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 vertebrae, during this pathological process often affects the discs of the spine. The structures that make up the intervertebral cartilaginous discs provide flexibility and also allow the human spine to move, meaning they provide movement.
In osteochondrosis, a number of processes occur that cause degeneration of the spinal discs, as a result of which they begin to lose elasticity and reduce the degree of flexibility, and at this time the disc itself becomes quite flat. The distance between the two discs decreases as it compresses the nerve endings and blood vessels and causes severe pain. The site of compression of the nerve node begins to swell, leading to increased pain and even greater disturbance.
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, the blood circulation and mobility of muscles and organs are disturbed. For example, the most common osteochondrosis is cervical osteochondrosis, which is accompanied by neck pain, nausea, dizziness, visual impairment, and often tinnitus. This disease has become much "younger": 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 who have severely impaired metabolism and hormonal levels of the body, as well as people who have disorders of the vascular nature. This is due to the fact that these diseases cause impaired oxygenation of the disc. If timely healing measures are not taken, then the ends of the affected intervertebral disc, which is compacted, will anatomically protrude beyond the boundaries of the spine, thus destroying the neurovascular bundles.
Therefore, the patient is at risk of a herniated disc. The main, significant cause of osteochondrosis is the uneven distribution of the load on the spine, which leads to the fact that the cartilage structure changes at points with excessive pressure. The nature of this disease depends on the stage and level of damage to the affected discs. Intervertebral discs change with age, similar to our hair. Large injuries or fractures of the spine can affect their functioning. Everyday clothing and some types of vibration can also accelerate the rate of spinal degeneration. In addition, data show that smoking increases the rate of spinal degeneration. Researchers have also found a link between family members, emphasizing the role of genetics in how quickly change occurs.
The disease can also be caused by various factors:
- injuries, bruises;
- spinal muscular dystrophy;
- bending and curvature of the spine;
- weight lifting;
- 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 way of life;
- radiation background;
- frostbite;
- congenital dystrophies;
- asymmetric work of the muscles of the spine;
- stress, depression.
These causes of osteochondrosis are only the assumptions of scientists, direct factors that cause the disease, science has not yet discovered and we are talking only about risk factors.
First perioddevelopment - characterized by early deployment of the intradiscal nucleus pulposus (nucleus pulpus of the eccentric intervertebral disc located next to the dorsal vertebra).
Second periodcharacterized by the appearance of instability of the spinal segment. The pathological substrates are represented by a fibrous core of the affected disc with degenerative processes of take-off and fragmentation of the posterior longitudinal ligament, pathological movements between the vertebrae develop.
Third periodthe development of the disease - total damage to the intervertebral disc, with the appearance of a "disc herniation" - displacement and exit of fragments of the nucleus pulposus outside the intervertebral space.
If the disease has reached the third phase, then the process of destruction is already irreversible and can lead to profound disability.
Types of osteochondrosis
The evolution of osteochondrosis is slow, with exacerbations caused by spinal injuries, exercise, weightlifting and more. The clinic depends on the location of the lesion.
Osteochondrosis of the cervical spinethere are local and distant symptoms of advanced forms - with strong dominance of the roots, ie contributes to the development of severe radicular pain. The symptoms of osteochondrosis in the cervical spine are accompanied by varying degrees of dysfunction, sometimes manifested in a sudden restriction of mobility of the cervical spine and functional blocks. The headache can be both pulling and paroxysmal in nature with irradiation in the interscapular or shoulder area. In the acute period, patients are diagnosed with attacks of pain in the neck, which prevent and restrict the movement of the head and neck. In addition to severe discomfort, the pain syndrome may be accompanied by dizziness, insomnia, pain, loss of appetite, depression, eye and pharyngeal diseases.
Osteochondrosis of the chest. . . 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 be chronic or acute in back pain with chest discomfort and limited muscle contracture, to verbal muscle atrophy. Chest pain can be diffuse, intercostal, and neuralgic. Palpation improves the axial rotation of the body of the spine. The disorders correspond to the level of irritation of the roots from Thl1 to Thl2 and can manifest as angina pectoris, reflected in dysfunctions of the liver and gastrointestinal tract. Disorders of the genitourinary system and genital area often occur. Patients report sensory disturbances such as paresthesias, superficial and deep sensitivity is significantly reduced.
Lumbar osteochondrosis. . . It is characterized by abdominal reflexes and dysfunction of the lower extremities. Muscle weakness in the legs and pelvic dysfunction may occur during the development of neurological disorders. Osteochondrosis is characterized by an assessment of damage to the sedentary process. The more advanced the stage of development of the lumbar spine lesion, the shorter the period of time in which the patient can sit. Lumbar forms are characterized by chronic and acute back pain, paravertebral muscle spasm and myofascial secondary syndrome. The pain radiates to the buttocks and posterior ilium.
Depending on the localization of the pathological process of osteochondrosis, the disease can lead the patient to a violation of surface sensitivity (tactile, thermal). Changes in reflexes (eg lack of Achilles reflex), muscle loss, muscle tone disorders, autonomic disorders (paleness, reddening of the skin, trophic changes in the nails, skin hypothermia in the distal limbs), sphincter dysfunction and sexual dysfunction are also common.
Clinical picture
Diagnosisbegins with a complete history and physical examination. The doctor asks questions about the symptoms, how the disease interferes with the patient's daily activities. Also, the specialist is interested in identifying positions and activities that emphasize or reduce the level of pain.
The doctor then examines the patient, checking the position and range of motion in the spine, thus determining which movements are causing the pain. Skin sensitivity, muscle strength and reflexes are tested equally. Based on the medical history and physical examination, the doctor determines which techniques will help.
Radiography rarely helps in diagnosis, no more than 30% of X-ray images show abnormalities in the early stages of the disease.
However, if the symptoms are severe and the disease is already in its second or third stage, the image may show defects in one or more intervertebral discs. 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 examine the soft tissues of the body. This is useful if the tissue core absorbs water or if there are cracks inside the disc. MRI can show problems in other soft tissues, such as the spinal nerves.
Discography can help with diagnosis. This test is performed using a contrast agent, which is injected into one or more discs, respectively. Subsequent radiographs provide useful information about the condition of the discs.
Treatment of osteochondrosis, depending on the varieties
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 resume 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 a problem. If the symptoms are severe, a few days of bed rest may be prescribed.
When the spine is displaced, an elastic belt is sometimes prescribed, which is worn for no more than 2-4 days to avoid atrophy of the back muscles.
Osteopathic sessions provide serious relief from osteochondrosis.Osteopathic doctornot only diagnoses the problem area, but also relieves pain with 1-2 doses, relieves the general condition of the body and "tightens" the visceral organs.
Patients may be prescribed medications to control their symptoms and to continue their normal activities for a long time. If symptoms continue to limit the patient's activity, a conventional physician may suggest an epidural injection of steroids.
Steroids are powerful anti-inflammatory drugs that help 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 themselves. Most often, however, it is combined with other drugs. In general, steroids are prescribed only 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 symptoms. The exercise program aims to improve flexibility and is useful for training the abdominal and back muscles to allow movement with the least pain.
Surgery
People with problems with osteochondrosis usually do not need surgical treatment. In fact, only 1-3% are working. 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 grounds indicating a surgical procedure.
Basic surgical procedures
Discectomy
The procedure is aimed at 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 disc herniation, it is necessary to remove some of the plates.
Today, surgery masters minimally invasive techniques that require only a small incision in the lumbar region. Proponents of this method claim that it is safe. They also believe that the procedure prevents scarring around nerves and joints and helps patients recover faster.
Merging
This is an intervention that connects two or more bones into one, preventing wear and tear on the ends of bones and joints.
Rehabilitation
The doctor may recommend that the patient visit a physiotherapist several times a week for 4-6 weeks. In some cases, patients need extra help.
The first year of treatment is needed to control symptoms. The therapist will work with you to find postures and movements that relieve pain. Heat, cold, ultrasound and electrical stimulation may be prescribed to relieve pain and muscle spasm. Massage or specialized forms of soft tissue mobilization can also be used. These procedures help the patient to perform movements with ease.
Usually, adjusting the treatment helps to restore the sensitivity of the spinal nerves and muscles, reducing pain and improving mobility.
The main goal of therapy is to teach the patient how to manipulate to prevent future problems. The patient will be recommended a series of exercises to improve flexibility. The patient will also receive a strategy to help in case of recurrent symptoms.
Everyone should study and consider all types of osteochondrosis to prevent the development of this disease in themselves and their loved ones. After all, the treatment of destroyed vertebrae is impossible, the therapy is aimed at relieving the symptoms of pain and achieving long-term remission. You also need to 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, daily morning warm-up, healthy and active lifestyle and a monthly visit.osteopathic sessionsfor correction and elimination of musculoskeletal tensions. Following these rules is enough to avoid the aforementioned problem and to avoid terrible symptoms and treatment for life.