The lumbar region has a higher load than all other parts of the spine. Osteochondrosis develops as a result of degenerative-dystrophic processes due to a decrease in the height of the disc. Marginal osteophytes develop along the edges of the spine. At the same time, the intervertebral foramen narrows, the root is compressed, and signs of osteochondrosis appear. Treatment of lumbar osteochondrosis depends on the stage of the disease.
Osteochondrosis sometimes manifests itself as if its symptoms "mimic" damage to other organs. It has a code on the ICD - 10. We will try to understand all the details in more detail.
International classification
According to ICD-10, osteochondrosis has the code M42 and is divided into subtypes. M42. Code 0, according to ICD-10, indicates that this is a younger variant, manifesting itself in osteochondrosis Scheuermann-Mao or Calve disease. M42 in accordance with ICD-10. Code 1 gives an idea about the disease in adults.
If the disease variant is not indicated, the code M42 in ICD-10. It will be 9. There are also complications of uterine osteochondrosis, for which the ICD-10 code is completely different. A complication in the form of juvenile kyphosis, which causes Scheuermann-Mao disease. Its code is ICD-10 M40. Corresponds to 0.
Reasons for appearance
It is not yet clear why everything looks the same, one thing is certain: the structure of the intervertebral disc develops, which leads to more changes in the spine. Symptoms can be clearly seen after 35 years, accelerate the process of damage, remain static for a long time due to the load. But not only is the load to blame, often the disease is genetic in nature. The reason may be flat feet, especially 3 or 4 degrees.
Symptoms
The insidiousness of this disease of the spine is undeniable and only progresses over time. In general, doctors distinguish four stages of development of this pathology.
The first degree does not cause any pain, a person can sit quietly and painlessly, but the characteristic changes of the disease already occur in the nucleus of the intervertebral disc. Vertebral ligaments can also suffer. Locally, concerns may be noted that may be able to move away from the problem area. As a result of disruption of the innervation of the vessels of the lower extremities, they become cold.
In the second degree, the destruction of the fibrous ring of the intervertebral disc occurs. Instability appears in the lumbar spine, increased mobility and local tension of the lumbar muscles may be noted. A person feels constant fatigue, some anxiety and insecurity in the back.
In the third degree, osteochondrosis causes the fibrous ring to completely lose its strength and explode, and the pulposus nucleus, in turn, protrudes from it, resulting in a hernia. There is compression of the roots of the spinal nerves, symptoms develop, primarily pain. Sensitivity is completely or partially reduced in the area of innervation of the compressed nerve root. Morning or daily exercise brings significant pain. In the early stages, the burning sensation, tingling sensation is disturbed, and then comes the turn to numbness. Decreased or no sensitivity may be the cause of paralysis, resulting in muscle atrophy.
According to the characteristic zones of the sensitivity disorder, it is possible to assume in which segment the failure occurred. If the fibers of the sciatic nerve (the thickest part of the body) are affected, the Lasègue symptom will be positive, making it easy to check at home. Need to lie on your back, a stranger helps to lift a straight leg above the knee. With a positive symptom, if the leg is bent at the knee joint, the pain will increase and disappear completely.
With a significant size of the hernia, spinal cord function may suffer. You can often see signs of "ponytail" compression, so osteochondrosis often manifests itself as a bundle of nerves that leave the spinal cord and travel to the lumbar and sacral spine. Symptoms are manifested by impaired mobility and sensitivity of the lower extremities. In addition, dysfunction of the pelvic organs is added, often it is the bladder.
In the fourth stage, the intervertebral joints and ligaments are involved in the degenerative process, showing signs of instability of the spine. Arthrosis of the joints between the vertebrae, spondylosis develops. There is practically no pain at this stage, but at the same time, for a person, movement, exercise or gymnastics almost completely disappears and becomes a real problem.
Their function may be impaired due to the defeat of various nerves that innervate the internal organs. Sometimes a person struggles with a problem for a long time, but in fact the cause is osteochondrosis. In addition to the presence of characteristic symptoms, osteochondrosis of the spine should be constructed instrumentally.
Diagnostics
Symptoms are important, but additional confirmation of osteochondrosis allows for a picture of the lumbar spine. Damage to the joints of the spine, a decrease in the height of the disc, narrowing of the intervertebral foramina. The spine is photographed in two projections, and additional functional tests may be required.
You can confirm the presence of a disc herniation with MRI, the image will show characteristic changes. CT will show the structure of the tissue more clearly, which is especially convenient because the techniques are performed on different planes and sections. It is possible to consider where the symptoms occur and where they are present.
Treatment
A neurologist should be consulted before treating lumbar osteochondrosis. Medications have always been effective in getting rid of the disease. They are prescribed in courses for about 10 days, completing all physiotherapy, daily exercises, gymnastics, massage.
With the help of medication, you can effectively relieve severe pain caused by inflammation and swelling. After treatment in the hospital, you can continue to take medication and follow your doctor's prescriptions at home.
Everyone starts with non-steroidal anti-inflammatory drugs or NSAIDs. In osteochondrosis, there is swelling and pain because they reduce the inflammatory process. The doctor deals with the choice of drugs: they have many contraindications. But at the same time, they allow you to quickly alleviate the situation, after a few days a person will get rid of the pain and sit normally, osteochondrosis will be reduced.
If you do not use drugs aimed at restoring cartilage structure, the treatment will be lower. They are called chondroprotectors and in the initial stage help to better nourish the cartilage and regenerate disc tissue. You need to take them for a long time, even at home.
Muscle relaxants allow you to get rid of spasms of the back muscles. This situation is a response to root compression.
Drugs that improve microcirculation are needed. All of this will eliminate swelling where compression occurs, giving more oxygen and nutrients to the nerve cells. Exercise and massage have a similar effect, can be done at home to relieve pain.
If your back hurts a lot and sitting becomes a real problem, analgesics will be required. This group of drugs will quickly get rid of the manifestations of the disease.
Vitamins improve the nutrition of nerve roots, strengthen them. Treatment is more effective with the use of this group of drugs. Perfectly eliminates the symptoms of pain ointment, which should be rubbed in the area of maximum pain.
If your back hurts a lot and you can't sit, your doctor will prescribe an ointment. By penetrating the tissues, the ointment has an anti-inflammatory effect on the roots. You can apply the ointment in the form of compresses at night. Apply the ointment to painful areas three times a day.
Physiotherapy
Complete rehabilitation treatment consists of:
- physiotherapy exercises;
- physiotherapy;
- massage;
- traction;
- hand therapy;
- reflexology.
Therapeutic gymnastics consists of applying a dosed load to the lower back. With its help, the compressed roots are released, the muscles are strengthened, the correct posture is established, and then supported by a charge. Gymnastics allows you to increase the range of motion and make the joints more elastic. Gymnastics is chosen individually for each person.
The technique, like charging, is easy to perform, helps normalize blood circulation and improves metabolism. Gymnastics helps to improve the nutrition of the intervertebral disc, increases the space between the vertebrae. Due to the formation of the corset, pain and load on the spine are reduced. Gymnastics is performed under the supervision of a specialist and should be recharged every morning, this will prevent osteochondrosis.
Physiotherapeutic methods, as well as charging, are widely used. Especially low frequency currents, alternating current, ultrasound, laser and more help. You can use an ointment in addition to ultrasound. The methods eliminate the inflammatory process, pain and swelling. The most popular:
- UHF;
- diodynamics;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is often used at a stage where it is possible to get rid of pain. Massage, like exercise, promotes cartilage nutrition, improves metabolic processes. It is a massage consisting of a combination of special techniques: rubbing, kneading, tapping and shock vibration.
Proper massage is the key to successful treatment and subsequent recovery. Massage should be performed only by a specialist. In addition, you can use an ointment with anti-inflammatory effect. Massage helps to relieve muscle spasms, improves blood flow and strengthens the back.
Manual therapy is also a massage, using only a special technique. Its effect is the same as the effect of massage.
Traction is carried out with the help of specially selected weights and techniques. The procedure helps to increase the space between the vertebrae, relieves pain, restores the anatomical axis of the spine.
Acupuncture is based on the effect of injections on the active points of the human body. The technique is especially indicated for severe pain syndrome.