The lumbar region bears 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 hole 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 was 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 code M42.0, according to ICD-10, indicates that it is a juvenile variant, osteochondrosis manifests itself with Scheuermann-Mao or Calve disease.The code M42.1 according to ICD-10 gives an idea of the disease in adults.
If the disease variant is not specified, in ICD-10 the code will be M42.9.There are also complications of childhood osteochondrosis;their ICD-10 code is completely different.A complication occurs in the form of juvenile kyphosis, which gives Scheuermann-Mao disease.Its code according to ICD is 10 M40.0.
Reasons for appearance
Why all this 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.Symptoms are clearly traceable after 35 years, 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;often the disease is genetic.The cause could be flat feet, especially grade 3 or 4.
Symptoms
The insidiousness of this spinal disease is undeniable and over time it 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 the changes characteristic of the disease are already occurring 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, coldness is observed in them.
In the second degree, destruction of the fibrous ring 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 fibrous ring completely loses its strength and bursts, the nucleus pulposus, in turn, goes beyond its limits, and this is how a hernia is formed.The spinal nerve roots are compressed and symptoms, mainly pain, develop.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, tingling disturbs, then comes the turn of numbness.Reduced or absent sensation may be considered the cause of paralysis, which causes muscle atrophy.
Based on the characteristic areas of sensitivity impairment, it can be deduced in which segment the fault occurred.If the fibers of the sciatic nerve (the largest nerve in the body) are damaged, Lassègue's symptom will be positive;it's easy to check it at home.You need to lie on your back, a stranger helps you raise your straight leg to knee height.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, the function of the spinal cord may be impaired.Symptoms of compression of the “cauda equina” can often be observed, as osteochondrosis often manifests itself, this is a bundle of nerves that, coming out of the spinal cord, crosses the lumbar and sacral spine.Symptoms include reduced mobility and sensitivity in the lower extremities.Added to this are dysfunctions of the pelvic organs, very often of 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 various 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 fact that there are characteristic symptoms, spinal osteochondrosis must be diagnosed instrumentally.
Diagnostics
Symptoms are important, but an image of the lumbar spine can further confirm osteochondrosis.It shows damage to the joints of the vertebrae, a decrease in disc height and a narrowing of the intervertebral foramen.A photograph of the spine is taken in two projections;further functional testing may be necessary.
The presence of a herniated disc can be confirmed using an MRI;characteristic changes will be visible on the image.A CT scan will show the structure of the tissue more clearly;it is particularly convenient because the techniques are performed on different planes and sections.You can look at the place where the symptoms appear and bother you.
Treatment
Before treating lumbar osteochondrosis, consultation with a neurologist is necessary.Medicines have always been effective in helping get rid of the disease.They are prescribed in courses lasting 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 hospital, taking medications and following the doctor's prescriptions can be continued at home.
Everyone starts with nonsteroidal anti-inflammatory drugs, or NSAIDs.Due to the fact that they reduce the inflammatory process in osteochondrosis, swelling and pain disappear.The doctor selects drugs: they have many contraindications.But at the same time they quickly alleviate the condition;in a couple of days the person will get rid of the pain and sit normally, the osteochondrosis will recede.
Treatment will be incomplete if you do not use drugs aimed at restoring the structure of the cartilage.They are called chondroprotectors and contribute to better nutrition of the cartilage and restoration of disc tissue in the initial stages.They must be taken for a long time, even at home.
Muscle relaxants help eliminate spasms of the lower back muscles.This condition is a response to root compression.
Drugs that improve microcirculation are needed.All this will remove the swelling where the compression occurred, providing the nerve cells with more oxygen and nutrients.Exercises and massages, 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 nerve roots and strengthen them.If this group of drugs is used, the treatment is much more effective.An ointment to be applied to the area of maximum pain is excellent for overcoming the symptoms of pain.
Your doctor prescribes an ointment if your back hurts a lot and you can't sit.Penetrating into the tissue, the ointment has an anti-inflammatory effect on the roots.The ointment can be used as compresses at night.Apply the ointment to the painful areas three times a day.
Physiotherapy
The complete rehabilitation treatment consists of:
- physical therapy;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying a dosed load on the lumbar spine.With its help, compressed roots are freed, muscles are strengthened and a correct posture is established, which is then supported by 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 to normalize blood circulation and improves metabolism.Gymnastics helps improve the nutrition of the intervertebral disc, increasing the space between the vertebrae.Thanks to the training of the corset, pain and stress on the spine are reduced.Gymnastics is performed under the supervision of a specialist, and exercise is necessary every morning to prevent osteochondrosis.
Physiotherapy methods are used very widely, like exercises.Particularly useful are low-frequency currents, alternating current, ultrasound, laser and much more.You can also use the ointment with ultrasound.The methods relieve inflammation, pain and swelling.The most popular:
- UHF;
- speaker diodes;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is often used at the stage when the 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 shock vibrations.
Properly performed massage is the key to successful treatment and subsequent recovery.Only a specialist should perform a massage.Also, you can use an ointment with anti-inflammatory effect.Massage relieves muscle spasms, improves blood flow and strengthens the back.
Manual therapy is also a massage, but it uses a special technique.Its effect is the same as massage.
Pulling 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 pricking a needle on active points of the human body.The technique is particularly suitable for severe pain syndrome.