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 vertebral cartilage, during this pathological process, the spinal discs are often affected. The structures, which are the intervertebral cartilage discs, provide flexibility and also allow the movement of the human spine, i. e. 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 as it compresses the nerve endings and blood vessels and causes severe pain. The site of compression of the nerve node begins to swell, which leads to an increase in 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 movement of muscles and organs are disturbed. For example, the most common osteochondrosis is cervical osteochondrosis, which is associated with pain in the back of the head, nausea, dizziness, impaired vision, and often tinnitus. This disease has become quite "new": a century ago, osteochondrosis was a disease of people of gerontological age, and today young people are also susceptible to it.
The most sensitive category of people are those who have severely impaired metabolism and hormonal levels of the body, as well as people who have disorders of vascular-venous nature. This is due to the fact that these diseases cause disruption of disc oxygenation. If they qualify, no timely measures are taken to heal, then the ends of the affected intervertebral disc, which is compressed, will protrude anatomically beyond the boundaries of the spine, thus destroying neurovascular bundles.
Because of this, the patient risks having a disc herniation. The main, 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. Intervertebral discs change with age, as does our hair. Major injuries or fractures of the spine can affect their functioning. Casual wear and certain types of vibrations can also accelerate the degree of spinal degeneration. In addition, 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 be caused by a number of factors:
- injuries, bruising;
- spinal muscular dystrophy;
- flexion and curvature of the spine;
- weight lifting;
- prolonged stay in one position;
- metabolic diseases;
- 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 spinal muscles;
- stress, depression.
These causes of osteochondrosis are just the assumptions of scientists, direct factors that cause the disease, science has not yet found them and we are only talking about risk factors.
The first perioddevelopment - is characterized by the early placement of the intradiscal pulposus nucleus (pulposus nucleus of the eccentric intervertebral disc, located near the dorsal part of the vertebra).
The second periodcharacterized by the appearance of spinal segment instability. Pathological substrates are represented by the fibrous nucleus of the disc affected by degenerative processes of erection and fragmentation of the posterior longitudinal ligament, pathological movements develop between the vertebrae.
The third perioddevelopment of the disease - total damage of the intervertebral disc, with the appearance of "disc herniation" - displacement and protrusion 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 evolution of osteochondrosis is slow, with exacerbations caused by spinal cord 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 strong root dominance, i. e. contributes to the development of severe radicular pain. Symptoms of osteochondrosis in the cervical spine are associated with varying degrees of dysfunction, sometimes manifested in a sudden restriction of mobility of the cervical spine and functional blocks. Headaches can be attractive and paroxysmal in nature with radiation to the intercapsular or shoulder region. In the acute period, patients are diagnosed with attacks of neck pain, which impede and inhibit the movement of the head and neck. In addition to severe discomfort, pain syndrome may be associated with dizziness, insomnia, pain, loss of appetite, depression, eye and pharyngeal diseases.
Chest 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 may have a chronic or acute nature of back pain with chest discomfort and limited muscle contracture, up to atrophy of the right oral muscle. Chest pain can appear as diffuse, intercostal and neuralgic. Palpation increases the axial rotation of the vertebral body. The disorders correspond to the level of root irritation from Thl1 to Thl2 and may appear as angina pectoris, reflected in liver and gastrointestinal tract dysfunctions. Disorders of the genitourinary system and genital area often occur. Patients notice sensory disturbances such as paresthesia, superficial and deep sensitivity is significantly reduced.
Osteochondrosis mesit. . . It is characterized by abdominal reflexes and dysfunction of the lower extremities. During the development of neurological disorders, weakness of the leg muscles and dysfunction of the pelvic organs may occur. Osteochondrosis is characterized by the assessment of damage to the lowering process. The more advanced the stage of development of the lumbar vertebral lesion, the shorter the period of time that the patient can sit. Lumbar forms are characterized by chronic and acute back pain, paravertebral muscle spasms, and secondary myofascial syndromes. The pain radiates to the buttocks and back illum.
Depending on the localization of the pathological process of osteochondrosis, the disease can lead the patient to a violation of superficial sensitivity (tangible, thermal). Also characteristic are changes in reflexes (for example, the Achilles reflex is absent), muscle loss, disorders of muscle tone, autonomic disorders (paleness, redness of the skin, trophic changes in the nails, hypothermia of the skin in the extremities), mosfunmuscular muscle and sexual dysfunctions.
Clinical photo
Diagnosingbegins with a full 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 cause the pain. Skin sensitivity, muscle strength and reflexes are tested equally. Based on 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 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 look at the soft tissues of the body. This is useful if the tissue nucleus 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 with the diagnosis. This examination is performed using a contrast agent, which is injected into one or more discs, respectively. Subsequent viewing on radiography 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 the relief of pain and other concerns 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 motion when the pain is not bothersome. If the symptoms are severe, a few days of bed rest may be prescribed.
When the spine is displaced, an elastic band is sometimes prescribed, which is worn for no more than 2-4 days in order 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 internal organs.
Patients may be prescribed medication to control symptoms and resume normal activities for a long time. If symptoms continue to limit the patient's activities, a conventional physician may suggest an epidural steroid injection.
Steroids are powerful anti-inflammatory drugs, helping to relieve pain and inflammation. Non-steroidal 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 steroids only. However, it is most often combined with other medications. Basically, steroids are only prescribed when other drugs are ineffective, but osteopathy almost always helps.
Moreover, 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 useful for training the abdominal and back muscles to allow movement with less pain.
Surgery
People with osteochondrosis problems usually do not require surgical treatment. In fact, only 1-3% are operable. Surgeons prescribe non-surgical treatment, namely craniosacral osteopathy, as a 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 that indicate a surgical procedure.
Basic surgical procedures
Discectomy
The procedure aims 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 herniated disc, it is necessary to remove some of the plaque.
Today, surgery has mastered minimally invasive techniques that require only a small incision in the lumbar region. Proponents of her case have been working to make the actual transcript of this statement available online. They also believe the procedure prevents scarring around nerves and joints and helps patients heal faster.
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It is an intervention that joins two or more bones into one, preventing the consumption of bone and joint endings.
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The doctor may recommend that the patient visit 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 the symptoms. The therapist will work with you to find positions and movements that relieve the pain. Heat, cold, ultrasound and electrical stimulation can be prescribed to relieve muscle pain and spasm. Massages or specialized soft tissue mobilization forms may also be used. These procedures help the patient to perform movements with ease.
Typically, treatment adjustment helps restore the sensitivity of the spinal nerves and muscles, reducing pain and improving movement.
The main purpose of therapy is to teach the patient how to manipulate to prevent problems in the future. The patient will be advised a series of exercises to improve flexibility. The patient will also be given a strategy to help in case of recurrent symptoms.
Every person should study and consider all types of osteochondrosis in order to prevent the development of this disease in him and his loved ones. After all, treatment of ruptured vertebrae is impossible, therapy aims to relieve pain symptoms and achieve 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's a healthy diet, regular muscle activity, daily warm-up in the morning, a healthy and active lifestyle and a monthly visit.osteopathic sessionsfor the correction and removal of musculoskeletal tension. Following these rules is enough to never face the aforementioned problem and avoid horrible symptoms and lifelong treatment.