The lumbar region has 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 vertebra. At the same time, the intervertebral foramen narrows, the root is squeezed, 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 ICD - 10. We will try to figure out all the subtleties in more detail.
International ranking
According to ICD-10, osteochondrosis has the code M42 and is divided into subspecies. The M42 code. 0, according to ICD-10, indicates that it is a juvenile variant, osteochondrosis manifesting as Scheuermann-Mao or Calve disease. The M42 code. 1 according to ICD-10 gives an idea of the disease in adults.
If the disease variant is not specified, then in 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 the appearance
Why everything appears is not yet completely known, one thing is established with certainty: a violation of the structure of the intervertebral disc develops, which leads to further changes in the spine. Symptoms can be clearly observed after 35 years, accelerate the process of injury, a long stay in a static position, due to the load. But not only the load is to blame, often the disease is genetic in nature. The cause may be flat feet, especially grade 3 or 4.
Symptoms
The insidious nature of this spinal disease is undeniable, and over time it only progresses. In total, doctors distinguish four degrees of development of this pathology.
The first degree does not cause any pain, a person can sit calmly and painlessly, but changes characteristic of the disease are already occurring in the heart of the intervertebral disc. The ligaments that strengthen the vertebrae can also suffer. Locally, discomfort may be noted, which may give away from 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, 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 can be noted. 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 bursts, the pulpy nucleus, in turn, overtakes it, so that a hernia is formed. There is compression of the roots of the spinal nerves, symptoms develop, mainly pain. In the zone of innervation of the compressed nerve root, the sensitivity completely or partially disappears. Morning or daily exercise brings significant pain. In the initial stages, the burning sensation, the tingling sensation disturbs, then comes the turn of numbness. A decrease or lack of sensitivity can be considered the cause of paralysis, leading to muscle atrophy.
According to the characteristic areas of impaired sensitivity, it can be assumed in which segment the breakdown occurred. If the fibers of the sciatic nerve (the thickest in the body) are affected, the symptom of Lasègue will be positive, it is easy to check it at home. It is necessary to lie on your back, a stranger helps to raise a straight leg to the knee. With a positive symptom, the pain will increase if the leg is bent at the knee joint, it completely disappears.
With a large size of the hernia, the function of the spinal cord may suffer. Often you can observe the symptoms of compression of the "ponytail", so osteochondrosis often manifests itself, it is a bundle of nerves that, leaving the spinal cord, passes into the lumbar and sacral spine. Symptoms are manifested by reduced mobility and tenderness of the lower limbs. 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. Arthrosis of the joints between the vertebrae, spondylarthrosis develops. There is practically no pain at this stage, but along with this, the ability to move in it, exercises or gymnastics for a person almost completely disappears and becomes a real problem.
Due to the defeat of various nerves that innervate internal organs, their function may be impaired. Sometimes for a long time a person struggles with a problem, but in fact the cause is osteochondrosis. In addition to the fact that there are characteristic symptoms, osteochondrosis of the spine should be established instrumentally.
Diagnostic
Symptoms are important, but further confirmation of osteochondrosis allows an image of the lumbar spine. It shows damage to the joints of the vertebrae, a decrease in the height of the disc, a narrowing of the intervertebral foramen. A radiograph of the spine is taken in two projections, additional functional tests may be necessary.
You can confirm the presence of a herniated disc with an MRI, the image will show characteristic changes. Computed tomography will more clearly show the structure of the tissue, this 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. Medicines have always been effective in helping to get rid of disease. They are prescribed in courses for about 10 days, complement all physiotherapy, daily exercises, gymnastics, massage.
With the help of medication, you can effectively get rid of severe pain caused by inflammation and swelling. After treatment in hospital, taking medication and following medical prescriptions can be continued at home.
Everyone starts 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 is engaged in the selection of drugs: they have a lot of contraindications. But along with this, they quickly allow to alleviate the condition, after a few days a person will get rid of pain and sit normally, osteochondrosis will recede.
The treatment will be inferior if you do not use drugs aimed at restoring the structure of the cartilage. They are called chondroprotectors and contribute to better cartilage nutrition, restoration of disc tissue in the early stages. You need to take them for a long time, even at home.
Muscle relaxants help get rid of spasms in the muscles of the lower back. This condition is a response to root compression.
Drugs that improve microcirculation are needed. All this will eliminate puffiness in the place where the compression occurred, give nerve cells more oxygen and nutrients. Exercise and massage have a similar effect, which can be done at home for pain relief.
If your back hurts badly and sitting becomes a real problem, painkillers will be needed. This group of drugs will quickly eliminate the manifestations of the disease.
Vitamins improve the nutrition of the nerve roots, strengthen them. With the use of this group of drugs, the treatment is much more effective. Perfectly overcomes the symptoms of painful ointment, which should be smeared in place of maximum pain.
The doctor prescribes an ointment if the back hurts badly and it is impossible to sit down. Penetrating into 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 the painful areas three times a day.
Physiotherapy
A complete rehabilitation cure consists of:
- physiotherapy exercises;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists in applying a dosed load to the lumbar spine. With its help, tight roots are released, muscles are strengthened, the correct posture is established, which is then supported by the load. Gymnastics allows you to increase the range of motion, make the ligaments more elastic. Gymnastics is selected 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, pain and load on the spine are reduced. Gymnastics is performed under the supervision of a specialist, and a load is needed every morning, this will prevent osteochondrosis.
Physiotherapeutic methods are very widely used, as well as the load. Especially low frequency currents, alternating current, ultrasound, laser and much more. With ultrasound, you can also use ointment. Methods relieve the inflammatory process, pain and swelling. The most popular:
- UHF;
- diodynamics;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is very often used at the stage when it was possible to get rid of pain. Massage, like exercise, promotes cartilage nutrition, improves metabolic processes. It is a massage that combines special techniques: friction, kneading, effleurage and shock vibration.
Properly performed massage is the key to successful treatment and subsequent recovery. Massage should only be performed by a specialist. Additionally, you can use an ointment with an anti-inflammatory effect. Massage allows you to relieve muscle spasms, improves blood circulation, strengthens the back.
Manual therapy is also a massage, using only 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 a needle prick on the active points of the human body. The technique is particularly indicated for severe pain syndrome.