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 the spinal column are often affected. The structures, which are the discs of the 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 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, 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 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 disturbances and often tinnitus. This disease has become quite "young": a century ago, osteochondrosis was a disease of people of gerontological age, and today even young people are susceptible to it.
The most vulnerable category of people is those who have severely impaired metabolism and hormone levels of the body, as well as people who have vascular-venous disorders. This is due to the fact that these diseases cause disruption of disc oxygenation. If timely and qualified measures are not taken to heal, the edges of the affected intervertebral disc, which is compacted, will anatomically protrude beyond the limits of the spine, thereby destroying the neurovascular bundles.
For this reason, the patient is at risk of having a herniated disc. The main and significant cause of osteochondrosis is the uneven distribution of the load on the spine, which leads to the fact that the cartilage structure changes in places 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. Severe 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 also found a link between family members, highlighting the role of genetics in how quickly change occurs.
The disease can also be triggered by a variety of factors:
- wounds, bruises;
- spinal muscle dystrophy;
- curvature and curvature of the spine;
- weightlifting;
- 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;
- asymmetrical work of the muscles of the spine;
- stress, depression.
These causes of osteochondrosis are just the assumptions of scientists, the direct factors causing the disease, science has not yet found, and we are only talking about risk factors.
First perioddevelopment - characterized by the early unfolding of the intradiscal nucleus pulposus (nucleus pulposus of the eccentric intervertebral disc, located near the dorsal part of the vertebra).
Second periodcharacterized by the appearance of instability of the spinal segment. Pathological substrates are represented by the fibrous core of the affected disc with degenerative processes of take-off 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 outside the intervertebral space.
If the disease has reached the third stage, the destruction process 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, carrying of weights, etc. The clinic depends on the location of the lesion.
Osteochondrosis of the cervical spinehas local and remote symptoms of advanced forms - with strong root domination, 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, sometimes manifested in a sudden limitation of the mobility of the cervical spine and functional blocks. Headache can be both pulling and paroxysmal in nature with irradiation in the interscapular region or in the shoulder region. In the acute period, patients are diagnosed with bouts of pain in the neck, which prevent and restrain the 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 injuries and processes of destruction of the nerve root structure. Thoracic osteochondrosis has a pronounced pain syndrome, which can have a chronic or acute nature of back pain with chest discomfort and limited muscle contracture, up to muscle atrophy of the right verb. 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 from Thl1 to Thl2 and can manifest as angina pectoris, reflected in dysfunction of the liver and gastrointestinal tract. Disorders of the genitourinary system and genital area often occur. Patients note that sensory disturbances such as paraesthesia, superficial and deep sensitivity are significantly reduced.
Lumbar osteochondrosis. . . It is characterized by abdominal reflexes and lower limb dysfunction. During the development of neurological disorders, muscle weakness in 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 developmental stage of the injury of the lumbar vertebrae, the shorter the period of time the patient can sit down. 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 ileum.
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 atrophy, muscle tone disorders, disorders of the autonomic nervous system (pallor, redness of the skin, trophic changes in the nails, cutaneous hypothermia in the distal extremities), sphincter dysfunctions and sexual dysfunctions.
Clinical picture
Diagnosticsbegins with a full 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, 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.
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 can be seen in the image. They can be penetrated by osteophytes between the vertebrae and joints.
If more information is needed, MRI is prescribed. MRI is used to visualize the soft tissues of the body. This is useful if the fabric core absorbs water or if there are cracks inside the disc. An MRI can show problems in other soft tissues, such as the spinal nerves.
The discography can help in the diagnosis. This examination is performed using a contrast agent, which is respectively injected into one or more discs. The subsequent display on the X-ray provides useful information on the condition 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 discomforts so that the patient can resume a comfortable standard of living as much as possible.
Doctors rarely prescribe bed rest for patients with osteochondrosis problems. Patients are encouraged to live in natural mobility when pain is not an issue. If symptoms are severe, several days of bed rest may be prescribed.
When the spine is moved, 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 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 limit the patient's activities, a conventional doctor may suggest an epidural steroid injection.
Steroids are powerful anti-inflammatories, they help relieve pain and inflammation. Injections of non-steroidal anti-inflammatory drugs 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 their 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 evaluating 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 minimal pain.
Surgery
People with osteochondrosis problems usually don't require surgical treatment. In fact, only 1-3% is usable. 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 lumbar region. Before removing a herniated disc, some of the plates must be removed.
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 the procedure prevents scarring around nerves and joints and helps patients recover faster.
Merge
It is an operation 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 consult 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 electricity can 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 the movements with ease.
Typically, treatment adjustment helps restore the sensitivity of the nerves and spinal 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 in order to prevent the development of this disease in himself 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 quite simple: it involves a healthy diet, regular muscle activity, daily morning warm-up, a healthy and active lifestyle, and a monthly visit.osteopathic sessionsfor the correction and removal of musculoskeletal tensions. Following these rules is enough to never face the above problem and avoid terrible symptoms and treatments for life.