The lumbar region bears more stress than any other part of the spine.Osteochondrosis arises as a result of degenerative-dystrophic processes due to a decrease in the height of the intervertebral discs.Marginal osteophytes develop along the vertebral edges.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 subtleties in more detail.
International classification
According to ICD-10, osteochondrosis has the code M42 and is divided into subtypes.According to ICD-10, code M42.0 indicates that this is a juvenile variant, osteochondrosis is manifested by Scheuermann-Mao or Calve disease.The code M42.1 according to ICD-10 provides an insight into the disease in adults.
If the disease variant is not specified, the code in ICD-10 is M42.9.There are also complications of childhood osteochondrosis;Your ICD-10 code is completely different.A complication occurs in the form of juvenile kyphosis, which leads to Scheuermann-Mao disease.His code according to the ICD is 10 M40.0.
Reasons for appearing
Why everything occurs is not yet entirely clear, one thing is certain: an injury to the structure of the intervertebral disc occurs, which leads to further changes in the spine.The symptoms are clearly visible after 35 years, the injury process is accelerated by prolonged stay in a static position due to stress.But it's not just the stress that's responsible;The disease is often genetic.The cause can be flat feet, especially grade 3 or 4.
Symptoms
The insidiousness of this spinal disease is undeniable and with time it only progresses.In total, doctors distinguish four degrees of development of this pathology.
The first degree does not cause any pain, the person can sit quietly and without pain, but changes typical of the disease are already occurring in the core of the intervertebral disc.The ligaments that strengthen the vertebrae can also suffer.Locally, you may notice discomfort that can radiate far from the problem area.As a result of disorders in the innervation of the vessels of the lower extremities, cold is observed in them.
In the second degree, the fibrous ring of the intervertebral disc is destroyed.Instability occurs in the lumbar spine;There is increased mobility and local tension in the lower back muscles.A person feels constant fatigue, a feeling of discomfort in the back and insecurity.
In the third degree, osteochondrosis causes the fibrous ring to completely lose its strength and burst, and the nucleus pulposus in turn expands beyond its limits, resulting in an inguinal hernia.The roots of the spinal nerves become compressed and symptoms occur, especially pain.In the area of innervation of the compressed nerve root, sensitivity is completely or partially lost.Morning or everyday exercises cause significant pain.In the early stages there is a burning sensation and a tingling sensation, then numbness occurs.Reduced or absent sensitivity can be considered a cause of paralysis, which results in muscle loss.
Based on the characteristic zones of sensory impairment, it can be assumed in which segment the error occurred.When the fibers of the sciatic nerve (the thickest nerve in the body) are damaged, Lassègue symptom is positive;It's easy to check it at home.You need to lie on your back, a stranger helps you raise your straight leg to the knee.If the symptom is positive, the pain increases;When the leg is bent at the knee joint, it disappears completely.
If the size of the hernia is significant, the function of the spinal cord may be impaired.Symptoms of compression of the “cauda equina”, which often manifests itself in osteochondrosis, can often be observed.This is a bundle of nerves that runs from the spinal cord through the lumbar and sacral spine.Symptoms include reduced mobility and tenderness of the lower extremities.In addition, there are dysfunctions of the pelvic organs, very often the bladder.
In the fourth stage, intervertebral joints and ligaments are involved in the degenerative process and symptoms of spinal instability appear.Osteoarthritis of the joints between the vertebrae, spondyloarthrosis, develops.At this stage there is practically no pain, but at the same time the ability to move almost completely disappears;Exercise or gymnastics becomes a real problem for a person.
Due to damage to various nerves that supply internal organs, their function may be impaired.Sometimes a person has been struggling with a problem for a long time, but in reality osteochondrosis is the cause.In addition to the characteristic symptoms, the diagnosis of spinal osteochondrosis must be made instrumentally.
diagnosis
The symptoms are important, but a lumbar spine scan can additionally confirm osteochondrosis.There is damage to the vertebral joints, a decrease in the height of the intervertebral discs and a narrowing of the intervertebral foramen.The spine is photographed in two projections;Additional functional testing may be required.
The presence of a herniated disc can be confirmed using MRI;Characteristic changes become visible in the image.A CT scan shows the structure of the tissue more clearly;This is particularly convenient because the techniques are performed in different levels and sections.It is possible to look where the symptoms appear and bother you.
Treatment
Before treating lumbar osteochondrosis, it is necessary to consult a neurologist.Medicines have always helped get rid of the disease.They are prescribed in courses for about 10 days, supplemented by all physical procedures, daily exercises, gymnastics, massage.
With the help of medication, you can effectively eliminate severe pain caused by inflammation and swelling.After treatment in the hospital, taking medications and following doctor's prescriptions can continue at home.
Everyone starts with nonsteroidal anti-inflammatory drugs, or NSAIDs.Since they reduce the inflammatory process in osteochondrosis, swelling and pain disappear.The doctor selects the drugs: they have many contraindications.But at the same time they quickly alleviate the condition;In a few days the person will get rid of the pain and will be able to sit normally, the osteochondrosis will recede.
Treatment will be incomplete if you do not take medications to restore the structure of cartilage.They are called chondroprotectors and contribute to better nutrition of cartilage and restoration of intervertebral disc tissue in the initial stages.They must be taken over a longer period of time, even at home.
Muscle relaxants allow you to eliminate spasms in the lower back muscles.This condition is a response to compression of the roots.
Drugs that improve microcirculation are needed.This eliminates the swelling where the compression occurred and provides more oxygen and nutrients to the nerve cells.Exercise and massage, which can be done at home to relieve pain, have a similar effect.
If your back hurts a lot and sitting becomes a real problem, you need painkillers.This group of drugs allows you to quickly eliminate the manifestations of the disease.
Vitamins improve the nutrition of the nerve roots and strengthen them.When this group of drugs is used, treatment is much more effective.An ointment that should be applied to the area of greatest pain is great for relieving pain symptoms.
The doctor prescribes an ointment if your back hurts badly and you cannot sit.By penetrating the tissue, the ointment has an anti-inflammatory effect on the roots.The ointment can be used as a compress at night.Apply the ointment to the painful areas three times a day.
Physiotherapy
The complete rehabilitation treatment consists of:
- physiotherapy;
- physiotherapy;
- Massage;
- traction;
- manual therapy;
- Reflexology.
Remedial gymnastics involves a measured load on the lumbar spine.With its help, compressed roots are released, the muscles are strengthened and correct posture is established, which is then supported through movement.Gymnastics allows you to expand the range of motion and make the ligaments more elastic.Gymnastics is selected individually for each person.
The technique, like training, is easy to perform, helps normalize blood circulation and improves metabolism.Gymnastics helps to improve the nutrition of the intervertebral disc and increase the space between the vertebrae.The formation of the corset reduces pain and strain on the spine.Gymnastics is performed under the supervision of a specialist and exercise is required every morning to prevent osteochondrosis.
Physiotherapeutic methods, like exercises, are used very frequently.Low-frequency currents, alternating current, ultrasound, lasers and much more are particularly helpful.You can additionally use the ointment with ultrasound.Methods relieve inflammation, pain and swelling.Most popular:
- UHF;
- diode speakers;
- Magnet;
- shock wave therapy;
- Ultrasonic;
- Electrophoresis.
Massages are very often used in the phase in which the pain is relieved.Massage, like exercise, helps nourish cartilage and improve metabolic processes.Massage is a combination of special techniques: rubbing, kneading, stroking and shock vibration.
Properly performed massage is the key to successful treatment and subsequent recovery.Only a professional should perform a massage.Additionally, you can use an ointment with anti-inflammatory effects.The massage relieves muscle spasms, improves blood circulation and strengthens the back.
Manual therapy is also a massage, but with a special technique.The effect is the same as a 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 spine.
Acupuncture is based on the effect of a needle prick on active points of the human body.The technique is especially indicated for severe pain syndrome.