The lumbar region bears more load than all other parts of the spine. The degenerative dystrophic process can lead to the development of osteochondrosis due to a reduction in the height of the intervertebral disc. Marginal osteophytes develop along the edges of the vertebrae. At the same time, the intervertebral foramen is narrowed, the root is compressed, and symptoms of osteochondrosis appear. Treatment for lumbar osteochondrosis depends on the stage of the disease.
Osteochondrosis sometimes manifests in a way that its symptoms "simulate" damage to other organs. He has assigned a code in ICD-10. We'll try to understand all the intricacies in more detail.
International Classification
According to the ICD-10, osteochondrosis has the code M42 and is divided into subspecies. According to ICD-10, code M42. 0 indicates a young variant with osteochondrosis manifesting as Scheuermann-Mao or Calve disease. The concept of adult disease is given according to the M42. 1 code of ICD-10.
If the variant of the disease is not specified, the code will be M42. 9 in ICD-10. Children with osteochondrosis also have complications, and the ICD-10 code is completely different for them. One complication occurs in the form of juvenile kyphosis, which causes Scheuermann-Mao disease. Its code conforms to ICD-10 M40. 0.
Reason for appearing
Why everything appears is not entirely clear, but one thing has been established: the structure of the intervertebral disc is damaged, causing further changes in the spine. Symptoms can be clearly seen after 35 years, accelerated injury process, prolonged stay in a static position due to load. But not only is the burden to blame, the disease is often hereditary. The cause may be flat feet, especially grade 3 or 4.
symptom
The insidious nature of this spinal disorder is undeniable, and it will only develop over time. In general, doctors distinguish four degrees of development of this pathology.
There is no pain in the first degree, and a person can sit calmly and painlessly, but the disc core has undergone changes characteristic of the disease. Ligaments that strengthen the vertebrae are also affected. Locally, discomfort can be noticed, which can be kept away from the problem area. They become cold due to the violation of the innervation of the blood vessels of the lower extremities.
At the second level, destruction of the annulus fibrosus of the intervertebral disc occurs. Instability of the lumbar spine occurs, and increased mobility and local tension of the lumbar muscles can be noted. A person experiences constant fatigue, some back discomfort and insecurity.
In the third degree, osteochondrosis causes the annulus fibrosus to completely lose strength and rupture, and the nucleus pulposus passes over it, thus forming a hernia. Spinal nerve root compression, symptoms, mainly pain. In the innervated area of the compressed nerve root, there is a complete or partial decrease in sensitivity. The pain can be noticeable in the morning or with daily exercise. In the initial stages, the burning, tingling sensations are distressing, then turn to numbness. Decreased or lacking sensitivity can be thought of as a cause of paralysis, causing muscle wasting.
Based on the characteristic area of sensitive damage, it can be inferred in which segment the fault occurs. If the fibers of the sciatic nerve (the thickest part of the body) are affected, Lasègue symptoms are positive and can be easily checked at home. It is necessary to lie on the back, with the help of the stranger to raise the straight leg to the knee. With positive symptoms, if the leg is bent at the knee joint, the pain increases and it goes away completely.
The hernia is large and the function of the spinal cord may be affected. Often you can observe symptoms of compression in the "ponytail", so osteochondrosis often manifests, which is a bundle of nerves that leave the spinal cord and run through the lumbar and sacral spine. Symptoms manifest as impaired lower extremity mobility and sensitivity. In addition, there is increased dysfunction of the pelvic organs, usually the bladder.
In the fourth stage, the intervertebral joints and ligaments are involved in the degenerative process, and symptoms of spinal instability appear. Arthropathy of the joints between the vertebrae, the development of spondyloarthropathies. There is little pain at this stage, but it follows that a person's ability to move, exercise or gymnastics in it is almost completely lost and becomes a real problem.
Due to damage to the various nerves that innervate the internal organs, their function may be impaired. Sometimes a person struggles with a problem for a long time when the actual cause is osteochondrosis. In addition to the fact that there are characteristic symptoms, osteochondrosis of the spine must be determined instrumentally.
diagnosis
Symptoms are important, but additional confirmation of osteochondrosis can provide a picture of the lumbar spine. It shows damage to the vertebral joints, reduced disc height, and narrowing of the intervertebral foramen. Snapshots of the spine were taken in both projections, additional functional testing may be required.
You can confirm the presence of a herniated disc with an MRI, which will show characteristic changes. CT will show the structure of the tissue more clearly, which is especially convenient because these techniques are performed in different planes and sections. Consider where symptoms appear and where they are disturbed.
treat
Before treating lumbar osteochondrosis, a neurologist should be consulted. Medicines have been very effective in helping to get rid of this disease. They prescribe about 10 days in the course, supplementing all physiotherapy, daily exercise, gymnastics, massage.
With the help of medication, severe pain caused by inflammation and swelling can be effectively eliminated. After treatment in the hospital, you can continue to take your medicines and follow your doctor's orders at home.
Everyone starts with NSAIDs or NSAIDs. Since they reduce the inflammatory process of osteochondrosis, swelling and pain disappear. Physicians are engaged in the choice of drugs: they have many contraindications. But what follows is that they get relief very quickly, and after a few days a person will be free of pain and sit normally, and the osteochondrosis will subside.
If you don't use medications designed to restore cartilage structure, treatment will be less effective. They are called chondroprotectants and contribute to better cartilage nutrition, restoring disc tissue in the initial stages. Even at home, you need to take them for a long time.
Muscle relaxants can eliminate spasms in the muscles of the lower back. This condition is a reaction to root compression.
Medications to improve microcirculation are needed. All of this will remove the puffiness where the compression occurs and give the nerve cells more oxygen and nutrients. Exercise and massage have similar effects and can be done at home to reduce pain.
If your back hurts and sitting becomes a real problem, pain relievers are needed. This group of drugs will quickly get rid of the manifestations of the disease.
Vitamins improve the nutrition of nerve roots, strengthening them. By using this group of drugs, the treatment is more effective. Perfect to overcome the symptoms of pain ointment, which must be applied to the areas of greatest pain.
If your back hurts and you can't sit still, your doctor will prescribe ointment. The ointment penetrates into the tissue and has an anti-inflammatory effect on the roots. You can apply the ointment in compressed form at night. Apply the ointment to the painful area three times a day.
physiotherapy
Complete rehabilitation includes:
- physical therapy exercises;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- Reflexology.
Therapeutic gymnastics consist of applying dose loads on the lumbar spine. With its help, the clamped root is released, the muscles are strengthened, and correct posture is established, which is then supported by charging. Gymnastics allows you to increase your range of motion and make your ligaments more elastic. Gymnastics is chosen individually for each individual.
The technique, like recharging, is easy to perform, helps normalize blood circulation, and improves metabolism. Gymnastics help improve the nutrition of the intervertebral discs and increase the space between the vertebrae. Due to the formation of the corset, the pain and load on the spine is relieved. Gymnastics are performed under the supervision of a specialist and require recharging every morning to prevent osteochondrosis.
Physical therapy methods as well as recharging are widely used. Especially low frequency current, alternating current, ultrasound, laser and more help. With ultrasound, you can also use ointment. The method relieves the inflammatory process, pain and swelling. Most Popular:
- UHF;
- dual power;
- magnet;
- shock wave therapy;
- Ultrasound;
- electrophoresis.
Massage is often used during periods when pain can be relieved. Massage, like exercise, promotes cartilage nutrition and improves metabolic processes. It is a massage that combines special techniques: rubbing, rubbing, stroking and shock vibration.
Proper massage is the key to successful treatment and subsequent recovery. Massages can only be performed by experts. Also, you can use ointments that have anti-inflammatory properties. Massage relieves muscle spasms, improves blood flow, and strengthens the back.
Manual therapy is also a type of massage, just using a special technique. The effect is the same as massage.
Traction with the help of specially selected weights and techniques. The procedure helps increase the space between the vertebrae, relieve pain, and restore the anatomical axis of the spine.
Acupuncture is based on the effect of acupuncture on points of movement in the human body. This technique is particularly useful for severe pain syndromes.