Spondylarthrosis according to ICD 10 in adults. Spondylarthrosis of the spine: treatment and prevention

A pathology in which deformation of the vertebrae occurs, leading to a narrowing of the spinal canal, is called spondylosis. The shape of the vertebrae changes as a result of the formation of bone growths that have protrusions and spikes. In some cases, the altered vertebrae grow together, and sometimes pinch the nerve endings.

Spondylosis is the body's reaction to the destruction of the discs between the vertebrae. The formed growths limit the mobility of the spine, and if the nerve endings are pinched, the patient may experience a dull pain at the pinched site.

Most often, this disease is diagnosed in the elderly, and the cervical region is considered the most common area of ​​spondylosis. As a rule, spondylosis is observed in people who are in motionless positions for a long time, for example, in those who work at the computer for a long time. ICD-10 code - M 47.

Kinds

Pathology is classified into three types, which differ depending on the localization of dystrophic changes:

1. cervical region;
2. chest;
3. lumbosacral.

Cervical

Each type of spondylosis has its own characteristic manifestations. Cervical spondylosis is accompanied by:

• pain in the occipital region, which become stronger with head movements;
• pain can fall on the shoulders, shoulder blades and give into the hands;
• limited movement of the neck;
• headaches and dizziness;
• decreased hearing and vision;
• the presence of ringing in the ears;
• sleep disturbance.

REFERENCE! Spondylosis that develops in the cervical region can provoke humeroscapular periarthritis, which is accompanied by a significant limitation of the mobility of the shoulder joint, as well as the presence of intense pain.

thoracic

Thoracic spondylosis is not so common, it is manifested by the following symptoms:

• pain on one side of the middle and lower spine, which can often cover the chest;
• increased pain during lateral bending;
• problems with the functioning of internal organs.

Lumbar

In lumbar spondylosis, in most cases, the 4th and 5th vertebrae are affected, this is accompanied by the following:

• the appearance of radicular syndrome;
• clinical picture of inflammatory processes in the sacrum and lower back;
• weakening of the lower extremities;
• pain in the legs;
• decreased sensation in the legs and a feeling of numbness;
• the pain becomes less intense when bending forward, because in this case the area of ​​\u200b\u200bthe affected disk increases.

If lumbar spondylosis is combined with osteochondrosis, radiculitis may occur, which develops as a result of pinched nerve roots.

Degrees

As for the degrees of development of pathology, they are as follows:

1. First degree. Symptoms of the disease appear infrequently and dimly, most often patients associate them with overwork. Diagnosis of this stage is difficult, since it is difficult to notice violations during a hardware examination.
2. Second degree- the symptomatology becomes more pronounced, and the changed structures of the disc are visible on the x-ray.
3. Third degree characterized by degenerative signs of the pathological process. The patient's physical abilities are limited, analgesics do not give an effect, or it is short-lived.

ankylosing

This form of the disease is typical for young people, in old age it occurs extremely rarely. In this case, the joints of the spine are affected, and most often the pathological process is localized in the region of the iliac-sacral joint.

This is a chronic inflammatory disease of a non-infectious nature, which results in damage to the intervertebral joints. In this case, the functionality of other organs - kidneys, heart, eyes - can be disturbed. In another way, this type of spondylosis is called Bechterew's disease, adolescents and young people under 30 are susceptible to the disease.

REFERENCE! The earlier the development of the disease, the greater the likelihood of various complications and disability.

The disease is incurable, drug therapy will reduce the intensity of the clinical picture and slow down the progress of the disease.

Signs and symptoms

Pathology can be suspected by the presence of pain:

• at an early stage of the disease, the pain is unstable, and mainly occurs during movement, an increase in pain during the day is characteristic;
• pain intensity can change with bad weather changes;
• on palpation of the spine in the affected part, the pain symptoms intensify.

With the progression of the disease, the mobility of the spine in the affected part begins to be gradually limited.

Diagnostics

The main diagnostic measure for suspected spondylosis is an x-ray of the spine. Osteophytes (growths) on radiographs are very visible. For a more detailed picture of the disease, an MRI or CT scan of the affected area may be prescribed.

How to treat diseases of the spine?

Treatment of spondylosis is more effective in the early stages of the development of pathology, when there are no large osteophytes yet. As a rule, conservative therapy is prescribed, aimed at:

• relief of pain;
• reduced inflammation;
• improvement of blood flow in the intervertebral discs;
• restoration of spine flexibility;
• posture correction.

As therapeutic approaches, pre-medications, massage, physiotherapy, exercise therapy, dietary nutrition and folk remedies are used.

Medical treatment

Since one of the most striking manifestations of spondylosis is pain, it is this symptom that prompts people to seek medical help. To relieve pain, as well as anti-inflammatory drugs, the following drugs are prescribed:

• Ibuprofen.
• Diclofenac.
• Indomethacin.
• Ketonal.
• Nimesulide.
• Movalis.

With pinched nerve fibers, appoint the following means:

• Baralgin, Ketoral.
• Kenalog, Hydrocartisone.
• Novocain-lidocaine blockade.

To normalize metabolic processes in the spinal column are used:

• Chondroxide, Aflutop, Gialgan.
• Karipain.
• vitamin complexes.

Very often spondylosis provokes increased muscle tone, to weaken it are assigned:

• Mydocalm.
• Flexeril.
• Zanaflex.

Gymnastics exercise therapy and exercises for the back

After the removal of the acute process, physiotherapy exercises are recommended for patients. It is necessary to normalize the flexibility of the spine, improve blood circulation in the affected part, and also to strengthen the muscles of the back.

Exercises that are prescribed for spondylosis are simple, however, to achieve a lasting positive effect, they must be done regularly. In addition, yoga, swimming, Pilates are recommended.

Treatment with gelatin

Treatment with gelatin is widely used in spondylosis. Gelatin helps to restore the cartilaginous base of the intervertebral disc, which means that the condition of the spine will improve significantly.

Diet

• limit the consumption of vegetable and animal fats;
• to monitor the sufficient intake of protein in the body;
• exclude the use of stone-forming products - salt, smoked meats, spicy dishes;
• give up strong tea and coffee, which can provoke narrowing of blood vessels.

It is important to understand that a diet for spondylosis is not just an additional method of therapy, but a significant component of the main treatment, since only with proper nutrition can the progression of the disease be prevented.

Massage

With spondylosis, massage is aimed at influencing the gluteal and paravertebral muscles, since it is they that hold the body in an anatomically correct position.

It begins with rubbing, stroking and kneading, after which the specialist proceeds to segmental procedures in the area where spasmodic muscle contraction has occurred. The duration of one session is on average 20 minutes. A total of 15-20 sessions are scheduled.

IMPORTANT! A traumatic effect - chopping, tapping, etc., is excluded with spondylosis.

The benefits of massage for spondylosis are invaluable - this is the only way to eliminate pain without the use of medications. In addition, massage is very effective in restoring blood flow, especially after exercise therapy, manual therapy, and so on.

Surgery

Operations for spondylosis are performed in very rare cases, as a rule, they become appropriate with the development of complications or with the complete absence of the effect of conservative treatment methods. The essence of the surgical intervention is cutting off bone growths with special tools. Also, in some cases, it is practiced to replace the affected vertebrae with implants.

Physiotherapy

Physiotherapy activities are as follows:

• impulse therapy;
• interference therapy;
• CHANCE;
• ultraviolet;
• mud treatment;
• baths;
• wearing special .

Folk remedies

Collection to speed up metabolic processes- wild rose, currant leaves, lingonberries, raspberries, mountaineer, nettle, horsetail, yarrow. All ingredients are taken in equal proportions, mixed. A tablespoon of the collection will require 2 cups of boiling water. Insist 2 hours. Half an hour before meals in the morning and evening, take a glass of funds.

pain reliever. Mix equal amounts of lemon balm, mint, plantain seeds, burdock, St. John's wort and fireweed. Brew and drink like regular tea.

Of the external agents for spondylosis, essential oils of oregano, fireweed, fir, lavender, cedar, thyme are actively used. A couple of drops of these oils are added to olive oil and rubbed into the affected area. In some cases, it is allowed to use tincture of capsicum.

What doctor treats?

If you suspect spinal spondylosis, you need to seek advice from, and if it is not in the clinic, you can make an appointment with a neurologist. If present in combination with spondylosis, it is recommended to consult a trauma surgeon.

What is the difference between spondylosis and osteochondrosis?

The term spondylosis refers to bony vertebral structures. In this case, there is a growth and change in the shape of the vertebrae, which are in close contact with the intervertebral discs.

When the discs are destroyed, the vertebrae begin to experience increased pressure, which makes them defend themselves - form. This is necessary to increase the area and reduce pressure.

In addition, in spondylosis, a large role is played by the anterior longitudinal ligament, which, stretching when osteophytes occur, provokes back pain. Doctors consider spondylosis a secondary phenomenon, as a response to long-term osteochondrosis.

But - this is the pathology that destroys the intervertebral discs. This destruction occurs as a result of disk overload or power failure. When destroyed, protrusion occurs - the exit of the gelatinous body beyond the disk. So there is a hernia of the spine, which can put pressure on the adjacent vertebra and provoke the development of osteophytes.

Possible Complications

Spondylosis of the spine can lead to the following complications:

• Herniation. Such a complication does not occur in all cases, sometimes a hernial protrusion precedes spondylosis, but if the osteophytes are closely adjacent to the intervertebral disc, a hernia can form as a result of spondylosis.
• Vascular compression leading to myelitis. Such a complication most often occurs with a long and neglected course of pathology. In this case, the blood supply to the brain may deteriorate. When there is a negative effect on the spinal artery, spinal Preobrazhensky syndrome or spinal cord infarction may develop.

Are spondylosis and spondylarthrosis the same thing?

It is impossible to say that these two pathologies are one and the same - rather, they are two varieties of the same disease. Spondylosis is a bone growth that can provoke the fusion of bone vertebrae, and spondyloarthrosis is the destruction or fusion of the facet joints.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Dorsopathy and back pain

2. Degenerative-dystrophic changes in the spine

Degenerative changes in the spine consist of three main options. These are osteochondrosis, spondylosis, spondylarthrosis. Various pathological variants can be combined with each other. Degenerative-dystrophic changes in the spine by old age are observed in almost all people.

Osteocondritis of the spine

ICD-10 code: M42 - Osteochondrosis of the spine.

Osteochondrosis of the spine is a decrease in the height of the intervertebral disc as a result of dystrophic processes without inflammatory phenomena. As a result, segmental instability develops (excessive degree of flexion and extension, sliding of the vertebrae forward during flexion or backward during extension), and the physiological curvature of the spine changes. The convergence of the vertebrae, and hence the articular processes, their excessive friction will inevitably lead to local spondylarthrosis in the future.

Osteochondrosis of the spine is an x-ray, but not a clinical diagnosis. In fact, osteochondrosis of the spine simply states the fact of the aging of the body. Calling back pain osteochondrosis is illiterate.

Spondylosis

ICD-10 code: M47 - Spondylosis.

Spondylosis is characterized by the appearance of marginal bone growths (along the upper and lower edges of the vertebrae), which on x-rays look like vertical spikes (osteophytes).

Clinically, spondylosis is insignificant. It is believed that spondylosis is an adaptive process: marginal growths (osteophytes), disc fibrosis, ankylosis of the facet joints, thickening of the ligaments - all this leads to immobilization of the problematic spinal motion segment, expansion of the supporting surface of the vertebral bodies.

Spondylarthrosis

ICD-10 code. M47 - Spondylosis Inclusions: arthrosis or osteoarthritis of the spine, degeneration of the facet joints

Spondylarthrosis is an arthrosis of the intervertebral joints. It has been proven that the processes of degeneration in the intervertebral and peripheral joints do not fundamentally differ. That is, in fact, spondylarthrosis is a type of osteoarthritis (therefore, chondroprotective drugs will be appropriate in the treatment).

Spondylarthrosis is the most common cause of back pain in the elderly. In contrast to discogenic pain in spondylarthrosis, the pain is bilateral and localized paravertebral; increases with prolonged standing and extension, decreases with walking and sitting.

3. Protrusion and herniation of the disc

ICD-10 code: M50 - Damage to the intervertebral discs of the cervical region; M51 - Damage to the intervertebral discs of other departments.

Protrusion and herniation of the disc are not a sign of osteochondrosis. Moreover, the less pronounced degenerative changes in the spine, the more the disk is "active" (that is, the more likely the occurrence of a hernia). That is why disc herniations are more common in young people (and even children) than in older people.

Schmorl's hernia is often considered a sign of osteochondrosis, which has no clinical significance (there are no back pains). Schmorl's hernia is a displacement of disc fragments into the spongy substance of the vertebral body (intracorporeal hernia) as a result of a violation of the formation of the vertebral bodies during growth (that is, in fact, Schmorl's hernia is dysplasia).

The intervertebral disc consists of the outer part - this is the fibrous ring (up to 90 layers of collagen fibers); and the inner part is the gelatinous nucleus pulposus. In young people, the nucleus pulposus is 90% water; in the elderly, the nucleus pulposus loses water and elasticity, fragmentation is possible. Protrusion and herniation of the disc occur both as a result of dystrophic changes in the disc, and as a result of repeated increased loads on the spine (excessive or frequent flexion and extension of the spine, vibration, trauma).

As a result of the transformation of vertical forces into radial forces, the nucleus pulposus (or its fragmented parts) shifts to the side, bending the fibrous ring outward - disc protrusion develops (from Latin Protrusum - push, push). The protrusion disappears as soon as the vertical load stops.

Spontaneous recovery is possible if fibrotization processes extend to the nucleus pulposus. Fibrous degeneration occurs and protrusion becomes impossible. If this does not happen, then as the protrusions become more frequent and repeated, the fibrous ring becomes more and more entangled and, finally, ruptures - this is a disc herniation.

A disc herniation can develop acutely or slowly (when fragments of the nucleus pulposus come out in small portions into the rupture of the fibrous ring). Posterior and posterolateral disc herniations can cause compression of the spinal root (radiculopathy), the spinal cord (myelopathy), or their vessels.

Most often, disc herniation occurs in the lumbar spine (75%), followed by the frequency of cervical (20%) and thoracic spine (5%).

• The cervical region is the most mobile. The frequency of hernias in the cervical spine is 50 cases per 100,000 population. The most common disc herniation occurs in the C5-C6 or C6-C7 segment.
• The lumbar region bears the greatest load, holding the entire body. The frequency of hernias in the lumbar spine is 300 cases per 100,000 population. Most often, disc herniation occurs in the L4-L5 segment (40% of all herniations in the lumbar spine) and in the L5-S1 segment (52%).

Disc herniation should be clinically confirmed, asymptomatic disc herniations, according to CT and MRI, occur in 30-40% of cases and do not require any treatment. It should be remembered that the detection of a herniated disc (especially small ones) on CT or MRI does not exclude another cause of back pain and cannot be the basis of a clinical diagnosis.

Contents of the file Dorsopathy and back pain:

Degenerative-dystrophic changes in the spine. Protrusion and herniation of the disc.

Inflammation of the facet joints or spondylarthrosis of the lumbosacral spine: how to treat and stop the destruction of the intervertebral discs

Spondylarthrosis of the lumbosacral spine is a disease of the musculoskeletal system, which is accompanied by the destruction of the intervertebral joints. The disease affects small facet joints, so spondyloarthrosis has a different name - facet arthropathy.

The last stages of the pathology are accompanied by the growth of osteophytes, which leads to an inflammatory process in the entire joint, to serious mobility disorders. The lumbar region suffers more often than other areas of the spine, against the background of a constant load on this area, the influence of a mass of negative factors.

Reasons for the development of pathology

The spine consists of vertebrae, between which there are arcs, other processes. Between the arches there are small facet joints (flat, covered with a thin layer of hyaline cartilage on top, limited by the articular bag). Between these bodies are intervertebral discs, they are designed for cushioning. The proper functioning of the vertebrae directly depends on the small joints between them.

Various negative factors lead to the destruction of the cartilage layer of the facet joints, the narrowing of the gap, and the increase in the pressure of the upper vertebra on the underlying one. The pathological process leads to inflammation of the articular cavity, nearby tissues (ligaments, blood vessels, nerves). Spondylarthrosis develops (ICD code 10 - M45-M49).

The advanced stages of the disease lead to the formation of osteophytes, bone growths contribute to pinching of nerve endings, and a decrease in motor activity. About 70% of patients with spondylarthrosis of the lumbar spine are elderly. Pathology develops against the background of age-related changes in the body.

In persons after twenty years, spondyloarthrosis develops against the background of various pathological processes:

• traumatic back injury;
• flat feet;
• posture disorders (scoliosis, kyphosis);
• lifting weights, other hard physical labor;
• lack of regular physical activity;
• professional sports;
• endocrine diseases (diabetes mellitus, obesity);
• congenital anomalies of the structure of the spine;
• the presence of dorsopathies (pathologies associated with the destruction of bones and cartilage).

Often, spondylarthrosis is formed against the background of the course of osteochondrosis (destruction of intervertebral discs, growth of osteophytes). The favorite area of ​​localization of the disease is the lumbar area, so the disease is often diagnosed in this area.

Find out the instructions for using Neuromultivit tablets to restore nervous regulation in diseases of the spinal column.

About the methods of treatment and possible consequences of a compression fracture of the vertebrae in the lumbar spine is written on this page.

Classification

Spondylarthrosis is divided into three groups, depending on the location of the pathology. There is another classification, given the course of the disease:

• deforming type. The vertebrae change their shape against the background of the growth of osteophytes;
• degenerative. It is manifested by the destruction of not only facet joints, but also intervertebral discs;
• arcuate. Degenerative processes affect the facet joints;
• ankylosing. It has a different name - Bechterew's disease, accompanied by damage to many joints, not only in the lumbar region. Often diagnosed in men under thirty;
• dysplastic. Manifested by severe deformation of the vertebrae;
• polysegmental. The pathological process affects not only the lumbar region, but also other areas of the spine.

Symptoms

This disease is manifested by chronic pain in the area of ​​localization of the pathological process. Often these are unpleasant sensations that spread to the buttocks, legs, without affecting the area below the knee. Prolonged stay in one position increases discomfort, and active movements worsen the situation. At rest, pain usually subsides.

As the disease progresses, patients complain of spinal stiffness in the morning immediately after waking up. The discomfort usually lasts a few hours and then subsides. Such an unpleasant symptom is due to the growth of osteophytes (bone growths). The formations themselves pose a serious threat to health, so this symptom cannot be ignored.

Spondylarthrosis is also characterized by a specific symptom - subluxation of the damaged joint. Against this background, the tone of nearby muscles increases, provoking restriction of mobility of the spine, increased pain symptoms.

Unpleasant sensations in spondylarthrosis in the lumbar region are formed against the background of the following pathological conditions:

• pinched nerve endings. Discomfort will spread along the entire affected nerve. There is also a decrease in sensitivity, numbness, muscle weakness;
• pain in muscles and ligaments. Discomfort in this case is very strong, intensifies during the vertical position of the body, movement. Pain will increase with palpation of the damaged muscle tissue.

Diagnostics

To make the correct diagnosis, the following manipulations are used:

• palpation of the damaged and painful area;
• radiography in several projections;
• CT, MRI. Studies allow you to assess the state of not only bone tissue, but also muscles, blood vessels, nerve endings;
• radioisotope scanning (doctors evaluate the inflammatory process in the articular processes).

Based on the data obtained, the doctor makes a diagnosis, chooses the appropriate therapy, taking into account the characteristics of the patient.

Effective Treatments

How to treat spondylarthrosis? The disease requires complex therapy, responsibility on the part of the patient. Therapy includes the use of medicines, physiotherapy, in difficult situations, doctors resort to surgical intervention.

Medical therapy

Effective drugs:

• NSAIDs. Medicines are the "gold" standard in the treatment of various pathologies associated with the spine, and spondylarthrosis is no exception. Nimesulide, Movalis, Celecoxib are modern drugs that rarely cause side effects. With spondyloarthrosis, short courses are recommended, NSAIDs are often used in the form of injections;
• muscle relaxants (Mydocalm, Baklosan, Sirdalud). The funds are used to stop muscle spasm in the damaged area, which helps to start blood circulation, reduce pain;
• novocaine blockade. Used for pinched nerve roots. Novocaine blockades allow you to cope with pain in the lumbar region, to enhance the positive effect, glucocorticosteroids are added to the drug;
• chondroprotectors (Don, Aflutop, Teraflex Advance). Means contain chondroitin sulfate, glucosamine. Substances restore cartilage tissue, prevent its further destruction;
• Start the blood flow will help products containing ascorbic acid. Vitamins of group B have a positive effect on nerve tissues.

The combination of the above groups of medicines can stop the symptoms of spondylarthrosis, prevent the development of complications.

Physiotherapy procedures

Outside the period of exacerbations, the patient is prescribed a course of physiotherapy, which positively affects the patient's condition, increases the mobility of damaged joints, and reduces discomfort.

• magnetotherapy. The magnetic field allows you to stop pain, eliminate swelling and inflammation;
• paraffin applications. Thermal influence on the affected area contributes to the relief of muscle spasms, activation of blood circulation;
• laser therapy. Manipulation eliminates pain, swelling. The procedure allows you to activate the metabolism in the bone tissues of the spine.

Acupuncture, UHF, electrophoresis are also used. All manipulations are prescribed by a physician, the duration of therapy is also indicated by a specialist.

Learn about the causes and treatment of herniated thoracic disc.

Indications for the use of Milgamma injections in the complex treatment of pathologies of the back and spine are described in this article.

On the page http://vse-o-spine.com/iskrivleniya/kak-ispravit.html read about how to correct the curvature of the lumbar spine with therapeutic exercises.

Surgery

Surgical therapy is used infrequently. This is due to the excellent results that conservative treatment methods provide.

The indications for the operation are:

• disorders of the intestines, urinary system;
• neurological disorders, numbness of the lower extremities;
• spinal stenosis;
• spinal instability.

The surgical solution of the problem in the lumbar zone is carried out in different ways (facectomy, laminectomy, laminotomy, foraminotomy). After the removal of damaged tissues, the risk of recurrence of neurological disorders increases, so the spine is fused (using bone grafts).

After the operation, soft tissue healing lasts several weeks, but the entire rehabilitation period lasts two months. Surgical intervention is used infrequently against the background of complications (infections, traumatic nerve damage, pain in the legs).

Preventive measures are divided into two groups: recommendations to prevent the formation of the disease and useful tips to prevent recurrence and progression of spondylarthrosis of the spine.

The first group of preventive measures include:

• lead a mobile lifestyle, do yoga, swimming, fitness, give up excessive physical exertion;
• watch your body weight, avoid obesity;
• timely treat diseases accompanied by degenerative-dystrophic changes;
• Strengthen your back muscles to prevent slouching and bad posture.

• refuse to lift weights, wear a special corset for the spine, especially in cases where you need to overcome a long distance (vibration adversely affects the course of spondylarthrosis in any part of the spine);
• Hiking, swimming, yoga, walking help prevent exacerbation of the disease, improve the patient's condition.

Video about the treatment of spondylarthrosis of the lumbosacral spine with the help of exercise therapy and gymnastics:

Spondylarthrosis of the spine: treatment and prevention

Spondylarthrosis until relatively recently was considered an exclusively ailment of the elderly. However, today this pathology of the spine is much younger. Many who suffer from back pain and do not know what spondylarthrosis is. According to statistical studies, more than 90% of cases associated with discomfort in the spine fall on this disease.

What is it, causes and symptoms

Back pain was previously mistaken for symptoms of sciatica or the consequences of poor posture. However, spondylarthrosis is by far one of the most common diseases associated with degeneration of the spinal column.

It is quite natural that with age, all organs and the musculoskeletal system gradually fail. The vertebrae are erased, and the movement of the joints is limited.

Recently, doctors have noted that many ailments are “getting younger” and even such manifestations as pain in the spine excite young people and middle-aged patients.

The occurrence of spondylarthrosis can be associated not only with the natural aging of the body, but also with such factors:

• past injuries;
• advanced stage of scoliosis;
• displacement of the vertebrae;
• osteochondrosis;
• congenital pathology of the vertebrae;
• obesity 3 and 4 degrees;
• the presence of autoimmune diseases;
• flat feet;
• constant pressure on the back.

1. Violation of the mobility of the spine (the symptom is especially noticeable in the morning after sleep).
2. Pain in one of the departments, which increases with changing weather conditions.
3. Rapid fatigue and discomfort in the back with a long stay in one position.
4. Unpleasant sensations disappear if the patient takes a comfortable horizontal position and bends his knees.

Classification according to ICD 10

Each pathology has its own diagnosis code. Spondylarthrosis is no exception. During the tenth revision of the international classification of diseases ICD 10, the disease was assigned the code M45-M49 (spondylopathy). At the initial stage, the disease does not show obvious signs. The symptoms are blurred, and the pathology is difficult to detect even with an x-ray.

The next stages of changes in the spine are manifested by distinct symptoms.

Depending on the location of the destructive process, the disease was divided into types:

In addition to the listed types, spondylarthrosis is divided into 4 degrees, which are determined by the stage of the destructive process:

1. The elasticity of discs, membranes and ligaments is lost, as well as the movement of the intervertebral joints is limited and the mobility of the vertebra is reduced.
2. The load on the cartilaginous lining between the bodies of the discs increases. Fibrous rings cease to perform their function.
3. It becomes possible to diagnose the disease. Pathological changes can be seen on the x-ray. Ligament degeneration develops.
4. Osteophytes reach large sizes. The spine becomes inactive. There is pressure of bone growths on the vessels and nerves.

Also in medicine, spondylarthrosis is divided into varieties that determine the course of the disease and the phase of development:

Types of treatment

Which doctor should be consulted with such a problem as cartilage tissue degeneration and spinal deformity? A few years ago, with similar manifestations, they went to a neurologist. Now many patients, faced with back pain, do not know which doctor treats spondyloarthrosis.

This disease is diagnosed by a specialist in abnormalities in the musculoskeletal system and spine - a vertebrologist. Patients with spondylarthrosis should be aware that this is a disease that requires the regular implementation of doctor's prescriptions and prolonged therapy with medications that relieve pain and relieve inflammation.

Patients whose disease is in the stage of weakening of manifestations, in addition to medications, are prescribed massage and certain exercises. It helps to improve blood and lymph circulation, and also relieves discomfort and back pain.

Acupuncture provides relief from muscle spasm and improves blood flow in the affected area.

Elderly people are concerned about the question of how to treat spinal spondyloarthrosis if exercise is contraindicated for them. The fact is that this active method of treatment is not used in the treatment of patients of respectable age and in younger patients with certain types of disease. If it is not possible to carry out exercise therapy for spondylarthrosis, then in such cases physiotherapy courses are prescribed (magnetic therapy, phonophoresis, ionogalvanization, sinusoidally modulated currents).

Currently, the treatment of spondyloarthrosis cannot be completed without the use of chondroprotectors (Chondroxide), which are indispensable in the restoration of damaged cartilage.

Treatment with folk remedies is ineffective for spondylarthrosis. The only way the patient can help himself to ease the pain is warming up the muscles (warm bath, compresses with tinctures, warming with a dog hair belt).

Special exercises for spondylarthrosis are performed during a prolonged subsidence of the disease. Their effectiveness is not lower than drug treatment, but on the contrary, with classes, they successfully achieve muscle strengthening, reduce pain, resume mobility of the spinal column, and prevent further progression. Wearing an orthopedic corset will unload problem areas.

Treatment includes the use of structure-modifying drugs. For this, glucosamine sulfate and chondroitin sulfate are prescribed. The action of these medicines is aimed at stopping the destruction of cartilage.

The condition for such a method of therapy as gymnastics for spondylarthrosis is the regularity of performing the necessary exercises.

Surgery is indicated only for patients with serious disorders. In other cases, minimally invasive operations are prescribed to alleviate the patient's condition (radiofrequency or chemical denervation, transpedicular fixation, microsurgery to remove the vertebral arch, insertion of stabilizing implants).

Possible Complications

Spondylarthrosis can be accompanied by such complications:

• restriction of movement of the spine;
• spinal stenosis;
• violations of coordination;
• problems in the work of the nervous system;
• numbness of the limbs, lameness;
• improper functioning of the pelvic organs;
• the occurrence of seizures;
• muscle dystrophy.

Prevention

Spondylarthrosis can be prevented by avoiding factors that provoke degenerative changes in the spine. Preventive measures are:

• exclusion of excessive loads on the back;
• getting rid of excess weight;
• posture tracking;
• sleeping on a hard bed;
• moderate exercise.

The disease in the absence of necessary therapy tends to progress. Treatment of spondylarthrosis is a set of measures that give the best result in the initial stages of the disease. Therefore, the first symptoms described above should not be ignored and treated with disdain.

spondylarthrosis of the spine mcb 10 code

Osteochondrosis code for ICb 10

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In none of the developed countries of the world, in any medical classification of degenerative-dystrophic diseases, there is a nosological unit "osteochondrosis of the spine". Only in the former German classification "osteochondrosis" previously denoted the classic "Schmorl's hernia". Webster's American English Dictionary does not even mention osteochondrosis of the spine, as well as in medical English dictionaries ..​

As mentioned above, osteochondrosis disease is classified under the ICD-10 code. The ICD-10 code is the classification of diseases of the 10th revision. The ICD-10 is assigned a code that indicates a specific back disease. Osteochondrosis in the ICD-10 classification has the M42 code and is determined by the age of the patient and the location.

Acupuncture helps to get rid of pain syndromes of osteochondrosis by using needles on certain dorsal points, which are determined by the doctor. It is worth holding only the position

Mkb 10 osteochondrosis of the spine

How does lumbar osteochondrosis manifest itself, code for microbial 10?

As a rubbing for patients who have a diagnosis of dorsopathy (intervertebral hernia), cinquefoil tincture helps well. It can also be taken as a medicine inside. In a glass of boiling water throw 2 tbsp. spoons of herbs. Insist, filter the remedy and rub it on sore spots. In addition, you can prepare and alcohol tincture. 100 g of cinquefoil insist in 1 liter of alcohol for three weeks. A few drops of tincture are added to a glass of water, taken three times a day.

Disease of the spine osteochondrosis - caused by a dystrophic lesion of the articular cartilage and bone tissue. It is also characterized by degenerative changes in the intervertebral discs, which eventually lead to a reduction in the height of the spine.

Lumbar osteochondrosis, which has the ICD code 10, refers to common diseases of the musculoskeletal system. Statistics show that if earlier this disease mainly affected people over 45 years old, now this disease is rapidly getting younger and is no longer a rarity for people under 35 years old.​

Using all of the above methods of treatment, one should not forget about the prevention of the disease. Much attention should be paid to strengthening the immune system, try not to overcool and control physical activity. At the first signs of the disease, you should not neglect a visit to the doctor - the deviations detected in time can be treated more quickly than the disease in the progressive stage.

Despite a number of characteristic prerequisites, doctors are inclined to believe that the main causes of this type of pathology are uncontrolled and constant loads, as a result of which the vertebrae in the lumbar region begin to put pressure on the intervertebral discs.

Deciding how to deal with cervical osteoch

Codes of injuries, bruises of the spine according to ICD-10

Unfortunately, spinal injuries are common in humans. Some of them relate to damage to the spinal column due to negligence, for example, when losing balance. A back injury has serious health consequences. The main danger is that a person does not seek medical help. Injuries of the spinal column, coccyx are listed in the international classification of diseases ICD-10, have their own special code in this system.

In the ICD-10, the region of the back, the spine is designated as T2. Depending on the nature of the damage, the possibility of developing complications, the impact on other organs, the patient's quality of life in the future, they are divided into subgroups. There are injuries of an obscure nature, with deterioration or minor, therefore each type has its own code or subgroup, and in addition to the code, conventional signs may be indicated indicating the ambiguity of the diagnosis, its ambiguity.

In sick leave, the ICD-10 code is more often indicated. This approach allows you to save space on the sick leave, the information capacity of one code when deciphering is more useful than a diagnosis described in words. Familiarity with this classification will allow you to understand what disease is discussed in the medical card, what diagnosis.

The T09 category includes injuries to the abdomen, back, the type of which is difficult to determine. Not attributed to T09: crushing of the body, multiple injuries, cut of the back, abdomen. The following types of damage can be attributed to T09 of an unclear nature:

T08 - Fracture of the vertebral column, type unspecified. This code is used as the main one when it makes no sense to add certain information, analyze damage, injury. The code can

What is dorsopathy of the spine, ICD-10 code, what are its symptoms and treatment?

Dorsopathy of the spine (ICD-10 code) is a complex of diseases that affect not only the spine, but also the ligaments, muscles, and nerve endings that surround it. If we take the literal translation of the word itself from English, then it means "pathology of the back."

This name appeared not so long ago, before that the well-known word osteochondrosis was used more often. The disease itself received the medical code ICD-10 in general terminology.

Causes of the disease

The work of all organs in the human body is controlled by the brain through neural connections with the spinal cord. If a patient is diagnosed with dorsopathy, this means that his spinal cord is compressed, thereby beginning to break connections with the brain, the functions of internal organs change, which adversely affects the state of the whole organism.

The main and initial cause of the development of this disease is low immunity. According to medical studies, the symptoms of the disease begin to appear after 45 years. But in certain cases: after injuries, infectious diseases, metabolic disorders - this process can develop at any age. There were cases when the disease manifested itself as a hereditary factor.

There are subtle changes in the vertebral disc in the body. At this stage, the patient practically does not feel symptoms, discomfort may occur in certain positions of the body. In studies in the hospital, pathological changes are not visible.

At the second stage, the disease begins to actively progress, the intervertebral joints, bones and neighboring vertebrae are affected.

The patient feels a constant manifestation of pain syndrome, which is caused by compression of the vessels and nerve endings of the vertebral

Causes of the development of spondylarthrosis of the lumbosacral spine and treatment of the disease with injections

Most adults are familiar with back pain. The older the person, the more problems with the spine he has. One of the causes of unpleasant symptoms may be spondyloarthrosis of the lumbosacral region. This is a chronic degenerative process in the vertebral joints, as a result of which pain occurs, mobility is limited. Spondylarthrosis ICD code 10 - M45-M49 (spondylopathy).

In order for the progression of the disease not to lead to disability, it is necessary to diagnose it in a timely manner and begin treatment. One of the methods of complex therapy for spondylarthrosis is the administration of drugs by injection.

general information

The structure of the spine includes vertebrae, which are interconnected by intervertebral discs. They act as a shock absorber. Processes emerge from the vertebrae, between which there are facet joints. The surface of the joint is covered with thin hyaline cartilage, bounded by the articular capsule. The structure of the discs and their function are directly related to the small articulations between the vertebral processes.

Under the influence of certain causes that contribute to degenerative processes, the cartilaginous layer of the facet joint begins to break down, the joint space narrows. This causes increased pressure on the vertebrae against each other. The joint cavity and surrounding tissues may become inflamed.

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The progression of spondylarthrosis without proper therapy leads to the formation of bone growths around the edges of the vertebrae (osteophytes). The growth of osteophytes damages the soft tissues around, which causes muscle spasms, compression of the spinal nerve roots. Running lumbosacral spondylarthrosis leads to the development of deforming spondylosis. Osteophytes among themselves

Schmorl's hernia: what is the danger of the disease and how to diagnose it?

The disease affects not only the elderly, but also the young as a result of injuries, physical exertion, unhealthy lifestyle and some other factors.

The initial stages of the pathology proceed without visible manifestations, therefore, often a hernia is detected quite by accident during an X-ray examination or at later stages.

Schmorl's hernia is.

A hernia or Schmorl's node is a deformity that is a breakthrough of the tissue of the nucleus pulposus into the vertebra, as a result of which the bone is pressed through. With this type of disorder, the spinal cord or spinal nerves are not compressed, as happens with an intervertebral hernia, so the disease is characterized by an asymptomatic course. Most often, the disease occurs in the lumbar or thoracic spine. In the cervical zone, pathology usually does not develop.

The first stages of the disease are not accompanied by pronounced symptoms, since the hernia does not compress the nerve endings. Only in the last stages of development do knots begin to manifest themselves. The first symptom of the disorder is numbness of the limbs after sports or physical labor.

In addition, patients experience rapid fatigue and fatigue of the back. The numbness spreads gradually: first, the fingers lose sensitivity, then the palms and hands.

When these signs appear, you need to lie down and relax. At this time, the blood circulation will gradually be restored and the numbness will disappear. If the load on the vertebrae continues, then after a while the hands will lose sensitivity, followed by the legs. In this case, the patient should immediately consult a doctor.

Protrusion of the discs of the lumbar spine is diagnosed quite often recently. The provoking factors for the occurrence of pathology are different. Next, we learn what a disc protrusion is. Treatment, what about

In the last stages of development, the main signs of a hernia are pain in the area

Spinal stenosis

Spinal stenosis is a chronic process characterized by pathological narrowing of the central spinal canal, lateral pocket or intervertebral foramen by bone, cartilage and soft tissue structures, with their invasion into the spaces occupied by the nerve roots and spinal cord.

Narrowing of the spinal canal caused by disc herniation, which leads to acute compression of the neurovascular structures, is not usually referred to as stenosis.

Stenosis of the lumbar spine [ edit | edit code]

Spinal stenosis is a disease that involves a combination of narrowing of the spinal canal, as seen on either computed tomography (CT) or magnetic resonance imaging (MRI) or x-ray of the spine (spondylography) and characteristic clinical symptoms. When conducting MRI in persons over 60 years of age, it was noted that 21% of them had radiographic signs of narrowing of the spinal canal at the lumbar level. Only a third (33%) presented complaints characteristic of stenosis.

Rickets and venereal diseases were the main cause of curvature. In one of the observations of this researcher, the lumen of the spinal canal was reduced by half. Particularly important is the development noted by the author of weakness in the legs, muscle atrophy and even paralysis of the lower extremities in some patients. Since 1954, Henk Verbiest began the development of this topic

He described the observation of 4 patients with a narrow spinal canal at the lumbar level, in which laminectomy led to the complete disappearance of complaints. The author introduced the concepts of "absolute" and "relative" stenosis, and also described the syndrome of "neurogenic intermittent claudication". Since then, there has been a steady increase in interest in this problem, the search for new methods of treatment.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Orthopedist: for the hundredth time I say, do not smear ointments and do not inject chemistry into the sore BACK and JOINTS.

In the 13th class of the international classification, osteochondrosis belongs to the subclass of dorsopathy (pathologies of the back - from M40 to M54). This disease is one of the deforming dorsopathies, which are recorded under the codes M40 - M43. According to ICD-10, osteochondrosis itself has the code M42.

• in the thoracic region;
• in the lower back;
• in the sacral vertebrae;

ICD-10 codes for varieties of osteochondrosis

Juvenile osteochondrosis

• M42.00 - Juvenile osteochondrosis, localized in multiple parts of the spine.
• M42.01 - Juvenile osteochondrosis, localized in the back of the head, as well as the first and second vertebrae of the cervical region.
• M42.02 - Juvenile cervical osteochondrosis - in ICD 10 this is a dystrophic process localized in the cervical vertebrae (C1-C7).
• M42.03 - Osteochondrosis of adolescence, localized in the cervical and thoracic regions of the spine.
• M42.04 - Juvenile osteochondrosis with isolated localization in the thoracic region.
• M42.05 - Juvenile osteochondrosis of the lumbar and thoracic vertebrae.
• M42.06 - Osteochondrosis of adolescence with localization of the pathological process in the lumbar vertebrae.
• M42.07 - Juvenile osteochondrosis of the lumbar and sacral regions.
• M42.08 - Osteochondrosis of young men, localized in the sacral and sacrococcygeal regions.
• M42.09 - Osteochondrosis of adolescence with unspecified (doubtful) localization.

Pain and crunching in the back and joints over time can lead to dire consequences - local or complete restriction of movement in the joint and spine, up to disability. People, taught by bitter experience, use a natural remedy recommended by orthopedist Bubnovsky to cure joints. Read more»

Osteochondrosis of adults

• M42.1 - Osteochondrosis of adult age with localization of pathology in multiple departments.
• M42.11 - Osteochondrosis of the adult occipital region and cervical vertebrae (C1-C2).
• M42.12 - Osteochondrosis of adults in the cervical spine.
• M42.13 - Adult chondrosis with localization in the cervicothoracic region.
• M42.14 - Dystrophic process in adults in the thoracic spine.
• M42.15 - Osteochondrosis in the thoracic and lumbar regions.
• M42.16 - in the ICD-10 osteochondrosis of the lumbar spine in adults.
• M42.17 - Osteochondrosis of the lumbosacral vertebrae in adults.
• M42.18 - Osteochondrosis of adults, localized in the region of the sacrococcygeal and sacral spine.
• M42.19 - Osteochondrosis of adults, unspecified localization.

Unspecified osteochondrosis

• M42.97 - Osteochondrosis, unspecified, with localization in the lumbosacral region of the spine.

Conclusion

Cervical, lumbar and thoracic osteochondrosis of the spine: ICD code 10

Civilization has brought many achievements to man. But you have to pay for everything. Modern man pays with what he (as he himself naively thinks) in abundance - health.

And today, osteochondrosis of the spine has become one of the most common ways to pay a person for progress. Here we have already covered the issue of drug treatment of various types of chondrosis.

First of all, what is osteochondrosis?

The disease begins with a deterioration in the trophism (nutrition) of the intervertebral discs and the vertebrae themselves, which leads to a violation of the normal structure of the tissues.

Due to this process, the elasticity of the disc, which consists of cartilage, decreases, its structure and shape change. Naturally, the gaps between the vertebrae become smaller, and the affected spine becomes unstable.

The process of dystrophic changes in the spine is accompanied by compression of the nerve roots that exit the spinal canal through the intervertebral foramina, and an increase in the tension of the spinal muscles. This can explain the occurrence of pain and neurological symptoms in osteochondrosis.

For example, with osteochondrosis of the lumbar spine, intervertebral hernias can form, and cervical osteochondrosis can impair the functioning of the brain.

The reasons for the development of this disease

First of all, these are factors associated with too high a load on the spine:

• excess weight;
• long labor associated with lifting and moving cargo manually;
• professions that require a long stay in a static position;
• constant walking in too high heels, asymmetrical load on the spinal column (for example, carrying a bag or backpack on only one shoulder);
• constant sitting at the computer in a hunched position and so on.

• spinal injury,
• nutrition with an insufficient content of vitamins and mineral compounds (especially vitamins D, C, group B, as well as calcium and phosphorus),
• bad habits (since they increase the loss of trace elements),
• sleeping on uncomfortable mattresses and pillows.

A separate line in the list of patients with osteochondrosis of the spine are professional athletes. This is because intense physical activity accelerates the wear of ligaments, joints, and intervertebral discs.

And these processes go much faster than that of an ordinary person.

MKB code - what is it?

Diseases that overcome people differ in stages, severity, nature, localization, and so on. And the further science goes, the more such differences are revealed.

And to make it easier for doctors around the world to work with them, the International Classification of Diseases (ICD) was created.

For the first time, the ICD saw the light in 1893 at the suggestion of the US Public Health Association. However, its creator is the head of the Statistical Office of Paris, Jacques Bertillon.

Today, the whole world uses the ICD of the tenth revision (ICD-10). By 2018, it is expected to start applying a new classification, which is currently under development - ICD-11.

The main goal of the International Classification of Diseases is to provide opportunities for systematic generalization of knowledge and data on the prevalence of diseases in different countries.

Also, the International Classification of Diseases allows solving the problem of generalization and classification of diseases on an international scale.

The ICD is an international standard diagnostic classification that is used in the compilation of mortality and morbidity statistics in the countries that have adopted it.

The main differences of the ICD-10

The main differences between the ICD-10 and the ICD-9 lie in the following:

1. The ICD-10 pioneered the principle of disease coding using a single letter and three or four digits separated by a dot. This made it possible to encode up to 100 three-digit categories in each class.
2. Of all the available letters of the Latin alphabet, 25 have been used in the ICD codes. The letter U has been retained as a backup.
3. Another rather important point was the inclusion at the end of a number of disease classes of a list of headings for disorders that may occur after medical interventions.

Forms of osteochondrosis in the international classification

Actually, osteochondrosis of the spine is placed in the ICD-10 under the code M42.

There are the following types of osteochondrosis:

• M42.0 x Juvenile osteochondrosis of the spine,
• M42.1 x Osteochondrosis of the spine in adults,
• M42.9 x Osteochondrosis of the spine, unspecified.

There are several areas of damage to the spine, each of which is indicated by the corresponding number, which is the fourth in the disease code and is placed in place of "x":

• .x0 - multiple sections of the spine
• .x1 - region of the back of the head, first and second cervical vertebrae
• .x2 - neck area
• .x3 - cervicothoracic region
• .x4 - thoracic region
• .x5 - lumbar-thoracic region
• .x6 - lumbar
• .x7 - lumbosacral region
• .x8 - sacral and sacrococcygeal department
• .x9 - unspecified localization

Thus, for example, when a patient over 18 is diagnosed with Osteochondrosis of the lumbar spine, the diagnosis code will look like this: M42.16.

Treatment of osteochondrosis

As you know, the best treatment for any disease is its prevention. And for osteochondrosis, this statement is completely true, since this disease brings a lot of inconvenience and constant pain.

Some of the main preventive measures are:

• rational nutrition (to prevent a set of extra pounds),
• physical education (usually a set of simple exercises for the back muscles),
• swimming lessons (especially on the back).

Treatment largely depends on the severity and neglect of the process. The main focus of treatment is to relieve pain and discomfort, return the patient to normal life.

1. Manual therapy. Helps relieve pain and increase range of motion, correct posture. Helps to improve the movement of lymph and blood.
2. Acupuncture.
3. Physiotherapy treatment. The effect of laser therapy, magnetotherapy is especially good. Low frequency currents are also successfully used.
4. Dry traction of the spine.
5. Massage. To achieve a positive result and conduct a safe course of treatment, it is necessary to trust your health only to a specialist in this field.
6. Rest up to 5 days. At the same time, the patient should avoid prolonged lying in bed, a large load on the spine (long sitting, lifting and moving heavy objects).

1. Non-steroidal anti-inflammatory drugs in various combinations and formulations. This is necessary for the relief of pain.
2. Muscle relaxants to relieve compression of the nerve roots by the muscles of the spine.
3. Anti-edematous therapy.
4. Preparations that improve microcirculation.
5. Chondroprotectors.
6. Vitamin therapy.
7. Surgery.

Conclusion

So, today osteochondrosis is, although unpleasant, but quite a disease subject to correction. It has been discovered, classified, studied to a sufficient extent.

Methods of dealing with its manifestations are available and, if used correctly, can not only relieve pain, but also significantly improve the quality of life, enable a person to work and benefit society without feeling inferior.

However, it largely depends on the person himself whether he will have to treat osteochondrosis or whether it will be possible to prevent its development.

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ICD code 10 cervical osteochondrosis

Features of the course of osteochondrosis of the lumbar spine and the disease code according to ICD-10

In order to perform the correct encryption and determine the subclass, the specialist must obtain diagnostic results. At the same time, he will definitely consider the existing syndromes (reflex, radicular). Pay attention to compression of the spinal cord. The correct diagnosis is important not only for competent encryption, but also for the appointment of appropriate treatment.

If such a diagnosis as osteochondrosis of the lumbosacral region is in question, the kidneys and intestinal tract of the patient should be further examined. If during the examination everything points to a pathological condition of the spine, then the patient is redirected from the therapist to the neurologist.

To clarify the condition of the vertebrae, ligaments and discs, a computed tomogram is performed. In some cases, an MRI is performed or an X-ray is prescribed. These examinations provide updated information about the degree of mobility of the spine and its components, while the doctor sees if there are any growths that prevent the spine from coping with its task. The specialist will definitely tell the patient about the possible complications of the disease, while noting the current state of the spinal column and surrounding tissues.

Causes

Osteochondrosis affects the following parts of the spinal column:

1. 1 Cervical, which has only 7 vertebrae, but performs a difficult task. The human head is constantly in motion, and its weight (about 4 kg) complicates the task. The vertebrae of the cervical spine must not only hold all this weight, but also make turns and tilts. Osteochondrosis of the cervical vertebra leads to various troubles. Everything will depend on which vertebra was injured. But headaches and problems with blood pressure are almost always companions of cervical osteochondrosis.
2. 2 The thoracic region suffers the least. Its anatomy does not require great mobility, which means that the deformation of the vertebrae rarely occurs.
3. 3 The lumbar region suffers very often. The entire weight of the human body is distributed on it. At the same time, a person loads him even more with all sorts of tasks: lifting loads, staying in the same position for a long time at the machine, at the computer, in the car seat.

Symptomatic manifestations

Osteochondrosis of the lumbar spine is the most common disorder associated with the functioning of the musculoskeletal system. If we consider statistical indicators, then the disease was previously diagnosed in patients whose age exceeded 45 years. The disease began to rejuvenate. Computers force young people to sit in front of screens for hours in an uncomfortable and monotonous position. All this affects the condition of the spine, and the bones and cartilages of the lumbar spine are especially affected. It withstands the main load that occurs when walking and sitting for a long time, when lifting weights.

The main causes leading to osteochondrosis in the lumbar region:

1. 1 Some professions lead to spinal disease in the lumbar region. This work is associated with physical activity. Athletes, loaders, builders - people of these professions are at risk, as their activities often lead to injuries of the vertebrae.
2. 2 The changed hormonal background in the elderly is the reason for the decrease in the mass of the muscular apparatus. And this leads to an increase in the load on the spine.
3. 3 Improper nutrition, lack of vitamins and calcium leads to a decrease in the strength of the musculoskeletal system. Bones become brittle and wear out. All this causes pain in the lumbar region.
4. 4 If in the family a person had relatives suffering from osteochondrosis, the likelihood of the disease increases several times. In this case, a genetic predisposition is claimed.
5. 5 Injuries of the spine become the culprits of the appearance of osteochondrosis. In this case, most often there is a lesion of not one department, but two at once, for example, the cervical and lumbar or thoracic and lumbar.

The symptoms of osteochondrosis that affected the lumbar region include the following manifestations:

1. 1 Severe pain syndrome, which is localized not only in the back. When the nerve endings are pinched, pain appears in various organs. It can be localized in the peritoneum, give to the lower extremities.
2. 2 Degenerative processes cause atrophy of the muscles in the legs, in the lower extremities the patient may notice tingling. Very often, patients suffer from chilliness, their limbs are constantly cold.
3. 3 There is a loss of sensation, starting from the buttocks and thighs, ending with the feet.
4. 4 There are problems in the sexual sphere. The patient complains of impaired sensitivity in the genitals.
5. 5 Sometimes the disease leads to the fact that the processes of urination and defecation are disturbed.
6. 6 Spasms in the arteries of the lower extremities are so strong that there is a periodic disappearance of the pulse.
7. 7 There are problems with the skin: they dry out and begin to peel off.
8. 8 When neglected, there are violations in the work of internal organs located in the abdominal cavity.

The opinion of experts about the ICD-10 classifier is different.

Some believe that the code for osteochondrosis should be located in the interval M50-54, and not in the existing one.

It is more correct to attribute osteochondrosis to other dorsopathies, and not to classify it as deforming dorsopathies.

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Osteochondrosis in the international classification of diseases of the 10th revision or (ICD-10)

Under the ICD-10 understand the international classification of diseases of the 10th revision. Its main meaning is that any diseases in this classification are assigned a specific code. It can be recorded in the outpatient card, medical history, and, most importantly, in the documents of the Medical Insurance Fund.

Sometimes diagnoses are very cumbersome, because some patients have a whole range of diseases. This is where ICD-10 comes to the rescue. Consider this on the example of such a common disease as osteochondrosis of the spine. Osteochondrosis in ICD-10 belongs to class XIII, which includes pathologies of the musculoskeletal system and connective tissues (codes from M00 to M99).

Forms of osteochondrosis in the international classification

In the 13th class of the international classification, osteochondrosis belongs to the subclass of dorsopathy (pathologies of the back - from M40 to M54). This disease is one of the deforming dorsopathies. which are recorded under the codes M40 - M43. According to ICD-10, osteochondrosis itself has the code M42.

The classification of this disease is based on the age of patients and the localization of the pathological process. Distinguish osteochondrosis adults and youthful.

The degenerative process can be localized:

• in the occipital region, including the first or second vertebrae of the neck;
• in the cervical region of the spine (from the first to the seventh cervical vertebrae);
• in the thoracic region;
• in the lower back;
• in the sacral vertebrae;
• at once in several departments of the spinal column.

In ICD-10, unspecified osteochondrosis of the spine implies that there is doubt about the time of occurrence - in adolescence or adulthood, or there is not enough data to establish an accurate diagnosis. Such forms of the disease in the international classification are under the code M42.9. These include:

• M42.9 - Unspecified osteochondrosis in multiple departments.
• M42.91 - Unspecified osteochondrosis of the region of 1-2 vertebrae of the neck and occipital region.
• M42.92 - in the ICD10 Osteochondrosis of the cervical region, unspecified.
• M42.93 - Localization of an unspecified dystrophic process in the thoracic and cervical regions.
• M42.94 - Unspecified osteochondrosis, isolated in the thoracic region.
• M42.95 Chondrosis of thoracic and lumbar vertebrae, unspecified.
• M42.96 Osteochondrosis, unspecified, of the lumbar vertebrae.
• M42.97 #8212; Osteochondrosis, unspecified with localization in the lumbosacral region of the spine.
• M42.98 - Chondrosis of the sacral and sacrococcygeal joints of the spine, unspecified.
• M42.99 - Unspecified osteochondrosis of unspecified localization.

Conclusion

It is this classification of varieties of osteochondrosis that is currently used. ICD-10, adopted in most countries, allows you to get rid of inaccuracies in the understanding of diseases and eliminate existing disagreements about the names of diseases. The use of ICD-10 codes for osteochondrosis and other diseases allows doctors from different countries and nationalities to share their experience.

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Osteochondrosis of the spine in the ICD-10

The abbreviation ICD stands for International Classification of Diseases. The document is used as the main statistical and classification basis of the health care system. The ICD is reviewed at regular intervals (every 10 years) and is a normative document, the use of which ensures the unity of comparability of materials and a unified approach on an international scale.

Today, the current classification is the tenth revision, or ICD-10. On the territory of Russia, the system was put into practice 15 years ago, in 1999, and is used as a single regulatory document to record morbidity, the reasons why the population goes to medical institutions of any departments, as well as the causes of death.

Goals and objectives of applying the classification

The main purpose of the ICD is to create appropriate conditions for the systematization of registration, analysis, interpretation and subsequent comparison of data that were obtained at different times in different countries and regions. The international classification is used to convert the verbal formulation of diagnoses of diseases, other health-related problems into codes in alphanumeric form (for example, osteochondrosis according to ICD-10 corresponds to code M42). Thanks to such a system, it is convenient to store data, extract it and further analyze it.

The use of a standardized diagnostic classification is appropriate both for general epidemiological purposes and for healthcare management. These include statistics on the frequency and prevalence of various diseases, analysis of their relationship with factors of a different nature, and the general situation with people's health.

Innovations of the tenth version

The main innovation of the tenth revision of the international classification was the use of an alphanumeric coding system, which assumes the presence of one letter in a four-digit rubric. It is followed by numbers. For example, to designate juvenile osteochondrosis of the cervical region with localization in the back of the head, at the level of the first and second vertebrae, according to MBK-10, the code M42.01 is adopted

Thanks to this system, the coding structure was almost doubled. The use of letters or groups of letters in rubrics makes it possible to encode up to 100 three-digit categories in each class. Of the 26 letters in the ICD codes, 25 are used. Possible codes are in the range from A to Z. The letter U is saved as a backup. As already mentioned, in accordance with the ICD-10, a code with the letter M was assigned to osteochondrosis of the spine.

Another important point was the inclusion at the end of some classes of diseases of the list of headings for disorders that may occur after medical procedures. The rubrics indicate serious conditions that may occur after some interventions.

Codes of the International classification for osteochondrosis of different types

In the ICD-10, osteochondrosis is classified as a subclass of dorsopathies (pathologies of the spine and paravertebral tissues of a degenerative-dystrophic nature). Dorsopathies were assigned codes M40-M54. As for osteochondrosis specifically, according to ICD-10 it is under the M42 code. The classification includes all types of the disease (with localization in the cervical, thoracic, lumbar regions. Separate codes are assigned to manifestations of the disease in adolescence, as well as an unspecified form of osteochondrosis.

M42 Spinal osteochondrosis

Diseases of the musculoskeletal system and connective tissue (M00 to M99)

Dorsopathies of a deforming nature (M40-M43).

What is osteochondrosis according to ICD 10

If a person has osteochondrosis, the ICD-10 (or International Classification of Diseases) has a special code for this disease, which facilitates the process of storing medical and health statistics. A specific number is selected depending on the type of disease.

Osteochondrosis in ICD-10

The tenth revision of the classification made some changes to this document. It was created in order to facilitate the process of collecting, storing and analyzing data on diagnoses, which is then used to compare the level of morbidity and mortality within the same state or in different countries.

The classification was created by the World Health Organization. The ICD-10 code can be written in the patient's personal card, his medical history, as well as in documents for the fund that deals with health insurance. There are often cases when the diagnoses are too cumbersome, so it is much more convenient to use alphanumeric codes.

This is where an international document with the classification of diseases is needed, where you can choose various numbers on your own. As a rule, a doctor does this, and ordinary patients do not need such codes. However, it is better to understand them at least at the initial level, so that you can independently figure out which diagnosis was written by a doctor or other health worker.

According to ICD-10, osteochondrosis belongs to the 13th class. This category includes all ailments that are associated with the human bone structure and muscular system, connective tissue pathologies. The classification of such diseases implies the use of codes from M00 to M99.

In the 13th grade, osteochondrosis belongs to a subclass of dorsopathies. For these pathologies of the back, numbers from M40 to M54 apply. Osteochondrosis is considered one of the forms of dorsopathies of a deforming nature, which are recorded under numbers from M40 to M43.

The very same osteochondrosis of the spine according to ICD-10 has the code M42.

The classification of this disease is based on the age factor and the place of distribution of pathological processes. There are juvenile and adult types of the disease. But degenerative processes can develop in such areas:

• on the back of the head - usually this is approximately the first and second vertebra in the neck;
• on the neck - this is approximately from the first to the seventh vertebra of the SHOP;
• in the chest;
• on the lower back;
• on the sacrum;
• at the same time on several parts of the back.

Depending on these factors, different codes are used.

There are many forms of osteochondrosis. Usually, all categories are divided by age and location of the pathology.

Juvenile osteochondrosis

Juvenile osteochondrosis implies a young age. If the disease is localized in patients in several parts of the back at once, then the number M42.00 is applied. If juvenile osteochondrosis develops only in the back of the head, then the digital code 42.01 with the same letter is applied. The same applies to the situation when degenerative processes cover the first and second vertebrae of the neck. If cervical osteochondrosis is detected in adolescence, then the number M42.02 is applied. At the same time, degenerative processes develop in the C1-C7 vertebrae.

If a patient at a young age is simultaneously diagnosed with osteochondrosis of the neck and chest, then code M42.03 is used. If only the thoracic back is involved, then number M42.04 applies. If both the lumbar and thoracic parts are affected at the same time, then the code M42.05 is written.

When a patient has lumbar osteochondrosis, ICD 10 applies the number M42.06. This is the most common form of the disease. When osteochondrosis of the lumbosacral spine is found in adolescence, the number M42.07 is written. For the sacral section, the number M42.08 is used. This includes both the coccygeal part and the sacrum. If the form of juvenile osteochondrosis has not been specified, then code M42.09 is written in the form.

Osteochondrosis of adults

Widespread osteochondrosis, which develops on several parts of the back, implies the use of the number M42.10. If osteochondrosis of the cervical spine develops, then code M42.11 is applied. This also includes osteochondrosis in the occipital part, and the vertebrae are counted only under the numbers C1 and 2. If only the neck is affected, then the number 42.12 is written with the letter M.

If thoracic osteochondrosis and cervical osteochondrosis develop simultaneously, then code M42.13 is used. This is a fairly common form of the disease. When the patient has exclusively osteochondrosis of the thoracic spine, then the number M42.14 is written. Here you need to take into account certain vertebrae.

When a person develops osteochondrosis of the lumbar spine simultaneously with the defeat of the thoracic back, then the code M42.15 is used. If the patient has exclusively lumbar osteochondrosis in the vertebrae, the ICD-10 code will be M42.16. When the disease also covers the cross area, then the number 42.17 is used with the same letter. When inflammation captures only the sacral and coccygeal sections, then the number M42.18 is written. If age-related osteochondrosis has an unspecified form, and it is not possible to determine the localization of degenerative processes, then the number 42.19 is written with the letter M.

Unspecified osteochondrosis

For each department, the ICD 10 code will be different. However, there are cases when it is difficult to determine at what age osteochondrosis began to develop - in adolescence or at an older age. In this case, separate codes apply.

For example, a person develops a polysegmental disease, but it is not possible to determine the age when the patient began to show degenerative processes, then the number M42.9 is applied. When the disease affects only the upper 2 vertebrae, the code 42.91 is used. This is the upper part of the neck and the back of the head.

For the cervical spine, code 42.92 is used. When the disease is not specified according to the age criterion, but pathological processes develop in the neck and thoracic part of the back, then the number 42.93 is written with the letter M. For isolated chest osteochondrosis, the number 42.94 is set, and if the disease develops simultaneously in the thoracic and lumbar parts of the back, then it is written code M42.95.

According to ICD-10, lumbar osteochondrosis, which has an unspecified form according to the age principle, involves the use of number 42.96. According to ICD-10, osteochondrosis of the lumbosacral region has a code of 42.97. If the sacral and coccygeal zone is affected, then number 42.98. For all other cases, code M42.99 applies.

Types and stages of osteochondrosis

There are several types of osteochondrosis:

1. Cervical. This form is considered one of the most common. It is because of problems with the neck that many people suffer, but they do not want to go to the hospital in time, as a result of which the intervertebral discs are deformed and gradually destroyed in this area. This leads to a number of serious complications, not only pain in the neck appears, but the head, shoulders, and sometimes arms hurt a lot.

Get acquainted with this information: How to get rid of OSTEOCHONDROSIS forever. Video session of Bazylkhan Dyusupov.

There are several stages of osteochondrosis, depending on the development of the pathological process:

First stage. The condition of the vertebra has not yet deteriorated, but the disc itself may shift or even rupture. This is usually caused by sudden movements or excessive physical exertion. For example, a person can sharply lift a weight, but the body is not positioned correctly, which is why the entire load is transferred only to a separate part of the back. The pain syndrome resembles the feeling of an electric current.

Second stage. At this stage, protrusion develops. Now the pain becomes constant, and if you do nothing for a long time, then it only intensifies. Periodically there are dizzinesses.

Third stage. In the clinical picture, this form resembles more the presence of an intervertebral hernia. There are various side effects, including deteriorating hearing and vision.

Fourth stage. In this case, the disease no longer has pronounced symptoms. But at the same time, the spine itself becomes unstable. The nerves of the back are compressed, coronary disease of the spinal cord develops.

What are the symptoms

At an early stage, back pain practically does not manifest itself. The first alarm signal of cervical osteochondrosis is only a headache, which occurs periodically. At first, unpleasant sensations are localized only in the back of the head, but then they pass to the temporal zone.

Usually people start taking headache medications, but the relief will be temporary.

If the patient stays in one position for a long time, then the pain syndrome gradually increases. As a rule, in the future, dizziness, nausea, and some even vomiting will appear. Hand numbness is also considered a possibility. Sometimes tachycardia develops. Older people may even faint, but for a short time. This is due to the fact that with osteochondrosis, blood circulation is disturbed, which leads to the appearance of such symptoms.

The thoracic spine is characterized by other symptoms. Usually there is neuralgia of the intercostal type. The defeat of the discs of the thoracic region has a clinical picture that resembles a failure of the functioning of the heart or diseases of the organs of the gastrointestinal tract.

As for the lumbar spine, the pain syndrome manifests itself in its lower part. Sometimes it goes to the sacral zone. As a rule, the legs become numb. Older people have problems emptying the bladder (it is involuntary).

As soon as these symptoms appear, you should immediately go to the hospital. This is required in order to establish a diagnosis as early as possible and begin treatment. If you start therapy in the early stages of the development of degenerative processes, you can significantly slow them down and stop them, avoiding many complications and side effects. In addition, there is a risk that the disease will become chronic, and it is very difficult to treat it.

But the problem is that many ignore the signals of their body and do not go to the hospital.

There is also another difficulty. It is difficult to determine the disease on your own, so patients in most cases go to the wrong specialists. For example, they can visit a therapist, a cardiologist, a gastroenterologist. But it is best to turn to a neurologist or other doctors. Be sure to start therapy as early as possible, but the treatment itself must be comprehensive.

In conclusion, it should be noted that if a person has osteochondrosis of the spine, the ICD-10 code will be selected depending on the type of this disease. Separate categories are distinguished according to the age at which the disease begins to develop, and according to the location of pathological processes in the back and neck. Usually such data is needed to clarify the diagnosis in the documents, but only doctors and other medical professionals use them. However, everyone should at least roughly understand the codes and know where they can be read.

Spondylosis- this is a pathological marginal bone growth (the appearance of osteophytes).

Spondylosis is not an independent disease, it is only a pathological complication that occurs after previous diseases of the spine or other organs.

This disease is a type of spinal deformity, therefore, in some medical reference books, you can also find another name for it - deforming spondylosis.

Given the fact that spondylosis is a complication or a consequence of other diseases, it is the primary source of problems that should be treated.

What is spondylosis?

Spondylosis is a chronic inflammation of the spine of a degenerative-dystrophic nature.. Usually, spondylosis is accompanied by deformities in the anterior intervertebral discs and the anterior longitudinal ligament.

For young and middle aged people characteristic is the appearance of spondylosis, affecting 1-2 vertebrae (no more). In this case, the disease does not lead to other pathological changes, therefore it is considered a milder form.

The appearance of violations most often occurs due to constant overloads of the spine, injuries or infectious diseases. Symptoms are rare or not so noticeable to the patient.

For elderly and senile people characteristic is the appearance of spondylosis in combination with other diseases of the spinal column (for example, osteochondrosis), so the clinical picture is revealed on the basis of the primary disease.

In this case, spondylosis most often affects the cervical and lumbar spine, although there are cases of other localization.

Clinical picture

Quite often spondylosis proceeds without pronounced symptoms, and if it is detected during the examination, then as an accident during the passage of an X-ray examination. This happens when spondylosis is only at an early (first) stage of development and is expressed in a slight bone growth of the vertebral bodies. At this stage, the disease may disturb the patient with mild pain during movement, after a warm-up, some limitations in the mobility of the spine.

The clinical picture is more clearly manifested in the second stage of spondylosis.. At this stage, dystrophic and reactive changes occur in the paravertebral tissues. Any movement of the spinal column is accompanied by pain, limited mobility, fatigue.

At the third stage bone deformities and growths that move towards each other begin to merge and form a single ossification blocking any movement in the corresponding section of the spinal column. From the point of view of symptoms, this can manifest itself in the disappearance of pain and immobility of a certain section of the spine.

Spondylosis in addition to its own symptoms may be associated with other diseases spinal column so the symptoms may be wider.

ICD code 10

According to the international classification of diseases, spondylosis has the code M47. It includes: degeneration of the facet joints; osteoarthritis and arthrosis of the spinal column.

Disease classification

Spondylosis is classified based on several criteria: according to the localization of deformities, according to the degree of progression and according to the stage of development.

In terms of localization spondylosis happens:

By degree of progression spondylosis happens:

• Lightning fast (begins abruptly, acutely, has an unfavorable development);
• Rapidly progressive (all spondylosis processes are short-lived in their development);
• Moderately progressive (the disease occurs with periodic exacerbations);
• Slowly progressive (symptoms are invisible to the patient, the disease itself develops for a very long time).

By stage of development spondylosis happens:

Stage	Clinical picture	Diagnostics
Spondylosis stage 1	The presence of lordor-kyphotic changes is characteristic, the patient feels some stiffness in the mobility of the spine.	An x-ray may show a large number of growths that do not extend beyond the vertebrae.
Spondylosis stage 2	Disturbance of mobility of vertebrae is characteristic, working capacity of the patient (up to the 3rd group of disability) is broken.	X-ray examination reveals a large number of growths on the vertebrae that go beyond.
Spondylosis stage 3	It is characterized by complete blocking of mobility due to the formation of a staple on the bone tissue. Most often, at this stage, the patient is given the 2nd group of disability. In especially advanced cases, such a fusion of the vertebrae can occur that will not allow the patient to exist independently.	The x-ray shows the accretion of osteophytes, which resemble a bracket in shape, and also shows the narrowing of the spinal canal, changes in the length of individual vertebrae.

Prevalence and Significance

The prevalence of spondylosis among different age groups is quite high.. There is evidence that states that spondylosis occurs in 10% of people in the age group of 25 years and older (in a mild form). The more severe form affects adults and the elderly under the age of 65 (in 95% of cases).

This disease does not always signal its presence with the help of symptoms, sometimes the patient does not even suspect anything. It has been scientifically proven that degenerative changes in the spine will affect most people sooner or later.

Risk factors and causes of spondylosis

The main and common cause of deformities on the spine is the wear and tear of the muscles that surround the spinal column. The manifestations of the disease can be completely different in different people. Many factors also depend on the genetic predisposition to problems with the spine.

Main Risk Factors:

• Overweight and obesity;
• Passive lifestyle, lack of physical activity;
• Surgery or back injury;
• Smoking;
• Work in which the patient has to make frequently repetitive movements;
• Frequent weight lifting;
• Osteocondritis of the spine;
• flat feet;
• Disorders of metabolism and nutrition of bone tissue;
• Infectious diseases;
• endocrine diseases;
• Depression or constant anxiety.

Symptoms of spondylosis

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Next fact

Depending on the localization of the deformity, a group of symptoms is distinguished for each type of spondylosis.

Symptoms of spondylosis of the cervical spine

For this localization of the disease, the following symptoms are characteristic:

1. Pain in occiput when turning head. Often the pain radiates to the eyes, ears, lower jaw, and shoulders. There are pain in the morning (due to circulatory stagnation);
2. Frequent headaches after static tension. Pain is usually accompanied by tinnitus, dizziness, flies or fog before the eyes;
3. Restriction in movements in the cervical vertebrae, most often appearing in the morning (if the neck does not turn already due to the formed brace, then this symptom is constantly observed and affects the patient's ability to work);
4. Fainting may appear (in the later stages of the disease), usually they are short-lived and are caused by disturbances in the work of the vascular system. If the patient has arterial compression, then the free access of blood to the brain stops and oxygen starvation begins.

Symptoms of spondylosis of the thoracic spine

Typical symptoms of thoracic spondylosis:

1. The presence of constant aching pain in the thoracic spine (between the shoulder blades). The pain is especially severe in the morning or after a nap. Also, pain may intensify after turning the torso or tilting;
2. Pain when breathing deeply, after a long walk or staying in one position. Also when raising hands, coughing, sudden movements;
3. Frequent burning in the chest, tingling, numbness, excessive sensitivity;
4. Stiffness when moving with your hands, as well as with mobility in the thoracic spine;
5. Pain in the heart, stomach, kidneys and other organs;
6. sleep disorders;
7. Rapid breathing;
8. Hypertonicity of the spinal muscles;
9. Leg disorders associated with excessive fatigue of the lower extremities. May be accompanied by tingling, goosebumps, burning.

Symptoms of spondylosis of the lumbosacral spine

The disease begins to manifest itself with a characteristic crunch in the neck.

At first, this condition causes slight discomfort, and the patient refuses the mandatory treatment in this case.

Gradually, unpleasant sensations are supplemented by severe pain in the head, problems with vision and hearing may appear.

Salt deposition has its own obvious symptoms, the knowledge of which will allow the patient to seek medical help in time and avoid complications.

Comments

Severe pain in the lumbar region may indicate the development of diseases of the spine.

In particular, discomfort can be caused by lumbar osteophytes arising from spondylosis.

Ignoring this problem is fraught with the development of serious complications, up to disability.

Comments

Pain in the back can be the cause of the growth of osteophytes.

Lumbodynia is a collective pain syndrome that characterizes most diseases of the spine and is localized in the lumbar and sacral region. Pathology can be not only vertebrogenic or spondylogenic in nature (associated with the functional characteristics of the spine), but also be the result of disturbances in the functioning of internal organs: the bladder, kidneys, organs of the reproductive system and the digestive tract. Regardless of the etiological factors, lumbalgia, according to the international classification of diseases (ICD 10), belongs to vertebroneurological diagnoses and has a universal, single code - M 54.5. Patients with acute or subacute lumbodynia are eligible for sick leave. Its duration depends on the intensity of pain, its effect on the mobility of a person and his ability to self-service, and the identified degenerative, deformative and dystrophic changes in the bone and cartilage structures of the spine.

Code M 54.5. in the international classification of diseases, vertebrogenic lumbodynia is indicated. This is not an independent disease, therefore this code is used only for the primary designation of the pathology, and after the diagnosis, the doctor enters the code of the underlying disease into the card and sick leave, which became the root cause of the pain syndrome (in most cases it is chronic osteochondrosis).

Lumbodynia is one of the varieties of dorsopathy (back pain). The terms "dorsopathy" and "dorsalgia" are used in modern medicine to refer to any pain localized in the region of the C3-S1 segment (from the third cervical vertebra to the first sacral vertebra).

Lumbodynia is called acute, subacute or recurrent (chronic) pain in the lower back segment - in the region of the lumbosacral vertebrae. The pain syndrome may have moderate or high intensity, unilateral or bilateral course, local or diffuse manifestations.

Local pain on the one hand almost always indicates a focal lesion and occurs against the background of compression of the spinal nerves and their roots. If the patient cannot accurately describe exactly where the pain occurs, that is, discomfort captures the entire lumbar region, there can be many reasons: from vertebro-neurological pathologies to malignant tumors of the spine and small pelvis.

What symptoms are the basis for diagnosing lumbodynia?

Lumbodynia is a primary diagnosis that cannot be regarded as an independent disease and is used to indicate existing disorders, in particular pain syndrome. The clinical significance of such a diagnosis is explained by the fact that this symptom is the basis for an X-ray and magnetic resonance examination of the patient in order to identify deformities of the spine and intervertebral discs, inflammatory processes in the paravertebral soft tissues, muscular-tonic status and various tumors.

The diagnosis of "vertebrogenic lumbalgia" can be made both by a local therapist and narrow specialists (neurologist, orthopedic surgeon, vertebrologist) based on the following symptoms:

• severe pain (stabbing, cutting, shooting, aching) or burning in the lower back with a transition to the coccyx area, located in the region of the intergluteal fold;

  

• violation of sensitivity in the affected segment (feeling of heat in the lower back, tingling, chills, tingling);
• reflection of pain in the lower limbs and buttocks (typical for the combined form of lumbalgia - with sciatica);

  

• decreased mobility and muscle stiffness in the lower back;
• increased pain after physical activity or physical activity;

  

• pain relief after prolonged muscle relaxation (at night).

In most cases, an attack of lumbodynia begins after exposure to any external factors, such as hypothermia, stress, increased stress, but in an acute course, a sudden onset is possible for no apparent reason. In this case, one of the symptoms of lumbodynia is lumbago - acute backache that occurs spontaneously and always has a high intensity.

Reflex and pain syndromes in lumbalgia depending on the affected segment

Despite the fact that the term "lumbalgia" can be used as an initial diagnosis in outpatient practice, the clinical course of the pathology is of great importance for a comprehensive diagnosis of the condition of the spine and its structures. With lumbarization of various segments of the lumbosacral spine, the patient has a decrease in reflex activity, as well as paresis and reversible paralysis with different localization and manifestations. These features make it possible to assume, even without instrumental and hardware diagnostics, in which part of the spine degenerative-dystrophic changes occurred.

Clinical picture of vertebrogenic lumbodynia depending on the affected segment of the spine

Affected vertebrae	Possible irradiation (reflection) of lumbar pain	Additional symptoms
Second and third lumbar vertebrae.	The area of ​​the hips and knee joints (along the front wall).	Violated flexion of the ankles and hip joints. Reflexes are usually preserved.
Fourth lumbar vertebra.	Popliteal fossa and lower leg area (mainly from the front side).	Extension of the ankles is difficult, hip abduction provokes pain and discomfort. In most patients, a pronounced decrease in the knee jerk is pronounced.
Fifth lumbar vertebra.	The entire surface of the leg, including the shins and feet. In some cases, pain may be reflected in the first toe of the feet.	Difficulty bending the foot forward and abducting the thumb.
sacral vertebrae.	The entire surface of the leg from the inside, including the foot, calcaneus and phalanges of the fingers.	Impaired Achilles tendon reflex and plantar flexion of the foot.

Important! In most cases, lumbodynia is manifested not only by reflex symptoms (this also includes neurodystrophic and vegetative-vascular changes), but also by radicular pathology that occurs against the background of pinched nerve endings.

Possible causes of pain

One of the main causes of acute and chronic lumbalgia in patients of different age groups is osteochondrosis. The disease is characterized by degeneration of the intervertebral discs, which connect the vertebrae to each other in a vertical sequence and act as a shock absorber. The dehydrated core loses its firmness and elasticity, which leads to thinning of the annulus fibrosus and displacement of the pulp beyond the end cartilaginous plates. This shift can take two forms:

Neurological symptoms during attacks of lumbodynia are provoked by compression of the nerve endings that extend from the nerve trunks located along the central spinal canal. Irritation of receptors located in the nerve bundles of the spinal nerves leads to attacks of severe pain, which most often has an aching, burning or shooting character.

Lumbalgia is often confused with radiculopathy, but these are different pathologies. (radicular syndrome) is a complex of pain and neurological syndromes, the cause of which is directly compression of the nerve roots of the spinal cord. With lumbodynia, pain can also be caused by myofascial syndromes, circulatory disorders, or mechanical irritation of pain receptors by bone and cartilage structures (for example, osteophytes).

Other reasons

Among the causes of chronic low back pain, there may also be other diseases, which include the following pathologies:

• diseases of the spine (displacement of the vertebrae, osteoarthritis, osteosclerosis, spondylitis, etc.);

  

• neoplasms of various origins in the spine and pelvic organs;
• infectious and inflammatory pathologies of the spine, abdominal organs and small pelvis (spondylodiscitis, epiduritis, osteomyelitis, cystitis, pyelonephritis, etc.);

  

• adhesive process in the small pelvis (often adhesions are formed after difficult childbirth and surgical interventions in this area);
• injuries and injuries of the lower back (fractures, dislocations, bruises);

  

  Swelling and bruising are the main symptoms of a lower back bruise

• pathology of the peripheral nervous system;
• myofascial syndrome with myogelosis (the formation of painful seals in the muscles during inadequate physical exertion that does not correspond to the age and physical fitness of the patient).

  

Provoking factors that increase the risk of lumbodynia can be obesity, alcohol and nicotine abuse, increased consumption of caffeinated drinks and foods, and chronic lack of sleep.

Factors in the development of acute shooting pain (lumbago) are usually strong emotional experiences and hypothermia.

Important! Lumbodynia during pregnancy is diagnosed in almost 70% of women. If the expectant mother did not have abnormalities in the functioning of internal organs or diseases of the musculoskeletal system that could worsen under the influence of hormones, the pathology is considered physiologically determined. Lower back pain in pregnant women can occur as a result of irritation of the nerve endings by the enlarging uterus or be the result of edema in the pelvic organs (edematous tissues compress the nerves and blood vessels, causing severe pain). There is no specific treatment for physiological lumbalgia, and all recommendations and prescriptions are aimed primarily at correcting nutrition, lifestyle and observing the daily routine.

Can I get sick leave for severe lower back pain?

Disease code M 54.5. is the basis for opening a sick leave in connection with temporary disability. The duration of sick leave depends on various factors and can range from 7 to 14 days. In especially severe cases, when the pain syndrome is combined with severe neurological disorders and prevents the patient from performing professional duties (and also temporarily limits the possibility of movement and full self-service), the sick leave can be extended up to 30 days.

The main factors affecting the duration of sick leave for lumbodynia are:

• pain intensity. This is the main indicator that the doctor evaluates when deciding whether a person can return to work. If the patient cannot move, or the movements cause him severe pain, the sick leave will be extended until the regression of these symptoms;

  

• working conditions. Office workers usually return to work earlier than those doing heavy physical work. This is due not only to the peculiarities of the motor activity of these categories of employees, but also to the possible risk of complications in case of incomplete relief of the causes that caused the appearance of pain;

  

• the presence of neurological disorders. If the patient complains about the presence of any neurological disorders (poor sensation in the legs, heat in the lower back, tingling in the limbs, etc.), the sick leave, as a rule, is extended until the possible causes are fully clarified.

  

For patients who need hospitalization, a sick leave is issued from the moment of admission to the hospital. If it is necessary to continue outpatient treatment, the temporary disability certificate is extended for the appropriate period.

Important! If surgical treatment is necessary (for example, with intervertebral hernias larger than 5-6 mm), a sick leave is issued for the entire period of stay in the hospital, as well as subsequent recovery and rehabilitation. Its duration can be from 1-2 weeks to 2-3 months (depending on the main diagnosis, the chosen method of treatment, the rate of tissue healing).

Limited ability to work with lumbalgia

It is important for patients with chronic lumbalgia to understand that closing the sick leave does not always mean a complete recovery (especially if the pathology is provoked by osteochondrosis and other diseases of the spine). In some cases, with vertebrogenic lumbodynia, the doctor may recommend light work to the patient, if the previous working conditions can complicate the course of the underlying disease and cause new complications. These recommendations should not be ignored, since vertebrogenic pathologies almost always have a chronic course, and hard physical labor is one of the main factors in exacerbating pain and neurological symptoms.

Usually people with limited working capacity are recognized as representatives of the professions indicated in the table below.

Professions requiring facilitated working conditions in patients with chronic lumbodynia

Professions (positions)	Reasons for disability
	Forced inclined position of the body (impairs blood circulation in the lumbar region, contributes to increased muscle tension, increases compression of nerve endings).
	Heavy lifting (may cause an increase in hernia or protrusion, as well as rupture of the fibrous membrane of the intervertebral disc).
	Prolonged sitting (increases the intensity of the pain syndrome due to severe hypodynamic disorders).
	Prolonged stay on the legs (increases swelling of tissues, contributes to increased neurological symptoms in lumbalgia).
	High risk of falling on your back and spinal injury.

Is it possible to serve in the army?

Lumbalgia is not included in the list of restrictions for military service, however, a conscript may be deemed unfit for military service due to a major disease, such as grade 4 osteochondrosis, pathological kyphosis of the lumbar spine, spondylolisthesis, etc.

Treatment: methods and preparations

Treatment of lumbodynia always begins with the relief of inflammatory processes and the elimination of pain. In most cases, anti-inflammatory drugs with analgesic action from the NSAID group (Ibuprofen, Ketoprofen, Diclofenac, Nimesulide) are used for this.

The most effective regimen is considered to be a combination of oral and local dosage forms, but with moderate lumbalgia, it is better to refuse to take pills, since almost all drugs in this group negatively affect the mucous membranes of the stomach, esophagus and intestines.

Back pain is a concern for most people, regardless of their age or gender. For severe pain, injection therapy can be performed. We recommend reading, which provides detailed information about injections for back pain: classification, purpose, effectiveness, side effects.

As auxiliary methods for the complex treatment of lumbodynia, the following can also be used:

• drugs to normalize muscle tone, improve blood flow and restore cartilage nutrition of intervertebral discs (microcirculation correctors, muscle relaxants, chondroprotectors, vitamin solutions);
• paravertebral blockade with novocaine and glucocorticoid hormones;

  

• massage;
• manual therapy (methods of traction traction, relaxation, manipulation and mobilization of the spine;
• acupuncture;

In the absence of the effect of conservative therapy, surgical methods of treatment are used.

Video - Exercises for the quick treatment of lower back pain

Lumbodynia is one of the most common diagnoses in neurological, surgical and neurosurgical practice. Pathology with severe severity is the basis for issuing a temporary disability sheet. Despite the fact that vertebrogenic lumbalgia has its own code in the international classification of diseases, treatment is always aimed at correcting the underlying disease and may include medication, physiotherapy, manual therapy, exercise therapy and massage.

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