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 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 osteochondrosis of the lumbar 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 allocated 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. Code M42. 0, according to ICD-10, indicates that this is a youthful 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 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 the appearance
Why everything appears is not yet completely known, one thing has been established for sure: 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 process of injury, a long stay in a static position, due to the load. But not only the load is to blame, 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 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 changes characteristic of the disease are already occurring in the core of the intervertebral disc. Ligaments that strengthen the vertebrae can also suffer. Locally, discomfort can be noted, which is able to give far 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 appears in the lumbar spine, increased mobility and local tension of the lumbar muscles can be noted. A person feels 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 bursts, the nucleus pulposus, in turn, goes beyond it, so a hernia is formed. There is compression of the roots of the spinal nerves, symptoms develop, primarily pain. In the zone of innervation of the compressed nerve root, sensitivity completely or partially drops out. Morning or daily exercise brings significant pain. At the initial stages, the burning sensation, tingling sensation bothers, then the turn of numbness comes. A decrease or lack of sensitivity can be considered the cause of paralysis, resulting in muscle atrophy.
According to the characteristic zones of sensitivity impairment, it can be assumed in which segment the failure occurred. If the fibers of the sciatic nerve (the thickest in the body) are affected, the Lasègue 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 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 may suffer. Often you can observe the symptoms of compression of the "ponytail", so osteochondrosis often manifests itself, this is a bundle of nerves that, leaving the spinal cord, passes in the lumbar and sacral spine. Symptoms are manifested by impaired mobility and sensitivity of the lower extremities. Additionally, disorders of the function of the pelvic organs are added, very often this is the bladder.
At 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 in it, exercises 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 for a long time a person struggles with one problem, but in fact 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 an additional confirmation of osteochondrosis allows a picture of the lumbar spine. It shows damage to the joints of the vertebrae, a decrease in 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 required.
You can confirm the presence of a disc herniation with an MRI, the image will show characteristic changes. CT will show the structure of the tissue more clearly, it is especially convenient because the techniques are performed in different planes and sections. It is possible to consider the place where the symptoms arise and are disturbed.
Treatment
Before treating osteochondrosis of the lumbar, a consultation with a neurologist is necessary. 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, massage.
With the help of drugs, you can effectively eliminate severe pain caused by inflammation and swelling. After treatment in a hospital, taking medications and following doctor's prescriptions can be continued at home.
Everyone starts with non-steroidal anti-inflammatory drugs, or NSAIDs. Due to the fact that they reduce the inflammatory process in osteochondrosis, swelling and pain go away. The doctor is engaged in the selection of drugs: they have a lot of 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 will sit normally, osteochondrosis will recede.
The treatment will be inferior if you do not use drugs aimed at restoring the structure of the cartilage. They are called chondroprotectors and contribute to better cartilage nutrition, restoration of disc tissue in the initial stages. You need to take them for a long time, even at home.
Muscle relaxants make it possible to get rid of spasm of the muscles of the lower back. This condition is a response to compression of the roots.
Drugs that improve microcirculation are needed. All this will remove puffiness 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 performed 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 the 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 must be smeared in the place of maximum soreness.
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 to the areas of soreness three times a day.
Physiotherapy
A complete rehabilitation treatment consists of:
- physiotherapy exercises;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists in applying a dosed load on the lumbar spine. With its help, the clamped roots are released, the muscles are strengthened, the correct posture is established, which is then supported by charging. Gymnastics allows you to increase the range of motion, make the ligaments more elastic. Gymnastics is selected 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, pain and load on the spine are reduced. Gymnastics is performed under the supervision of a specialist, and charging is needed every morning, it will prevent osteochondrosis.
Physiotherapeutic methods are used, as well as charging, very widely. Especially low-frequency currents, alternating current, ultrasound, laser and much more help. With ultrasound, you can additionally use an ointment. 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 when it was possible to get rid of pain. Massage, like exercise, promotes cartilage nutrition, improves metabolic processes. It is a massage a set of special techniques: rubbing, kneading, stroking and shock vibration.
Properly performed massage is the key to successful treatment and subsequent recovery. Massage should only be carried out by a specialist. Additionally, 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, only using a special technique. Its effect is the same as massage.
With the help of specially selected weights and techniques, traction is carried out. The procedure helps to increase the space between the vertebrae, relieves pain, restores the anatomical axis of the spinal column.
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.