Inflammation of the facet joints or spondyloarthrosis of the lumbosacral spine: how to treat and stop the destruction of intervertebral discs. Spondylosis deformans: what is the prognosis for treatment and signs of spondyloarthrosis according to ICD 10 in adults

The main reasons why spondyloarthrosis of the spine develops are age-related changes in the body, severe damage to the spine during traumatic sports, physical overload or congenital pathologies of the structure of the musculoskeletal system. The disease is characterized by pronounced symptoms; in advanced stages, a neurological complication is added. Often the disease can be cured conservatively; surgery is prescribed in exceptional situations.

The international classification of diseases ICD 10 provides for pathology code M 47 “Spondylosis”.

Causes

Spondyloarthrosis or - a disease of degenerative etiology that affects the structures of the facet joints of the spine. The pathology often develops against the background of advanced osteochondrosis, in which degeneration of the vertebrae and intervertebral structures occurs. This diagnosis is often made in older patients, but the disease is also common in young men and women. In this case, the main causes of pathology are:

• congenital developmental anomalies - pathological enlargement (lumbarization) or, conversely, reduction (sacralization) of the lumbar vertebrae sacral region;
• back injuries, bruises, dislocations and subluxations;
• spondylolisthesis, in which there is a displacement of the vertebrae in relation to each other;
• instability of vertebral bodies;
• autoimmune diseases;
• systemic pathologies, for example, diabetes mellitus;
• malnutrition;
• genetic predisposition;
• hormonal changes, such as pregnancy or menopause.

What types are there?

In case of defeat lumbar region the pain radiates to the lower extremities.

The development of degenerative processes can be observed in different parts of the spine. Therefore, taking into account the location of spondylosis, they distinguish:

• Lumbar. Dystrophic phenomena in this department progress most often. The person is being bothered acute symptoms, spreading from the lumbar region to the buttocks and thighs. If spondyloarthrosis progresses at the level of the TH12-S1 segments, the pain bothers you for a long time, but the symptoms subside after the patient has done warm-up exercises.
• Chest. Damage to the thoracic region occurs least often, since this area is considered sedentary and unloaded. The pain syndrome is moderate, because the nerves and blood vessels are practically not injured.
• Cervical or uncovertebral arthrosis. With the development of this pathology, the vertebrae of the neck at the level of C3-C5 most often suffer, while the discomfort spreads to the shoulder, scapular and interscapular zones, the shoulder girdle, and the back of the head.

To prevent the negative consequences of spondylosis, at the first manifestations you need to urgently consult a doctor, and not treat yourself at home, taking pills at your own discretion.

Characteristic symptoms

With inflammation and degeneration of the intervertebral joints, the patient feels stiffness of the spine, which is especially pronounced in the morning, immediately after waking up. The pain is of a moderate nature, but if the disease progresses for a long time, the signs of spondyloarthrosis become more pronounced and disappear even after rest. In advanced situations, a crunching sound appears when moving, which is direct evidence of the proliferation of intervertebral osteophytes.

Degenerative changes in the spine disrupt the blood supply to the brain.

Spondyloarthrosis of the uncovertebral joints disrupts the normal blood supply and nutrition of the brain, the patient complains of such manifestations as:

• headache;
• dizziness;
• tinnitus;
• visual impairment;
• memory loss.

When the thoracolumbar spine is affected, the following are observed:

• acute pain when moving, which in the last stages does not go away even at rest;
• dysfunction of the joint;
• neuritis;
• exacerbation when weather conditions change;
• atrophy of muscle tissue located in the affected area.

Negative consequences

If the initial manifestations were noticed in a timely manner and the specialist prescribed adequate treatment, the prognosis for full recovery is favorable. Otherwise, the patient runs the risk of disability, because degenerative processes lead to impaired blood supply to brain cells, resulting in a high risk of developing cerebral ischemia or infarction. And also the functional mobility of the joint is completely disrupted, the person becomes immobile and is unable to care for himself without outside help.

Diagnosis of spinal spondyloarthrosis

The study will accurately determine the degree of damage to articular tissues.

A neurologist with whom you need to make an appointment will help diagnose bilateral or unilateral dysplastic spondyloarthrosis. The doctor will conduct general examination spine, will collect all important information. Next, instrumental diagnostics are carried out, during which the following methods are used:

• Radiography. It will help determine the location of dystrophic changes and see the degree of proliferation of osteophytes.
• CT or MRI. They are used for a more detailed and in-depth study of the condition of the affected intervertebral articular structures.

Differential diagnosis will help to exclude the development of pathologies such as osteochondrosis, spinal hernia, osteoporosis, and uncoarthrosis.

What treatment is prescribed?

Drugs

NSAID drugs will relieve pain and inflammation.

If initial spondyloarthrosis is diagnosed, drug treatment is prescribed, the main goal of which is to reduce inflammation, relieve pain and normalize the functioning of the affected areas. The following groups of drugs are used:

• Non-steroidal anti-inflammatory drugs. Relieves inflammation, swelling, acute pain. It is recommended to treat spondyloarthrosis during an exacerbation using injections. When the symptoms begin to subside, you can take the pills.
• Painkillers. They are used for acute pain, when NSAIDs alone are not able to cope with increasing symptoms.
• Muscle relaxants. They relax the muscles, due to which the pinched nerves are released, and the pain syndrome gradually decreases.
• Chondroprotectors. Restore damaged intervertebral cartilage, accelerating their regeneration.
• Vitamin and mineral complexes. Improve functioning immune system, speed up recovery time.

Massage and exercise therapy

Therapeutic exercise will improve the mobility of the joints and spine.

Manual therapy is always prescribed for the treatment of spondyloarthrosis of the cervical, thoracic or lumbar spine. Massage is especially effective if a disc herniation is diagnosed: L5-S1, C3-C7, D1D-12. Massage manipulations help improve blood circulation in the affected area, resulting in faster recovery. Contraindications to manual therapy are acute infectious diseases, high body temperature, formations of malignant etiology, erosion and wounds on the skin.

It is recommended to combine massage with therapeutic exercises, with the help of which it will be possible to normalize the functioning of the affected areas and strengthen muscle tissue. It is recommended to perform the following simple recovery exercises:

• Right-sided and left-sided swings of a straight limb.
• Flexion-extension of the leg in the area of ​​the knee and then the hip joint.
• Bend the torso with your hands touching your toes.
• Raising and lowering level lower limbs from a lying position.
• Performing exercises “cat”, “bicycle”, “mill”.

In order for recovery to proceed as planned, the patient is issued a sick leave certificate for the period of treatment.

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

The last stages of the pathology are accompanied by the proliferation of osteophytes, which leads to an inflammatory process throughout the entire joint and to serious mobility impairments. The lumbar region suffers more often than other areas of the spine, due to the constant load on this area and the influence of a host of negative factors.

Reasons for the development of pathology

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

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

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 lumbar spondyloarthrosis are elderly. Pathology develops against the background of age-related changes in the body.

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

• traumatic injuries backs;
• flat feet;
• postural disorders (current,);
• lifting weights, other heavy physical labor;
• lack of regular physical activity;
• professional sports;
• endocrine diseases (diabetes, obesity);
• congenital anomalies of the structure of the spine;
• the presence of dorsopathies (pathologies associated with the destruction of bones and cartilage).

Often, spondyloarthrosis develops against the background of a progression (destruction of intervertebral discs, proliferation of osteophytes). The favorite area of ​​localization of the disease is the lumbar area, so the disease is often diagnosed in this area.

On the page, read about how to correct the curvature of the lumbar spine using therapeutic exercises.

Surgery

Surgical therapy is used infrequently. This is due to the excellent results achieved by conservative treatment methods.

Indications for the operation are:

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

Surgical solution to the problem in the lumbar area is carried out in different ways (facetomy, laminectomy, laminotomy, foraminotomy). After removal of damaged tissue, the risk of recurrence of neurological disorders increases, so spinal fusion (using bone grafts) is performed.

After surgery, soft tissue healing takes several weeks, but the entire rehabilitation period lasts two months. Surgery is used infrequently due to complications (infections, traumatic nerve damage, leg pain).

Preventive measures are divided into two groups: recommendations to prevent the formation of the disease and useful tips to prevent relapse and progression of spinal spondyloarthrosis.

The first group of preventive measures includes:

• lead an active lifestyle, do yoga, swimming, fitness, avoid excessive physical activity;
• Monitor your body weight and avoid obesity;
• promptly treat diseases accompanied by;
• strengthen your back muscles, preventing slouching and poor posture.

• stop lifting heavy objects, wear a special one, especially in cases where you need to cover a long distance (vibration negatively affects the course of spondyloarthrosis in any part of the spine);
• hiking, swimming, yoga, walking help prevent exacerbation of the disease and improve the patient’s condition.

Video about the treatment of spondyloarthrosis of the lumbosacral spine using exercise therapy and gymnastics:

Until relatively recently, spondyloarthrosis was considered exclusively an ailment of older people. However, today this pathology of the spine has become significantly “younger”. Many who suffer from back pain and have no idea what spondyloarthrosis 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 radiculitis or the consequences of poor posture. However, spondyloarthrosis today is one of the most common diseases associated with degeneration of the spinal column.

It is completely natural that with age, all organs and the musculoskeletal system gradually fail. The vertebrae are worn out and joint movement is limited.

IN Lately doctors note that many ailments are “getting younger” and even manifestations such as pain in the spine worry young people and middle-aged patients.

The occurrence of spondyloarthrosis may be associated not only with natural aging body, but also with the following factors:

• suffered 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 load on the back.

Signs of spondyloarthrosis:

1. Impaired spinal mobility (the symptom is especially noticeable in the morning after sleep).
2. Pain syndrome in one of the departments, which intensifies with changing weather conditions.
3. Rapid fatigue and discomfort in the back when staying in one position for a long time.
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. Spondyloarthrosis is no exception. During the tenth revision of the international classification of diseases ICD 10, the disease was assigned the code M45-M49 (spondylopathies). At the initial stage, the disease does not manifest obvious signs. The symptoms are vague, and the pathology is difficult to identify even with an x-ray.

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

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

View	Characteristic
Cervical (cervicoarthrosis)	The pain is localized in the neck and can spread to the shoulders, to the area between the shoulder blades, to the back of the head and arms. The pathology is accompanied by a narrowing of the lumen of the canal in the spine and the development of osteophytes. In parallel with this, pressure on the artery may be observed, which entails the development of migraines and dizziness. With cervicoarthrosis, hearing problems are also observed: tinnitus and tinnitus.
Thoracic (dorsarthrosis)	It appears less frequently than other types of disease and is characterized by difficult diagnosis due to the hidden area behind the ribs. Symptoms of thoracic spondyloarthrosis are decreased mobility in the chest area, aching pain in the back, and numbness of the upper extremities.
Lumbar (lumboarthrosis)	Lumboarthrosis is a fairly common occurrence due to the mobility of the area. This species is characterized by the presence nagging pain in the lower back. Sometimes symptoms spread to the thighs and buttocks.
Lesions in the lumbosacral region	The pain is localized in the lumbosacral region and can radiate to the hips, buttocks and legs to the knees.

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

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

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

Definition	Description
Degenerative	Degeneration of joints and annulus fibrosus.
Uncovertebral	Chronic disease of the facet joints with signs of deformation and limited movement.
Destruction of the facet joints	Degeneration of the facet and spinal costal joints alone is a rare occurrence. As a rule, the disease also affects the facet joints.
Ankylosing	This type of spondyloarthrosis has a second name - ankylosing spondylitis, which affects mainly men aged 20 to 30 years. In addition to the intervertebral joints, the joints of the limbs also suffer.
Polysegmental spondyloarthrosis	With this type of pathology, several parts of the spine are simultaneously exposed to destructive changes.
Dysplastic	The definition means a violation of the structure of movable bone joints, a change in their shape and size.
Deforming	The term can be applied to all types of spondyloarthrosis of joints and discs, leading to their deformation.

1. Gymnastics for spondyloarthrosis of the lumbosacral region
2. Prevention cervical osteochondrosis
3. Do ears hurt with osteochondrosis?

Types of treatment

Which doctor should you consult with a problem such as degeneration of cartilage tissue and spinal deformity? Several years ago, with similar manifestations, we 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 spondyloarthrosis should know that this is a disease that requires regular compliance with doctor’s orders and long-term therapy with the use of medications that relieve painful sensations and relieving inflammatory processes.

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

Acupuncture relieves muscle spasms 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 advanced age and in younger patients with certain types of disease. If it is not possible to carry out exercise therapy for spondyloarthrosis, then in such cases courses of physiotherapy (magnetic therapy, phonophoresis, ionogalvanization, sinusoidally modulated currents) are prescribed.

Currently, the treatment of spondyloarthrosis cannot take place without the use of chondroprotectors (Chondroxide), which are irreplaceable in restoring damaged cartilage.

Treatment with folk remedies is ineffective for spondyloarthrosis. The only thing a patient can do to help relieve pain is warming up the muscles (warm bath, compresses with tinctures, insulation with a dog hair belt).

Special exercises for spondyloarthrosis are performed during prolonged subsidence of the disease. Their effectiveness is no lower than drug treatment, but on the contrary, with exercises they successfully achieve muscle strengthening, pain reduction, restoration of spinal column mobility, and prevention of further progression. Wearing an orthopedic corset will relieve problem areas.

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

The condition for such a method of therapy as gymnastics for spondyloarthrosis 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

Spondyloarthrosis can be accompanied by the following complications:

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

Prevention

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

• eliminating unnecessary stress 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 spondyloarthrosis is a set of measures that give the best results in the initial stages of the disease. Therefore, the first symptoms described above should not be ignored or treated with disdain.

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Causes

Vertebrologists identify several main reasons for the development of spondyloarthrosis:

There are also a number of predisposing factors that increase the risk of developing this pathology:

• Age after 65 years;
• Obesity;
• Women after menopause;
• Hereditary predisposition to diseases of the spinal column;
• Autoimmune diseases;
• Presence of diabetes mellitus, gout;
• Violation of diet and balance.

Spondyloarthrosis develops gradually and begins with atrophic changes in joint cartilage. As the disease progresses, cartilage cells die, degenerative processes occur in the cartilage, and their elasticity is lost (from the center to the periphery).

Then there is a decrease in the size of the cartilage and, as a consequence, exposure of the articular surfaces on the bony components of the joints. Bone tissue is replaced by connective tissue (sclerosation) and minor inflammatory processes occur in the joints. This occurs because the deteriorating cartilage crumbles into small fragments and these fragments enter the synovial fluid. The marginal parts of the bony surfaces of the joints begin to grow and form osteophytes.

Classification

Spondyloarthrosis is divided into three large groups, depending on the location of the process:

• Cervicoarthrosis – spondyloarthrosis of the cervical spine;
• Dorsarthrosis – spondyloarthrosis of the thoracic spine;
• Lumboarthrosis is spondyloarthrosis of the lumbar spine.

There are also 4 stages of disease development:

• Stage 1 – asymptomatic with initial processes in the joints (loss of elasticity of the disc, disorders in the ligaments and articular membranes), diagnosed by chance, with prof. examinations;
• Stage 2 – the first ones appear pain symptoms, fatigue in the back, impaired mobility of the spine, disorders already at the level of the fibrous rings;
• Stage 3 – inflammatory processes occur, the bone surface of the joint is affected, small osteophytes appear, and the function of the ligamentous apparatus is impaired;
• Stage 4 – there is no movement in the affected part of the spine, ankylosis and spondylosis, large osteophytes, and disturbances in vascular and nerve patency occur. This stage is not reversible..

Depending on the course of the pathological process, spondyloarthrosis is divided into several types:

• Deforming type – the shape of the vertebrae is deformed by osteophytes;
• Degenerative type - destruction of the articular surfaces occurs at the junction of the spine with the ribs and in the area of ​​the vertebral arches, as well as destruction of the structure of the intervertebral disc;
• Ankylosing type - called ankylosing spondylitis, affects many human joints, significantly deforming them;
• Facet type - processes occur in the joints between the spine and ribs and in the facet joints;
• Uncovertebral type - located between the spinous processes along the posterior surface between the 1st and 2nd cervical vertebrae;
• Dysplastic type - manifested by a complete violation of the structure of the joints, their deformation;
• Polysegmental type - affects 2 or more parts of the spine simultaneously.

Symptoms of spondyloarthrosis

The symptoms of damage to the joints of the spine are somewhat different in different parts.

Cervicoarthrosis (cervical spine)

• Pain in the neck area, radiating (radiating) to the back of the head, shoulder blades, shoulders and arms, from periodically occurring after exertion or an uncomfortable position, to constant, aching, shooting;
• Noise in ears;
• Discomfort when turning and tilting the head, progressing to complete immobilization of the neck;
• Crunching in the joints of the neck;
• Aching pain when the weather changes (especially high humidity).

Dorsarthrosis (thoracic region)

• Pain in the thoracic spine - initially periodic, after exercise, and subsequently constant;
• Discomfort or aching pain in wet weather;
• Restricted mobility in the affected part of the spine;
• Morning stiffness in the spine;
• Atrophy of the back muscles in the projection of the affected area of ​​the spine;
• Crunching noise with sudden movements.

Lumboarthrosis (lumbar region)

• Pain in the lumbar region, hips, buttocks, aching, occurs on early stages spondyloarthrosis, aggravated by movement of the spine in the affected area;
• Morning stiffness;
• Impaired mobility in the affected joints;
• Poor posture and gait.

Diagnostics

As diagnostic methods, first of all, the patient’s complaints, the course of his disease (when it first arose, with what manifestations it began and how it progressed) and examination (muscle atrophy, impaired posture and mobility) are used. After these methods, instrumental studies are prescribed:

Treatment of spondyloarthrosis

Treatment of spondyloarthrosis can be divided into 2 main groups:

• Conservative (medication, physiotherapy);
• Operational.

Drug treatment

This type of therapy is aimed both at eliminating the symptoms of the disease and at the mechanism of development of the pathology. Several groups of drugs are used:

• NSAIDs – reduce pain and inflammation. Both tablet forms are used (1-3 tablets per day for pain) and injection forms (1-2 injections per day for severe pain). These are Diclofenac, Dikloberl, Analgin, Piroxicam, Baralgin, etc.;
• Chondroprotectors – reduce the process of cartilage destruction and partially restore cartilage cells. They are most often used in tablet form, but intra-articular administration is also possible. These are Glucosamine, Chondroflex, Mucosat, Artrin, Elbona, etc.;
• Muscle relaxants are prescribed as additional therapy when reflex tension in the muscular frame of the back occurs. These are Tolperizon, Sirdalud, Mydocalm, etc.;
• B vitamins – it is most effective to use injections of vitamins B1, B2, B6.

Physiotherapeutic treatment

Physiotherapy can enhance the effects of taking medications, speed up the healing process, and prevent the progression of the disease. The most used and effective methods:

• Magnetotherapy;
• Back massage;
• Electrophoresis;
• Spinal traction;
• Acupuncture;
• Swimming;
• Thermotherapy;
• Laser therapy.

Back corsets are also quite effective, helping to unload the spine and thereby reducing the progression of the disease and accelerating recovery processes.

Surgical treatment

It is performed quite rarely and for certain indications:

• Dysfunction pelvic organs with compression of the spinal cord;
• Stenosis (narrowing) of the spinal canal;
• Paresis or paralysis due to spinal cord injury;
• Spinal instability;
• Progression of the disease and lack of effect from conservative treatment.

Most often, for spondyloarthrosis, facetectomy is used - removal of the affected joint and creation of a fixed block. In this way, it is possible to completely eliminate the pain syndrome, but the area of ​​the spine will be motionless. Osteophytes are also removed and the joint is replaced with an artificial implant. In case of narrowing of the spinal canal and the development of neurological symptoms, conduction through the nerve endings and the spinal cord is restored.

Complications

Stages 3 and 4 of spondyloarthrosis quite often give complications:

• Traumatization of the vertebral artery;
• Spondylolisthesis;
• Death;
• Disability;
• Paresis and paralysis;
• Dysfunction of the pelvic organs;
• Spinal instability.

Prevention

As a preventive measure primary development spondyloarthrosis, its exacerbations and progression, it is recommended to follow a number of simple rules:

• Losing excess weight and combating obesity;
• Regular exercise or light physical activity (fitness, exercise equipment, etc.);
• Rational and balanced diet(adequate distribution of proteins, fats and carbohydrates, intake of vitamins and minerals);
• Prevention of injuries;
• Walking around fresh air(at least 5 km daily);
• Correct distribution of the load on the spine;
• Correctly selected mattress and pillow;
• Wearing orthopedic shoes.

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Anatomical structure of the spine

To understand how spondyloarthrosis develops according to the type of facet joints, you should understand how the human spine is structured. Its main function is support; it holds muscle, bone, connective tissue and internal organs of a person in a certain position. Inside the column is the spinal cord.

The spine itself consists of 32 or 34 vertebrae. They are connected to each other by the following elements:

• Intervertebral discs connecting the vertebral bodies;
• Vertebral joints, which are formed from sections of the overlying and underlying vertebrae;
• Ligaments.

The vertebra itself consists of seven processes: two upper, two lower, two transverse and one spinous. The lower and upper processes participate in the formation of the facet joints.

The vertebrae connect to the ribs to form the vertebral joints. The rib head joint consists of the articular surface of the rib bone and the costal notch, which is formed by the vertebra. And the costotransverse joint consists of the articular surface of the costal tubercle and the transverse process of the vertebra.

There are special hooks on the lateral surfaces of the vertebrae of the cervical spine. With their help, uncovertebral joints are formed. Hooks protect the cervical spine from excessive flexion to the sides.

In the area of ​​the uncovertebral joints pass the nerve endings of the spinal cord and the most important vessels supplying the brain and spinal cord.

What happens in the joints of the spine during the development of spondyloarthrosis?

Spondyloarthrosis - symptoms and course

Arthrosis is a joint disease in which the cartilage layers are primarily destroyed. If spondyloarthrosis of the intervertebral joints develops, an inflammatory process begins in their tissues, which leads to degenerative changes in the cartilage and stiffness of the spine.

The main reason for the development of the disease is trophic disorders. Without enough nutrition, cartilage stops producing chondrocytes and eventually breaks down.

Stages of development of spondyloarthrosis of the intervertebral joints:

1. Changes in the structure of cartilage tissue associated with metabolic disorders or age-related changes in the body.
2. Loss of the main components of cartilage tissue: chondrocyte substances and proteoglycans.
3. Decreased elasticity of the cartilage: first it becomes thinner and cracks in the central part, then the lesions spread to the periphery.
4. Abrasion of damaged cartilage, as a result of which the articular surfaces of the bones are exposed.
5. Sclerosis of the tissues around the joint develops.
6. Remains of destroyed cartilage accumulated in the joint cavity in synovial fluid, cause an inflammatory process in the joint capsule.
7. The articular surfaces become denser and increase in size, and bone growths - marginal osteophytes - form on their lateral surfaces.

Such changes can occur in tissues under the influence of both internal and external factors. External ones include:

• Excessive physical activity that the joints are unable to cope with;
• Overweight and obesity;
• Injuries and damage to the spinal column.

Internal factors are pathologies of other organs that became the impetus for the development of spondyloarthrosis. This may be a hereditary predisposition, or an autoimmune disease, serious metabolic disorders - for example, gout.

Or malfunctions endocrine system, development of diabetes mellitus.

Polysegmental spondyloarthrosis can be recognized by the following symptoms:

• Stiffness of the spine in the morning, after prolonged immobility of the spine. Usually within half an hour after the patient gets out of bed, mobility is restored.
• Painful sensations that initially intensify during physical activity, and then occur at rest. This is explained by the fact that there are no nerve endings in the cartilage itself, just like blood vessels. They don't hurt when they break. Pain appears only when the lesions spread to other joint elements.
• When osteophytes grow, both the patient and others hear a characteristic crunch in the spine when bending or turning.
• Discomfort and back pain that occurs when climate conditions change - the spine begins to ache “due to the weather.”
• Initially, minor, and then increasing restrictions on the mobility of the spine, turning into muscle-tendon contractures at the late stage of the disease.

Spondyloarthrosis of the thoracic spine can be expressed very weakly, since this particular section is the least mobile.

Late diagnosis significantly complicates successful treatment of the disease.

How is spondyloarthrosis of the thoracic spine treated?

The main goal of treatment is to maintain mobility of the spine, that is, to enable the patient to lead a full life, work and actively rest. To do this, it is important to eliminate pain and inflammation as the cause of pain and progression of the disease, and then restore damaged joints.

If thoracic spondyloarthrosis was diagnosed in the early stages, you can do without medication - the main thing in this case is the patient’s perseverance and his willingness to cooperate with the doctor. The following methods and procedures are used:

1. Certain therapeutic exercises for spondyloarthrosis. It is important not to let the joints become ossified; they need to be constantly developed in order to maintain the mobility of the spine. But at the same time, you cannot overload the spinal axis itself, so gymnastics is performed in a sitting or lying position with a gradual increase in loads. It is necessary to strengthen the muscular corset of the back - swimming is best in this case;
2. Diet therapy. Need to get rid of extra pounds, which give very heavy load on collapsing joints;
3. Wearing a corset and other orthopedic structures. They perform several functions at once; protect against unauthorized movements, have a massaging effect, improving blood circulation, and thereby help reduce pain;
4. Thermal procedures. They are prescribed only when the period of exacerbation of the disease has passed - they also partially relieve pain and restore mobility to the joints;
5. Ultrasound therapy during remission;
6. Blockade of intercostal nerves, if the pain is very severe or neuritis is noted;

Reflexotherapy sometimes gives positive results, but is not a common method of treating spondyloarthrosis.

Treatment with medications

All medications that are used to treat spondyloarthrosis can be divided into two large groups: fast-acting and slow-acting.

Drugs of the first group are necessary during exacerbation of the disease, when it is important to relieve pain and relieve joint stiffness. This non-steroidal drugs with anti-inflammatory action, analgesics and tramadol.

The second group includes drugs whose effectiveness will be noticeable only after months, but at the same time they are able to restore cartilage tissue and protect it from destruction.

These are chondroitin sulfate, glucosamine, diaceirin. Hormones can be used for intra-articular injections, and opiates can be used for severe pain.

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Main symptoms

In almost all cases, it is a secondary disease, developing against the background of existing osteochondrosis. It is for this reason that at first there is no clinical picture of the pathology, but there are symptoms of the underlying disease, usually osteochondrosis. And by and large, the disease does not have any special symptoms, does not exist typical signs, which could accurately identify spondyloarthrosis.

Often, even specialists cannot immediately assume exactly this disease, so a preliminary diagnosis is often made - osteochondrosis.

An important event is to conduct differential diagnosis spinal pain, which will allow you to distinguish one pathology from another.

Specifics of pain syndrome in spondyloarthrosis	Pain syndrome in osteochondrosis
It is observed constantly, becoming more pronounced after a long stay at rest, for example, after sleep. It decreases after a little physical activity, this can be normal exercise, but at the same time, it can intensify after increased exercise.	As a rule, it is paroxysmal in nature, intensifies after physical activity, not necessarily prolonged or intense.
The main localization of pain in case of violation is paravertebral points, the symptom is especially pronounced upon palpation.	When collecting anamnesis, the patient complains of pain in the lower back, but cannot indicate the exact localized location. Pain is observed in the buttocks, thighs, and radiates to the legs.

A preliminary diagnosis can be confirmed using CT or X-ray examination. Imaging shows a narrowing of the joint spaces, as well as the presence of osteophytes (overgrowth of bone tissue) along the edges of the vertebrae. Is there any involvement in pathological process soft tissues can be seen using an MRI examination.

Dystrophic changes in the spine and symptoms:

Early clinical picture	Pain that has a clear localization - lower back, sacrum. At the same time, there is a clear feeling of discomfort after minor exertion. The same signs can be observed after sleeping or walking.
Main symptoms	The aching pain syndrome intensifies when turning the spine or bending.
	Further spreads to the gluteal region and lower limbs.
	A feeling of stiffness in the morning, especially noticeable in the lumbar region.
	Impaired mobility in the lumbar region.
Neurological signs in case of parallel development of osteochondrosis	The pain syndrome is accompanied by a burning sensation and tingling sensation in the affected area. The patient complains of weakness muscular apparatus legs
	At later stages, the pelvic organs are involved in the pathological process: genitourinary dysfunction. Problems with bowel movements may also occur.

Lumbar spondyloarthrosis: 1, 2, 3, degrees of development

In the practice of vertebrology, it is customary to distinguish three degrees of development of the disease. There is also a fourth condition, in which joint fusion occurs and complete immobility develops, which cannot be restored.

As for conscripts, the army exempts military service young people with the third confirmed stage of pathology. In the case of the fourth, disability is established in accordance with ICD10.

1st degree violation. There is no pronounced clinical picture, there is no pain syndrome, but it can occur during prolonged periods of rest. The pain is quite mild, so it rarely causes suspicion and passes quickly. This time of development is the most favorable period, since it is possible to effectively stop the degenerative process with the help of therapeutic massage.

Spondyloarthrosis of the spine 2 degrees. The signs become much more noticeable. The pain is severe and can only be eliminated by taking painkillers.

Degenerative process 3 degrees. It is an advanced stage. The manifestations are constant, pronounced, and have a burning character. An integrated approach is required - drug therapy, exercise therapy, physiotherapy, acupuncture and more.

It is very important not to miss the first signs of the disease. If you experience pain in your back, for example, after sleeping or sitting on a chair, you should see a specialist as soon as possible.

Basic treatment methods

In most cases, when this is not yet an advanced stage, the use of conservative measures is possible in grades 1-2. No matter how strange it may be, the leading role in this pathological development non-medicinal therapy is reserved - exercise therapy, therapeutic massage, electrophoresis, magnetic therapy, exposure to folk remedies. Naturally, in the initial stages, such methods are the most effective; you can even get by with just this, without using painkillers or non-steroidal drugs.

If pain is still present, painkillers are prescribed - Panadol, Ibuprofen. When diagnosing inflammation, a course of non-steroidal anti-inflammatory drugs - Diclofenac, Nimesulide - will be required. They are prescribed for oral administration and topical use. When symptoms are accompanied by spasms, it is advisable to use muscle relaxants, the most popular are Mydocalm, Traumeel S, Baclofen. Also, recently the use of chondroprotectors has been actively recommended - drugs that inhibit the process of destruction of cartilage tissue. At the last stages of the process, when the manifestations are pronounced and cannot be stopped with standard drugs, novocaine blockades are performed.

If the above methods are not effective enough, then radiofrequency destruction of nerve endings is recommended. This is a modern technique for destroying nerves, thereby eliminating pain. The procedure lasts no more than 30 minutes and local anesthesia is used.

Radiofrequency destruction is only gaining momentum in the treatment of pathologies of the musculoskeletal system. The effect of the technique is quite impressive, but is not permanent. Before the manipulation, the patient should be warned that nerve fibers are capable of regeneration, hence, after some time, the pain may return.

In some cases, when the deforming process becomes pronounced, more radical methods are needed - surgical intervention. Surgery remains the only option when other methods do not provide the desired result. In particular, the operation is extremely important for young people. The procedure involves installing special implants, in neurosurgery they are called - interspinous spoilers.

If we talk about prognoses, they are quite favorable, however, subject to adequate influence and compliance with all doctor’s recommendations, including if surgical therapy is necessary. As a rule, if such conditions are met, it is quite possible to restore the motor activity of the spine and relieve pain, and most importantly, stop the pathological course.

During treatment, manual therapy is often prescribed or recommended. This is quite good method in the initial stages of development of spondyloarthritis, when symptoms and signs are more moderate. Therefore, it is important to pay attention to the specialist you contact. If the manipulations are performed by an unqualified doctor, simply “anyone”, there is an extremely high risk of not only being left without the necessary therapeutic effect, but also earn a lot of complications.

Physiotherapeutic procedures

The use of physiotherapeutic procedures for intervertebral osteochondrosis of the spine often takes a leading place, especially in the initial stages. There are various methods of physiotherapy, the most popular are the following:

• Magnetotherapy using local painkillers, in most cases novocaine.
• Phonophoresis with hydrocortisone ointment. The manipulation involves the use of ultrasound of a special frequency, which is converted into thermal energy, which allows penetration medicines into the deep layers of the skin, increasing the therapeutic effect.
• Quite often it is practiced to administer chondroitin ointment using an ultrasound machine. The procedure allows you to slow down the destruction of cartilage tissue and reduce pain. At least 10 procedures are required for a positive result.
• Also important point remains therapeutic exercises in combination with manual therapy. Thus, exercise therapy actively strengthens the muscle corset, helps restore motor activity, improves blood circulation and at the same time relaxes muscle tissue, reducing spasms.

Recovery using manual techniques is an integral part of maintaining the therapeutic effect during the period of remission. A good option will be spending some time in specialized sanatoriums, where courses of manual therapy are also possible.

Exercises for lumbar spondyloarthrosis

Performing physical therapy exercises for various arthrosis - important stage in the treatment of this disease and other diseases of the musculoskeletal system. However, the result depends on the correct execution and professional approach. This means that you don't have to try to pick up exercise therapy complex independently, relying on information from the Internet. As a rule, only general recommendations and exercises that are most often prescribed, but this does not mean that they are right for you.

Therapeutic gymnastics for disorders of the functioning of the spine is selected exclusively in the individual case, taking into account all the nuances of the patient - the course of the pathology, age, concomitant diseases, lifestyle and much more.

The best option is to perform it under the supervision of a specialist, especially if we are talking about an elderly person. It is also possible to use exercise therapy at home, but after detailed instructions from a rehabilitation specialist.

When exercising at home using a set of exercises, you should adhere to the following rules:

• Physical education should not be carried out during the period of exacerbation of pathology.
• At the very beginning, physical activity should be minimal, it should be increased gradually.
• Exercise therapy is carried out daily, this is the only way to achieve results.
• The duration of physical activity should be at least 10 minutes and no more than half an hour.
• It is best to do gymnastics in the morning, this will allow you to relax your muscles and eliminate stiffness.

The doctor selects various complexes, depending on the location of the pain and the general state of health. But, at the same time, there are also universal physical therapy exercises. Let us describe the main ones below.

To relax muscles

Starting position - lying on your back, arms along your body. Do deep breath, count to two and exhale. This procedure should be performed for at least 5 minutes.

Exercise therapy for traction for arthrosis of the lumbar spine

Exercises that work to stretch the spine can eliminate pain, but during an exacerbation they are not performed.

It is a little difficult because it requires a special crossbar - a horizontal bar. It’s quite simple to do: you need to hang on the bar and hold in this position for several minutes. Then rest for a few minutes and repeat again. 3-5 approaches are recommended.

Physiotherapy for vertebral disorders and chondroprotectors would also be an excellent addition.

Spondyloarthrosis deformans

Spondyloarthrosis of a deforming nature is one of the forms of osteoarthritis. The pathology is quite common and is accompanied by degenerative changes in the spinal column.

Typical clinical picture of spinal disease:

• Pain that spreads throughout the back, intensifies at rest.
• Pain syndrome, initially moderate, later aching, severe.
• Gradually, as it progresses, motor activity in the joints decreases - the ability to perform simple actions, for example, turning the neck or bending over, becomes difficult, the disease becomes bilateral.

An important point is the early diagnosis of the pathological process, since in this case, the chance to stop the further development of the disease is as high as possible. The main therapeutic effect will include various methods of manual therapy, exercise therapy, and physiotherapy.

Lumbosacral zone

What does this diagnosis mean? Refers to diseases of the musculoskeletal system, also characterized by the destruction of cartilage tissue of the vertebrae, the main localization is the lumbar spine. On x-rays it appears as changes at the l4 l5 s1 level.

The disease mostly affects older people and is diagnosed in almost 75% of cases. It also occurs in young patients, more often in those who exclude from their lifestyle physical activity and balanced nutrition.

In the early stages of development, symptoms are sparse, so patients come in already in advanced cases. It is important not to miss the first signs: pain that appears occasionally in the lumbar area, intensifying after a long stay in one position (after sleeping, standing, sitting).

Previously, it was believed that spondyloarthrosis inevitably leads to disability, even with long-term treatment spine. Today, it is quite possible to prevent such an outcome, especially in grade 1 - modern methods of therapy, correctly developed complexes, effectively help slow down the process of disease development.

Traditional treatment

Traumatologists, orthopedists, and vertebrologists will help you develop the right treatment regimen for the spine. It is highly not recommended to change the treatment tactics yourself, and even more so, medications.

How exactly to treat? Treatment will be carried out and selected on an individual basis, however, there are certain tactics:

• NSAIDs(non-steroidal anti-inflammatory drugs). They are prescribed to reduce the inflammatory process and help reduce pain. Available in tablet form and for local use - gels, ointments. Shared use is often recommended.
• Drugs that reduce skeletal muscle tone (muscle relaxants). Allows you to remove muscle spasm, reduce the manifestation of pain.
• Blockades(injections) with painkillers. Novocain is used more often. This procedure is necessary if there is no analgesic effect from other medications.
• Chondroprotectors(inhibit the process of destruction of articular tissue, have a regenerative effect). Drugs in this group are part of complex treatment and often require long-term use, at least several months.

In addition to medicinal effects, physiotherapeutic manipulations are prescribed - UHF, magnetic therapy, applications with drugs.

When not positive effect from the methods described above and during diagnosis, large growths of osteophytes are identified, more radical ways therapy - surgery.

Exercise therapy

Against the backdrop of the need to use drugs for disorders of the musculoskeletal system, exercise therapy procedures remain no less important methods for speeding up the healing process.

The goal of therapeutic exercises for dystrophic disorders is to strengthen muscle muscles, improve motor activity, and increase overall tone.

An important aspect is direct control by a specialist. It is the doctor who selects the technique physical exercise based on the course of the pathology and the individual characteristics of the patient’s body.

The exercises are performed for a very long time and you need to be prepared for this. The first positive changes are often visible after 8-12 or more weeks.

Fulfill therapeutic exercises, exercise is necessary regularly and in the absence of pain. Exercise therapy and any other exercise stress during the period of exacerbation.

• swimming;
• yoga;
• race walking.

Unfortunately, spondyloarthrosis is a chronic disease that cannot be completely cured. However, constant compliance with all medical recommendations allows you to achieve long-term remission and significantly slow down the progression of the pathology.

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Pathology

What is spondyloarthrosis? As you know, arthrosis is a chronic pathological disease articular apparatus, which is associated with their functional changes (deformation) and decrease (limitation) of mobility. Consequently, spinal spondyloarthrosis is a pathological deformation of the small intervertebral joints of the spinal column.

The disease develops against the background of long-term undiagnosed or untreated osteochondrosis. In 90% of cases it occurs in elderly people (over 75 years of age), more often observed in men due to a heavier load. Often a similar diagnosis is given to athletes, loaders, and those who work in a bent position (office workers, doctors, drivers). This is due to the fact that under heavy load or uncomfortable body position, the intervertebral space decreases. Then the following happens:

1. After a decrease in the space between the vertebrae, atrophy of the cartilaginous structures of the articulation occurs (the doctor can determine it from a magnetic resonance imaging image).
2. Cartilage endures degenerative changes, the total number of proteoglycans and chondrocytes decreases.
3. The elastic function of cartilage decreases. The process goes from the center (from the core) to the periphery.
4. The articular surfaces that were covered with cartilage are “exposed.”
5. The periarticular tissue becomes sclerotic.
6. Inflammation occurs in the joint capsule.
7. arise bone formations which are called osteophytes.

Thus, the formation and development of this serious pathology occurs.

Degrees

For faster and accurate diagnosis spondyloarthrosis has 4 degrees. Doctors highlight:

• First degree. Is initial and often proceeds without clear severe symptoms As a result, it is difficult to diagnose. Most often, patients note a slight limitation of mobility in the back (in the morning), periodic attacks of pain (lumbago) that occur when lifting heavy objects, and discomfort in the affected area. In this case, the doctor may advise treating spondyloarthrosis with regular exercises and massage. The goal is to adequately correct the position of the vertebrae, relax the back muscles and increase blood flow.
• Second degree. Occurs if the symptoms of the initial stage are not detected in time. At this stage, symptoms are more pronounced. Characterized by acute, long-lasting pain after sleep or when starting to move. Stiffness increases and mobility decreases. Swelling may occur in the affected area. Physical therapy (physical therapy) can no longer cope with the symptoms; it is necessary to relieve pain with a blockade or other available medications. In addition, drugs are prescribed that protect and restore cartilage tissue (chondroprotectors) and reduce inflammation (NSAIDs). After the attack has stopped, exercise therapy and massage can be prescribed.
• Third degree. Occurs during long-term treatment at home, without medical intervention. The pain is burning, constant, and can radiate to the arms or legs. It is caused by overgrown osteophytes that put pressure on nerve fibers and blood vessels. At this stage, treatment of spondyloarthrosis consists of the complex action of medications (chondroprotectors and NSAIDs), manual correction, massage, exercise therapy and physiotherapy.
• Fourth degree. The most unfavorable, characterized by complete exclusion of the affected area of ​​the back from the act of flexion and extension (fusion or ankylosis of the joint), bone tissue grows more strongly, involving other tissues and joints in the process. In this case, treatment of spondyloarthrosis is aimed at restoring motor activity in the affected area of ​​the spine thanks to surgical intervention, prescribing NSAIDs and chondroprotectors (injections into the joint cavity), and then exercise therapy, physiotherapy and other methods.

The earlier this pathology can be identified, the more favorable the prognosis both in terms of quality of life and treatment.

Symptoms and types

The symptomatic picture strongly depends on the localization of the process. Depending on the affected area of ​​the back, the symptoms will be as follows:

• Spondyloarthrosis of the facet joints.
• Spondyloarthrosis of the costovertebral joints.
• Spondyloarthrosis of the cervical spine.
• Spondyloarthrosis of the thoracic region.
• Spondyloarthrosis of the lumbosacral spine.
• Polysegmental spondyloarthrosis.

If the facet joints are affected, morning stiffness of the spinal column will be observed, which can last up to 30 minutes. The pain symptom with damage to the facet joints intensifies during movements, and in the later stages at rest. A crunching sound often occurs when the joints of the spinal column move. Pathology of the facet joints occurs extremely rarely.

If the costovertebral joints are involved in the process, localized pain will be observed during movement, and then at rest, decreased mobility in the joint, neuritis, a feeling of discomfort when weather conditions change; in advanced stages, atrophy of the muscular frame (spondylomyelodysplasia) may develop.

Unverbal connections (cervical) are characterized by the development of a pain attack along the nerve fibers. Impaired blood supply to the brain (brain and spinal column) can lead to dizziness, migraines, ringing in the ears, nausea, decreased memory and visual acuity. Cervical and brachial neuritis may also occur, which must be treated promptly.

Spondyloarthrosis of the thoracic region or dorsarthrosis. The clinical picture is similar to other arthrosis, the only difference is in the localization of the pain symptom (pain in the chest), but with a long-term progressive disease, nearby organs, such as the heart, lungs, and stomach, can be involved in the pathological process.

Spondyloarthrosis of the lumbosacral spine or lumbospondyloarthrosis. Occurs much more often than others. Characteristic signs lumbar spondyloarthrosis: at an early stage, pain in the lower back is aching and intensifies during movement; if left untreated, the pain can become shooting, burning, which characterizes inflammatory changes. It can radiate to the leg, hip and reach the foot. Numbness and weakness in the legs may develop. In any case, spondyloarthrosis deformans of the lumbar spine is the most common disease of the spinal column, which affects its joints.

And the most terrible spondyloarthrosis of several departments (polysegmental). The clinical picture develops depending on the affected areas and the degree of damage. The doctor must prescribe treatment for spondyloarthrosis of several parts surgical method in combination with taking medications.

The clinic is specific to most of the listed departments and strongly depends on the degree of damage to the spinal joints.

Treatment at home

What treatment the doctor will prescribe depends on the location of the process and how early the pathology was detected. But what method can help prevent or help treat the early stages of the disease at home? Treatment at home will consist of regular exercise therapy, gymnastics and massage sessions. A consultation with a medical specialist is required first.

Gymnastic activities should be aimed at maintaining or restoring the mobility of the spinal column, at stretching and placing the vertebrae in their original place. In addition, it is necessary to begin monitoring nutrition, body weight and physical activity.

If you are obese, you should visit a nutritionist. Exclusion from life bad habits will contribute to a slower progression of the disease and a high quality of future life.

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. No. 170

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

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Orthopedist: I say for the hundredth time, do not apply ointments and do not inject chemicals into your sore BACK and JOINTS.

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

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

ICD-10 codes for types of osteochondrosis

Juvenile osteochondrosis

• M42.00 – Juvenile osteochondrosis, localized in multiple parts of the spine.
• M42.01 – Juvenile osteochondrosis, localized in the occipital region, as well as the first and second vertebrae cervical region.
• M42.02 – Juvenile cervical osteochondrosis – in ICD 10 this is a degenerative 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.

Over time, pain and crunching in the back and joints can lead to dire consequences - local or complete restriction of movements in the joint and spine, even to the point of disability. People, taught by bitter experience, use natural remedy, which is recommended by orthopedist Bubnovsky. Read more"

Osteochondrosis in adults

• M42.1 – Adult osteochondrosis with localization of pathology in multiple parts.
• 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 localized 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 ICD-10, lumbar osteochondrosis in adults.
• M42.17 – Osteochondrosis of the lumbosacral vertebrae in adults.
• M42.18 – Osteochondrosis of adults, localized in the area of ​​the sacrococcygeal and sacral spine.
• M42.19 – Osteochondrosis in adults, unspecified localization.

Unspecified osteochondrosis

• M42.97 - Osteochondrosis, unspecified, localized 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 naively thinks) has in abundance - health.

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

First of all, what is osteochondrosis?

The disease begins with deterioration of trophism (nutrition) intervertebral discs and the vertebrae themselves, which leads to disruption normal structure fabrics.

Because of this process, the elasticity of the disc, consisting of cartilage, decreases, its structure and shape change. Naturally, the spaces between the vertebrae become smaller, and the affected part of the 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 tension in the spinal muscles. This may explain the occurrence of pain and neurological symptoms in osteochondrosis.

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

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);
• constantly sitting at the computer in a hunched position, and so on.

• spinal injuries,
• diet with insufficient vitamins and mineral compounds (especially vitamins D, C, group B, as well as calcium and phosphorus),
• bad habits (as they contribute to increased loss of microelements),
• sleeping on uncomfortable mattresses and pillows.

Professional athletes are a separate line on the list of patients with spinal osteochondrosis. This happens because intense physical activity accelerates the wear of ligaments, joints, and intervertebral discs.

And these processes go much faster than for an ordinary person.

ICD code - what is it?

Diseases that beset people vary in stages, severity, nature, location, and so on. And the further science advances, 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.

The ICD was first published in 1893 at the suggestion of the Association public health USA. However, its creator is the head of the Paris Statistical Service, Jacques Bertillon.

Today, the whole world uses the ICD, tenth revision (ICD-10). By 2018, it is expected that a new classification, which is currently under development, will begin to be applied - ICD-11.

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

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

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

Main differences of ICD-10

The main differences between ICD-10 and ICD-9 are as follows:

1. ICD-10 pioneered the principle of coding diseases using one letter and three or four numbers separated by a period. This made it possible to code up to 100 three-digit categories in each class.
2. Of all the available letters of the Latin alphabet, 25 were used in the ICD codes. The letter U was 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 categories for disorders that may arise after medical interventions.

Forms of osteochondrosis in the international classification

Actually, spinal osteochondrosis is located in ICD-10 under code M42.

There are the following types of osteochondrosis:

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

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

• .x0 – multiple sections of the spine
• .x1 - area of ​​the back of the head, first and second cervical vertebrae
• .x2 - neck area
• .х3 – cervicothoracic region
• .х4 – thoracic region
• .х5 – lumbar-thoracic region
• .х6 – lumbar region
• .х7 – lumbosacral region
• .х8 – sacral and sacrococcygeal region
• .х9 - unspecified localization

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

Treatment of osteochondrosis

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

One of the main preventive measures are:

• rational nutrition (to prevent gaining 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 and return the patient to normal life.

1. Manual therapy. Helps relieve pain and increase range of motion, correct posture. Helps improve the movement of lymph and blood.
2. Acupuncture.
3. Physiotherapeutic treatment. The effect of laser therapy and magnetic therapy 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, you must 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 and heavy load on the spine (long sitting, lifting and moving heavy objects).

1. Nonsteroidal anti-inflammatory drugs in various combinations and forms of release. This is necessary to relieve pain.
2. Muscle relaxants to relieve compression of the nerve roots by the spinal muscles.
3. Decongestant therapy.
4. Drugs that improve microcirculation.
5. Chondroprotectors.
6. Vitamin therapy.
7. Surgery.

Conclusion

So, osteochondrosis today is, although an unpleasant, but completely correctable disease. It has been discovered, classified, and studied sufficiently.

Methods to combat its manifestations are also available when correct use 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 osteochondrosis of the cervical spine

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

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

If a diagnosis such as osteochondrosis of the lumbosacral region is in question, the patient’s kidneys and intestinal tract should be further examined. If during the examination everything indicates 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 whether there are any growths that prevent the spine from coping with its task. The specialist will definitely tell the patient about possible complications 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 support all this weight, but also produce turns and tilts. Osteochondrosis cervical vertebra leads to various troubles. Everything will depend on which vertebra is damaged. But headaches and problems with blood pressure are almost always accompanying cervical osteochondrosis.
2. 2 The thoracic region suffers the least. Its anatomy does not require great mobility, which means that vertebral deformation rarely occurs.
3. 3 The lumbar region suffers very often. The entire weight of the human body is distributed onto it. At the same time, a person burdens him even more with all sorts of tasks: lifting loads, staying in the same position for a long time at a machine, at a computer, in a car seat.

Symptomatic manifestations

Osteochondrosis of the lumbar region is the most common disorder associated with the functioning of the musculoskeletal system. If we consider statistical indicators, the disease was previously diagnosed in patients whose age exceeded 45 years. The disease began to grow younger. Computers force young people to sit for hours in front of screens 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 can withstand the main load that occurs when walking and sitting for long periods of time, or when lifting heavy objects.

The main causes leading to osteochondrosis in the lumbar region:

1. 1 Some professions lead to diseases of the lumbar spine. This job involves physical activity. Athletes, loaders, builders - people in these professions are at risk, since their activities often lead to vertebral injuries.
2. 2 Changed hormonal background in older people it causes a decrease in muscle mass. And this leads to an increase in the load on the spine.
3. 3 Poor nutrition, lack of vitamins and calcium lead to a decrease in the strength of the musculoskeletal system. Bones become brittle and abrasion occurs. All this causes pain in the lumbar region.
4. 4 If a person has relatives in their family who suffer from osteochondrosis, the likelihood of the disease increasing several times. In this case, a genetic predisposition is asserted.
5. 5 Spinal injuries are responsible for the appearance of osteochondrosis. In this case, most often there is damage not to one department, but to two at once, for example, the cervical region and lumbar or thoracic and lumbar.

The symptoms of osteochondrosis affecting the lumbar region include the following manifestations:

1. 1 Severe pain syndrome, which is localized not only in the back. When nerve endings are pinched, pain appears in various organs. It can be localized in the peritoneum and spread to the lower extremities.
2. 2 Degenerative processes cause atrophy of the muscles in the legs; the patient may experience tingling in the lower extremities. Very often, patients suffer from chilliness, their limbs are constantly cold.
3. 3 There is a loss of sensitivity, starting from the buttocks and thighs, ending with the feet.
4. 4 Problems appear in the sexual sphere. The patient complains of impaired sensitivity in the genitals.
5. 5 Sometimes the disease leads to disruption of the processes of urination and defecation.
6. 6 Spasms in the arteries of the lower extremities are so strong that the pulse periodically disappears.
7. 7 Problems arise with skin: They dry out and begin to peel off.
8. 8 When neglected, disturbances in the functioning of internal organs located in the abdominal cavity are observed.

Experts have different opinions about the ICD-10 classifier.

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

It is more correct to classify osteochondrosis as other dorsopathies, rather than classify it as deforming dorsopathies.

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Osteochondrosis in the International Classification of Diseases, 10th revision or (ICD-10)

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

Sometimes diagnoses can be very cumbersome, because some patients have a whole range of diseases. This is where ICD-10 comes to the rescue. Let's consider this using the example of such a common disease as spinal osteochondrosis. Osteochondrosis in ICD-10 belongs to class XIII, which includes pathologies musculoskeletal system and connective tissues (codes M00 to M99).

Forms of osteochondrosis in the international classification

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

The classification of this disease is based on the age of the patients and the localization of the pathological process. There are osteochondrosis of adults and youth.

The degenerative process can be localized:

• in the occipital region, including the first and 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;
• in several parts of the spinal column at once.

In ICD-10, unspecified osteochondrosis of the spine implies that there is doubt about the time of occurrence - in adolescence or in adulthood, or there is insufficient data to establish an accurate diagnosis. Such forms of the disease in the international classification are coded M42.9. These include:

• M42.9 – Unspecified osteochondrosis in multiple areas.
• M42.91 – Unspecified osteochondrosis of the 1-2 vertebrae of the neck and occipital region.
• M42.92 – in ICD10 Osteochondrosis of the cervical spine, 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 the thoracic and lumbar vertebrae, unspecified.
• M42.96 – Unspecified osteochondrosis of the lumbar vertebrae.
• M42.97 #8212; Osteochondrosis, unspecified, localized 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

This is the classification of types of osteochondrosis that is currently used. ICD-10, adopted in most countries, allows us to get rid of inaccuracies in understanding diseases and eliminate existing disagreements regarding the names of diseases. The use of ICD-10 codes for osteochondrosis and other diseases allows doctors from different countries and nationalities to exchange their experience.

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Osteochondrosis of the spine in ICD-10

The abbreviation ICD stands for “International Classification of Diseases”. The document is used as the main statistical and classification basis of the healthcare system. The ICD is revised at certain 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 take into account morbidity, the reasons why the population turns to medical institutions of any department, as well as causes of death.

Goals and objectives of applying the classification

The main goal of the ICD is to create appropriate conditions for systematizing the registration, analysis, interpretation and subsequent comparison of data that was obtained in different time V various countries and regions. The international classification is used to convert the verbal formulation of diagnoses of diseases and other problems related to public health into codes in alphanumeric form (for example, osteochondrosis according to ICD-10 corresponds to code M42). Thanks to such a system, the convenience of data storage, retrieval and further analysis is ensured.

The use of a standardized diagnostic classification is advisable 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 various nature, and the general situation with people’s health.

Innovations in 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-character category. It is followed by numbers. For example, to designate juvenile osteochondrosis of the cervical spine localized in the occipital region, at the level of the first and second vertebrae according to MBK-10, code M42.01 was adopted

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

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

International classification codes for different types of osteochondrosis

In 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 coded M42. The classification includes all types of 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 Osteochondrosis of the spine

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

Dorsopathies of a deforming nature (M40-M43).

What is osteochondrosis according to ICD 10

If a person has osteochondrosis, ICD-10 (or international classification diseases) has a special code for this ailment, which facilitates the process of storing statistical data in the field of medicine and healthcare. 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 to facilitate the process of collecting, storing and analyzing data on diagnoses, which is subsequently used to compare morbidity and mortality rates within one state or in different countries.

The classification was created by the World Health Organization. The ICD-10 code can be recorded 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 diagnoses are too cumbersome, so it is much more convenient to use alphanumeric codes.

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

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

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

Osteochondrosis of the spine itself according to ICD-10 has code M42.

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

• on the back of the head - usually this is approximately the first and second vertebrae in the neck area;
• on the neck - this is approximately from the first to the seventh vertebrae of the spine;
• in the chest;
• on the lower back;
• on the sacrum;
• simultaneously on several areas of the back.

Depending on these factors, different codes are used.

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

Juvenile osteochondrosis

Juvenile osteochondrosis implies young age. If the disease is localized in patients in several parts of the back at once, then number M42.00 is used. 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 number M42.02 is used. In this case, 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 is used. If both the lumbar and thoracic part, 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 discovered in adolescence, the number M42.07 is written. For the sacral region, the number M42.08 is used. This includes both the coccygeal part and the sacrum. If the form of juvenile osteochondrosis is not specified, then code M42.09 is written on the form.

Osteochondrosis in adults

Common osteochondrosis, which develops on several parts of the back, implies the use of 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 with the letter M is written.

If thoracic osteochondrosis and cervical osteochondrosis develop simultaneously, then code M42.13 is used. This is a fairly common form of the disease. When a patient has only osteochondrosis of the thoracic spine, 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 damage to the thoracic part of the back, then 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 affects the cruciate area, the number 42.17 with the same letter is used. When inflammation affects only the sacral and coccygeal sections, the number M42.18 is written. If age-related osteochondrosis has an unspecified form, and the localization of degenerative processes cannot be determined, then number 42.19 with the letter M is written.

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 in older age. In this case, separate codes are applied.

For example, a person develops a polysegmental disease, but it is not possible to determine the age when the patient began to exhibit degenerative processes, then the number M42.9 is used. 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 thoracic 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 based on age, requires the use of number 42.96. According to ICD-10, osteochondrosis of the lumbosacral region has code 42.97. If the sacral and coccygeal areas are affected, then the number is 42.98. For all other cases, code M42.99 is used.

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 become deformed and gradually collapse in this area. This leads to a number of serious complications, not only pain in the neck, but also severe pain in the head, shoulders, and sometimes arms.

Read 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 worsened, but the disc itself may become displaced or even rupture. This is usually caused by sudden body movements or excessive physical activity. For example, a person can suddenly lift a weight, but the body is positioned incorrectly, which is why the entire load is transferred only to a separate part of the back. The pain syndrome resembles the sensation of an electric current.

Second stage. At this stage, protrusion develops. Now the pain becomes constant, and if you remain inactive for a long time, it only gets worse. Dizziness appears periodically.

Third stage. In the clinical picture, this form resembles more the presence intervertebral hernia. Various side effects appear, including hearing and vision deterioration.

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, and ischemic disease of the spinal cord develops.

What are the symptoms

At an early stage, back disease practically does not manifest itself in any way. The first warning sign of cervical osteochondrosis is only a headache, which occurs periodically. At first discomfort are localized only in the back of the head, but then they move to the temporal zone.

People usually start taking headache medications, but the relief will be temporary.

If the patient remains in one body position for a long time, the pain syndrome gradually intensifies. As a rule, in the future, dizziness, nausea, and in some cases even vomiting attacks will appear. Numbness of the hands is also considered possible. Sometimes tachycardia develops. Elderly people may even faint, but only briefly. This is due to the fact that with osteochondrosis, blood circulation is disrupted, which leads to the appearance of similar symptoms.

Other symptoms are characteristic of the thoracic spine. Intercostal neuralgia usually appears. Damage to the thoracic discs has a clinical picture that resembles cardiac dysfunction or diseases of the gastrointestinal tract.

As for the lumbar back, the pain syndrome manifests itself in its lower part. Sometimes it spreads to the sacral area. As a rule, the legs go numb. Older people have problems with bowel movements Bladder(it is involuntary).

As soon as such 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.

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

There is also another difficulty. It is difficult to determine the disease on your own, so in most cases patients go to the wrong specialists. For example, they can visit a therapist, cardiologist, or gastroenterologist. But it is best to consult a neurologist or other doctors. It is imperative 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 spinal osteochondrosis, 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. Typically, such data is needed to clarify the diagnosis in documents, but only doctors and other medical professionals use it. However, every person should at least roughly understand the codes and know where they can be read.

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 projections and spines. In some cases, the altered vertebrae grow together, and sometimes the nerve endings are pinched.

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

Most often, this disease is diagnosed in older people, and the most common area of ​​spondylosis is the cervical region. As a rule, spondylosis is observed in people who remain in immobile positions for a long time, for example, in those who work at a computer for a long time. The ICD-10 code is 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 becomes stronger when moving the head;
• the pain may fall to the shoulders, shoulder blades and radiate into the arms;
• limited neck movement;
• headaches and dizziness;
• decreased hearing and vision;
• presence of ringing in the ears;
• sleep disturbance.

REFERENCE! Spondylosis developing in the cervical spine can provoke glenohumeral periarthritis, which is accompanied by significant limited mobility of the shoulder joint, as well as the presence of intense pain.

Chest

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 extend to the chest;
• increased pain when bending sideways;
• problems with the functioning of internal organs.

Lumbar

With 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;
• leg pain;
• decreased sensitivity in the legs and a feeling of numbness;
• the pain becomes less intense when bending forward, because in this case the area of ​​​​the affected disc 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. Signs of the disease appear infrequently and faintly; most often, patients associate them with overwork. Diagnosis of this stage is difficult, since it is difficult to notice abnormalities during a hardware examination.
2. Second degree– the symptoms become more pronounced, and x-rays show altered disc structures.
3. Third degree characterized by degenerative signs of the pathological process. The patient is limited physical abilities, analgesics do not have 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 area of ​​the iliosacral joint.

This is a chronic inflammatory disease of a non-infectious nature, which results in damage to the intervertebral joints. At the same time, the functionality of other organs - kidneys, heart, eyes - may be impaired. In another way, this type of spondylosis is called ankylosing spondylosis; teenagers and young people under 30 years of age are susceptible to the disease.

REFERENCE! The earlier the disease develops, the greater the likelihood of occurrence 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 the early stage of the disease, the pain is not constant, and mainly occurs during movement, and an increase in pain during the day is typical;
• the intensity of pain may change with bad weather changes;
• When palpating the spine in the affected part, the pain symptoms intensify.

As the disease progresses, the mobility of the spine in the affected part begins to gradually become limited.

Diagnostics

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

How to treat spinal diseases?

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

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

Prem medications, massage, physiotherapy, exercise therapy, dietary food and folk remedies.

Drug 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 as anti-inflammatory drugs, the following drugs are prescribed:

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

When nerve fibers are pinched, the following drugs are prescribed:

• Baralgin, Ketoral.
• Kenalog, Hydrocartisone.
• Novocaine-lidocaine blockades.

To normalize metabolic processes in spinal column are used:

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

Very often spondylosis provokes increased muscle tone, to weaken it the following are prescribed:

• Mydocalm.
• Flexeril.
• Zanaflex.

Gymnastics exercise therapy and back exercises

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

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

Treatment with gelatin

Gelatin treatment is widely used for spondylosis. Gelatin helps restore the cartilaginous basis of the intervertebral disc, which means the condition of the spine will significantly improve.

Diet

• limit the consumption of vegetable and animal fats;
• monitor sufficient protein intake in the body;
• exclude the use of stone-forming products - salt, smoked meats, spicy dishes;
• give up strong tea and coffee, which can cause constriction 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 progression of the disease can be prevented.

Massage

For spondylosis, massage is aimed at influencing the gluteal and paravertebral muscles, since they are the ones that hold the body in the anatomically correct position.

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

IMPORTANT! Traumatic effects - chopping, beating, etc., are excluded with spondylosis.

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

Surgery

Surgeries for spondylosis are performed in very rare cases; as a rule, they become advisable when complications develop or there is a complete lack of effect from conservative treatment methods. The essence of the surgical intervention is cutting down bone growths with special tools. Also in some cases, it is practiced to replace the affected vertebrae with implants.

Physiotherapy

Physiotherapeutic measures are as follows:

• pulse therapy;
• interference therapy;
• TENS;
• ultraviolet;
• mud therapy;
• baths;
• wearing a special one.

Folk remedies

Collection to speed up metabolic processes– rose hips, currant leaves, lingonberries, raspberries, bird knotweed, nettle, horsetail, yarrow. All ingredients are taken in equal proportions and mixed. For a tablespoon of the mixture you will need 2 cups of boiling water. Leave for 2 hours. Half an hour before meals, take a glass of the product in the morning and evening.

Painkiller. Mix lemon balm, mint, plantain seeds, burdock, St. John's wort and fireweed in equal quantities. Brew and drink like regular tea.

External remedies for spondylosis are actively used essential oils oregano, fireweed, fir, lavender, cedar, thyme. 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 capsicum tincture.

Which doctor treats you?

If you suspect spinal spondylosis, you should seek advice from, and if the clinic does not have one, 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 the 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 forces them to defend themselves - to form. This is necessary to increase the area and reduce pressure.

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

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

Possible complications

Spinal spondylosis can lead to the following complications:

• Herniation. This complication does not occur in all cases; sometimes a hernial protrusion precedes spondylosis, but if osteophytes are closely adjacent to the intervertebral disc, a hernia can form as a result of spondylosis.
• Compression of blood vessels, which leads to myelitis. This complication most often occurs with a long and advanced course of the pathology. In this case, the blood supply to the brain may deteriorate. When it happens negative impact on the spinal artery, spinal Preobrazhensky syndrome or spinal cord infarction may develop.

Are spondylosis and spondyloarthrosis the same thing?

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