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 disc height.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 is assigned a code in ICD - 10. We will try to understand all the complications in more detail.
International classification
According to ICD-10, osteochondrosis has the 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 ICD code is 10 M40.0.
Reasons for submission
Why everything appears is still not 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 can be clearly traced after 35 years, the injury process is accelerated by prolonged standing in a static position due to stress.But the load is not the only one 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 pain, a person can sit quietly and without pain, but the characteristic changes of the disease are already occurring in the core 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, the destruction of the fibrous ring of the intervertebral disc occurs.Instability appears in the lumbar spine;increased mobility and local tension in the muscles of the lower back can be observed.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, on the other hand, goes beyond its limits, and thus a hernia is formed.The roots of the spinal nerves are compressed and symptoms appear, mainly pain.In the area of innervation of the compressed nerve root, sensitivity is completely or partially lost.Morning or daily exercise brings considerable pain.In the initial stages, a burning sensation, a tingling sensation is disturbing, then comes the turn of numbness.Decreased or absent sensation can be considered the cause of paralysis, which results in muscle atrophy.
Based on the characteristic areas of sensitivity damage, 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's easy to check at home.You need to lie on your back, a stranger helps you raise your right leg up to the knee.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 can be affected.You can often observe symptoms of compression of the "cauda equina", which is how osteochondrosis often appears, this is a bundle of nerves that, leaving the spinal cord, passes through the lumbar and sacral spine.Symptoms include impaired mobility and sensation of the lower extremities.In addition, there are also 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 develops, spondyloarthrosis.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 the internal organs, their function can be impaired.Sometimes a person is 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, osteochondrosis of the spine must be diagnosed instrumentally.
Diagnosing
Symptoms are important, but an image of the lumbar spine can also confirm osteochondrosis.It shows damage to the vertebral joints, decreased disc height and narrowing of the intervertebral foramen.A picture of the spine is taken in two projections;additional functional tests may be required.
The presence of a herniated disc can be confirmed using an MRI;Characteristic changes will be visible in the image.A CT scan will show the structure of the tissue more clearly;it is particularly suitable because the techniques are performed in different planes and sections.It is possible to see 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 to eliminate the disease.They are prescribed in courses for about 10 days, supplemented with all physical procedures, daily exercises, gymnastics, massage.
With the help of medicines, you can effectively eliminate severe pain caused by inflammation and swelling.After hospital treatment, taking medications and following the doctor's orders can be continued at home.
All start 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 chooses the drugs: they have many contraindications.But at the same time, they quickly relieve the condition;after a few days the person will get rid of the pain and sit normally, the osteochondrosis will recede.
The treatment will be incomplete if you do not use drugs aimed at restoring the cartilage structure.They are called chondroprotectors and contribute to better nutrition of cartilage and restoration of disc tissue in the initial stages.They should be taken for a long time, even at home.
Muscle relaxants make it possible to relieve lower back muscle spasms.This condition is a response to root compression.
Medicines that improve microcirculation are needed.All this will remove the swelling in the place where the compression occurred, giving the nerve cells more oxygen and nutrients.Exercises and massages, which can be performed at home to relieve pain, have a similar effect.
If your back hurts a lot and sitting becomes a real problem, you'll 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 that should be applied to the area of maximum pain is excellent for overcoming pain symptoms.
The doctor prescribes the ointment if your back hurts a lot and you can't sit down.Penetrating the tissues, the oil has an anti-inflammatory effect on the roots.The ointment can be used as a compress at night.Apply the ointment to the painful areas three times a day.
Physiotherapy
Complete rehabilitation treatment consists of:
- physical therapy;
- physiotherapy;
- massage;
- withdrawal;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying a dosed load to the lumbar spine.With its help, compressed roots are released, muscles are strengthened and proper posture is established, which is then supported by exercises.Gymnastics allows you to increase the range of motion and make the ligaments more elastic.Gymnastics is chosen individually for each person.
The technique, like exercise, is easy to perform, helps normalize blood circulation and improves metabolism.Gymnastics helps improve the nutrition of the intervertebral disc, increasing the space between the vertebrae.Due to the shape 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, it will prevent osteochondrosis.
Physiotherapy methods are used, like exercises, very widely.Low-frequency currents, alternating current, ultrasound, lasers and much more are particularly useful.You can also use ultrasound ointment.The methods relieve inflammation, pain and swelling.The most popular:
- UHF;
- diode speaker;
- magnets;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is very often used in the phase when the pain has eased.Massage, like exercise, helps nourish the cartilage and improves metabolic processes.Massage is a combination of special techniques: rubbing, kneading, shock and shock vibration.
Properly performed massage is the key to successful treatment and subsequent recovery.Only a specialist should perform a massage.In addition, you can use an ointment with an anti-inflammatory effect.Massage relieves muscle spasms, improves blood circulation and strengthens the back.
Manual therapy is also a massage, but using a special technique.Its effect is the same as that of massage.
Pulling is performed using specially selected weights and techniques.The procedure helps increase the space between the vertebrae, relieves pain and restores the anatomical axis of the spine.
Acupuncture is based on the effect of piercing the needle on the active points of the human body.The technique is particularly indicated for severe pain syndrome.