The lumbar region is more stressful than all the other parts of the spine. Osteochondrosis results from degenerative-dystrophic processes due to a decrease in the height of the disc. Marginal osteophytes develop along the edges of the vertebrae. However, 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 as "simulating" damage to other organs. He was given a code in the ICD - 10. We will try to understand all the complexities in more detail.
International classification
According to ICD-10, osteochondrosis has the code M42 and is divided into subspecies. The M42. Code 0 according to ICD-10 indicates that it is a youthful variant, osteochondrosis manifested by Scheuermann-Mao or Calf disease. M42 according to ICD-10. Code 1 gives an idea of the disease in adults.
If the disease variant is not specified, the code in ICD-10 is M42. It will be 9. There are also complications of childhood osteochondrosis, the ICD-10 code is completely different for them. A complication occurs in the form of juvenile kyphosis, which causes Scheuermann-Mao disease. The code is ICD-10 M40. According to 0.
Reasons for appearance
Why everything appears is not yet fully known, one thing is certain: a violation of the structure of the intervertebral disc develops, leading to further changes in the spine. After 35 years, the symptoms are clearly visible, accelerating the process of injury, staying in a long static position due to the load. But not only is the load to blame, often the disease is genetic in nature. This may be due to flat feet, especially grade 3 or 4.
Symptoms
The insidiousness of this spinal disease is undeniable and will only progress over time. Overall, physicians distinguish four stages of development of the pathology.
The first stage does not cause pain, one can sit calmly and painlessly, but the lesions characteristic of the disease are already present in the core of the disc. The ligaments that strengthen the vertebrae may also suffer. There is a locally unpleasant sensation that can give away from the problem area. They cool down due to damage to the innervation of the vessels in the lower extremities.
In the second degree, the fibrous ring of the intervertebral disc is destroyed. Instability appears in the lumbar spine, with increased mobility and local tension in the lumbar muscles. One feels constant fatigue, some discomfort in the back, and insecurity.
In the third degree, osteochondrosis leads to the fact that the fibrous ring completely loses its strength and explodes, while the nucleus pulposus goes beyond it, forming a hernia. The roots of the spinal nerves are compressed, with symptoms, mainly pain. Sensitivity is completely or partially lost in the innervation zone of the compressed nerve root. Exercising in the morning or daily can cause significant pain. In the initial stage, a burning, tingling sensation disturbs, and then comes the turn of numbness. Decreased or absent sensitivity is considered to be the cause of paralysis, which results in muscle atrophy.
Based on the characteristic zones of the sensitivity impairment, it can be assumed in which segment the error occurred. If the fibers of the sciatic nerve (the thickest in the body) are affected, the Lasègue symptom will be positive, easily controlled at home. You have to lie on your back, a stranger will help lift your straight leg to your knees up. In the case of a positive symptom, the pain increases when the foot bends in the knee joint and disappears completely.
A hernia of significant size can impair spinal cord function. You can often observe symptoms of "ponytail" compression, so osteochondrosis often manifests as a nerve bundle that leaves the spinal cord, passing through the lumbar and sacral spine. Symptoms are manifested in mobility and sensitivity of the lower extremities. In addition, dysfunction of the pelvic organs is added, very often this 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 virtually no pain, but at the same time, the ability to move, exercise, or exercise almost completely disappears and becomes a real problem.
The defeat of the various nerves that innervate the internal organs can impair their function. Sometimes a person struggles with a problem for a long time, but the cause is actually osteochondrosis. In addition to the characteristic symptoms, osteochondrosis of the spine should be determined instrumentally.
Diagnostics
Symptoms matter, but further confirmation of osteochondrosis allows for an image of the lumbar spine. It shows damage to the joints of the vertebrae, a decrease in the height of the disc, and a narrowing of the intervertebral foramen. Snapshots of the spine are taken in two projections, further functional studies may be required.
You can confirm the presence of a disc herniation with an MRI, with characteristic changes in the image. CT shows the structure of the tissue more clearly, especially because the techniques are performed in different planes and sections. The place where the symptoms appear and disturb you can be considered.
Treatment
You should consult a neurologist before treating lumbar osteochondrosis. Medications have always been effective in getting rid of the disease. It is prescribed in approximately 10-day courses, supplementing all physiotherapy, daily exercises, gymnastics, and massage.
With the help of medications, you can effectively eliminate the severe pain caused by inflammation and swelling. After hospitalization, medication and medical prescriptions 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, the swelling and pain disappear. Your doctor will choose your medication: it has many contraindications. But at the same time they quickly allow the condition to be relieved, after a few days the person gets rid of the pain and sits normally, the osteochondrosis recedes.
Treatment will be weaker if you do not use medications designed to restore cartilage structure. They are called chondroprotectors and contribute to better nutrition of the cartilage, the recovery of the disc tissue in the initial stage. They need to be taken for a long time, even at home.
Muscle relaxants allow you to get rid of muscle cramps in your lower back. This condition is a response to root compression.
There is a need for drugs that improve microcirculation. All of this removes the bloating at the site of compression, providing more oxygen and nutrients to the nerve cells. Exercise and massage, which can be done at home to relieve pain, have a similar effect.
If your back hurts a lot and sitting is a real problem, you will need painkillers. This group of drugs quickly gets rid of the manifestations of the disease.
Vitamins improve the nutrition of nerve roots, strengthen them. With this group of drugs, treatment is much more effective. It perfectly overcomes the symptoms of pain ointment, which should be applied in place of maximum pain.
Your doctor will prescribe an ointment if your back hurts a lot and you can’t sit. Penetrating into the tissues, the ointment has an anti-inflammatory effect on the roots. You can apply the ointment at night. Apply the ointment three times a day to the painful areas.
Physiotherapy
Complete rehabilitation treatment consists of:
- physiotherapy exercises;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of a dosed load on the lumbar spine. With its help, the trapped roots are released, the muscles are strengthened, and the correct posture is formed, which is then supported by recharging. Gymnastics allows you to increase the range of motion, making the straps more flexible. Gymnastics is selected individually for each person.
The technique, like charging, is easy to perform, contributes to the normalization of blood circulation, and improves metabolism. Exercise helps to improve the nutrition of the intervertebral disc by increasing the space between the vertebrae. The formation of the corset reduces the pain and strain on the spine. Gymnastics is performed under the supervision of a specialist and a charge is required each morning to prevent the development of osteochondrosis.
Physiotherapy methods as well as charging are very widely used. Especially low frequency currents, alternating current, ultrasound, laser and much more help. You can also use an ointment with ultrasound. The methods relieve the inflammatory process, pain and swelling. The most popular:
- UHF;
- diodynamics;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is very often used at the stage when you have managed to get rid of the pain. Massage, like exercises, promotes the nutrition of cartilage and improves metabolic processes. A combination of special techniques: rubbing, kneading, caressing and shock vibration.
Properly performed massage is the key to successful treatment and subsequent recovery. The massage can only be performed by a specialist. You can also use an anti-inflammatory ointment. Massage allows to relieve muscle cramps, improves blood flow, strengthens the back.
Manual therapy is also a massage, using only special techniques. Its effect is the same as that of a massage.
Towing is done 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 needle puncture on active points in the human body. The technique is especially recommended for severe pain syndrome.