The lumbar region has more load than all other parts of the spine. Osteochondrosis develops as a result of degenerative-dystrophic processes due to decreased disc height. Marginal osteophytes develop along the edges of the vertebra. 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 appears in such a way that its symptoms "simulate" damage to other organs. He has been assigned a code in 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 subspecies. Code M42. 0, according to ICD-10, indicates that this is a youth 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 in the ICD-10 the code will be M42. 9. There are also complications of childhood osteochondrosis, the ICD-10 code is completely different for them. A complication occurs in the form of juvenile kyphosis, which gives Scheuermann-Mao disease. Its code according to ICD-10 M40. 0.
Reasons for submission
Why everything appears is not yet fully known, one thing is certain: a violation of the structure of the intervertebral disc develops, which leads to further changes in the spine. Symptoms can be clearly seen after 35 years, accelerate the process of injury, long stay in a static position, due to the load. But not only is the load to blame, often the disease is genetic in nature. The cause may be flat feet, especially grades 3 or 4.
Symptoms
The cunning of this spinal disease is undeniable and over time it only progresses. In total, physicians distinguish four stages of development of this pathology.
The first degree gives no pain, a person can sit quietly and without pain, but the characteristic changes of the disease are already occurring in the core of the intervertebral disc. The ligaments that strengthen the vertebrae may also suffer. Locally, discomfort can be noticed, which is able to give away the problem area. As a result of violations of the innervation of the vessels of the lower extremities, they become cold.
In the second degree, 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 can be observed. A person feels constant fatigue, a feeling of discomfort in the back and insecurity.
In the third degree, osteochondrosis leads to the fact that the fibrous ring completely loses its strength and explodes, the nucleus pulposus, in turn, goes beyond it, so a hernia is formed. There is compression of the spinal nerve roots, symptoms appear, mainly pain. In the area of innervation of the compressed nerve root, sensitivity decreases completely or partially. Morning or daily exercise brings considerable pain. In the initial stages, the burning sensation, the tingling sensation is disturbed, then comes the numbness. Decreased or lack of sensitivity can be considered the cause of paralysis, resulting in muscle atrophy.
According to the characteristic areas of sensitivity impairment, it can be assumed in which segment the failure occurred. If the sciatic nerve fibers are affected (thicker in the body), Lasègue symptoms will be positive, it is easy to control it at home. It is necessary to lie on your back, a stranger helps to raise a straight leg at the knee up. With a positive symptom, the pain will increase if the leg is bent at the knee joint, it disappears completely.
With a considerable size of hernia, spinal cord function may suffer. You can often observe the symptoms of "tail" compression, so osteochondrosis often manifests, it is a bundle of nerves that, leaving the spinal cord, passes into the lumbar and sacral spine. Symptoms are manifested by impaired mobility and sensitivity of the lower extremities. In addition, disorders of the function of the pelvic organs are added, very often it is the bladder.
In the fourth stage, the intervertebral joints and ligaments are involved in the degenerative process and symptoms of spinal instability appear. Osteoarthritis of the joints between the vertebrae, spondylarthrosis develops. There is virtually no pain at this stage, but along with that, the ability to move in, exercise or gymnastics for a person almost completely disappears and becomes a real problem.
Due to the damage to the various nerves that irritate the internal organs, their function can be impaired. Sometimes a person struggles for a long time with a problem, but in fact the cause is osteochondrosis. In addition to the fact that there are characteristic symptoms, spinal osteochondrosis should be placed instrumentally.
Diagnosing
Symptoms are important, but an additional confirmation of osteochondrosis allows a view of the lumbar spine. Indicates damage to the vertebral joints, decrease in disc height, narrowing of the intervertebral foramen. A photograph of the spine is taken in two projections, additional functional tests may be required.
You can confirm the presence of a disc herniation with an MRI, the image will show characteristic changes. CT will show the structure of the tissue more clearly, it is especially convenient because the techniques are performed in different planes and sections. It is possible to consider the place where the symptoms appear and are disturbed.
Treatment
Before treating lumbar osteochondrosis, a consultation with a neurologist is necessary. Medications have always been effective in helping eliminate the disease. They are described in courses for about 10 days, complement all physiotherapy, daily exercises, gymnastics, massage.
With the help of medications, you can effectively eliminate the severe pain caused by inflammation and swelling. After hospital treatment, taking medication and following the doctor’s prescriptions can be continued at home.
They all start with non-steroidal anti-inflammatory drugs, or NSAIDs. Due to the fact that they reduce the inflammatory process in osteochondrosis, the swelling and pain go away. The doctor is engaged in the selection of drugs: they have many contraindications. But along with this, they quickly allow to alleviate the condition, after a few days a person will get rid of the pain and sit down normally, osteochondrosis will subside.
Treatment will be inferior if you do not use medications aimed at restoring cartilage structure. They are called chondroprotectors and contribute to better cartilage nutrition, restoration of disc tissue in the early stages. You have to take them for a long time, even at home.
Muscle relaxants make it possible to relieve lower back muscle spasm. This condition is a response to root compression.
Drugs that improve microcirculation are needed. All of this will remove the swelling at the site of the compression, give the nerve cells more oxygen and nutrients. Exercises and massages, 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, 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. With the use of this group of drugs, the treatment is much more effective. Perfectly overcomes the symptoms of pain ointment, which should be applied to the site of maximum pain.
The doctor prescribes an ointment if your back hurts a lot and it is impossible to sit down. By penetrating the tissues, the oil has an anti-inflammatory effect on the roots. You can apply the ointment in the form of compresses at night. Apply the ointment to the painful areas three times a day.
Physiotherapy
A complete rehabilitation treatment consists of:
- physiotherapy exercises;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying a dosed load to the lumbar spine. With its help, the stuck roots are released, the muscles are strengthened, the proper posture is established, which is then supported by charging. Gymnastics allows you to increase the range of motion, make the ligaments more elastic. Gymnastics is chosen individually for each person.
The technique, like charging, is easy to perform, contributes to the normalization of blood circulation and improves metabolism. Gymnastics helps to improve the nutrition of the intervertebral disc, increasing the space between the vertebrae. Due to the formation of a corset, the pain and load on the back are reduced. Gymnastics is performed under the supervision of a specialist, and charging is necessary every morning, will prevent osteochondrosis.
Physiotherapeutic methods are used, as well as charging, very widely. Low frequency currents, alternating currents, ultrasound, lasers and much more help especially. With ultrasound, you can also use an ointment. The methods relieve the inflammatory process, pain and swelling. Most popular:
- UHF;
- diodynamics;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is used very often at the stage when it was possible to get rid of the pain. Massage, like exercise, stimulates cartilage nutrition, improves metabolic processes. It is a massage a combination of special techniques: rubbing, kneading, stroking and shock vibration.
Properly performed massage is the key to successful treatment and subsequent healing. Massage should be performed only by a specialist. In addition, you can use an ointment with an anti-inflammatory effect. Massage allows you to relieve muscle spasm, improves blood flow, strengthens the back.
Manual therapy is also a massage, only using a special technique. Its effect is the same as that of a massage.
With the help of specially selected weights and techniques, traction is performed. 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 needle piercing on the active points of the human body. The technique is especially indicated for severe pain syndrome.