Osteochondrosis is a disease of the spine characterized by the degeneration of the intervertebral disc with a significant decrease in its height, sclerosis of the disk surfaces of the vertebrae and reactive growth of regional osteophytes.
The cartilage tissue of discs affected by osteochondrosis is gradually reborn and turns into a semblance of bone.The hardened disk decreases in size, loses the properties of the shock absorber between the vertebrae and begins to press on the nerve endings, which leads to the appearance of painful sensations.
The initial stage of osteochondrosis most often does not manifest itself with any unpleasant sensations in the spine and can be diagnosed as a disease of internal organs, and a true diagnosis is detected only after passing numerous examinations.
By localization, cervical, thoracic, lumbar, sacral and common osteochondrosis are distinguished.Most often, lumbar osteochondrosis (over 50%of cases), cervical osteochondrosis (more than 25%) and common (about 12%) are diagnosed.
The intervertebral disk is a fiber-chip plate.In the middle of the disk there is a core surrounded by a fibrous ring (fabric resembling tendons).The intervertebral disk does not have its vascular system and therefore eats at the expense of other tissues.An important source of nutrients for the disk is the back muscles, it is their dystrophy that most often leads to the development of the disease.When lifting weights, jumps and other physical exertion, discs act as a shock absorber and support the required distance between the vertebrae.Since the largest load falls on the lumbar spine, it is in it, protrusions and intervertebral hernias, which are a complication of this disease, are most often formed.
Protency of the intervertebral disc- protrusion (prolapse) of the disk without rupture of the fibrous ring.
A hernia of the intervertebral disc- protrusion (prolapse) of a disk with a rupture of a fibrous ring and a “flow” of a jet nucleus.Especially often, the hernia is formed when the spine or during the simultaneous tilt and turning the torso to the side is formed, especially if there is a heavy object in the hands.In this position, the intervertebral discs experience a very large load, the pressure inside the intervertebral disk rises, the vertebrae is pressed on one side of the disk and the core is forced to shift in the opposite side and press on the fibrous ring.At some point, the fibrous ring does not withstand such a load and the disk is protruding (the fibrous ring is stretched, but it remains whole) or the hernia is formed (the fibrous ring breaks and part of the contents of the nucleus “flows” through the breakthrough).With an increase in the load on the spine and creating conditions for increasing pressure in the damaged intervertebral disk, the hernia increases in size.
It is very important to the direction of protrusion and the size of the hernia, if the hernia comes forward or to the sides, this can lead to pain and impaired work of some organs, and when protruding towards the spinal cord and damage, the consequences can be much more serious.If the intervertebral hernia affected the nerve processes or roots of a certain segment of the spine, then this leads to a violation of the work of the organ, for which the damaged segment of the spine is responsible.Another option is possible: due to the protrusion of the disk in one direction, in the opposite side the distance between the vertebrae decreases and this leads to pinches of nerve processes by the vertebrae itself.The intervertebral hernia in the lumbar region most often causes pain in the legs, hernia in the thoracic region contributes to dizziness, pain in the heart, violations of respiratory organs, etc., hernia in the cervical spine can cause headaches, dizziness, and numbness of the hands.The most dangerous intervertebral hernias are more than 10 mm in size, sharply narrowing the spinal canal, clamping blood vessels and injuring nerve endings, prolonged exposure to which leads not only to severe pain, but also to circulatory disorders, loss of sensitivity in the limbs with subsequent complications.But the most dangerous are sequestered hernias of intervertebral discs, i.e.The hernias are ready for destruction or separation of the fragment, followed by lowering it in the spinal canal, which can lead to severe consequences: impaired functions of the pelvic organs and paralysis of the lower extremities.
Causes of osteochondrosis
The causes that cause changes in the intervertebral discs are not fully studied.People begin to feel manifestations of osteochondrosis most often after 35 years.The development and exacerbation of this ailment is facilitated by various back injuries, static and dynamic overloads, as well as vibration.The older the person, the more manifestations he has.But in recent years, more and more people aged 18 to 30 years have been complaining about back pain.There are a lot of reasons for the early manifestation of the disease: weak physical training, violation of posture and curvature of the spine, flat feet and excess weight.
And so, we will highlight the main reasons:
- hereditary (genetic) predisposition;
- metabolic disorder in the body, infection, intoxication;
- overweight, improper nutrition (lack of trace elements and liquid);
- age -related changes;
- spine injuries (bruises, fractures);
- violation of posture, curvature of the spine, hypermobility (instability) of the segments of the spinal column, flat feet;
- adverse environmental conditions;
- sedentary lifestyle;
- work associated with lifting weights, frequent changes in the position of the body (turns, bending and extension, jerking movements);
- prolonged exposure to inconvenient poses in the standing position, sitting, lying, when lifting and transferring weights, when performing another work in which the pressure in the discs and the load on the spine in general increases;
- excessive physical activity, unevenly developed bone-muscular system;
- spinal overloads associated with diseases of the foot, as well as as a result of wearing uncomfortable shoes, high heels and pregnancy in women;
- sharp cessation of regular training by professional athletes;
- nervous overstrain, stressful situations, smoking;
- hypothermia, adverse weather conditions (high humidity at low temperature).
Symptoms characteristic of osteochondrosis
Patients suffering from osteochondrosis complain of constant aching back pain, to which numbness and a feeling of ache in the limbs often join.In the absence of adequate treatment, weight loss and atrophy of the limbs occurs.
The main symptoms:
- constant aching pain in the back, a feeling of numbness and aches in the limbs;
- increased pain during sudden movements, physical exertion, lifting weights, coughing and sneezing;
- reduction in the volume of movements, muscle cramps;
- with osteochondrosis of the cervical spine: pain in the hands, shoulders, headaches;It is possible to develop the so -called vertebral artery syndrome, which consists of the following complaints: noise in the head, dizziness, flickering of “flies”, colored spots before the eyes in combination with a burning pulsating headache.The cause of the vertebral artery syndrome may be its spasm in response to the direct irritation of its sympathetic plexus due to bone growths, disk hernia, arthrosis of the intervertebral joint, and reflex reaction due to irritation of any spine receptors.The presence of the vertebral artery syndrome can aggravate the course of coronary or heart-muscular pathology if any;
- with osteochondrosis of the thoracic spine: pain in the chest (like a “stake” in the chest), in the heart and other internal organs;
- with osteochondrosis of the lumbosacral spine: lower back pain, radiating into the sacrum, lower limbs, sometimes into the pelvic organs;
- The lesion of the nerve roots (with hernias of intervertebral discs, bone growths, spondylolistz, spondylo arthrosis): shooting pain and sensitivity, hypotrophy, hypotension, weakness in the innervated muscles, and a decrease in reflexes.
Diagnosis of osteochondrosis
The preliminary diagnosis is established during the initial examination of the patient.An examination is usually conducted by a neurologist in connection with the patient’s complaints to local changes, which can manifest itself by pain, deformation or limitation of mobility.The spine is examined in the position of the patient standing, sitting and lying, both at rest and in motion.The level of damage to the spine is determined by counting the number of vertebrae from certain anatomical landmarks or according to a special scheme.
When examining the back, attention is paid to posture, the structural features of the body, the line of spinous processes (median furrow of the back), the lower corners of the shoulder blades, the ridges of the iliac bones, the side contours of the waist and neck, the rejection of the intra -annual groove from the verticals are paid, the protrusion of the verticals is revealed, the protrusionmuscles located next to the spine.
Feeling the spine allows you to supplement the inspection data (the presence or absence of deformation), determine the localization, degree and nature of pain.When feeling, the tension of muscles located next to the spine is also noted, becauseMost injuries and diseases of the spine are accompanied by an increase in muscle tone.
Flexion of the spine is used to determine the amplitude of movements in various parts of the spine.
The main role in the study of the spine is assigned to radiography, computed tomography and magnetic resonance imaging, with which the level of damage is determined, the diagnosis is specified and concretized, hidden pathologies are revealed.These diagnostics allow the attending physician to determine the tactics of treatment and choose the most effective treatment methods.
Methods of treatment of osteochondrosis and its complications
Treatment of osteochondrosisAnd its complications are carried out using conservative methods aimed at eliminating the pain syndrome, disorders of the function of spinal roots and preventing the progression of dystrophic changes in the structures of the spine.With the ineffectiveness of conservative treatment and in special indications, surgical (surgical) treatment is carried out, the volume of which depends on the level of damage and clinical manifestations of the disease.
The duration of the treatment of osteochondrosis and its complications mainly depends on the severity of the disease, age -related changes, treatment methods, as well as conscientious prescription and recommendations of the attending physician.As practice shows, the active phase of treatment in most cases lasts 1-3 months when using conservative methods, and the recovery period after surgery is about 1 year.At the beginning of treatment, in some patients, it is possible to increase the pain syndrome associated with the reaction of the muscle system and other formations to exposure unusual for the body.Pain is stopped in a short time with physiotherapeutic procedures, medications, as well as special physical exercises.The result of treatment largely depends on the behavior of the patients themselves, on which patience, perseverance, perseverance, certain willpower are required, as well as the desire to recover.The greatest efficiency of conservative therapy and rehabilitation after surgery can be achieved in conditions of specialized medical centers and sanatoriums equipped with a modern diagnostic and therapeutic base, as well as highly qualified practitioners who use comprehensive treatment of diseases of the musculoskeletal system.
Complex conservative treatment includes physiotherapy, physiotherapy, massage, manual therapy, traction (traction) of the spine, reflexology, and drug therapy.
Medical physical education (exercise therapy)-the main method of conservative treatment of diseases of the musculoskeletal system, is to create dosed loads aimed at decompression of nerve roots, correction and strengthening of the muscle corset, increase the volume and development of a certain stereotype of movements and proper posture, and the ligamentous apparatus of the necessary flexibility, as well as onPrevention of complications.This is achieved by regular classes on rehabilitation equipment and articular gymnastics.As a result of the exercises, blood circulation improves, metabolism and nutrition of the intervertebral discs are normalized, the intervertebral space increases, muscle corset is formed and the load on the spine is reduced.
Physiotherapy is a treatment method that uses physical factors: low frequency currents, magnetic fields, ultrasound, laser, etc. It is used to relieve pain, inflammatory processes, rehabilitation after injuries and operations.When using physiotherapy methods, the treatment of many diseases is reduced, the effectiveness of the use of medicines and a decrease in their dosage are increased, there are no side effects inherent in drug treatment.
Massage is a set of techniques of mechanical dosed effects in the form of friction, pressure, vibration, carried out directly on the surface of the human body with hands.Effectively relieves muscle tension, muscle pain, improves blood circulation, has a general strengthening effect.
Manual therapy is an individually selected manual effect on the bone -muscular system for removing acute and chronic pain in the spine and joints, as well as an increase in the volume of movements and posture correction.One of the areas of manual therapy is visceral manual therapy, which helps to restore the normal mobility of organs, improves blood supply, lymphocylication, normalizes metabolism, restores immunity, prevents the dispersal of chronic diseases.
Extension (traction) of the spine is an effective method of treating pain syndromes in the spine, and joints using individually selected load using special equipment.The procedure is aimed at increasing the intervertebral space, removing pain and restoring an anatomically correct shape of the spine.
Reflexotherapy - various therapeutic techniques and methods of influence on the reflexogenic zones of the human body and acupuncture points.The use of reflexology in combination with other therapeutic methods significantly increases their effectiveness.Most often, reflexology is used for osteochondrosis, accompanied by pain, diseases of the nervous system, sleep disorders, mental imbalance, as well as with overweight and tobacco curls.By acting on certain points, one can bring the body into harmony and treat many diseases.
Drug therapy is indicated during the period of exacerbation of the disease, aimed at stopping the pain syndrome, removing the inflammatory process and increasing metabolic processes by taking or administering drugs using intramuscular or intravenous injections.
Although each of the above methods is a highly effective, still persistent therapeutic effect can only be obtained with their combination with classes on rehabilitation equipment, i.e.When creating a full muscle corset.