The lumbar area bears more load than all other parts of the spine.Osteochondrosis is the result of a degenerative dystrophic process due to a reduction in disc height.Marginal osteophytes develop along the edges of the vertebrae.At the same time, the intervertebral foramen becomes narrowed, the tooth root is compressed, and symptoms of osteochondrosis appear.Treatment of lumbar osteochondrosis depends on the stage of the disease.
Osteochondrosis sometimes presents with symptoms that "mimic" damage to other organs.He has been assigned a code in ICD-10.We will try to understand all the intricacies in more detail.
international classification
According to ICD-10, the code for osteochondrosis is M42 and is divided into multiple subtypes.According to ICD-10, code M42.0 indicates that this is a juvenile variant, with osteochondrosis manifesting as Scheuermann-Mao or Calve disease.The concept of adult disease is given according to ICD-10 code M42.1.
If the disease variant was not specified, the code in ICD-10 would be M42.9.There are also complications of osteochondrosis in children; their ICD-10 codes are completely different.One complication occurs in the form of kyphosis in adolescents, leading to Scheuermann's disease.According to the ICD, its code is 10 M40.0.
Reason for occurrence
Why everything happens is not entirely clear, but one thing is certain: the disc structure is destroyed, causing further changes in the spine.After 35 years, these symptoms can clearly become apparent, and the process of damage is accelerated by prolonged periods of static posture due to stress.But it’s not just about the load;Usually the disease is hereditary.The cause may be flat feet, especially grade 3 or 4 flat feet.
symptom
The insidious nature of this spinal disease is undeniable, and it only gets worse over time.In general, doctors distinguish four degrees of development of this pathology.
The first degree does not cause any pain, a person can sit quietly and without pain, but changes characteristic of the disease already occur in the core of the intervertebral disc.The ligaments that strengthen the vertebrae can also be affected.Locally, you will notice that discomfort may radiate away from the problem area.Due to the disorder of vascular innervation of the lower limbs, coldness in the lower limbs occurs.
In the second degree, the annulus fibrosus of the intervertebral disc is destroyed.Instability occurs in the lumbar spine; increased flexibility and localized tension in the lower back muscles may be noted.A person experiences constant fatigue, back discomfort, and uncertainty.
In the third degree, osteochondrosis causes the annulus fibrosus to completely lose its strength and rupture, and the nucleus pulposus in turn exceeds its limits, which is the formation of a hernia.The spinal nerve roots are compressed and symptoms, mainly pain, occur.Complete or partial loss of sensitivity in the innervated area of the compressed nerve root.Significant pain may occur with morning or daily exercise.In the initial stages, there is a disturbing sensation of burning, tingling, and then numbness.Reduced or absent sensitivity may be considered a cause of paralysis, leading to muscle atrophy.
Based on the characteristic area with impaired sensitivity, it can be inferred in which segment the fault occurred.Lasegue symptoms are positive if the fibers of the sciatic nerve (the thickest nerve in the body) are damaged; it's easy to check for it at home.You will need to lie on your back and have a stranger help you raise your straight leg to the knee.If the symptoms are positive, the pain will increase; if the leg is bent at the knee joint, it will completely disappear.
If the hernia is large, the function of the spinal cord may be affected.You can often observe symptoms of compression of the “cauda equina,” a bundle of nerves that leaves the spinal cord and travels through the lumbar and sacral vertebrae, which is what osteochondrosis often exhibits.Symptoms include impaired mobility and sensitivity in the lower extremities.In addition, there is increased dysfunction of the pelvic organs, usually the bladder.
In the fourth stage, intervertebral joints and ligaments participate in the degeneration process, causing symptoms of spinal instability.Arthropathy occurs in the joints between the vertebrae, known as spondyloarthrosis.There is almost no pain in this stage, but along with it the ability to move in it disappears almost completely; exercises or gymnastics become a real problem for a person.
As the various nerves that innervate internal organs are damaged, their function may be impaired.Sometimes, a person has been battling a problem for a long time, but the cause is actually osteochondrosis.In addition to having characteristic symptoms, spinal osteochondrosis must be diagnosed instrumentally.
diagnosis
Symptoms are important, but lumbar spine images can also confirm osteochondrosis.It shows damage to the vertebral joints, reduced disc height, and narrowing of the intervertebral foramina.Spine photographs are taken with two projections; additional functional testing may be required.
An MRI can be used to confirm the presence of a herniated disc; 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 these techniques are performed in different planes and sections.You can see where symptoms are occurring and bothering you.
treat
Before treating lumbar osteochondrosis, a consultation with a neurologist is required.Medications have been effective in helping eliminate the disease.The course lasts approximately 10 days and is supplemented by all body procedures, daily exercises, gymnastics, massage.
With the help of medications, severe pain caused by inflammation and swelling can be effectively eliminated.After treatment in the hospital, you can continue to take medications at home and follow your doctor's instructions.
Everyone starts with a nonsteroidal anti-inflammatory drug (NSAID).Since they reduce the inflammatory process of osteochondrosis, swelling and pain disappear.Doctors choose drugs: they have many contraindications.But at the same time, their condition is quickly relieved; after a few days, the patient will be free of pain and sit normally, and the bone and cartilage will disappear.
Treatment would be incomplete without the use of medications aimed at restoring the cartilage structure.They are called chondroprotectants and help to better nourish cartilage and repair disc tissue in the initial stages.Even at home, they need to be taken long-term.
Muscle relaxants can eliminate spasms in the lower back muscles.This condition is a reaction to root compression.
Medications are needed to improve microcirculation.All of this will eliminate swelling in the area of stress and provide more oxygen and nutrients to the nerve cells.Exercise and massage can be done at home to relieve pain and have similar effects.
If your back pain is severe and sitting becomes a real problem, you will need pain medication.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 effect will be much better.Ointments that should be applied to the most painful areas can work well to overcome painful symptoms.
If your back pain is severe and you can't sit down, your doctor will prescribe ointments.The ointment penetrates into the tissue and has an anti-inflammatory effect on the roots.The ointment can be used as a compress at night.Apply the ointment to the painful area 3 times daily.
physical therapy
Complete rehabilitation treatment includes:
- physical therapy;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- Reflexology.
Therapeutic gymnastics involves applying measured loads to the lumbar spine.With its help, stressed roots are released, muscles are strengthened, and correct posture is established, which is then supported through exercises.Gymnastics allows you to increase your range of motion and make your ligaments more elastic.Gymnastics is chosen individually for each person.
This technique, like exercise, is easy to perform, helps normalize blood circulation, and improves metabolism.Gymnastics helps improve nutrition of the intervertebral discs and increases the space between the vertebrae.Due to the formation of the corset, pain and pressure on the spine are reduced.Gymnastics is performed under the supervision of experts and is required every morning to prevent osteochondrosis.
Physiotherapy methods such as exercise are widely used.Low-frequency current, alternating current, ultrasonic waves, lasers, etc. are particularly useful.You can also use ultrasound ointment.Methods to relieve inflammation, pain and swelling.Most popular:
- UHF;
- diode speakers;
- magnet;
- shockwave therapy;
- ultrasound;
- Electrophoresis.
Massage is often used during the pain relief phase.Massage, like exercise, helps nourish cartilage and improves metabolic processes.Massage is a combination of special techniques such as kneading, kneading, caressing, and vibration.
Massage performed correctly is key to successful treatment and subsequent recovery.Only experts can perform massage.Additionally, you can use ointments with anti-inflammatory properties.Massage can relieve muscle spasms, improve blood flow, and strengthen your back.
Manual therapy is also a type of massage, but uses special techniques.The effect is the same as massage.
Pulling is performed using specially selected weights and techniques.This surgery helps increase the space between vertebrae, relieves pain, and restores the spine's anatomical axis.
Acupuncture is based on the action of acupuncture on active points in the human body.This technique is particularly useful in severe pain syndromes.