The lumbar region bears a greater load than all other parts of the spine.Osteochondrosis develops as a result of degenerative-dystrophic processes due to a decrease in disc height.Marginal osteophytes develop along the edges of the vertebrae.At the same time, the intervertebral foramen narrows, the root is compressed and symptoms of osteochondrosis appear.Treatment of lumbar osteochondrosis depends on the stage of the disease.
Osteochondrosis sometimes manifests itself in such a way that its symptoms "simulate" damage to other organs.He was assigned a code in the ICD - 10. We will try to understand all the intricacies in more detail.
International classification
According to ICD-10, osteochondrosis has the code M42 and is divided into subtypes.Code M42.0, according to ICD-10, indicates that it is a juvenile variant, osteochondrosis is manifested by Scheuermann-Mao or Calve disease.Code M42.1 according to ICD-10 gives an idea of the disease in adults.
If the disease variant is not specified, then the ICD-10 code will be M42.9.There are also complications of childhood osteochondrosis;their ICD-10 code is completely different.A complication occurs in the form of juvenile kyphosis, which causes Scheuermann-Mao disease.Its ICD code is 10 M40.0.
Reasons for occurrence
Why everything appears is still not completely known, one thing is certain: there is a violation of the structure of the intervertebral disc, which leads to further changes in the spine.Symptoms can be clearly observed after 35 years, the injury process is accelerated by prolonged stay in a static position due to stress.But it's not just the load that's to blame;often the disease is genetic.Flat feet, especially grade 3 or 4, can be the cause.
Symptoms
The insidiousness of this spinal disease is undeniable, and it only progresses over time.In total, doctors distinguish four stages of development of this pathology.
The first degree does not cause pain, a person can sit quietly and painlessly, but the changes characteristic of the disease already appear in the core of the intervertebral disc.The ligaments that strengthen the vertebrae can also suffer.Locally, you may notice discomfort that may radiate far from the problem area.As a result of disruption of the innervation of the blood vessels of the lower extremities, coldness is observed in them.
In the second stage, the fibrous ring of the intervertebral disc is destroyed.Instability appears in the lumbar spine;increased mobility and local tension of the muscles of the lower back can be observed.The person feels constant fatigue, a feeling of discomfort in the back and insecurity.
In the third stage, osteochondrosis leads to the fact that the fibrous ring completely loses its strength and bursts, the nucleus pulposus, in turn, exceeds its limits and thus a hernia occurs.Spinal nerve roots are compressed and symptoms develop, primarily pain.In the area of innervation of the compressed nerve root, sensitivity is completely or partially lost.Morning or daily exercise brings significant pain.In the initial stages, the sensation of burning, tingling, then comes numbness.Reduced or absent sensitivity can be considered a cause of paralysis, resulting in muscle atrophy.
Based on the characteristic zones of sensitivity damage, it can be assumed in which segment the fault occurred.If the fibers of the sciatic nerve (the thickest nerve in the body) are damaged, Lassegue's symptom will be positive;it's easy to check at home.You have to lie on your back, a stranger helps you raise your straight leg at the knee.If the symptom is positive, the pain will increase;if the leg is bent at the knee joint, it disappears completely.
With a significant size of the hernia, the function of the spinal cord can be affected.You can often notice symptoms of compression of the "cauda equina", which often manifests osteochondrosis, it is a bundle of nerves that, leaving the spinal cord, passes through the lumbar and sacral spine.Symptoms include reduced mobility and sensitivity of the lower extremities.In addition, dysfunctions of the pelvic organs are also added, very often also the bladder.
In the fourth stage, intervertebral joints and ligaments are involved in the degenerative process and symptoms of spinal instability appear.Arthrosis of the joints between the vertebrae, spondyloarthrosis, develops.In this phase, there is practically no pain, but along with that, the ability to move in it almost completely disappears;exercise or gymnastics becomes a real problem for a person.
Due to damage to various nerves that innervate internal organs, their function may be disturbed.Sometimes a person struggles with one problem for a long time, and it is actually the cause of osteochondrosis.Apart from the fact that there are characteristic symptoms, osteochondrosis of the spine must be diagnosed instrumentally.
Diagnostics
Symptoms are important, but an image of the lumbar spine can further confirm osteochondrosis.It shows damage to the vertebral joints, a decrease in disc height and a narrowing of the intervertebral foramen.The photograph of the spine was made in two projections;additional functional tests may be required.
The presence of a herniated disc can be confirmed by MRI;characteristic changes will be visible in the image.A CT scan will show the tissue structure more clearly;it is especially convenient because the techniques are performed in different planes and sections.It is possible to look at the place where symptoms occur and bother.
Treatment
Before treating lumbar osteochondrosis, a consultation with a neurologist is necessary.Medicines have always been effective in helping us get rid of disease.They are prescribed in courses of about 10 days, supplemented by all physical procedures, daily exercises, gymnastics, massage.
With the help of medicines, you can effectively remove severe pain caused by inflammation and swelling.After treatment in the hospital, taking medication and following the doctor's instructions can be continued at home.
All start with nonsteroidal anti-inflammatory drugs, or NSAIDs.Due to the fact that they reduce the inflammatory process in osteochondrosis, swelling and pain disappear.The doctor chooses medicines: they have many contraindications.But at the same time, they quickly relieve the condition;in a few days the person will get rid of the pain and will sit normally, the osteochondrosis will go away.
Treatment will be incomplete if you do not use drugs aimed at restoring the cartilage structure.They are called chondroprotectors and contribute to better nutrition of cartilage and restoration of disc tissue in the initial stages.They should be taken for a long time, even at home.
Muscle relaxants allow you to get rid of lower back muscle spasms.This condition is a response to root compression.
Medicines that improve microcirculation are needed.All this will remove the swelling in the place where the compression occurred, giving the nerve cells more oxygen and nutrients.Exercise and massage, which can be performed at home to relieve pain, have a similar effect.
If your back hurts a lot and sitting becomes a real problem, you will need pain relievers.This group of drugs will allow you to quickly get rid of the manifestations of the disease.
Vitamins improve the nutrition of nerve roots and strengthen them.If this group of drugs is used, the treatment is much more effective.Ointment that should be applied to the area of greatest pain is excellent in overcoming pain symptoms.
Your doctor prescribes an ointment if your back hurts a lot and you can't sit.Penetrating the tissue, the ointment has an anti-inflammatory effect on the roots.Ointment can be used as compresses at night.Apply the ointment to the painful areas three times a day.
Physiotherapy
Complete rehabilitation treatment consists of:
- physical therapy;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying a dosed load to the lumbar spine.With its help, compressed roots are released, muscles are strengthened and proper posture is established, which is then supported by exercise.Gymnastics allows you to increase the range of motion and make the ligaments more elastic.Gymnastics is chosen individually for each person.
The technique, like exercise, is easy to perform, helps to normalize blood circulation and improves metabolism.Gymnastics helps improve the nutrition of the intervertebral disc, increasing the space between the vertebrae.Due to the formation of the corset, pain and stress on the spine are reduced.Gymnastics is performed under the supervision of a specialist, and exercise is required every morning, it will prevent osteochondrosis.
Physiotherapy methods are used, like exercises, very widely.Low frequency currents, alternating current, ultrasound, laser and more are especially useful.You can additionally use ointment with ultrasound.The methods relieve inflammation, pain and swelling.Most popular:
- UHF;
- diodespeaker;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is very often used in the phase when the pain is alleviated.Massage, like exercise, helps nourish cartilage and improves metabolic processes.Massage is a combination of special techniques: rubbing, kneading, caressing and shock vibrations.
A properly performed massage is the key to successful treatment and subsequent recovery.Massage should only be performed by a specialist.In addition, you can also use an ointment with anti-inflammatory effects.Massage relieves muscle spasms, improves blood flow and strengthens the back.
Manual therapy is also a massage, but with a special technique.Its effect is the same as that of massage.
Traction is performed using specially selected weights and techniques.The procedure helps to increase the distance between the vertebrae, relieve pain and restore the anatomical axis of the spinal column.
Acupuncture is based on the effect of needles on the active points of the human body.The technique is especially indicated for severe pain syndrome.