The lower back supports more load than all other parts of the spine.Osteochondrosis develops as a result of degenerative-dystrophic processes due to a decrease in disc height.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.He received 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.Code M42.0, according to ICD-10, indicates that this is a juvenile variant, osteochondrosis is manifested by Scheuermann-Mao or Calve's disease.ICD-10 code M42.1 gives an idea of the disease in adults.
If the variant of the disease is not specified, in ICD-10 the 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 gives Scheuermann-Mao disease.Its CID code is 10 M40.0.
Reasons for the appearance
It is still not fully known why everything appears, one thing is certain: a violation of the structure of the intervertebral disc develops, which leads to new changes in the spine.Symptoms can be clearly traced after the age of 35, the injury process is accelerated by prolonged stay in a static position due to stress.But it's not just the cargo that's to blame;The disease is often 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 pain, the person can sit calmly and without pain, but changes characteristic of the disease already occur in the nucleus 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, cold is observed in them.
In the second degree, destruction of the fibrous ring of the intervertebral disc occurs.Instability appears in the lumbar spine;one may notice increased mobility and local tension in the lumbar muscles.The person feels constant tiredness, a feeling of some discomfort in the back and uncertainty.
In the third degree, osteochondrosis causes the fibrous ring to completely lose its strength and rupture, 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 area of innervation of the compressed nerve root, sensitivity is completely or partially lost.Morning or daily exercise brings significant pain.In the initial stages, a burning sensation, a tingling sensation is disturbing, then numbness comes.Decreased or absent sensitivity can be considered the cause of paralysis, which results in muscle atrophy.
Based on 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 nerve in the body) are damaged, Lassègue's symptom will be positive;it's easy to check at home.You need to lie on your back, a stranger helps you raise your straight leg 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 significant size of the hernia, spinal cord function may be affected.It is often possible to observe symptoms of compression of the “cauda equina”, which is how osteochondrosis often manifests itself, it is a bundle of nerves that, leaving the spinal cord, passes through the lumbar and sacral spine.Symptoms include impaired mobility and sensitivity of the lower extremities.In addition, there are dysfunctions of the pelvic organs, 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, spondyloarthrosis, 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 several nerves that innervate internal organs, their function may be impaired.Sometimes a person has been struggling with a problem for a long time, but in fact the cause is osteochondrosis.In addition to the characteristic symptoms, spinal osteochondrosis must be diagnosed instrumentally.
Diagnosis
Symptoms are important, but imaging 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 spine is taken in two projections;additional functional testing may be required.
The presence of a herniated disc can be confirmed using 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 appear and bother you.
Treatment
Before treating lumbar osteochondrosis, a consultation with a neurologist is necessary.Medications have always been effective in helping eliminate the disease.They are prescribed in courses of 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 the hospital, taking medications and following doctor's orders can continue at home.
Everyone starts with nonsteroidal anti-inflammatory drugs, or NSAIDs.Because they reduce the inflammatory process in osteochondrosis, swelling and pain disappear.The doctor selects medicines: they have many contraindications.But at the same time they quickly alleviate the condition;In a few days the person will get rid of the pain and sit normally, the osteochondrosis will regress.
Treatment will be incomplete if you do not use medications aimed at restoring the cartilage structure.They are called chondroprotectors and contribute to better cartilage nutrition and restoration of disc tissue in the early stages.They need to be taken for a long time, even at home.
Muscle relaxants allow you to eliminate spasms in the muscles in the lower back.This condition is a response to root compression.
Medicines that improve microcirculation are needed.All of this will remove the swelling in the place 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'll need painkillers.This group of medicines 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 an ointment if your back hurts a lot and you can't sit down.Penetrating into the tissue, the ointment has an anti-inflammatory effect on the roots.The ointment can be used as compresses at night.Apply ointment to painful areas three times a day.
Physiotherapy
Complete rehabilitation treatment consists of:
- physiotherapy;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying a dosed load to the lumbar spine.With its help, compressed roots are released, muscles are strengthened and correct posture is established, which is then supported by exercises.Gymnastics allows you to increase range of motion and make 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.Due to the formation of the corset, pain and stress on the spine are reduced.Gymnastics is carried out under the supervision of a specialist, and it is necessary to do exercises every morning to prevent osteochondrosis.
Physiotherapeutic methods are widely used, as are exercises.Low-frequency currents, alternating current, ultrasound, lasers, and more are especially useful.You can also use ultrasound ointment.The methods relieve inflammation, pain and swelling.The most popular:
- UHF;
- speaker with diode;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is often used in the pain relief phase.Massage, like exercise, helps nourish cartilage and improves metabolic processes.Massage is a combination of special techniques: rubbing, kneading, stroking and shock vibration.
Correctly performed massage is the key to successful treatment and subsequent recovery.Only a specialist should perform the massage.Additionally, you can use an ointment with an anti-inflammatory effect.Massage relieves muscle spasms, improves blood flow and strengthens the back.
Manual therapy is also a massage, but with a special technique.Its effect is the same as massage.
Traction is performed using specially selected weights and techniques.The procedure helps to increase the space between the vertebrae, relieves pain and restores the anatomical axis of the spine.
Acupuncture is based on the effect of a needle prick on active points on the human body.The technique is especially indicated for intense pain syndrome.