The lower back has more load than all other parts of the spine. Osteochondrosis develops as a result of degenerative-dystrophic processes due to decreased 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 osteochondrosis of the lumbar depends on the stage of the disease.
Osteochondrosis sometimes manifests itself in such a way that its symptoms "simulate" damage to other organs. He received a code at CID - 10. We will try to understand all the intricacies 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 this is a young variant, osteochondrosis is manifested by Scheuermann-Mao or Calve disease. The M42 code. 1 according to the ICD-10 gives an idea of the disease in adults.
If the disease variant is not specified, the ICD-10 code will be M42. 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 gives Scheuermann-Mao disease. Its code according to ICD-10 M40. 0.
appearance reasons
Why everything appears is still not completely known, one thing has been established for sure: a violation of the structure of the intervertebral disc develops, which leads to further changes in the spine. Symptoms can be clearly seen after 35 years, accelerate the process of injury, a long stay in a static position, due to load. But not only is the burden to blame, often the disease is genetic in nature. The cause can be flat feet, especially grades 3 or 4.
Symptoms
The insidiousness of this spinal disease is undeniable, and with time it only progresses. In total, doctors distinguish four stages of development of this pathology.
The first degree does not cause pain, a person can sit calmly and without pain, but the characteristic changes of the disease are already occurring in the nucleus of the intervertebral disc. The ligaments that strengthen the vertebrae can also suffer. Locally, discomfort is noted, which is able to distance oneself from the problem area. As a result of violations of the innervation of the vessels of the lower extremities, they become cold.
In the second degree, there is destruction of the fibrous ring of the intervertebral disc. Instability appears in the lumbar spine, increased mobility and local tension of the lumbar muscles can be noted. A person feels constant fatigue, feeling of some discomfort in the back and insecurity.
In the third degree, osteochondrosis leads to the fact that the annulus fibrosus completely loses its strength and breaks, the nucleus pulposus, in turn, passes through it, forming a hernia. There is compression of the spinal nerve roots, symptoms develop, mainly pain. In the area of innervation of the compressed nerve root, sensitivity totally or partially drops. Morning or daily exercise brings significant pain. In the initial stages, the burning sensation, tingling sensation bothers, then comes the turn of numbness. A decrease or lack of sensation can be considered to be the cause of the paralysis, resulting in muscle atrophy.
According to 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 in the body) are affected, Lasègue's symptom will be positive, it is easy to check at home. It is necessary to lie on your back, a stranger helps to lift a straight leg to the knee. With a positive symptom, the pain will increase if the leg is bent at the knee joint, disappearing completely.
With a significant size of the hernia, spinal cord function may suffer. You can often observe the symptoms of compression of the "ponytail", then osteochondrosis is often manifested, this is a bundle of nerves that, leaving the spinal cord, passes through the lumbar and sacral spine. Symptoms are manifested by impaired mobility and sensitivity of the lower extremities. In addition, disorders of the function of pelvic organs are added, often it is 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 spondylarthrosis. There is practically no pain at this stage, but along with this, the ability to move, exercise or gymnastics for a person almost completely disappears and becomes a real problem.
Due to the defeat of several nerves that innervate the internal organs, their function can be impaired. Sometimes for a long time a person struggles with a problem, but in fact the cause is osteochondrosis. In addition to the fact that there are characteristic symptoms, osteochondrosis of the spine must be established instrumentally.
Diagnosis
Symptoms are important, but further confirmation of osteochondrosis allows for an image of the lumbar spine. It shows damage to the joints of the vertebrae, decreased disc height, narrowing of the intervertebral foramen. A snapshot of the column is taken in two projections, additional functional testing may be required.
You can confirm the presence of a herniated disc with an MRI, the image will show characteristic changes. CT will show the tissue structure more clearly, it is especially convenient as the techniques are performed in different planes and slices. It is possible to consider the place where the symptoms arise and are disturbed.
Treatment
Before treating osteochondrosis of the lumbar, consultation with a neurologist is necessary. Medications have always been effective in helping to get rid of the disease. They are prescribed in courses for about 10 days, they complement all physiotherapy, daily exercises, gymnastics, massage.
With the help of medications, you can effectively eliminate intense pain caused by inflammation and swelling. After treatment in a hospital, taking medications and following the doctor's 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, swelling and pain disappear. The doctor is involved in the selection of drugs: they have many contraindications. But along with this, they quickly allow you to alleviate the condition, after a few days a person will get rid of pain and sit up normally, osteochondrosis will recede.
Treatment will be inferior if you do not use medications intended to restore cartilage structure. They are called chondroprotectors and contribute to better cartilage nutrition, restoration of disc tissue in the early stages. You need to take them for a long time, even at home.
Muscle relaxants make it possible to get rid of spasm of the muscles of the lower back. This condition is a response to root compression.
Medications that improve microcirculation are needed. All this will remove the swelling at the place where the compression occurred, give the nerve cells more oxygen and nutrients. Exercise and massage have a similar effect, which can be performed at home to relieve pain.
If your back hurts a lot and sitting becomes a real problem, painkillers will be needed. This group of drugs will quickly get rid of the manifestations of the disease.
Vitamins improve the nutrition of the nerve roots, strengthen them. With the use of this group of drugs, treatment is much more effective. It perfectly overcomes the symptoms of pain ointment, which must be spread on the site of maximum pain.
The doctor prescribes an ointment if the back hurts a lot and it is impossible to sit up. Penetrating the tissues, the ointment has an anti-inflammatory effect on the roots. You can apply the ointment in the form of compresses at night. Apply the ointment to the painful areas three times a day.
Physiotherapy
A complete rehabilitation treatment consists of:
- physical therapy exercises;
- physiotherapy;
- massage;
- traction;
- manual therapy;
- reflexology.
Therapeutic gymnastics consists of applying a dosed load to the lumbar spine. With its help, the trapped roots are released, the muscles are strengthened, the correct posture is established, which is then supported by the load. Gymnastics allows you to increase the range of motion, make the ligaments more elastic. Gymnastics are selected individually for each person.
The technique, as well as the loading, is easy to perform, contributes to the normalization of blood circulation and improves metabolism. Gymnastics helps improve intervertebral disc nutrition by increasing the space between the vertebrae. Due to the formation of a corset, pain and load on the spine are reduced. Gymnastics is carried out under the supervision of a specialist and it is necessary to charge every morning, which will prevent osteochondrosis.
Physiotherapeutic methods are used, as well as charging, very widely. Especially low frequency currents, alternating current, ultrasound, laser and much more help. With ultrasound, you can also use an ointment. The methods relieve the inflammatory process, pain and swelling. Most popular:
- UHF;
- diodynamic;
- magnetic;
- shock wave therapy;
- ultrasound;
- electrophoresis.
Massage is often used in the phase when it was possible to get rid of pain. Massage, like exercise, promotes cartilage nutrition, improves metabolic processes. It is a massage a combination of special techniques: rubbing, kneading, caressing and shock vibration.
Massage performed correctly is the key to successful treatment and subsequent recovery. Massage should only be performed by a specialist. Also, you can use an ointment with an anti-inflammatory effect. Massage allows you to relieve muscle spasm, improves blood flow, strengthens the back.
Manual therapy is also a massage, using only a special technique. Its effect is the same as a massage.
With the help of specially selected weights and techniques, traction is performed. The procedure helps to increase the space between the vertebrae, relieves pain, restores the anatomical axis of the spine.
Acupuncture is based on the effect of a needle prick on the active points of the human body. The technique is especially indicated for severe pain syndrome.