The lumbar region carries 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 vertebrae.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.You have 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 subtypes.The M42.0 code, according to the ICD-10, indicates that it is a juvenile variant, osteochondrosis is manifested by Scheuermann-Mao or Calve disease.The M42.1 code according to the ICD-10 gives an idea of the disease in adults.
If the disease variant is not specified, the ICD-10 code will be M42.9.There are also complications of childhood osteochondrosis;your ICD-10 code is completely different.A complication occurs in the form of juvenile kyphosis, which causes Scheuermann-Mao disease.Its ICD code is 10 M40.0.
Reasons for appearance
It is not yet fully known why everything appears, 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 traced after 35 years;The injury process is accelerated by prolonged stay in a static position due to stress.But guilt is not just the burden;Often the disease is genetic.The cause may be flat feet, especially grade 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 cause any pain, a person can sit calmly and without pain, but changes characteristic of the disease are already occurring 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 extremities, coldness is observed in them.
In the second degree, the destruction of the annulus fibrosus of the intervertebral disc occurs.Instability appears in the lumbar spine;You may notice an increase in mobility and local tension in the lumbar muscles.A person feels constant fatigue, a feeling of 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, goes beyond its limits and thus a hernia is formed.The spinal nerve roots become compressed and symptoms, mainly pain, develop.In the zone of innervation of the compressed nerve root, sensitivity is completely or partially lost.Morning or daily exercise produces significant pain.In the initial stages, a burning and tingling sensation is disturbing, then it is the turn of numbness.Decreased or absent sensation can be considered the cause of paralysis, which causes muscle atrophy.
From the characteristic areas of sensitivity deterioration, 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 must lie on your back, a stranger helps you raise your straight leg to knee level.If the symptom is positive, the pain will intensify;if the leg is bent at the knee joint, it disappears completely.
With a significant hernia size, the function of the spinal cord may be impaired.Symptoms of compression of the “cauda equina” can often be observed, which is how osteochondrosis usually manifests, this is a bundle of nerves that, leaving the spinal cord, passes through the lumbar and sacral column.Symptoms include problems with mobility and sensation in the lower extremities.Added to this are dysfunctions of the pelvic organs, very often 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 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 affected.Sometimes a person has been struggling with a problem for a long time, but in reality the cause is osteochondrosis.In addition to the fact that there are characteristic symptoms, spinal osteochondrosis must be diagnosed instrumentally.
Diagnosis
Symptoms are important, but an image of the lumbar spine can also confirm osteochondrosis.It shows damage to the joints of the vertebrae, decreased disc height and narrowing of the intervertebral foramen.A photograph of the column 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 tissue structure more clearly;It is especially convenient because the techniques are performed in different planes and sections.It is possible to look at the place where the symptoms arise and bother you.
Treatment
Before treating lumbar osteochondrosis, consultation with a neurologist is necessary.Medications have always been effective in helping get rid of the disease.They are prescribed in courses of about 10 days, complemented by all physical procedures, daily exercises, gymnastics, massages.
With the help of medications, you can effectively eliminate severe pain caused by inflammation and swelling.After treatment in a hospital, you can continue taking medications and following your doctor's instructions at home.
Everyone starts on non-steroidal anti-inflammatory drugs or NSAIDs.Due to the fact that they reduce the inflammatory process in osteochondrosis, swelling and pain disappear.The doctor selects medications: they have many contraindications.But at the same time, they quickly relieve the condition;In a couple of days the person will be free of pain and will sit normally, osteochondrosis will disappear.
Treatment will be incomplete if drugs aimed at restoring the cartilage structure are not used.They are called chondroprotectors and contribute to better nutrition of cartilage and restoration of disc tissue in the initial stages.They should be taken for a long time, even at home.
Muscle relaxants allow you to eliminate spasms in the muscles of the lower back.This condition is a response to root compression.
Medications that improve microcirculation are needed.All of this will eliminate swelling at the site 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 the nerve roots and strengthen them.If this group of medications 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 an ointment if your back hurts a lot and you cannot sit down.Penetrating into the tissue, the ointment has an anti-inflammatory effect on the roots.The ointment can be used in the form of compresses at night.Apply ointment to painful areas three times a day.
Physiotherapy
The complete rehabilitation treatment consists of:
- physiotherapy;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying a measured load on the lumbar spine.With its help, compressed roots are released, muscles are strengthened and correct posture is established, which is then reinforced with exercise.Gymnastics allows you to increase the range of motion and make the ligaments more elastic.Gymnastics is selected individually for each person.
The technique, like exercise, is easy to perform, helps normalize blood circulation and improves metabolism.Gymnastics helps to improve the nutrition of the intervertebral disc, increasing the space between the vertebrae.Thanks to the corset formation, pain and tension in the spine are reduced.Gymnastics is performed under the supervision of a specialist and it is necessary to exercise every morning to prevent osteochondrosis.
Physiotherapeutic methods, like exercises, are widely used.Low frequency currents, alternating current, ultrasound, laser and much more are especially useful.You can also use ointment with ultrasound.The methods relieve inflammation, pain and swelling.The most popular:
- ultrahigh frequency;
- diode speaker;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is very often used at the stage when pain has been relieved.Massage, like exercise, helps nourish cartilage and improves metabolic processes.Massage is a combination of special techniques: rubbing, kneading, stroking and vibration.
A properly performed massage is the key to successful treatment and subsequent recovery.Only a specialist should perform a massage.Additionally, you can use an ointment with an anti-inflammatory effect.The massage relieves muscle spasms, improves blood flow and strengthens the back.
Manual therapy is also a massage, but using a special technique.Its effect is the same as that of massage.
Traction is performed using specially selected weights and techniques.The procedure helps increase the space between the vertebrae, relieves pain and restores the anatomical axis of the spine.
Acupuncture is based on the effect of needle puncture on active points on the human body.The technique is especially indicated for severe pain syndrome.