing down the pace of development, which is not encouraging.

The body of any person is an extremely delicate and well-functioning system. And it is not surprising that changes in the activity of at least one of its components inevitably entail disruptions in the functioning of all other parts of the body. Behind last years The incidence of diseases of the musculoskeletal system has increased greatly among the population. Because of this, people's ability to meet their needs has decreased.

The spine is a component of the human skeleton. This organ plays a certain number of vital functions:

• support;
• participation in the movement;
• giving the body flexibility;
• distribution of nerve fibers throughout the body.

Due to the high complexity of the structure of the body, it is not so rare for its organs and tissues to age earlier than the time allotted by nature. Degenerative dystrophic changes begin to appear in the spine, which necessarily cause osteochondrosis, coupled with extremely severe pain.

Without such changes in the spine, none of its known diseases is possible. Any osteochondrosis, spondyloarthrosis, intervertebral disc herniation and the like are precisely the results of untreated degenerative dystrophic pathologies of the intervertebral disc, which can be detected by doing necessary examination from a specialist. However, an examination is not so necessary when the disease can be indicated by the most common symptoms of pathology, which can be detected during the first examination.

Despite the fact that a person may not have a very strong tendency towards this pathology, inherited to him, in reality its root lies in the combination of many genes. Degenerative processes are also possible due to the aging process or due to any injury. And yet, extensive injuries like the same car accident do not often lead to this. In most cases, they occur due to a slow traumatic process that damages the intervertebral disc. Moreover, this damage gradually becomes more pronounced, which leads to the disease.

The intervertebral disc does not receive blood, and therefore, in case of damage, it will not be able to “patch” them in the same way as other organs and tissues. For this reason, any, even the slightest, damage to this tissue can lead to the most serious consequences, starting the so-called “degenerative cascade.” This inevitably leads to the destruction of the intervertebral disc. And this severe pathology has a very high “popularity”. According to modern statistics, almost a third of the world's population who have reached the age of four to six decades has this problem, at least to the smallest extent. This means that almost every elderly patient has such a diagnosis or pain, if not both.

Why does the disease begin?

In more than half of the cases, this problem occurs for at least one of the following reasons:

• inflammatory processes that begin due to the fact that the nerve roots are irritated by the protein located in the disc space during the appearance of a hernia;
• microscopic damage that occurs if the annulus fibrosus wears out, completely losing any ability to bear load. The consequence is excess mobility in the affected area.

Most often, the combination of these two factors occurs when an intervertebral hernia begins to develop, which is a complication of the pathological process in the intervertebral discs. When it appears, the neurovascular bundle passing through the spinal canal is compressed by mechanical action. Because of this factor, lower back pain becomes much stronger and does not stop.

In general, degenerative-dystrophic pathologies most often cannot arise without an incorrect lifestyle. This is characterized by a lack of moderate exercise, an unbalanced diet, as well as insufficient sleep and, of course, bad habits like addiction to tobacco and drinking alcohol. Other reasons why dystrophy of the lumbar spine may begin:

• the harmful effects of heavy loads on the spine, due to which the segments of the lumbar region become less elastic. Because of this circumstance, the greatest danger of contracting one or another lower back disease is faced by people who constantly expose themselves to heavy physical activity, especially if it is required for work;
• staying in a sitting position for a long time, and with incorrect posture, which also leads to impaired blood supply. And this affects both the lumbar region and the rest of the body. This entails metabolic disorders in bones and muscles. Metabolic disorders spoil the structure of tissues. And because of all this, microtraumas can easily appear in the spine from any movement. In this regard, pathology may begin to develop;
• infectious pathologies, as well as diseases associated with the endocrine system. Because of them, harmful processes in the lower back can also easily begin;
• certain mechanical injuries of the spine. They cause injuries to bones and muscles;
• back muscle damage. This, of course, also has a detrimental effect on the spine in general, and on its lumbar region in particular;
• Often the cause of the pathology can be described by just one in a simple word: "old age". Then the disease can hardly be cured. In this case, they do not try to cure the person, but only provide supportive therapeutic procedures to prevent the disease from worsening.

What can happen due to this pathology

Once you start degenerative changes in the spine, severe complications in the lumbar region cannot be ruled out:

• hernias;
• osteochondropathy;
• numbness and partial paralysis lower limbs;
• complete paralysis of the legs;
• difficulty going to the toilet;
• decrease/loss of libido.

To avoid such problems, you should promptly and wisely choose what and how to cure the pathology. This way you can most effectively keep the intervertebral discs intact.

How to recognize the disease

More than half of the patients who have degenerative-dystrophic pathologies in the lower back complain of ongoing pain, which, however, can be tolerated. But sometimes they become stronger for a long time. For the most part, each patient has his own symptoms of the disease, but there are several common signs:

• the back hurts, and pain in the hips and legs is possible;
• pain in the lumbar region lasting over one and a half months;
• in the lower back the pain is dull/aching, and in the hips and legs it is burning;
• when the patient sits, the pain becomes stronger. Standing, walking or lying down, he feels less pain. Standing for too long, bending forward or lifting something heavy, the patient feels a more “bright” pain;
• If a person has a herniated disc, his legs may go numb and their legs may tingle. In addition, he may have trouble walking;
• if the hernia turns out to be medium in size, it is possible that the nerve root that exits the spinal cord at the affected level will be compressed (foraminal stenosis), and this will already provoke pain in the legs ();

• symptoms of neuralgia, such as weakened legs, as well as various problems in the functioning of organs in the pelvic area (difficulty going to the toilet) can quite eloquently “hint” at the appearance of cauda equina syndrome. Then you need to urgently consult a doctor;
• inflammation caused by proteins trapped in the disc causes the nerves to react more sharply to stimuli. This is what makes your legs go numb and tingling. Moreover, in most cases, such sensations are localized in the knee or higher.

If you want to learn more about how to treat, and also consider the symptoms, diagnosis and alternative methods treatment, you can read an article about this on our portal.

Lower back pain can easily appear not only due to pathological processes in the discs, but also from the following:

• narrowing (stenosis) of the spinal canal, osteoarthritis, any other spinal pathology that worsens over time, caused by deterioration of the discs. However, this does not mean that such diseases cannot be combined;
• hernia caused by disc pathology.

Moreover, with the development of the disease, as well as the transition from one stage to another caused by it, its symptoms become increasingly stronger:

• stage№1 . The disease rarely manifests itself in any way. Perhaps after physical work you may feel a dull pain, but in most cases it is mistaken for normal fatigue;
• stage№2 . You can clearly distinguish symptoms from normal phenomena. From time to time there is a “shoot” in the back. It's also hard to bend sometimes. The reason lies in the nerve endings: they are compressed, and therefore the pelvic area “tingles”;
• stage№3 . Spicy. At this time, metabolism in the lower back is disrupted because blood vessels. Ischemia, cramps, and numbness of the legs appear. The pain becomes stronger;
• stage№4 . Due to deformation of the spinal cord, the legs may become paralyzed. This pathology has exacerbations - the time of greatest severity of symptoms. If dystrophy becomes chronic, the symptoms weaken to a state of tolerable discomfort.

Prices for lumbosacral corset

Diagnostics

It is very important that the disease is diagnosed before the first complications appear. For this purpose, diagnostics are made using a variety of methods so that they capture many types of stimuli. However, the patient must first be examined by a neurologist. After the examination, the specialist must prescribe additional examinations to make the diagnosis more accurate.

In most cases, the following methods are used: x-rays, computed tomography (CT), and MRI.

X-rays are the most accessible, but at the same time they are the least useful. This technique allows you to diagnose pathology when it has already reached one of the fairly late stages. MRI and CT are much more useful. Using these methods, it is possible to more reliably determine both where the focus of the disease is and how far it has developed.

Moreover, it is best to rely on MRI for information about the presence/absence of changes.

What an MRI can show for disc degeneration:

• destruction of the disk if it exceeds half of it;
• disc dehydration. On MRI, such tissue is shown darker;
• the presence of hernias, as well as protrusions;
• erosion of the cartilage plate that allows the disc to receive nutrients.

Sometimes electroneuromyography is necessary to determine where and how the nerve is damaged. Of course, doctors take blood tests. They need this to identify infections and endocrine pathologies.

If you want to find out in more detail and also consider when a magnetic resonance examination is indicated, you can read an article about this on our portal.

How to treat

First of all, conservative therapy procedures are carried out. Among them are the use of painkillers, warming ointments, therapeutic exercises, massage, and physiotherapy. If there is no benefit from these treatment methods, surgery is performed.

Medicines

First of all, the pain should be relieved so that the patient can walk normally. For this purpose, the doctor prescribes the necessary painkillers (for example, Ketanov and Ketonal), as well as anti-inflammatory drugs (Movalis and Diclofenac).

Next, to relax the lower back muscles, muscle relaxants (Mydocalm and Sirdalud) are used. These drugs are not used constantly, but with periodic breaks, since otherwise they make the muscular system less strong.

Chondroprotectors are also used in treatment. With their help, you can quickly restore cartilage and joints.

But with all the miraculousness of the complex of drugs, it is necessary to remember that they can easily cause an unpleasant “side effect”, disrupting the functioning of the gastrointestinal tract.

Exercise therapy

Of course, therapeutic exercises should be done both during treatment and rehabilitation. Properly selected and planned exercises are very useful for any symptoms of degenerative-dystrophic pathologies in the lower back. When selecting and planning exercises, it is necessary to look at the causes, severity and main signs of the disease.

If the pathology is acute, of course, it is recommended to abstain from exercise therapy. First, it is necessary to use other methods to alleviate pain: NSAIDs, a state of complete rest, local cooling, blockades.

If the symptoms are severe, static gymnastics with low amplitude will be very useful. But it should be done extremely carefully, and haste can only do harm. IN rehabilitation period It is much better to use dynamic exercises.

As the patient’s condition improves, you can make it more complicated and also begin to use weighting agents in it.

Massage and physiological procedures

Massage tables and chairs

Doctors still cannot come to a consensus about the advisability and safety of massage for dystrophic changes in the lumbar spine. Even for a spine that is not affected by disease, it is harmful when it is mechanically affected. If you really can’t do without a massage, such a procedure should only be carried out by a real professional. And only while the pathology is at the first stage of development.

During the acute period, the back is not massaged. This is because due to this action, blood rushes to it, and after this the sore spot begins to become more inflamed and swollen.

In case of remission, that is, a temporary absence of inflammation and acute pain, physiological procedures can be used. Thanks to electrophoresis, acupuncture, and magnetic therapy, the patient can quickly recover from the disease. And with the help of manual therapy, the vertebrae can be placed where they are supposed to be by nature.

Surgery

Surgical intervention is carried out in case of revealed uselessness of massage, therapeutic exercises, as well as taking medications, and further progression of the disease. This method is also used for the diagnosis of intervertebral hernia. During the operation, the doctor installs devices in the patient’s body to support the diseased area of ​​the spine. This allows you to reduce pressure on the ridge to avoid further development of the disease.

Table. Types of spine surgeries

Possibility of complications

Launching this pathology, a hernia may occur. This term refers to the displacement of a deformed disc. This can rarely be cured without surgery. Also, with advanced dystrophic processes, it can become inflamed. sciatic nerve and malfunction begins genitourinary system. Moreover, there are usually problems with going to the toilet “for minor needs.”

Prevention

You can prevent such pathologies in the spine by following simple rules. First of all, you need a large physical activity. You should start your morning with exercise. Moreover, it is worth choosing exactly the kind of exercises that would help make your back muscles stronger. Those who are forced to sit for long periods of time while working should sometimes pause to stretch their muscles.

Also, to maintain the health of the spine, it is useful to know how to choose a mattress: it should be firm, but in moderation. It is best to also use orthopedic pillows. It is important that the width of such a pillow is suitable for the distance of the shoulders. If you are obese, you should lose weight: it puts extra strain on the spine.

Orthopedic mattresses

Bottom line

Regular back pain is a reason to consult a doctor. Alas, any organism is not eternal, and with aging, the spine suffers first. If a person begins to feel the first signs of the disease, he should immediately be examined by a doctor. Many serious illnesses first signal themselves with completely minor discomfort, but if you miss the moment, you can forget about normal life for a long time. Degenerative-dystrophic pathologies cannot always be cured, but it is quite possible to stop their development and maintain health.

Video - What are degenerative-dystrophic changes in the lumbosacral region?

Other diseases - clinics in Moscow

Choose among the best clinics according to reviews and best price and make an appointment

Other diseases - specialists in Moscow

Choose among the best specialists based on reviews and the best price and make an appointment

Degenerative-dystrophic changes in the lumbosacral spine are the slow destruction of tissue structures related to the discs. All this happens for the simple reason that the tissues are no longer supplied with sufficient nutrition, and this leads to their dryness and loss of elasticity.

Dystrophic changes lumbosacral spine is dangerous disease. It is almost impossible to detect pathology immediately. In such situations, there is nothing left to do but take various medications and go to the hospital for procedures. The situation is further aggravated by the fact that in order to bring the spine back to normal, you may have to change some habits, and not rely only on the power of medicine.

DDZD includes several pathological conditions in its group. They are united by some generalized characteristics and features. In practice, the following types of changes are traditionally encountered:

• – problems associated with impaired integrity of discs, their thinning, deformation;
• spondylosis is a manifestation of growths of a pathological nature in the vertebral area, these elements limit the patient’s motor capabilities;
• Spondyloarthrosis is a phenomenon in which joint dysfunction occurs, which entails severe pain when moving.

These are the types of these conditions. To clinical picture has been identified as clearly and clearly as possible, a detailed diagnosis is necessary.

Causes of the disease

There are several causative factors for degenerative-dystrophic changes in the lumbosacral region:

• Maintaining a sedentary lifestyle. If the body is healthy, there is an even distribution of the load along the spine. But insufficient mobility leads to excessive weakness of the muscular corset and weakening of the muscles. Therefore, even a minimal load factor can lead to displacement of the vertebrae.
• Excessive physical activity. The opposite state of affairs can also lead to pathology, when a person intensively engages in sports, not sparing his own muscles. Statistics show that joint diseases occur in 90% of athletes.
• Traumatic phenomena. If we are talking about young patients, then such pathologies (arthrosis, nerve entrapment, hernia) most often result from injuries, including birth processes.
• Aging is another process that causes irreversible changes. In the treatment process there can be no talk of surgery, since dystrophy is natural. Only supportive therapy is considered acceptable.
• Poor nutrition. Due to problems with metabolic reactions, body cells do not receive the proper quality of nutrition. This has a negative impact on the condition of the entire body and creates unnecessary stress.
• Inflammatory processes. Changes can occur against the background of inflammation. For example, the most common causative agents of such conditions are arthritis and ankylosing spondylitis.

Thus, degenerative changes in the lumbar spine can manifest themselves due to various causative factors. To accurately determine them, it is necessary to pay a visit to the treating specialist.

Progression of pathology

The spinal column, especially the sacral region, is subject to increased load during any body movements. Because of this, disruptions in the supply of nutrients to cells and tissues occur. The discs lack blood vessels that could hypothetically provide direct nutrition. Therefore, there is a gradual loss of tissue elasticity and its slow destruction. In the next stage, the tissue becomes thinner and can be weakened.

The cartilage dries out and the discs lose their height. In response to these processes, the immune function comes into active operation. Its cellular structures begin to produce inflammatory inducers. As a result, the tissues swell and pain appears. Typically, the course of degenerative-dystrophic changes in the lumbosacral spine is slow and chronic. In the future, other dangerous conditions may develop against their background.

Stages of progression and main symptoms

In the lion's share of clinical situations, problems are observed in independently determining the onset of the disease. The fact is that there are no obvious signs at first. As the practical side of the issue shows, there are 4 stages of pathology progression. And each of them is accompanied by special signs.

1. First stage. A person without medical education may not notice any changes in health, since there are in fact no signs of degenerative changes. Some patients note that they have experienced excessive stiffness in the lumbar region.
2. Second stage. More severe symptoms may come into play in this process. First of all, we are talking about limiting movements in the lumbar spine. Even with the slightest bending, shooting pain and attacks of initial radiculitis can make themselves felt.
3. Third stage. There are problems with the nutrition of the soft tissues that surround the spinal column. As for physical manifestations, there is increasing pain, numbness of the limbs and a convulsive state.
4. Fourth stage. This is the most advanced condition in which obvious damage to the spinal cord and roots can progress. This condition entails the formation of paresis and paralysis.

As you can see, there is a direct relationship between the stage to which the pathological process has passed and the characteristic manifestations of the disease. Thus, DDSD of the lumbar spine occurs in several stages and is dangerous condition. It is important to identify the condition as early as possible in order to begin the treatment process in a timely manner.

Diagnostic measures

The complex of examinations is quite simple and is carried out in three common stages.

1. Compiling a general history of the disease. In this case, attention is paid to the symptoms of the disease and general conditions, within which the attack began.
2. Examination of the patient. At this stage, the specialist checks the characteristic signs of degeneration, examines the degree of mobility, determines muscle strength and the area in which the lesion is localized.
3. Carrying out. This event serves to discover the evidence base for dystrophic changes and causative factors in the development of pathology.

As additional tests In order to determine dystrophic changes in the spine, other measures can be used. This is a blood test. But not each of these activities is able to demonstrate symptoms of pathology at an early stage. The most in-depth examination methods are measures such as CT and MRI. But patients resort to them when damage to the lumbar region has already begun to actively develop.

Complex of therapeutic measures

The list of treatment methods is quite wide, most often it involves a complex of drug, physical and surgical treatment. The required method of therapy is selected by a medical specialist.

Drugs to treat the disease

First, doctors prescribe conservative treatment. It involves the use medicines analgesic, warming effect. They help relieve pain and ensure free movement and normal performance. Most often, preference is given to representatives of the group of non-steroidal anti-inflammatory compounds:

• Diclofenac.
• Nise.
• Meloxicam.
• Ibuprofen.
• Movalis.

They are effective, but are accompanied by rather dangerous side effects for the intestines, including the formation of ulcers.

To improve overall well-being, degenerative-dystrophic changes involve the use of protozoa medicinal compositions- Ketonal, Ketanov. The principle of action of the drugs is to eliminate pain and relief of general well-being.

In order to relax tense muscles, Sirdalud and Mydocalm are prescribed. These drugs are indicated for use only intermittently, since they have a serious effect on the condition of the muscles.

In addition to the above remedies, doctors prescribe regular use, which are aimed at activating the regeneration of joints and tissues.

Complexes are often used to restore the body special vitamins and minerals. Group B drugs have the greatest effect (6, 12).

If the pain is severe enough and cannot be suppressed with popular medications, novocaine blockade is used. The procedure involves injecting a drug directly into the spinal cord area.

It is quite simple to cure dystrophic changes in the lumbar region if you follow all the rules for using medications and follow the dosages.

Therapeutic exercise and massage

This set of procedures usually helps to normalize blood circulation in the problem area. It is also aimed at muscle relaxation and providing thinned tissues with the necessary nutrition. Exercise therapy for degenerative lesions helps improve metabolic processes and bring blood to the lumbar region. In addition, the event will be useful for obese people, as it helps eliminate excess weight.

It is important to plan the complex correctly physical activity, and as a result, it will be possible to achieve strengthening of the muscles, which will subsequently be able to take on moderate loads.

The main nuance of these measures is the possibility of increasing the distance between the lumbar vertebrae, as well as the ability to release nerves that have been compressed. Thus, with degenerative-dystrophic changes in the lumbosacral spine, it will be possible to get rid of pain syndrome and relieve inflammation.

And it is also advisable to sign up for a swimming pool, because high-quality classes will help strengthen your muscles and ensure their smooth stretching. By losing weight you can remove excess stress. But at this time, it is important to properly think through and plan your diet so that the body receives a sufficient amount of vitamins and minerals.

Surgery

Fortunately, in a huge number of clinical cases, the use of medications and therapeutic exercise comes to the rescue. Surgery is needed only in case of active progression of the disease, even with timely and regularly taken therapy measures. At the same time, the doctor looks at the MR picture of degenerative-dystrophic changes. During the event, devices are installed that help maintain the lumbar spine. This approach allows you to relieve excess pressure and prevent further deformation of the intervertebral discs.

Another common case is the formation of a serious lumbar hernia, suggesting the release of the disc from the vertebral boundaries. The pulp that has left the disc is then cauterized with a laser or pulled out.

The operating process involves the ability to simultaneously solve several clinical problems:

• decompression in the area of ​​spinal nerves;
• elimination of the object leading to compression of the nerve fibers;
• removal of stenosis that has developed in the spinal cord.

If the phenomenon of degenerative change is acute, emergency intervention is indicated. It aims to prevent neurological disorders. With this measure, specialists can eliminate cerebral compression and restore the options of the pelvic organs.

Preventive actions

Due to the vast scope on which these changes are occurring, certain preventive measures. They will help protect against loss of ability to work at a young age, as well as extend the time of activity until old age. To improve the MR picture of degenerative-dystrophic changes in the lumbosacral region and improve general well-being in the present and future, it is worth taking certain actions.

Degenerative-dystrophic changes in the lumbosacral spine are the result complex impact 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 various diseases, which 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 important structural element 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.

At 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 cells connective tissue. Nutrition here occurs indirectly, so degenerative-dystrophic 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 feel 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 occur when standing or sitting for a long time in an uncomfortable position. Then It's a dull pain becomes acute: when you try to turn or bend over, you can feel a sharp stabbing in your 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 fail to apply in a timely manner medical care such complications can seriously deteriorate a person's health.

Diagnostics

Diagnostics for identifying degenerative-dystrophic changes in the lumbar and coccyx areas is complex. Together with the simplest techniques, we also use modern technologies, helping to 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 high level With more 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 inflammation and eliminate pain.

Another task of medications is to improve the nutrition of 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 painful sensations;
• 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.

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

Essential positive effect provides physiotherapeutic treatment and massage. 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 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.

Physical therapy 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 perform several 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 pathology is mainly caused by 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 critical. Based on the research results, treatment is prescribed - drug therapy, physiotherapy and exercise therapy. Prevention of violations plays an important role.

With a modern sedentary lifestyle, constant sudden movements, injuries, when the spine takes on a large load, temporary changes and deformation of cartilage tissue may occur.

The pathology has a long development and can lead to chronic form diseases. The main disease with degenerative changes in the lower back is osteochondrosis. Spinal degeneration has several types.

Often, doctors give patients diagnoses such as spondylosis, osteochondrosis, spondyloarthrosis. The degenerative process in the intervertebral discs of the spine develops in 4 stages, and symptoms vary depending on the case.

If you encounter the symptoms listed below, then you need to see a doctor and start treatment.

What are degenerative-dystrophic changes in the lumbosacral spine?

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.

Degenerative-dystrophic changes in the lumbosacral spine is a syndrome in which the pathology of the intervertebral disc provokes the appearance of pain in the lower back.

Although there is a slight genetic predisposition to developing this disease, the real reason The appearance of degenerative changes in the spine appears to be multifactorial in nature.

Degenerative changes can be caused by the natural aging process of the body or have a traumatic nature. However, they are rarely the result of extensive trauma, such as a car accident.

Most often, we will be talking about a slow traumatic process leading to damage to the intervertebral disc, which progresses over time.

The intervertebral disc itself does not have a blood supply, so if it is damaged, it cannot repair itself in the same way as other tissues in the body. Therefore, even minor damage to the disk can lead to the so-called. a “degenerative cascade” due to which the intervertebral disc begins to deteriorate.

Despite the relative severity of this disease It is very common and current estimates suggest that at least 30% of people aged 30-50 years have some degree of disc space degeneration, although not all experience pain or are diagnosed with it.

In fact, in patients over 60 years of age, some level of intervertebral disc degeneration detected by MRI is the rule rather than the exception.

The spine in the lumbar and sacral areas is subject to the greatest loads in comparison with its other parts. Therefore, degenerative and dystrophic changes in it develop more often. The incidence is high - up to 30% of the population over 35 years of age.

Degenerative-dystrophic changes in the lumbosacral spine are a multifactorial pathology, their development is provoked by many reasons.
The main steps of the process are the same, regardless of the reason:

• malnutrition (dystrophy) of the cartilage of the discs between the vertebrae, which leads to their destruction (degeneration);
• degeneration of cartilage tissue causes height changes intervertebral discs,
• the appearance of protrusions in them with destruction of the fibrous membrane (hernia) or without (protrusion).

All these factors cause a violation of the proportional relationship of the vertebrae, with subsequent infringement of the spinal roots; development of inflammation in the area of ​​degenerative changes in cartilage - cells immune system As a result of destruction processes, substances that induce the inflammatory process (prostaglandins) are produced, which cause pain, increased blood supply (hyperemia) and tissue swelling.

The pathological process proceeds long time, tends to gradually progress and chronic course. The main disease with degenerative changes in the lower back and sacrum is osteochondrosis, which can be accompanied by hernias or protrusions of discs between the vertebrae.

In the case of predominant damage to the cartilage of the vertebral joints, spondylosis develops. 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.

Those few who seek help from a doctor with the firm intention of curing (or at least getting rid of the pain) an illness most often receive the following diagnoses:

• Spondylosis. Atypical bone growths form along the edges of the vertebrae. The disease is characterized by marginal bone growths that look like vertical spines on an x-ray. Experts consider this disease to be clinically insignificant. Doctors around the world believe that osteophytes (marginal growths) and thickening of ligaments lead to immobilization (immobilis - motionless) of the problem-prone segment of the spine;
• Osteocondritis of the spine. There is a visible thinning of the intervertebral disc, which occurs without inflammation. Simply put, this is a decrease in the height of the disc located between the vertebrae. As a rule, the disease appears as a result of processes of degeneration of vertebral tissues; osteochondrosis is characterized by the absence of inflammatory phenomena. During osteochondrosis, the vertebrae and articular processes come closer together, as a result of which their frequent friction is inevitable - it will inevitably lead in the future to local spondyloarthrosis;
• Spondyloarthrosis. This disease is a consequence of osteochondrosis. It is arthrosis of the intervertebral joints. In simple terms, spondyloarthrosis is a type of osteoarthritis.

There are many more similar diseases, the consequences of each of which boil down to disruption of the functioning of the spine, and in some cases even to the loss of a person’s ability to work.

Causes of the disease

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. 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; including generic;
• natural aging of the body;
• inflammatory diseases of the spine;
• poor nutrition.

Degenerative-dystrophic changes in the lumbosacral spine are usually provoked by one or both of the following two reasons:

• Inflammation that occurs when proteins in the disc space, when a herniated disc forms, irritate the nerve roots.
• Pathological instability of micromotion, when the outer shell of the disc (annulus fibrosus) wears out and cannot effectively withstand the load on the spine, which leads to excessive mobility in the affected spinal segment.

The combination of both factors can lead to persistent lower back pain. The combination of both factors is most common in the formation of intervertebral hernia, which is a complication of the degenerative process in the intervertebral discs.

When a disc herniation occurs, mechanical compression of the neurovascular bundle passing in the spinal canal is also added, as a result of which the pain in the lower back increases significantly and becomes permanent.

Symptoms

Symptoms of diseases 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.

A progressive degenerative process in the intervertebral discs of the spine can lead to serious and dangerous complications. Degenerative changes develop in stages.

initial stage
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 normal level life and performance. Complaints of pain directly depend on the location of the lesion.

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

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

Third stage
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.

Fourth stage
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 violation blood circulation of the spinal cord.

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

Most patients with degenerative-dystrophic changes in the lumbosacral spine experience constant but tolerable pain, which intensifies from time to time for several days or more. Symptoms may vary depending on the individual case, but the main symptoms of this disease are as follows:

• Pain localized in the lower back, which can radiate to the hips and legs;
• Long-lasting pain in the lower back (lasting more than 6 weeks);
• Low back pain is usually described as dull or aching, as opposed to a burning pain in the areas to which it radiates;
• The pain is usually worse in a sitting position, when the discs are subjected to more pronounced stress compared to what is placed on the spine when the patient stands, walks or lies down. Prolonged standing can also increase pain, as can bending forward and lifting objects;
• The pain worsens when performing certain movements, especially when bending, turning the body and lifting heavy objects;
• When a disc herniates, symptoms may include numbness and tingling in the legs and difficulty walking;
• With a medium or large disc herniation, the nerve root emerging from the spinal cord at the affected level may be compressed (foraminal stenosis), which, in turn, can lead to pain in the legs (sciatica);
• Neurological symptoms (eg, weakness in the lower extremities) or pelvic organ dysfunction ( various disorders urination and defecation) may be a consequence of the development of cauda equina syndrome. Cauda equina syndrome requires immediate action to provide qualified medical care.
• In addition to lower back pain, the patient may also experience leg pain, numbness, or tingling. Even without compression nerve root, other vertebral structures can cause pain to radiate to the buttocks and legs. The nerves become more sensitive due to inflammation caused by proteins within the disc space, causing numbness and tingling sensations. Usually in such cases the pain does not go below the knee;

In addition to degenerative changes in the intervertebral discs, the cause of pain can be:

• Stenosis (narrowing) of the spinal canal and/or osteoarthritis, as well as other progressive diseases of the spine, the occurrence of which is facilitated by degeneration of the intervertebral discs;
• Intervertebral hernia, a consequence of intervertebral disc degeneration.

• X-ray;
• CT ( CT scan);
• MRI (magnetic resonance imaging).

The first of these methods is the most accessible, but at the same time the least informative. X-rays provide information about the location of the bones and deformities of the spine. He is able to detect the disease by late stages. CT and MRI are more modern methods.

MRI allows you to see the destruction of the disc space, dehydration of the disc, erosion of the cartilaginous end plate of the vertebral body, the presence of an intervertebral hernia, and a rupture in the annulus fibrosus. But such procedures are usually expensive.

Diagnosis of the presence of degenerative-dystrophic changes in the lumbosacral spine is usually carried out in three steps:

• Compiling a history of the patient, including when the pain began, a description of pain and other symptoms, as well as actions, positions and treatments (if treatment was carried out) that relieve or, conversely, increase pain;
• Medical checkup, during which the doctor checks the patient for signs of intervertebral disc degeneration. This examination may include checking the patient's range of motion, muscle strength, looking for painful areas, etc.
• MRI scanning, which is used to confirm suspicions of degenerative changes in the spine, as well as to identify other potential causes that led to the appearance of painful symptoms in the patient.

MRI results most likely indicating the presence of degenerative changes as the cause of pain symptoms:

• Disk space is destroyed by more than 50%;
• Initial signs of disc space degeneration, such as disc dehydration (on MRI such a disc will appear darker because it will contain less water than a healthy disc);
• Rupture in the annulus fibrosus;
• The presence of protrusion or intervertebral hernia;
• There are signs of erosion of the cartilaginous end plate of the vertebral body. The disc does not have its own blood supply system, but, nevertheless, living cells are located inside the disc space. These cells receive nutrition by diffusion through the end plate. Pathological changes in the end plate as a result of degeneration lead to disruption of cell nutrition.

Such changes are best seen on T2-weighted images taken in the sagittal plane. Typically, the end plate appears as a black line on MRI. If this black line is not visible, it indicates endplate erosion.

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.

There are two methods of treating degenerative-dystrophic changes in the spine - conservative and surgical. The conservative treatment method includes the following actions: Limiting the mobility of the spine (carried out using orthopedic bandages or bed rest is prescribed).

• Drug treatment. Drugs are used aimed at combating inflammatory and degradation processes and improving vascular patency. Sedatives and vitamin complexes group B.
• Novocaine blockades.
• Physiotherapy (laser therapy, diadynamic currents, inductothermy, electrophoresis).
• Therapeutic methods(flat traction, underwater traction). Traction is considered the most dangerous method of treating degenerative diseases.
• Physiotherapy.
• Manual therapy.
• Acupuncture, acupuncture.

The vast majority of cases of intervertebral disc degeneration do not require surgical intervention and are treated using conservative methods, which include special therapeutic exercises, physiotherapy, different kinds massages.

In addition, spinal traction helps very well with disc degeneration, since it increases the distance between the vertebrae, allows the intervertebral disc to receive the water and nutrients it needs, which contributes to its recovery.

Separately, it is worth highlighting percutaneous nucleotomy. This method is a borderline method between conservative and surgical treatment. This type of treatment involves a puncture biopsy, the purpose of which is to reduce the volume of the affected intervertebral disc.

This type has a large list of contraindications. Surgical intervention is required only in cases of rapidly progressive neurological symptoms of the disease, persistent long-term pain syndrome, ineffectiveness conservative treatment.

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;
• improving blood flow and tissue supply nutrients and oxygen, normalization of metabolic processes;
• removal or reduction of inflammation;
• normalization of lumbar sensitivity;

Non-stress spinal traction is ideal for the treatment of degenerative lesions of the intervertebral discs (spinal osteochondrosis) and its complications - spondylosis, spondyloarthrosis, intervertebral hernias and protrusions. Traction takes place while maintaining all the physiological curves of the spine and is safe, since no force is used during traction.

As the intervertebral distance increases, the nutrition of all intervertebral discs improves, their structure is restored and pain is relieved.
By using complex treatment it is possible to achieve complete recovery of the patient, and not just pain relief for a limited period.

Complication

Degenerative-dystrophic changes do not occur simultaneously, however, a person is able to feel the symptoms of the disease even at the earliest stages. First of all, nerve damage caused by pinching due to narrowed intervertebral canals makes itself felt. This position causes the nerve endings to swell and reduces their conductivity.

The patient feels this as numbness in the limbs, a feeling of fatigue in the shoulders, neck, and back. Vertebrae change their tissue growth patterns. To reduce the load, the vertebrae expands, which subsequently leads to osteochondrosis and even greater pinched nerves. People suffering from similar ailments note increased fatigue, changes in gait, constant back pain.

And if bacteria and/or fungi are added to these lesions, then arthrosis, arthritis and osteochondropathy cannot be avoided. Subsequently, these ailments transform into herniated intervertebral discs. Also, degenerative changes in muscles lead to scoliosis or even displacement of the vertebrae.

In more severe stages of the disease, ischemia, impaired blood supply, paresis, and paralysis of the limbs are observed.

Prevention

Due to the scale of the spread of degenerative-dystrophic changes in the spine, it is worth paying attention to compliance with preventive recommendations.

These rules will protect you from loss of ability to work in your youth and extend your years of activity into old age:

• You should keep your back dry and warm. Humidity and hypothermia are the primary enemies of the spine.
• Excessive, sudden physical activity should be avoided. Exercises aimed at developing the back muscles will also protect against degenerative changes in the spine.
• When working in a static position, it is necessary to change your body position as often as possible. For office workers, it is recommended to lean back in your chair every half hour. Every hour and a half you need to get up from your chair and make small walks for 5-10 minutes.

Minimum measures to prevent back diseases include:

• daily strengthening of the back muscles. This can be done by doing basic physical exercises every day (for example, exercise);
• when getting out of bed, “land” on both legs (this will avoid a sharp load on the spine);
• Under no circumstances should you keep your back in a curved position (try to keep your back straight even while brushing your teeth);
• a serious approach to choosing a mattress. Since ancient times, we have been repeating the truth that sleep is health, because during sleep the muscles of the body relax: if this process is accompanied by an uncomfortable bed that is unable to provide sufficient support to the back, this will lead to the fact that you will wake up with the syndrome "stiff back"

Sources: “www.spinabezoli.ru, prohondroz.ru, vashaspina.com, vashpozvonochnik.ru, moisustav.ru, lecheniespiny.ru.”

megan92 2 weeks ago

Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!

Daria 2 weeks ago

I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are

megan92 13 days ago

Daria 12 days ago

megan92, that’s what I wrote in my first comment) Well, I’ll duplicate it, it’s not difficult for me, catch it - link to professor's article.

Sonya 10 days ago

Isn't this a scam? Why do they sell on the Internet?

Yulek26 10 days ago

Sonya, what country do you live in?.. They sell it on the Internet because stores and pharmacies charge a brutal markup. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars

Editor's response 10 days ago

Sonya, hello. This drug for the treatment of joints is indeed not sold through the pharmacy chain in order to avoid inflated prices. Currently you can only order from Official website. Be healthy!

Sonya 10 days ago

I apologize, I didn’t notice the information about cash on delivery at first. Then, it's OK! Everything is fine - for sure, if payment is made upon receipt. Thanks a lot!!))

Margo 8 days ago

Has anyone tried traditional methods of treating joints? Grandma doesn’t trust pills, the poor thing has been suffering from pain for many years...

Andrey A week ago

Which ones folk remedies I didn't try, nothing helped, it only got worse...

Ekaterina A week ago

I tried drinking a decoction of bay leaves, it didn’t do any good, I just ruined my stomach!! I no longer believe in these folk methods - complete nonsense!!

Maria 5 days ago

I recently watched a program on Channel One, it was also about this Federal program to combat joint diseases talked. It is also headed by some famous Chinese professor. They say that they have found a way to permanently cure joints and back, and the state fully finances the treatment for each patient