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 at the edges of the vertebrae.At the same time, the intervertebral opening narrows, the root is pressed, 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.It is assigned a code in ICD - 10. We will try to understand all the subtleties in more detail.
International classification
According to ICD-10, osteochondrosis has code M42 and is divided into subspecies.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 insight into 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 the appearance
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 additional changes in the spine.Symptoms can be clearly traced after 35 years, the injury process is accelerated by prolonged stay in a static position due to stress.But it's not just the workload that's to blame;often the disease is genetic.Flat feet, especially grade 3 or 4, may be the cause.
Symptoms
The insidiousness of this spinal disease is undeniable, and it 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 calmly and painlessly, but in the core of the intervertebral disc, changes characteristic of the disease are already occurring.The ligaments that strengthen the vertebrae can also be affected.Locally, you may notice discomfort that may radiate far from the problem area.As a result of disturbances in the innervation of the vessels of the lower limbs, 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 muscles of the lower back can be noticed.A person experiences 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 thus a hernia is formed.Spinal nerve roots are compressed and symptoms develop, mainly pain.In the area of innervation of the compressed nerve root, sensitivity is completely or partially lost.Morning or daily exercise causes significant pain.In the initial stages, a burning sensation, tingling is disturbed, then comes the turn of numbness.Decreased or absent sensitivity can be considered a cause of paralysis, which leads to muscle atrophy.
Based on the characteristic areas of sensitivity violation, 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 sign 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 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 can be affected.You can often observe symptoms of compression of the "cauda equina", this 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.In addition, dysfunctions of the pelvic organs are added, very often of the bladder.
At 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.At this stage, there is practically no pain, 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 may be impaired.Sometimes a person struggles 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.
Diagnosis
Symptoms are important, but imaging of the lumbar spine can further 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 picture of the spine is taken in two projections;additional functional tests may be required.
The presence of a herniated disc can be confirmed by MRI;characteristic changes will be visible in the image.CT will show the structure of the tissue more clearly;this is especially convenient because the techniques are performed in different planes and sections.It is possible to look at the place where the symptoms occur and bother you.
Treatment
Before the treatment of lumbar osteochondrosis, a consultation with a neurologist is necessary.Medicines have always been effective to get rid of the disease.They are prescribed in courses for about 10 days, supplemented by all physical procedures, daily exercises, gymnastics, massage.
With the help of medicines, you can effectively eliminate the severe pain caused by inflammation and swelling.After treatment in hospital, taking medicines 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 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 subside.
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 cartilage nutrition and the recovery of disc tissue in the initial stages.They must be taken for a long time, even at home.
Muscle relaxants allow you to get rid of spasms in the muscles of the lower back.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 that 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 pain relievers.This group of drugs will allow you to quickly get rid of the manifestations of the disease.
Vitamins improve the nutrition of the 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 an ointment if your back hurts a lot and you can't sit.Penetrating the tissue, the ointment has an anti-inflammatory effect on the roots.Ointment can be used as compresses at night.Apply ointment to the pain areas three times a day.
Physiotherapy
Complete rehabilitation treatment consists of:
- physical therapy;
- physical therapy;
- massage;
- grip;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists in applying a dosed load on the lumbar vertebrae.With its help, compressed roots are released, muscles are strengthened and a correct posture is established, which is then maintained with 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 exercises, is easy to perform, helps to normalize blood circulation and improves metabolism.Gymnastics helps to improve the nutrition of the intervertebral disc, increasing the space between the vertebrae.Thanks to the formation of the corset, pain and stress on the spine are reduced.Gymnastics is performed under the supervision of a specialist, and exercises are necessary every morning, this will prevent osteochondrosis.
Physiotherapy methods are used, as well as exercises, very widely.Low frequency currents, alternating current, ultrasound, laser and many others are particularly useful.You can additionally use ultrasound ointment.Methods to relieve inflammation, pain and swelling.The most popular:
- UHF;
- diode speaker;
- magnet;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is very often used at the stage when the pain is relieved.Massage, like exercise, helps nourish the 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.In addition, 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 action is the same as a massage.
Pulling is done with 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 pricking on the active points of the human body.The technique is especially indicated for severe pain syndrome.