Osteochondrosis is one of the most common diseases of the musculoskeletal system, manifested as a result of a complex of certain dystrophic changes in the cartilage of the vertebra, during this pathological process, the discs of the spine are often affected. The structures, which are the intervertebral cartilage discs, 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 in 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 itself becomes quite flat. The distance between the two discs decreases, while compressing the nerve endings and blood vessels and causing severe pain. The compression site of the nerve node begins to swell, which leads to increased pain and even greater infringement.
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 infringement of the neurovascular bundle, blood circulation and motility of muscles and organs is 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 "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 with severely impaired metabolism and hormonal levels in the body, as well as people suffering from vascular-venous disorders. This is due to the fact that these diseases lead to 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, thus 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 distribution of load on the spine, which leads to the fact that the cartilaginous structure changes at points with excessive pressure. The nature of this disease depends on the stage and level of damage to the affected discs. The intervertebral discs change with age, like our hair. Serious injuries or fractures of the spine can affect its function. 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 changes occur.
The disease can also be triggered by a variety of factors:
- wounds, bruises;
- spinal muscle dystrophy;
- stooping 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;
- freezing;
- 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 the early deployment of the intradiscal nucleus pulposus (nucleus pulposus of the eccentric intervertebral disc, located next to the dorsal part of the vertebra).
Second termcharacterized by the appearance of instability of the spinal segment. The 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 develop between the vertebrae.
Third periodthe development of the disease - total damage to the intervertebral disc, with the appearance of "herniated disc" - dislocation and exit of fragments of the nucleus pulposus out of 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 evolution of osteochondrosis is slow, with exacerbations caused by spinal injuries, exercise, weight bearing, etc. The clinic depends on the location of the injury.
Osteochondrosis of the cervical spine.it has local and remote symptoms of advanced forms, with a strong dominance of the roots, that is, it contributes to the development of severe root pain. Symptoms of osteochondrosis in the cervical spine are accompanied by varying degrees of dysfunction, which sometimes manifests itself in sudden limitation of mobility of the cervical spine and functional blocks. Headaches can be both pulling and paroxysmal by irradiation in the interscapular region or in the region of the shoulder. In the acute period, patients are diagnosed with attacks of neck pain, which impede 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. . . The clinical manifestations are due to local lesions and processes of destruction of the nerve root structure. Thoracic osteochondrosis has a pronounced pain syndrome, which can be chronic or acute in nature from back pain with chest discomfort and limited muscle contracture, up to right verbal 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 root of 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 are often present. Patients note sensory disorders such as paresthesia, superficial and deep sensitivity is significantly reduced.
Lumbar osteochondrosis. . . It is characterized by abdominal reflexes and lower extremity dysfunction. During the development of neurological disorders, muscle weakness in the legs and dysfunctions of the pelvic organs can occur. Osteochondrosis is characterized by evaluating the damage in the sitting process. The more advanced the stage of development of the injury to the lumbar vertebrae, the shorter the period of time that the patient can sit. The lumbar forms are characterized by chronic and acute back pain, spasm of the paravertebral muscles, and secondary myofascial syndrome. The pain radiates to the buttocks and posterior iliac bone.
Depending on the localization of the pathological process of osteochondrosis, the disease can lead the patient to a violation of surface sensitivity (tactile, thermal). Also characteristic are changes in reflexes (for example, the Achilles reflex is absent), muscle wasting, alterations in muscle tone, autonomic disorders (paleness, redness of the skin, trophic changes in the nails, cutaneous hypothermia in the distal extremities), sphincter dysfunctions and sexual dysfunctions.
Clinical picture
DiagnosticsIt begins with a complete medical history and physical exam. The doctor asks questions 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 emphasize or reduce the level of pain.
The doctor then examines the patient, checks the position and range of motion in the spine, thus determining which movements are causing the pain. Skin sensitivity, muscle strength, and reflexes are evaluated equally. Based on the medical history and physical exam, the doctor determines which techniques will help.
Radiography rarely helps with diagnosis, no more than 30% of radiographic images show abnormalities in the early stages of the development of the disease.
However, if the symptoms are severe and the disease is already in its second or third stage, defects in one or more intervertebral discs may be seen on the image. They can be penetrated by osteophytes between the vertebrae and the joints.
If additional information is needed, magnetic resonance imaging is prescribed. MRI is used to view soft tissues in the body. This is useful if the core of the tissue absorbs water or if there are cracks within the disc. An MRI scan can show problems in other soft tissues, such as the spinal nerves.
Discography can help in the diagnosis. This test is performed using a contrast agent, which is injected respectively into one or more discs. The posterior X-ray display provides useful information on the status of the discs.
Treatment of osteochondrosis, depending on the varieties.
Non-surgical treatment of osteochondrosis.
Whenever possible, doctors prefer nonsurgical 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 problems. Patients are encouraged to live with natural mobility when pain is not a concern. If symptoms are severe, several days of bed rest may be prescribed.
When the spine is shifted, an elastic belt is sometimes prescribed, which is worn for no more than 2-4 days to prevent atrophy of the back muscles.
Osteopathic sessions provide great relief from osteochondrosis.Osteopathic doctornot only diagnoses a problem area, but also relieves pain in 1-2 doses, relieves the general condition of the body and "tightens" the visceral organs.
Patients may be prescribed medications to control symptoms and resume normal activities for a long time. If symptoms continue to restrict the patient's activities, a conventional physician may suggest an epidural steroid injection.
Steroids are powerful anti-inflammatories 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 alone. However, most of the time it is combined with other medications. Steroids are basically prescribed only when other medications are ineffective, but osteopathy almost always helps.
Additionally, patients often work with physical therapists. After assessing the patient's condition, the therapist prescribes exercises to reduce symptoms. The exercise program aims to improve flexibility and is helpful in training the abdominal and back muscles to allow movement with the least pain.
Surgery
People with osteochondrosis problems generally do not require surgical treatment. In fact, only 1-3% are operable. Surgeons prescribe nonsurgical 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 that indicate a surgical procedure.
Basic surgical procedures
Discectomy
The procedure is aimed at the partial or complete removal of the disc in the lumbar region. Surgeons usually perform the operation through an incision in the lower back. Before removing a herniated disc, it is necessary to remove some of the plates.
Today, surgery has mastered 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.
Join
It is an intervention that joins two or more bones into one, preventing wear on the endings of the bones and joints.
Rehabilitation
The doctor may recommend that the patient see a physical therapist 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 positions and movements that relieve pain. Heat, cold, ultrasound, and electrical stimulation may be prescribed to relieve pain and muscle spasms. Massage or specialized forms of soft tissue mobilization can also be used. These procedures help the patient to move easily.
Generally, adjusting the treatment helps restore sensitivity to 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 advised a series of exercises to improve flexibility. The patient will also be given a strategy to help with recurring symptoms.
Each person should study and consider all types of osteochondrosis to prevent the development of this disease in him and his loved ones. After all, the treatment of destroyed vertebrae is impossible, therapy is aimed at relieving pain symptoms and achieving long-term remission. You also need to remember a simple but effective rule:The best cure is prevention. . .
Prevention of osteochondrosis.
Prevention is pretty simple - it's a healthy diet, regular muscle activity, daily morning warm-up, a healthy, active lifestyle, and a monthly visit.osteopathic sessionsfor the correction and elimination of musculoskeletal tensions. Following these rules is enough to never face the aforementioned problem and avoid terrible symptoms and lifelong treatments.