The lumbar spine is more stressed than any other part of the spine. Osteochondrosis develops as a result of degenerative-dystrophic processes due to a decrease in the height of the intervertebral 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 osteochondrosis of the lumbar spine 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 subtleties in more detail.
International classification
Osteochondrosis has the code M42 according to ICD-10 and is divided into subtypes. Code M42. 0 according to ICD-10 indicates that it is a juvenile variant, osteochondrosis is manifested by Scheuermann-Mao or Calve's disease. The M42. 1 code according to ICD-10 gives an idea of \u200b\u200bthe disease in adults.
If the disease variant is not specified, the code in ICD-10 is M42. 9. There are also complications of childhood osteochondrosis, the ICD-10 code for them is completely different. A complication occurs in the form of juvenile kyphosis, leading to Scheuermann-Mao disease. Its code according to ICD-10 M40. 0
Reasons for appearing
Why everything appears is not yet fully known, one thing is certain: an injury to the structure of the intervertebral discs occurs, which leads to further changes in the spine. Symptoms are 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 stress is to blame, often the disease is genetic. The cause can be flat feet, especially grade 3 or 4.
symptoms
The insidiousness of this spinal disease is undeniable and only progresses over time. In total, doctors distinguish four degrees of development of this pathology.
The first degree does not cause pain, a person can sit quietly 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. Discomfort can be noted locally, which can be 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 fibrous ring of the intervertebral disc is destroyed. Instability occurs in the lumbar spine, increased mobility and local tension of the lumbar muscles can be noted. A person experiences constant fatigue, a feeling of back pain and insecurity.
In the third degree, osteochondrosis causes the fibrous ring to completely lose its strength and rupture, the nucleus pulposus in turn protruding, resulting in a hernia. Compression of the roots of the spinal nerves occurs, symptoms develop, mainly pain. In the innervation zone of the compressed nerve root, sensitivity is lost completely or partially. Morning or daily exercise causes significant pain. In the initial phase, the burning, tingling disturbs, then comes the turn of numbness. A decrease or lack of sensitivity can be considered the cause of paralysis leading to muscle atrophy.
Based on the characteristic areas of sensory impairment, it can be assumed in which segment the loss occurred. If the fibers of the sciatic nerve (the thickest in the body) are affected, the Lasègue symptom is positive, it is easy to check at home. It is necessary to lie on your back, a stranger will help to lift a straight leg by the knee. With a positive symptom, the pain increases when bending the leg at the knee joint, it disappears completely.
If the hernia is large, spinal cord function may suffer. Often you can observe the symptoms of compression of the "ponytail", therefore osteochondrosis often manifests itself, this is a bundle of nerves that leaves the spinal cord and passes into the lumbar and sacral spine. Symptoms are limited mobility and sensitivity of the lower extremities. In addition, there are functional disorders of the pelvic organs, very often this is 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. At this stage there is practically no pain, but at the same time 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 innervating the internal organs, their functioning can be impaired. Sometimes a person struggles with a problem for a long time, but in fact the cause is osteochondrosis. In addition to the fact that there are characteristic symptoms, it is necessary to identify spinal osteochondrosis instrumentally.
diagnosis
Symptoms are important, but additional confirmation of osteochondrosis allows for a picture of the lumbar spine. It shows damage to the vertebral joints, a decrease in the height of the intervertebral discs, a narrowing of the intervertebral foramen. A snapshot of the spine is taken in two projections, additional functional testing may be required.
You can confirm the presence of a herniated disc using an MRI, the picture shows 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 appear and are disturbed.
treatment
Before treating osteochondrosis of the lumbar spine, a consultation with a neurologist is necessary. Medicines have always helped 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 medication, you can effectively get rid of severe pain caused by inflammation and swelling. After treatment in a hospital, taking medication and following doctor's orders can continue at home.
Everyone starts with nonsteroidal anti-inflammatory drugs, or NSAIDs. Since they reduce the inflammatory process in osteochondrosis, swelling and pain disappear. The doctor is engaged in the selection of drugs: they have a lot of contraindications. But together with this, they allow to quickly relieve the condition, after a few days a person will get rid of pain and will sit normally, osteochondrosis will recede.
Treatment is worse if you do not use drugs to restore the structure of the cartilage. They are called chondroprotectors and they contribute to better cartilage nutrition and restoration of disc tissue in the early stages. You also need to take them at home for a long time.
Muscle relaxants allow you to get rid of spasms in the muscles of the lower back. This condition is a reaction to compression of the roots.
Drugs that improve microcirculation are needed. All this eliminates swelling in the place where compression occurred and gives more oxygen and nutrients to nerve cells. Exercise and massage, which can be done at home to relieve pain, have a similar effect.
When your back hurts badly and sitting becomes a real problem, analgesics are needed. This group of drugs will quickly eliminate the manifestations of the disease.
Vitamins improve the nutrition of the nerve roots, strengthen them. With the use of this group of drugs, the treatment is much more effective. Perfectly overcomes the symptoms of pain ointment, which needs to be smeared in the place of maximum pain.
The doctor prescribes an ointment if the back hurts badly and sitting is impossible. The ointment penetrates into the tissues and has an anti-inflammatory effect on the roots. You can apply the ointment at night in the form of compresses. Apply the ointment to the painful areas three times a day.
physical therapy
A complete rehabilitation treatment consists of:
- physiotherapeutic exercises;
- Physical therapy;
- Massage;
- traction;
- manual therapy;
- reflexology.
The remedial gymnastics consists of a dosed load on the lumbar spine. With its help, the pinched roots are released, the muscles are strengthened, the correct posture is established, which is then supported by recharging. 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 recharging, is easy to perform, helps normalize blood circulation and improves metabolism. Gymnastics helps to improve intervertebral disc nutrition and increase the distance between the vertebrae. The formation of a corset reduces pain and stress on the spine. Gymnastics are performed under the supervision of a specialist, and recharging is required every morning to prevent osteochondrosis.
Physiotherapeutic methods, in addition to recharging, are used very widely. Low-frequency currents, alternating current, ultrasound, lasers 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;
- Ultrasonic;
- electrophoresis.
Massage is very often used at the stage when it was possible to get rid of pain. Like exercise, massage promotes cartilage nutrition and improves metabolic processes. It is a massage, a combination of special techniques: rubbing, kneading, stroking and impact vibration.
Properly performed massage is the key to successful treatment and subsequent recovery. Massages should only be performed by a professional. Additionally, you can use an ointment with an anti-inflammatory effect. With massage, you can relieve muscle spasms, improve blood circulation and strengthen your back.
Manual therapy is also a massage, only with a special technique. The effect is the same as with a massage.
Traction is carried out with the help of specially selected weights and techniques. The procedure helps to increase the distance between the vertebrae, reduce pain and restore the anatomical axis of the spine.
Acupuncture is based on the action of a needle prick on the active points of the human body. The technique is especially indicated for severe pain syndrome.