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 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 has 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 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 disease.Code M42.1 according to ICD-10 gives an idea of the disease in adults.
If the variant of the disease is not specified, then 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 everything appears is not yet entirely known, one thing is certain: a violation of the structure of the intervertebral disc develops, which leads to further changes in the spine.The symptoms can clearly be traced after 35 years, the process of injury is accelerated by prolonged stay in a static position due to stress.But it’s not just the load that’s to blame; 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 quietly and painlessly, 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 can notice discomfort that can radiate far 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; increased mobility and local tension in the lower back muscles can be noted.A person feels constant fatigue, a feeling of some 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 forms.The roots of the spinal nerves are compressed, and symptoms develop, primarily pain.In the area of innervation of the compressed nerve root, sensitivity is completely or partially lost.Morning or everyday exercise brings significant pain.At the initial stages, a burning sensation, a tingling sensation is disturbing, then comes the turn of numbness.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 is easy to check it at home.You need to lie on your back, a stranger helps you raise your straight leg up at the knee.If the symptom is positive, the pain will intensify; if the leg is bent at the knee joint, it completely disappears.
With a significant size of the hernia, the function of the spinal cord may be affected.You can often observe symptoms of compression of the “cauda equina,” which is how osteochondrosis often manifests itself, this 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.Additionally, dysfunctions of the pelvic organs are added, very often the bladder.
At the fourth stage, 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 in it 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 one 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 additionally confirm osteochondrosis.It shows damage to the joints of the vertebrae, a decrease in the height of the disc, and a narrowing of the intervertebral foramen.A photograph of the spine is taken in two projections; additional functional tests may be required.
The presence of a disc herniation 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 especially convenient because the techniques are performed in different planes and sections.It is possible to look at the place where symptoms arise and bother you.
Treatment
Before treating lumbar osteochondrosis, consultation with a neurologist is necessary.Medicines have always been effective in helping to get rid of the disease.They are prescribed in courses for about 10 days, complemented by all physical procedures, daily exercises, gymnastics, massage.
With the help of drugs, you can effectively eliminate severe pain caused by inflammation and swelling.After treatment in a hospital, taking medications and following doctor’s orders can be continued at home.
Everyone starts with non-steroidal anti-inflammatory drugs, or NSAIDs.Due to the fact that they reduce the inflammatory process in osteochondrosis, swelling and pain go away.The doctor selects the drugs: they have a lot of 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 will sit normally, osteochondrosis will recede.
Treatment will be incomplete if you do not use drugs aimed at restoring the structure of cartilage.They are called chondroprotectors and contribute to better nutrition of cartilage and restoration of disc tissue in the initial stages.They need to be taken for a long time, even at home.
Muscle relaxants make it possible to get rid of spasms of the lower back muscles.This condition is a response to compression of the roots.
Drugs that improve microcirculation are needed.All this will remove swelling in the place where the compression occurred, giving the nerve cells more oxygen and nutrients.Exercise and massage, which can be performed at home to relieve pain, have a similar effect.
If your back hurts badly and sitting becomes a real problem, you will need analgesics.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, treatment is much more effective.An ointment that should be applied to the area of maximum pain is excellent at overcoming the symptoms of pain.
The doctor prescribes ointment if your back hurts badly 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 ointment to areas of pain three times a day.
Physiotherapy
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 released, muscles are strengthened, and correct posture is established, which is then supported by exercise.Gymnastics allows you to increase the range of movements 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 improve 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 performed under the supervision of a specialist, and exercise is needed every morning, it will prevent osteochondrosis.
Physiotherapeutic methods are used, like exercises, very widely.Low frequency currents, alternating current, ultrasound, laser and much more are especially helpful.You can additionally use ointment with ultrasound.Methods relieve inflammation, pain and swelling.The most popular:
- UHF;
- diodespeaker;
- 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 shock vibration.
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.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 to increase the space between the vertebrae, relieves pain, and restores the anatomical axis of the spinal column.
Acupuncture is based on the effect of a needle prick on active points of the human body.The technique is especially indicated for severe pain syndrome.