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 reduction in the height of the disc. Marginal osteophytes grow along the ends of the vertebra. 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. He has been assigned a code on the ICD - 10. We will try to understand all the intricacies in more detail.
International classification
According to ICD-10, osteochondrosis is codenamed M42 and is divided into subspecies. The code M42. 0, according to the ICD-10, indicates that it is a juvenile variant, osteochondrosis is manifested by Scheuermann-Mao or Calve disease. The code M42. 1 according to ICD-10 gives an idea of the disease to adults.
If the variant of the disease is not identified, 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 in the form of juvenile kyphosis occurs, 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 is certain: a violation of the structure of the intervertebral disc develops, which leads to further changes in the spine. The symptoms can be clearly seen after 35 years, accelerate the process of injury, long stay in a static position due to the load. But it is not only the load that is to blame, but often the disease is genetic in nature. The cause may be flat feet, especially grades 3 or 4.
Symptoms
The insidiousness of this disease of the spine is indisputable and only evolves over time. In total, doctors distinguish four stages of development of this pathology.
The first degree does not cause pain, a person can sit calmly and painlessly, but changes characteristic of the disease already occur in the nucleus of the intervertebral disc. Ligaments that strengthen the vertebrae can also suffer. Locally, discomfort may occur, 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 occurs in the lumbar spine, there may be increased mobility and local tension of the lumbar muscles. 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 explodes, the pulpal nucleus, in turn, exceeds this, thus forming a hernia. There is compression of the roots of the spinal nerves, symptoms develop, mainly pain. In the nerve zone of the compressed nerve root, the sensitivity drops completely or partially. Morning or daily exercise brings significant pain. In the initial stages, the burning sensation bothers, tingling and then comes the numbness. Decreased or lack of sensitivity can be considered the cause of paralysis, resulting in muscle atrophy.
According to the characteristic sensitivity reduction zones, it can be assumed in which part the failure occurred. If the sciatic nerve fibers (the thickest in the body) are affected, the Lasègue symptom will be positive, it is easy to control at home. It is necessary to lie on your back, a stranger helps to lift a straight leg at the knee upwards. With a positive symptom, the pain will increase if the leg is bent at the knee joint, it disappears completely.
With a significant hernia size, spinal cord function may suffer. You can often notice the symptoms of "ponytail" compression, so osteochondrosis often occurs, this is a bundle of nerves that, leaving the spinal cord, passes to the lumbar and sacrum. Symptoms are manifested by reduced mobility and sensitivity of the lower extremities. In addition, disorders of the function of the pelvic organs are added, very 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. Joints of the joints between the vertebrae, vertebral arthritis develops. There is virtually no pain at this stage, but along with it, the ability to move in it, exercise or gymnastics for a person disappears almost completely and becomes a real problem.
Due to the defeat of the various nerves that innervate the internal organs, their function can be affected. 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 detected organically.
Diagnostics
The symptoms are important, but an additional confirmation of osteochondrosis allows an image of the lumbar spine. It presents damage to the joints of the vertebrae, reduction of the height of the disc, narrowing of the intervertebral foramen. A snapshot of the spine is taken in two views, additional functional examinations may be required.
You can confirm the presence of a disc herniation with MRI, the image will show characteristic changes. Computed tomography will show the structure of the tissue more clearly, it is particularly convenient because the techniques are performed at different levels and incisions. It is possible to examine the area where the symptoms appear and are disturbed.
Treatment
Before treating osteochondrosis of the lumbar spine, it is necessary to consult a neurologist. Medications have always been effective in getting rid of the disease. They are prescribed in courses for about 10 days, they complete all the physiotherapy, daily exercises, gymnastics, massage.
With the help of medication, you can effectively eliminate the intense pain caused by inflammation and swelling. After hospital treatment, medication and following a doctor's prescription can be continued at home.
They all start with non-steroidal anti-inflammatory drugs or NSAIDs. Due to the fact that they reduce the inflammatory process in osteochondrosis, the swelling and pain subside. The doctor deals with the choice of drugs: they have many contraindications. But along with this, they allow quick relief of the condition, after a few days a person will get rid of the pain and sit normally, the osteochondrosis will subside.
The treatment will be inferior if you do not use drugs aimed at restoring the structure of the cartilage. They are called chondroprotectants and contribute to the better nutrition of cartilage, to the restoration of disc tissue in the early stages. You have to take them for a long time, even at home.
Muscle relaxants make it possible to get rid of lower back muscle spasm. This condition is a response to root compression.
Drugs that improve microcirculation are required. All this will remove the swelling at the point where the compression took place, will give the nerve cells more oxygen and nutrients. Exercise and massage have a similar effect, which can be done at home to relieve pain.
If your back hurts a lot and sitting becomes a real problem, analgesics will be required. 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, the treatment is much more effective. Perfectly overcomes the symptoms of pain ointment, which should be soiled in 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 anti-inflammatory action on the roots. You can apply the ointment in the form of a compress at night. 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 dosing load to the lumbar spine. With its help, the tight roots are released, the muscles are strengthened, the correct posture is established, which is then supported by a charge. Exercise allows you to increase the range of motion, make the joints more elastic. Exercise is selected individually for each person.
The technique, like charging, is easy to perform, helps to normalize blood circulation and improves metabolism. Exercise helps to improve the nutrition of the intervertebral disc, increasing the space between the vertebrae. Due to the formation of corsets, the pain and load on the spine are reduced. Exercise is performed under the supervision of a specialist and requires loading every morning, it will prevent osteochondrosis.
Physiotherapy methods are used, as well as charging, very widely. Especially low frequency currents, alternating current, ultrasound, laser and many more help. With ultrasound, you can also use an ointment. The methods relieve the inflammatory process, pain and swelling. Most Popular:
- UHF;
- Diodynamics?
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is used very often at the stage when it was possible to get rid of the pain. Massage, like exercise, promotes cartilage nutrition, improves metabolic processes. A massage is a combination of special techniques: rubbing, kneading, stroking and shaking.
Properly performed massage is the key to successful treatment and subsequent rehabilitation. The massage should be done only by a specialist. In addition, you can use an ointment with anti-inflammatory action. 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 piercing on the active parts of the human body. The technique is especially suitable for severe pain syndrome.