The lumbar region carries more 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 in such a way that its symptoms "imitate" 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.Code M42.0, according to ICD-10, indicates that this is a juvenile variant, osteochondrosis manifests itself with Scheuermann-Mao or Calve disease.According to ICD-10, the M42.1 code gives an idea about the disease in adults.
If the variant of the disease is not specified, the code in ICD-10 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.According to the ICD, its code is 10 M40.0.
Reasons for appearance
It is not yet fully known why everything appears, but one thing is certain: the intervertebral disc structure breaks down, which leads to further changes in the spine.Symptoms can be clearly observed after 35 years, the damage process is accelerated by staying in a static position for a long time due to stress.But it's not just the burden that's to blame;Often the disease is genetic.The reason may be flat feet, especially 3 or 4 degrees.
Symptoms
The insidiousness of this spinal disease is undeniable and only progresses with time.In general, doctors distinguish four degrees of development of this pathology.
The first degree does not cause any pain, a person can sit quietly and without pain, but the characteristic changes of the disease already occur in the core of the intervertebral disc.The ligaments that strengthen the spine can also suffer.Locally, you may feel discomfort that can move away from the problem area.As a result of disturbances in the innervation of the vessels of the lower extremities, coldness is observed in them.
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 in the lower back muscles may be noted.A person feels constant fatigue, some discomfort in the back and uncertainty.
In the third degree, osteochondrosis causes the annulus fibrosus to completely lose its strength and burst, and the nucleus pulposus, in turn, protrudes beyond its limits, forming a hernia.Spinal nerve roots are compressed and symptoms, primarily pain, develop.Sensitivity is completely or partially lost in the area of innervation of the compressed nerve root.Morning or daily exercise brings significant pain.In the initial stages, burning sensation, tingling sensation is bothering, then numbness comes.Decreased or absent sensitivity can be considered the cause of paralysis, which results in muscle atrophy.
Based on the characteristic zones of sensitivity impairment, 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;easy to check at home.You need to lie on your back, a stranger helps to raise your straight leg above the knee.If the symptom is positive, the pain will intensify;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 observe signs of compression of the "cauda equina", which is how osteochondrosis often manifests itself, which is the nerve bundle that leaves the spinal cord and passes through the lumbar and sacral spine.Symptoms include impaired mobility and sensitivity of the lower extremities.In addition, dysfunctions of the pelvic organs are added, often the bladder.
In the fourth stage, intervertebral joints and ligaments are involved in the degenerative process, and signs of instability of the spine appear.Between the vertebrae, arthrosis of the joints, spondyloarthrosis develops.At this stage, there is practically no pain, but in addition, the ability to move there almost completely disappears;for a person, exercise or gymnastics becomes a real problem.
Due to the damage of various nerves innervating the internal organs, their function may be disturbed.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, spinal osteochondrosis should be diagnosed instrumentally.
Diagnostics
Symptoms are important, but an image of the lumbar spine can additionally confirm osteochondrosis.This indicates damage to the joints of the vertebrae, a decrease in the height of the disc and a narrowing of the intervertebral foramina.The spine is photographed in two projections;additional functional tests may be required.
The presence of a herniated disc can be confirmed using MRI;Characteristic changes will appear in the image.A CT scan 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 look at the location of the symptoms and worry about them.
Treatment
Before treating lumbar osteochondrosis, a consultation with a neurologist is necessary.Medicines have always been effective in curing disease.They are appointed in courses completed with all physical procedures, daily exercises, gymnastics, massage for about 10 days.
With the help of drugs, you can effectively relieve severe pain caused by inflammation and swelling.After being treated in the hospital, taking medication and following the doctor's instructions can be continued at home.
Everyone starts with nonsteroidal anti-inflammatory drugs, or NSAIDs.Because they reduce the inflammatory process in osteochondrosis, swelling and pain go away.The doctor chooses drugs: they have many contraindications.But at the same time, they quickly alleviate the situation;after a few days, the person will get rid of pain and sit normally, osteochondrosis will recede.
If you do not use drugs aimed at restoring the cartilage structure, the treatment will not be complete.They are called chondroprotectors and contribute to better nutrition of cartilage and regeneration of disc tissue at the initial stage.They should be taken for a long time, even at home.
Muscle relaxants allow you to get rid of spasms of the lower back muscles.This condition is a response to compression of the roots.
Medicines that improve microcirculation are needed.All this will remove swelling in the place of compression, give 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 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.The ointment, which should be applied to the area of maximum pain, is excellent in relieving pain symptoms.
If your back hurts a lot and you can't sit, the doctor prescribes an ointment.Penetrating the tissue, the ointment has an anti-inflammatory effect on the roots.The ointment can be used as a compress at night.Apply ointment to 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 lower back.With its help, compressed roots are released, muscles are strengthened and correct posture is established, which is then supported by exercise.Gymnastics allows you to increase the range of motion and make the ligaments more flexible.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 nutrition of the intervertebral disc, increases the space between the vertebrae.Due to the formation of a corset, pain and tension in the spine is reduced.Gymnastics is performed under the supervision of a specialist, and it is necessary to exercise every morning, this will prevent osteochondrosis.
Physiotherapy methods, like exercises, are very widely used.Low frequency currents, alternating current, ultrasound, laser and more are especially useful.You can additionally use the ointment with ultrasound.The methods eliminate inflammation, pain and swelling.The most popular:
- UHF;
- diocesan;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is often used during the pain relief phase.Massage, like exercise, helps nourish cartilage and improves metabolic processes.Massage is a combination of special techniques: rubbing, kneading, tapping and shock vibration.
Properly performed massage is the key to successful treatment and subsequent recovery.Only a specialist should do the massage.In addition, you can use an ointment with an anti-inflammatory effect.Massage relieves muscle spasms, improves blood flow and strengthens the back.
Manual therapy is also a massage, but uses a special technique.Its effect is the same as the effect of massage.
Stretching is performed using specially selected weights and techniques.The procedure helps to increase the space between the vertebrae, relieves pain and restores the anatomical axis of the spine.
Acupuncture is based on the effect of needle pricking on the active points of the human body.The technique is especially indicated for severe pain syndrome.