The lumbar region has a greater 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 vertebrae. At the same time, the intervertebral foramen narrows, the root is compressed and symptoms of osteochondrosis appear. The 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. It is distributed 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 subtypes. Code M42. 0, according to ICD-10, indicates that this is a juvenile 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 variant of the disease is not specified, then in ICD-10 the code will be M42. 9. There are also complications of pediatric 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 occurs is not yet fully known, one thing is certain: a disorder of the structure of the intervertebral disc develops, which leads to further changes in the spine. Symptoms can be seen clearly after 35 years, accelerate the process of injury, long stay in a static position due to stress. But not only is the load to blame, the disease is often genetic. The cause may be flat feet, especially grade 3 or 4.
Symptoms
The insidiousness of this disease of the spine is undeniable and over time it only progresses. In general, doctors distinguish four stages of development of this pathology.
The first degree does not cause pain, a person can sit quietly and painlessly, but in the core of the intervertebral disc are already occurring changes characteristic of the disease. Ligaments that strengthen the vertebrae can also be damaged. Locally, discomfort can be noted, which is able to give away from the problem area. As a result of disorders of the innervation of the vessels of the lower extremities, they become cold.
In the second stage, the destruction of the fibrous ring of the intervertebral disc occurs. Instability occurs in the lumbar part of the spine, increased mobility and local tension of the lumbar muscles can be noted. One experiences constant fatigue, a feeling of some discomfort in the back and insecurity.
In the third degree, osteochondrosis leads to the fact that the fibrous ring completely loses its strength and ruptures, the pulpal nucleus in turn goes out of it, so that a hernia is formed. There is compression of the roots of the spinal nerves, symptoms develop, mostly pain. In the area of innervation of the compressed nerve root, the sensitivity is completely or partially eliminated. Morning or daily exercises bring significant pain. In the initial stages, the feeling of burning, tingling is disturbed, then comes the tingling sensation. Decreased or lack of sensitivity can be considered a cause of paralysis leading to muscle atrophy.
According to the characteristic areas of sensitivity damage, it can be assumed in which segment the damage 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 at the knee up. With a positive symptom, the pain will increase if the leg is bent at the knee joint, it completely disappears.
With a significant size of the hernia, the function of the spinal cord can be affected. You can often observe the symptoms of "horsetail" compression, so osteochondrosis often occurs, it is a bundle of nerves that, leaving the spinal cord, passes into the lumbar and sacral spine. The symptoms are manifested by impaired mobility and sensitivity of the lower extremities. Additionally, disorders in the function of the pelvic organs are added, very often it is the bladder.
In the fourth stage, the intervertebral joints and ligaments become involved in the degenerative process and symptoms of spinal instability appear. Arthrosis of the joints between the vertebrae, spondylarthrosis develops. At this stage there is practically no pain, but at the same time the ability to move in it, exercise or gymnastics for a person almost completely disappears and becomes a real problem.
Due to the defeat of various nerves that innervate the internal organs, their function may be impaired. Sometimes a person struggles with a problem for a long time, but in fact the cause is osteochondrosis. In addition to the fact that there are characteristic symptoms, osteochondrosis of the spine should be diagnosed instrumentally.
Diagnosis
Symptoms matter, but further confirmation of osteochondrosis allows a picture of the lumbar spine. Shows damage to the joints of the vertebrae, reducing the height of the disc, narrowing of the intervertebral foramen. A snapshot of the spine is taken in two projections, additional functional tests may be needed.
You can confirm the presence of a herniated disc with MRI, the image will show characteristic changes. CT will show the structure of the tissue more clearly, this is especially convenient because the techniques are performed in different planes and sections. It is possible to examine the place where the symptoms appear and are disturbed.
Treatment
A consultation with a neurologist is required before treating lumbar osteochondrosis. Medications have always helped to get rid of the disease. They are prescribed in courses for about 10 days, complement any physiotherapy, daily exercises, gymnastics, massage.
With the help of medication you can effectively eliminate the severe pain caused by inflammation and swelling. After hospital treatment, medication and prescription may continue 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 deals with the choice of drugs: they have many contraindications. But at the same time they quickly allow to alleviate the condition, after a few days a person will get rid of the pain and sit normally, osteochondrosis will recede.
Treatment will be worse if you do not use drugs aimed at restoring the structure of cartilage. They are called chondroprotectors and contribute to better nutrition of cartilage, recovery of disc tissue in the early stages. You need to take them for a long time, even at home.
Muscle relaxants allow you to get rid of muscle spasms in the lower back. This condition is a response to root compression.
Drugs that improve microcirculation are needed. All this will remove the puffiness at the place where the compression occurred, will give the nerve cells more oxygen and nutrients. Exercises and massage, 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, you will need analgesics. 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, 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 the back hurts a lot and it is impossible to sit. 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 on the sore areas three times a day.
Physiotherapy
Complete rehabilitation treatment consists of:
- physiotherapy exercises;
- physiotherapy;
- massage;
- adhesion;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists in applying a dosed load on the lumbar spine. With its help, the pinched roots are released, the muscles are strengthened, the correct posture is established, which is then maintained by charging. Gymnastics allows you to increase the range of motion, to make the connections 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 strain on the spine are reduced. Gymnastics is performed under the supervision of a specialist and requires recharging every morning, this will prevent osteochondrosis.
Physiotherapeutic methods are used, as well as recharging, very widely. Low-frequency currents, alternating current, ultrasound, laser and many others are especially helpful. With ultrasound you can additionally use an ointment. The methods relieve the inflammatory process, pain and swelling. Most famous:
- UHF;
- diodynamic;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is used very often at the stage when it is possible to get rid of the pain. Massage, like exercise, promotes cartilage nutrition, improves metabolic processes. This is a massage combined with special techniques: rubbing, kneading, stroking and shock vibration.
Properly performed massage is the key to successful treatment and subsequent recovery. The massage should be performed only by a specialist. You can also use an ointment with anti-inflammatory effect. Massage allows you to relieve muscle spasm, improves blood flow, strengthens the back.
Manual therapy is also a massage, only with the help of a special technique. Its effect is the same as that of massage.
With the help of specially selected weights and techniques, traction is achieved. 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 especially indicated for severe pain syndrome.