The lumbar region bears 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 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 “simulate” damage to other organs.It was assigned a code in ICD - 10. We will try to understand all the subtleties in more detail.
International ranking
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.The M42.1 code according to ICD-10 gives an idea of the disease in adults.
If the disease variant is not specified, the code in ICD-10 will be M42.9.There are also complications of infantile osteochondrosis;their ICD-10 code is completely different.A complication occurs in the form of juvenile kyphosis, which gives Scheuermann-Mao disease.Its ICD code is 10 M40.0.
Reasons for the appearance
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 are clearly visible after 35 years, the injury process is accelerated by prolonged stay in a static position due to stress.But it’s not just the charge that’s at issue;the disease is often genetic.The cause may be flat feet, especially at level 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 quietly and without pain, but changes characteristic of the disease occur already in the core of the intervertebral disc.The ligaments that strengthen the vertebrae can also suffer.Locally, you may notice discomfort that may radiate away from the problem area.As a result of disturbances in the innervation of the vessels of the lower limbs, cold is observed.
In the second degree, there is destruction of the annulus fibrosus of the intervertebral disc.Instability appears in the lumbar spine;increased mobility and local tension in the lower back muscles may be noted.A person feels constant fatigue, discomfort in the back and uncertainty.
In the third degree, osteochondrosis leads to the fact that the annulus fibrosus completely loses its strength and bursts, the nucleus pulposus, in turn, exceeds its limits, and this is how a hernia is formed.The roots of the spinal nerves are compressed and symptoms appear, mainly pain.In the zone of innervation of the compressed nerve root, sensitivity is completely or partially lost.Morning or daily exercise causes significant pain.At first, a burning sensation, a tingling sensation is worrying, then comes the numbness.Decreased or absent sensitivity may be considered the cause of paralysis, which leads to muscle atrophy.
Based on the characteristic zones of sensitivity deficiency, it can be assumed in which segment the failure occurred.If the fibers of the sciatic nerve (the thickest nerve in the body) are damaged, the Lassègue symptom will be positive;it is easy to check it at home.You need to lie on your back, a stranger helps you raise your right leg up to 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 large hernia, spinal cord function may be affected.Symptoms of compression of the "horse's tail" can often be observed, this is how osteochondrosis often manifests itself, this is a bundle of nerves which, leaving the spinal cord, passes through the lumbar and sacral spine.Symptoms include reduced mobility and tenderness in the lower extremities.Added to this are dysfunctions of the pelvic organs, very often the bladder.
In the fourth stage, the joints and intervertebral ligaments are involved in the degenerative process and symptoms of spinal instability appear.Osteoarthritis of the joints between the vertebrae develops, spondyloarthrosis.There is practically no pain at this stage, but with it the ability to move there almost completely disappears;exercise or gymnastics for a person becomes a real problem.
Due to damage to various nerves that innervate internal organs, their function may be impaired.Sometimes a person has been struggling with a problem for a long time, but the cause is actually osteochondrosis.In addition to the fact that there are characteristic symptoms, osteochondrosis of the spine must be diagnosed instrumentally.
Diagnosis
The symptoms are important, but an image of the lumbar spine can additionally confirm osteochondrosis.It shows damage to the joints of the vertebrae, a decrease in the height of the disc and narrowing of the intervertebral foramen.A photograph of the spine is taken in two projections;additional functional testing may be required.
The presence of a herniated disc can be confirmed by an MRI;Characteristic changes will be visible in the image.A CT scan will show the structure of the tissue more clearly;This is particularly convenient because the techniques are performed in different planes and sections.It is possible to look at the place where the symptoms appear and bother you.
Treatment
Before treating lumbar osteochondrosis, a consultation with a neurologist is necessary.Medicines have always been effective in helping to get rid of the disease.They are prescribed courses lasting about 10 days, supplemented by all physical procedures, daily exercises, gymnastics, massage.
With the help of medications, you can effectively eliminate severe pain caused by inflammation and swelling.After treatment in hospital, taking medication and following the doctor's prescriptions can be continued at home.
Everyone starts by taking nonsteroidal anti-inflammatory drugs, or NSAIDs.Due to the fact that they reduce the inflammatory process associated with osteochondrosis, swelling and pain disappear.The doctor selects the medications: they have many contraindications.But at the same time, they quickly alleviate the situation;in a few days the person will get rid of the pain and sit normally, osteochondrosis will disappear.
Treatment will be incomplete if you do not use drugs aimed at restoring the structure of cartilage.They are called chondroprotectors and contribute to better nutrition of cartilage and restoration of disc tissue in the early stages.You have to take them for a long time, even at home.
Muscle relaxers help get rid of spasms in the lower back muscles.This condition is a response to root compression.
Drugs that improve microcirculation are necessary.All of this will eliminate the swelling 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 a similar effect.
If your back hurts a lot and sitting becomes a real problem, you will need painkillers.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.An ointment that should be applied to the area of maximum pain is excellent for overcoming pain symptoms.
The doctor prescribes ointment if your back hurts very much and you cannot sit down.Penetrating into the tissues, the ointment has an anti-inflammatory effect on the roots.The ointment can be used in the form of compresses at night.Apply the ointment to painful areas three times a day.
Physiotherapy
Comprehensive rehabilitation treatment includes:
- physiotherapy;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying a measured load to the lumbar spine.With its help, compressed roots are released, muscles are strengthened and correct posture is established, which is subsequently supported by exercise.Gymnastics helps increase the range of motion and makes the ligaments more elastic.Gymnastics is selected individually for each person.
The technique, like exercise, is easy to perform, helps to normalize blood circulation and improves metabolism.Gymnastics helps to improve the nutrition of the intervertebral disc, increasing the space between the vertebrae.Through corset training, pain and stress on the spine are reduced.Gymnastics is carried out under the supervision of a specialist, and exercises are necessary every morning to prevent osteochondrosis.
Physiotherapeutic methods are very widely used, such as exercises.Particularly useful are low-frequency currents, alternating current, ultrasound, laser and much more.You can also use ultrasound ointment.The methods relieve inflammation, pain and swelling.The most popular:
- Ultra-high frequency;
- diode speaker;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is very often used at the stage where the pain has been relieved.Massage, like exercise, helps nourish cartilage and improves metabolic processes.Massage is a combination of special techniques: friction, kneading, stroking and shock vibration.
Correctly performed massage is the key to successful treatment and subsequent recovery.Only a specialist should perform massage.Additionally, you can use an ointment that has an anti-inflammatory effect.Massage relieves muscle spasms, improves blood circulation and strengthens the back.
Manual therapy is also a massage, but using a particular technique.Its effect is the same as that of massage.
Pull-up is performed using specially selected weights and techniques.The 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 a needle prick on active points of the human body.The technique is particularly indicated in cases of intense pain syndrome.