Lumbar Spondylosis – Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

Lumbar spondylosis is the most common diagnosis you find when you approach a physician complaining about low back pain and stiffness. It is a degenerative condition affecting the discs, vertebral bodies and associated joints of the lumbar spine. Low back pain and other discomforts started from the time human beings started walking on two legs, with an erect posture and the spine had to bear the extra burden. In the earlier days, poverty and physical exertion caused deficiencies in most people which led to low backache and other problems. Nowadays, sedentary lifestyle and obesity cause most of the low back diseases. Lumbar spondylosis is enlisted in many of the postural problems, yet it can happen due to other reasons, though. Adults, mostly women suffer from lumbar spondylosis mostly.

Anzeichen und Symptome

Most cases show no symptoms at all. In later stage, symptoms include:

  • Intermittent back pain that may radiate to the extremities
  • Joint or muscular stiffness upon awakening
  • Muscle weakness and/or tingling in the back, buttocks, legs, and other affected areas
  • Numbness or loss of sensation in the affected areas
  • Tenderness in the area of nerve compression
  • Loss of bowel or bladder control

Pathophysiologie

Lumbar spondylosis (spondylosis deformans, lumbar osteoarthritis), is known to be bony overgrowths (osteophytes), mostly at the anterior, lateral margins of vertebral bodies. Lumbar spondylosis occurs as a result of new bone formation in areas where the anular ligament is stressed. Normal vertebral bodies have smooth margins. Growth of new bone projecting horizontally at these margins identifies osteophytes. Most osteophytes are anterior or lateral in projection. Posterior vertebral osteophytes are very rare. This process increases with age. Lumbar osteophytes have long been thought to cause back pain because of their frequency and size. But studies show that frequency of signs or symptoms among individuals with osteophytes is no greater than among those individuals without osteophytes.

The high incidence of simultaneous degenerative changes to the intervertebral disk, vertebral body, and associated joints suggests a progressive and dynamic mechanism, with interdependent changes occurring secondary to disk space narrowing. Intervertebral disks are believed to undergo what Kirkaldy Willis and Bernard first coined a “degenerative cascade” of three overlapping phases that may occur over the course of decades.

Phase I (Dysfunction Phase)

Beginning of repetitive microtrauma with the development of circumferential painful tears of the outer, innervated anulus, and associated end-plate separation that may compromise disk nutritional supply and waste removal. Such tears may coalesce to become radial tears, more prone to protrusion, and impact the disk’s capacity to maintain water, resulting in desiccation and reduced disk height. Fissures may become ingrown by vascular tissue and nerve endings, increasing innervation and the disk’s capacity for pain signal transmission.

Phase II (Instability Phase)

It explains the loss of mechanical integrity, with progressive disk changes of resorption, internal disruption, and additional annular tears, combined with further facet degeneration that may induce subluxation and instability.

Phase III (Stabilization Phase)

It is the time when continued disk space narrowing and fibrosis occur along with the formation of osteophytes and trans discal bridging.

The spectrum of pathological changes in facial joints & the disk and the interaction of these changes. The upper light horizontal bar represents dysfunction, the middle darker bar instability, and the lower dark bar stabilization

Osteophyte lipping is believed to form at periosteum through the proliferation of peripheral articular cartilage which subsequently undergoes endochondral calcification and ossification. Changing weight mechanics and pressure forces as well as alterations in oxygen tension and dynamic fluid pressure appear to be influential factors in osteophyte formation. Mesenchymal stem cells of the synovium or periosteum are likely precursors, with synovial macrophages and a milieu of growth factors and extracellular matrix molecules acting as probable mediators in this process.

Verursacht

Since the purpose of the lumbar spine is to support your body weight, over time the L1-S1 vertebrae become worn and compressed from repetitive motion, heavy lifting, and weight gain.

Common causes include:

  • Herniated or bulging discs
  • Bone spurs
  • Spine abnormalities
  • Arthritis of the spine

In most cases, lumbar spondylosis only causes noticeable symptoms when the spinal cord or nerves around the spine become irritated or compressed. When symptoms do occur, they can differ greatly from person to person.

Diagnose

Physical examination to assess the range of motion, reflexes, and fine motor skills.

Imaging and other tests to determine the exact cause of symptoms and what treatment is appropriate.

These tests include:

  • X-rays of the back to discover any abnormalities
  • CT scan for more detailed imaging of bones
  • MRI to find any areas where nerves may be compressed
  • Myelography in which a dye is injected into the spinal canal prior to imaging tests
  • A nerve function test called electromyography (EMG) that tests electrical activity in nerves
  • A nerve conduction study during which electrodes attached to the skin measures strength and speed of nerve signals

Behandlung

Treatment for lumbar spondylosis depends on the severity of symptoms. Aim of the treatment is to relief from pain, avoid future damage, and help improve the quality.

This treatment plan may include nonsurgical options, including:

  • Physical therapy
  • Restorative yoga
  • Lifestyle changes, such as weight loss
  • Pain medication

 

In cases when nonsurgical treatment doesn’t relieve symptoms, minimally invasive surgery to decompress the spine can be performed.

Prognose

Generally, the prognosis of spondylosis is favourable. Many people with spondylosis do not have any symptoms. Of those who develop back or neck pain due to spondylosis, most improve within a few weeks of the onset of their symptoms. Few people go on to develop chronic pain due to spondylosis.

Komplikationen

Spinal stenosis if lumbar spondylosis projects into the spinal canal.

If osteophytes disappear, look for aortic aneurysm. Aortic aneurysms can cause pressure erosions of the adjacent vertebrae.

Krankheit & Ayurveda

Katigraha

Nidana

Physikalisch

  • Trockene, kalte und alte Lebensmittel
  • Übermäßiges Reisen und Überanstrengung
  • Trauma/Verletzung
  • Exposition gegenüber Wind
  • Schlafentzug

Psychologisch

Stress 

Purvaaroopa

Nicht erwähnt

Samprapti

Due to the causative factors, Vaatadosha vitiates and move irregularly all over the body and cause imbalance in circulation & metabolism. Due to either obstruction in the channels or degeneration of body tissues, the movement of Vaata gets in an unbalanced state. This vitiated Vaata gets lodged inside the spine in the lumbar area and causes pain and stiffness.

Lakshana

        Pain in the lowback

Stiffness of the back especially in lumbar region

Restricted movements of spine.

  • If Saama, loss of appetite, fatigue, swelling and hardness will be there.
  • In niraama, only pain and associated symptoms will be present. Appetite and bowel movements will be normal.

Abteilungen

Saama

Niraama

Prognose

Sukhasadya in new and with no restricted movements.

Yaapya in chronic cases

Chikithsa

The ayurvedic treatment depends upon whether the katigraha is saama or niraama. If aama is present, only rooksha therapies are done in the beginning. Application of Vaatahara oils and ghee preparations should wait until the aama is completely cleared and the srotas (channels) are open completely. If the Vaatakopa is due to obstruction, the pain will be relieved once the channels are open and the movement of Vaata is in normal balanced condition.

Samana

In Saama condition

Lepanam with Rookshana dravyas

Soolaharakwathaparisheka

Upanaha

Sodhana

Sneha-sweada

Virechana

Asthapanavasti

Anuvasanavasti

Commonly used Medicines

Verfügbare Marken

  • AVS Kottakal
  • AVP Coimbatore
  • SNA oushadhasala
  • Vaidyaratnam oushadhasala

Hausmittel

Over-the-counter pain medications can frequently alleviate the pain.

Take enough rest. Immobilisation is very important in relieving the pain.

Applying ice can help with pain and inflammation.

A hip or low back brace/belt can help immobilisation and support. It should not be tight and should be removed at night.

Diät

  • Zu vermeiden sind

Schwere Mahlzeiten und schwer verdauliche Lebensmittel - verursachen Verdauungsstörungen.

Junk Food - stört die Verdauung und verringert die Bioverfügbarkeit des Medikaments

Kohlensäurehaltige Getränke - erhöhen den Säuregehalt des Magens und stören die Verdauung

Gekühlte und gefrorene Lebensmittel - verursachen eine schwache und träge Verdauung durch Schwächung von Agni (Verdauungsfeuer)

Milch und Milchprodukte - erhöhen Kapha, verursachen Verstopfung in den Kanälen und Fettleibigkeit

Quark - verursacht Vidaaha und damit viele andere Krankheiten

  • Noch zu ergänzen

Leichte Mahlzeiten und leicht verdauliche Lebensmittel

Green gram, soups, sesame oil, ragi.

Frisch gekochte und warme Speisen, verarbeitet mit Kreuzkümmel, Ingwer, schwarzem Pfeffer, Ajwain usw.

Verhaltensweisen:

  • Protect yourself from cold climate.
  • Vermeiden Sie übermäßige Sonneneinstrahlung, Wind, Regen oder Staub.
  • Halten Sie einen regelmäßigen Essens- und Schlafplan ein.
  • Vermeiden Sie es, Triebe wie Urin, Stuhlgang, Husten, Niesen usw. zurückzuhalten oder zu erzwingen.
  • Vermeiden Sie eine sitzende Lebensweise. Aktiv sein
  • Avoid lifting heavy weights

Yoga

In lowback pain, exercises are to be done only under supervision.

Exercises are contraindicated in patients with severe pain and stiffness.

Regular stretching and mild cardio exercises are advised in mild cases. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.

Regelmäßige Bewegung trägt dazu bei, die Bioverfügbarkeit der eingenommenen Medikamente und Nahrungsmittel zu verbessern, und führt zu einer positiven Gesundheit.

Yoga kann die Harmonie im Körper und mit dem umgebenden System aufrechterhalten.

Pavanamuktasana

Nadisudhi Pranayama

Bhujangasana

Einfache Übungen für die Gesundheit von Lunge und Herz

Alle Übungen und körperlichen Anstrengungen dürfen nur unter der Aufsicht eines medizinischen Experten durchgeführt werden.

Forschungsartikel

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697338/#Sec6title

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697338/

https://pubmed.ncbi.nlm.nih.gov/24252032/