Osteochondrosis is one of the most common diseases of the musculoskeletal system, which manifests itself as a result of a complex of certain dystrophic changes in the cartilage of the vertebra, during this pathological process the discs of thespine are often affected. The structures, which are the discs of intervertebral cartilage, provide flexibility and also allow the human spine to move, that is, they provide movement.
With osteochondrosis, a number of processes occur that cause degeneration of the vertebral discs, as a result of which they begin to lose elasticity and reduce the degree of flexibility, and at this time the disc itselfbecomes quite flat. The distance between the two discs decreases, while compressing nerve endings and blood vessels and causing severe pain. The nerve node compression site begins to swell, which leads to increased pain and even greater violation.
During the development of osteochondrosis, muscle structures and most organs of the body are often involved in this pathological process. This is due to the fact that during the maximum violation of the neurovascular bundle, blood circulation and motility of muscles and organs are disturbed. For example, the most common osteochondrosis is cervical osteochondrosis, which is accompanied by pain in the back of the head, nausea, dizziness, visual impairment, and often tinnitus. This disease has become quite "young": a century ago, osteochondrosis was a disease of people of gerontological age, and today young people are also susceptible to it.
The most vulnerable category of people are those with severely impaired metabolism and hormonal levels in the body, as well as people with disorders of a vascular-venous nature. This is due to the fact that these diseases cause disruption of the oxygenation of the disc. If qualified and timely measures are not taken to heal, the edges of the affected intervertebral disc, which is compacted, will protrude anatomically beyond the limits of the spine, thereby destroying the neurovascular bundles.
Because of this, the patient is at risk of having a herniated disc. The main and significant cause of osteochondrosis is the uneven load distribution on the spine, which leads to the fact that the cartilage structure changes at points of excessive pressure. The nature of this disease depends on the stage and level of damage to the affected discs. Intervertebral discs change with age, like our hair. Serious injuries or fractures of the spine can affect their functioning. Casual clothing and certain types of vibrations can also accelerate the rate of spinal degeneration. Additionally, evidence suggests that smoking increases the rate of spinal degeneration. Scientists have also found a link between family members, highlighting the role of genetics in how quickly change occurs.
The disease can also be triggered by various factors:
- injuries, bruises;
- dystrophy of the spinal muscles;
- arch and curvature of the spine;
- lifting weights;
- prolonged stay in one position;
- metabolic disease;
- lack of trace elements and vitamins - manganese, magnesium, zinc and vitamins D and F;
- hereditary predisposition;
- physical overload;
- sedentary lifestyle;
- radiation background;
- frostbite;
- congenital dystrophies;
- asymmetric work of the muscles of the spine;
- stress, depression.
These causes of osteochondrosis are just the hypotheses of scientists, direct factors that cause the disease, science has not yet found, and we are only talking about risk factors.
First perioddevelopment - characterized by early deployment of the intradiscal nucleus pulposus (nucleus pulposus of the eccentric intervertebral disc, located next to the dorsal part of the vertebra).
Second periodcharacterized by the appearance of instability of the spinal segment. Pathological substrates are represented by the fibrous nucleus of the affected disc with degenerative processes of detachment and fragmentation of the posterior longitudinal ligament, pathological movements between the vertebrae develop.
Third periodthe development of the disease - total lesion of the intervertebral disc, with the appearance of a "herniated disc" - dislocation and exit of fragments of the nucleus pulposus outside the intervertebral space.
If the disease has reached the third stage, then the process of destruction is already irreversible and can lead to profound disability.
Types of osteochondrosis
The course of osteochondrosis is slow, with exacerbations caused by spinal injuries, exercise, weight bearing, etc. The clinic depends on the location of the lesion.
Osteochondrosis of the cervical spinehas local and distant symptoms of advanced forms - with a strong domination of the roots, that is, it contributes to the development of severe radicular pain. Symptoms of osteochondrosis of the cervical spine are accompanied by varying degrees of dysfunction, sometimes manifested by sudden limitation of cervical spine mobility and functional blockages. Headaches can be both pulling and paroxysmal with irradiation in the interscapular region or in the shoulder region. In the acute period, patients are diagnosed with attacks of pain in the neck, which hinder and restrict movement of the head and neck. In addition to severe discomfort, the pain syndrome can be accompanied by dizziness, insomnia, pain, loss of appetite, depression, diseases of the eyes and pharynx.
Thoracic osteochondrosis. . . Clinical manifestations are due to local lesions and processes of destruction of the root structure of the nerve. Thoracic osteochondrosis has a pronounced pain syndrome, which can have a chronic or acute nature from back pain with discomfort in the chest and limited muscle contracture, up to verbal right muscle atrophy. Chest pain can manifest as diffuse, intercostal, and neuralgic. Palpation improves axial rotation of the vertebral body. The disorders correspond to the level of irritation of the roots of Thl1 to Thl2, and can manifest as angina pectoris, which results in dysfunctions of the liver and gastrointestinal tract. Disorders of the genitourinary system and the genital area often occur. Patients note that sensory disturbances such as paresthesia, superficial and deep sensitivity is significantly reduced.
Lumbar osteochondrosis. . . It is characterized by abdominal reflexes and dysfunction of the lower limbs. During the development of neurological disorders, muscle weakness of the legs and dysfunction of the pelvic organs can occur. Osteochondrosis is characterized by the assessment of damage to the sitting process. The more advanced the stage of development of the lesion of the lumbar vertebrae, the shorter the period during which the patient can sit. Lumbar forms are characterized by chronic and acute back pain, paravertebral muscle spasms and secondary myofascial syndrome. The pain radiates to the buttocks and the posterior ilium.
Depending on the location of the pathological process of osteochondrosis, the disease can lead the patient to a violation of superficial sensitivity (tactile, thermal). Changes in reflexes (for example, the Achilles reflex is absent), muscle wasting, disorders of muscle tone, autonomic disorders (pallor, redness of the skin, trophic changes of the nails, hypothermia of the skin in the distal extremities), sphincter dysfunctions are also characteristic. and sexual dysfunctions.
Clinical picture
Diagnosticbegins with a complete history and physical examination. The doctor asks about the symptoms, how the disease interferes with the patient's daily activities. In addition, the specialist is interested in identifying positions and activities that accentuate or reduce the level of pain.
The doctor then examines the patient, checking the position and range of motion of the spine, thereby determining which movements are causing the pain. Skin sensitivity, muscle strength and reflexes are tested in the same way. Based on the medical history and physical examination, the doctor determines which techniques will help.
X-ray rarely helps in diagnosis, no more than 30% of X-ray images show abnormalities in the early stages of disease development.
However, if the symptoms are severe and the disease is already in its second or third stage, defects in one or more intervertebral discs can be seen in the image. They can be penetrated by osteophytes between the vertebrae and joints.
If additional information is needed, magnetic resonance imaging is prescribed. MRI is used to visualize the soft tissues of the body. This is useful if the core of the fabric absorbs water or if there are cracks inside the disc. An MRI can show problems in other soft tissues, such as the spinal nerves.
Discography can help in the diagnosis. This examination is carried out using a contrast agent, which is respectively injected into one or more discs. Viewing the x-ray later provides useful information about the condition of the discs.
Treatment of osteochondrosis, depending on the variety
Non-surgical treatment of osteochondrosis
When possible, doctors prefer non-surgical treatment. The most important thing in non-surgical treatment is to relieve pain and other discomfort so that the patient can return to a comfortable standard of living as much as possible.
Doctors rarely prescribe bed rest for patients with osteochondrosis. Patients are encouraged to live in natural mobility when pain is not an issue. If the symptoms are severe, several days of bed rest may be prescribed.
When the spine is moved, an elastic belt is sometimes prescribed, which is not worn for more than 2-4 days in order to prevent atrophy of the back muscles.
Osteopathy sessions seriously relieve osteochondrosis.Osteopathic doctornot only diagnoses a problem area, but also relieves pain in 1 to 2 doses, relieves general condition of the body and "tightens" visceral organs.
Patients may be prescribed medication to control symptoms and resume normal activities for a long time. If the symptoms continue to restrict the patient's activities, a conventional doctor may suggest an epidural steroid injection.
Steroids are powerful anti-inflammatory drugs, helping to relieve pain and inflammation. Nonsteroidal anti-inflammatory injections are injected into the space around the spinal roots of the spine. This site is called the epidural space. Some doctors inject the steroid on its own. However, it is most often combined with other drugs. Basically, steroids are only prescribed when other drugs are ineffective, but osteopathy almost always helps.
In addition, patients often work with physiotherapists. After assessing the patient's condition, the therapist prescribes exercises to reduce the symptoms. The exercise program aims to improve flexibility and is useful for training the abdominal and back muscles to allow movements with the least pain.
Surgery
People with osteochondrosis problems usually do not need surgical treatment. In fact, only 1 to 3% can be used. Surgeons prescribe non-surgical treatment, namely craniosacral osteopathy, as rehabilitation therapy, for at least 3 months before considering surgery. If after 3 months of non-surgical treatment there are no results, only then there are reasons indicating a surgical intervention.
Basic surgical procedures
Discectomy
The procedure aims at the partial or complete removal of the disc in the lumbar region. Surgeons usually perform the operation through an incision in the lumbar region. Before removing a herniated disc, it is necessary to remove some of the plaques.
Today, surgery masters minimally invasive techniques requiring only a small incision in the lumbar region. Supporters of this method claim that it is safe. They also believe the procedure prevents scarring around nerves and joints and helps patients recover faster.
Merge
It is a procedure that combines two or more bones into one, preventing the endings of the bones and joints from wearing out.
Rehabilitation
The doctor may recommend that the patient see a physiotherapist several times a week for 4-6 weeks. In some cases, patients need additional help.
The first year of treatment is needed to control symptoms. The therapist will work with you to find positions and movements that relieve the pain. Heat, cold, ultrasound, and electrical stimulation may be prescribed to relieve pain and muscle spasms. Massages or specialized forms of soft tissue mobilization can also be used. These procedures help the patient to perform movements with ease.
Typically, adjusting treatment helps restore sensitivity to nerves and spinal muscles, reducing pain and improving mobility.
The main goal of therapy is to teach the patient how to manipulate to avoid future problems. The patient will be given a series of exercises to improve his flexibility. The patient will also be given a strategy to help them with recurring symptoms.
Each person should study and take into account all types of osteochondrosis in order to prevent the development of this disease in himself and those close to him. After all, the treatment of the destroyed vertebrae is impossible, the therapy is aimed at relieving the symptoms of pain and achieving long-term remission. You should also remember a simple but effective rule:the best medicine is prevention. . .
Prevention of osteochondrosis
Prevention is quite simple - it's a healthy diet, regular muscle activity, a daily warm-up in the morning, a healthy active lifestyle, and a monthly visit.osteopathy sessionsfor the correction and elimination of musculoskeletal tension. Following these rules is enough to never face the aforementioned problem and avoid terrible symptoms and lifelong treatment.