The lumbar region bears more load than all other parts of the spine.Osteochondrosis develops as a result of a degenerative-dystrophic process due to a decrease in disc height.Marginal osteophytes develop along the edges of the vertebrae.At the same time, the intervertebral foramen narrows, the roots are compressed, 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 "imitate" damage to other organs.He was 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 subtypes.Code M42.0, according to ICD-10, indicates that this is a juvenile variant, osteochondrosis is indicated by Scheuermann-Mao or Calve's disease.Code M42.1 according to ICD-10 gives an overview of the disease in adults.
If the disease variant is not specified, then in ICD-10 the code is M42.9.There are also complications of childhood osteochondrosis;their ICD-10 codes are completely different.Complications occur in the form of juvenile kyphosis, which gives Scheuermann-Mao disease.The code according to the ICD is 10 M40.0.
Because of appearance
Why everything appeared 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 detected after 35 years, the injury 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 cause may be flat feet, especially grade 3 or 4.
symptoms
The peculiarity of this spinal disease cannot be denied, and over time it only develops.In total, 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 have already occurred in the core of the intervertebral disc.The ligaments that strengthen the vertebrae can also suffer.Locally, you can see discomfort that can radiate far from the problem area.As a result of the disturbance in the preservation of the vessels in the lower part of the foot, coldness is observed in it.
In the second stage, 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 can be observed.A person feels constant fatigue, discomfort in the back and uncertainty.
In the third stage, osteochondrosis leads to the fact that the fibrous ring completely loses its strength and breaks, the nucleus pulposus, in turn, exceeds its limits, and this is how a hernia is formed.Spinal nerve roots are compressed, and symptoms develop, especially pain.In the preserved area of the compressed nerve root, the sensitivity is completely or partially lost.Morning or daily exercise brings significant pain.At the initial stage, the burning sensation, the tingling sensation bothers, then comes the turn of numbness.Reduced or absent sensitivity can be considered the cause of paralysis, which results in muscle atrophy.
Based on the characteristic zone of sensitivity degradation, it can be assumed in which segment the failure occurred.If the sciatic nerve fiber (the thickest nerve in the body) is damaged, Lassègue's symptoms will be positive;easy to check it at home.You need to lie on your back, a stranger helps you raise your legs straight above the knees.If the symptoms are positive, the pain will increase;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 may be affected.You can often see symptoms of compression of the "cauda equina," which is how osteochondrosis often manifests itself, this is a group of nerves that, leaving the spinal cord, pass through the lumbar and sacral spine.Symptoms include impaired movement and tenderness of the lower legs.In addition, pelvic organ dysfunction is added, often the bladder.
In the fourth stage, intervertebral joints and ligaments are involved in the degenerative process, and symptoms of spinal instability appear.Arthrosis of the joints between the vertebrae, spondyloarthrosis, develops.There is almost no pain at this stage, but along with this, the ability to move in it is almost completely lost;exercise or gymnastics for someone becomes a real problem.
Due to damage to the various nerves innervating the internal organs, their function may be affected.Sometimes a person has been struggling with one 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 must be diagnosed instrumentally.
Diagnostics
Symptoms are important, but images of the lumbar spine can also confirm osteochondrosis.It shows damage to the vertebral joints, decreased disc height, and narrowing of the intervertebral foramen.Pictures of the spine are taken in two projections;additional functional testing may be required.
The presence of disc herniation can be confirmed using MRI;characteristic changes will be visible on the image.A CT scan will show the tissue structure more clearly;it is very easy because this technique is done in different planes and parts.It is possible to see the place where symptoms arise and bother you.
Treatment
Before treating lumbar osteochondrosis, consultation with a neurologist is necessary.Medicines are always effective in helping to get rid of this disease.They are set in a course for about 10 days, equipped with all physical procedures, daily exercises, gymnastics, massage.
With the help of medicines, you can effectively eliminate severe pain caused by inflammation and swelling.After treatment in the hospital, taking medicines and following the doctor's instructions 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.Doctors choose drugs: they have many contraindications.But at the same time, they quickly reduce the situation;in a few days the person will get rid of the pain and will sit as usual, osteochondrosis will recede.
Treatment will be incomplete if you do not use drugs aimed at restoring the cartilage structure.They are called chondroprotectors and contribute to better cartilage nutrition and recovery of disc tissue at an early stage.They need to be taken for a long time, even at home.
Relaxing the muscles makes it possible to get rid of lower back muscle spasms.This condition is a response to root compression.
Medicines that improve microcirculation are needed.All this will remove the swelling in the place where the compression occurred, giving the nerve cells more oxygen and nutrients.Exercise and massage, which can be done at home to relieve pain, have the same effect.
If your back hurts badly and sitting is a real problem, you need an analgesic.This group of drugs will allow you to quickly get rid of the manifestations of this disease.
Vitamins increase the nutrition of nerve roots and strengthen them.If this group of drugs is used, the treatment is more effective.Ointment that should be applied to the area of maximum pain is very good to overcome the symptoms of pain.
The doctor prescribes ointment if your back hurts badly and you can't sit.Penetrating into the tissue, the ointment has an anti-inflammatory effect on the roots.Ointment can be used as a compress at night.Apply the ointment to the affected area three times a day.
Physiotherapy
Complete recovery treatment consists of:
- physical therapy;
- physiotherapy;
- massage;
- attraction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying dosed loads to the lumbar spine.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 elastic.Gymnastics is chosen individually for each person.
This technique, like exercise, is easy to do, helps normalize blood circulation, and improves metabolism.Gymnastics helps improve the nutrition of the intervertebral disc, increasing the space between the vertebrae.Due to the formation of the corset, pain and pressure on the spine is reduced.Gymnastics is performed under the supervision of a specialist, and exercise is required every morning, it will prevent osteochondrosis.
Physiotherapy methods are used, such as exercise, very widely.Low frequency currents, alternating currents, ultrasound, lasers and more are very helpful.You can also use ointment with ultrasound.Methods to relieve inflammation, pain and swelling.The most popular:
- UHF;
- diodespeaker;
- magnets;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is very often used at the stage when the pain has been relieved.Massage, like exercise, helps nourish cartilage and improve metabolic processes.Massage is a combination of special techniques: rubbing, kneading, stroking 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 ointments with anti-inflammatory effects.Massage relieves muscle spasms, increases blood flow, and strengthens the back.
Manual therapy is also a massage, but uses special techniques.The effect is the same as a massage.
Traction is performed using specially selected weights and techniques.This procedure helps increase the space between the vertebrae, relieve pain, and restore the anatomical axis of the spine.
Acupuncture is based on the effect of needle puncture on the active points of the human body.This technique is indicated mainly for severe pain syndrome.