The lumbar region has more load than all other parts of the spine. Osteochondrosis develops due to 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 the 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 "mimic" damage to other organs. It has been assigned a code in the 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 subspecies. The code M42. 0, according to ICD-10, indicates that this is a juvenile variant, osteochondrosis is manifested by Scheuermann-Mao or Calve disease. The code M42. 1 second 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 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 appearance
Why everything appears is not yet fully known, one thing has been 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 seen after 35 years, accelerate the injury process, a long stay in a static position, due to the load. But it's not just the burden to blame, the disease is often genetic in nature. The cause could be flat feet, especially grades 3 or 4.
Symptoms
The insidiousness 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 give any pain, a person can sit calmly and painlessly, but the changes characteristic of the disease are already occurring in the nucleus of the intervertebral disc. Ligaments that strengthen the vertebrae can also suffer. Locally, discomfort can be noted, which is able to give away from the problem area. Due to 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 experiences 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, overcomes it, then a hernia is formed. There is a compression of the roots of the spinal nerves, symptoms develop, mainly pain. In the zone of innervation of the compressed nerve root, the sensitivity disappears completely or partially. Morning or daily exercise brings significant pain. In the initial stages, the burning, tingling sensation bothers, then comes the turn of numbness. A decrease or lack of sensation can be considered the cause of paralysis, resulting in muscle wasting.
Based on the characteristic zones of sensitivity deterioration, it can be assumed in which segment the fault occurred. If the sciatic nerve fibers (the thickest in the body) are affected, Lasègue's symptom 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 disappears completely.
With a significant size of the hernia, the function of the spinal cord may be affected. Often you can observe the symptoms of compression of the "ponytail", therefore osteochondrosis often occurs, this is a bundle of nerves that, leaving the spinal cord, passes into the lumbar and sacral spine. Symptoms occur with reduced mobility and sensitivity of the lower limbs. In addition, disturbances in the function of the pelvic organs are added, most often this 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, exercise 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 reality the cause is osteochondrosis. In addition to the fact that there are characteristic symptoms, osteochondrosis of the spine must be established instrumentally.
Diagnostics
Symptoms matter, but further confirmation of osteochondrosis allows for 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 snapshot of the spine is taken in two projections, further functional tests may be required.
You can confirm the presence of a herniated disc with an MRI, the picture will show characteristic changes. CT will show the structure of the tissue more clearly, it is especially convenient because the techniques are performed on different planes and sections. It is possible to consider the place where the symptoms manifest themselves and are disturbed.
Treatment
Before treating lumbar osteochondrosis, a consultation with a neurologist is required. Medicines have always been effective in helping to get rid of the disease. They are prescribed in courses for about 10 days, complement all physiotherapy, daily exercises, gymnastics, massages.
With the help of drugs, you can effectively get rid of severe pain caused by inflammation and swelling. After hospital treatment, medication and doctor's prescriptions can be continued at home.
They all start 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 many contraindications. But along with this, they quickly allow to alleviate the condition, after a couple of days a person will get rid of pain and sit normally, osteochondrosis will recede.
The treatment will be less if you do not use drugs aimed at restoring the structure of the cartilage. They are called chondroprotectors and contribute to better nutrition of cartilage, restoration of disc tissue in the early stages. You need to take them for a long time, even at home.
Muscle relaxants allow you to eliminate the spasm of the muscles of the lower back. This condition is a response to the compression of the roots.
Drugs that improve microcirculation are needed. All this will remove the swelling in the place where the compression occurred, give the 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 a lot and sitting becomes a real problem, pain relievers will be needed. This group of drugs will quickly eliminate the manifestations of the disease.
Vitamins improve the nutrition of nerve roots, strengthen them. With the use of this group of drugs, the treatment is much more effective. Perfectly overcomes the symptoms of pain ointment, which must be smeared in the place of maximum pain.
The doctor prescribes an ointment if the back hurts a lot 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 overnight. Apply the ointment to the sore areas three times a day.
Physiotherapy
A complete rehabilitation treatment consists of:
- physiotherapy exercises;
- Physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying a dosed load on the lumbar spine. With its help, the blocked roots are released, the muscles are strengthened, the correct posture is established, which is then supported by the charge. Gymnastics allows you to increase the range of motion, make the ligaments more elastic. Gymnastics is selected individually for each person.
The technique, like recharging, is easy to perform, contributes to the normalization of blood circulation and improves metabolism. Gymnastics helps improve the nutrition of the intervertebral disc by 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 recharging is needed every morning to prevent osteochondrosis.
Physiotherapeutic methods are used, in addition to bulking, very widely. Especially low-frequency currents, alternating current, ultrasound, lasers and much more. With ultrasound, you can also use ointment. The methods relieve the inflammatory process, pain and swelling. Most popular:
- UHF;
- diodynamic;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is very often used at the stage where it was possible to eliminate the pain. Massage, like exercise, promotes the nutrition of cartilage, improves metabolic processes. It is a massage a combination of special techniques: rubbing, kneading, stroking and shock vibrations.
Properly performed massage is the key to successful treatment and subsequent recovery. The massage should only be performed by a specialist. Also, you can use an ointment with an anti-inflammatory effect. Massage allows you to relieve muscle spasm, improves blood flow, 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 suitable for severe pain syndrome.