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 spine, during this pathological process the discs of the spine are often affected. The structures, which are intervertebral cartilaginous discs, provide flexibility, and also enable the movement of the human spine, that is, they enable movement.
With osteochondrosis, a number of processes occur that cause degeneration of the vertebral discs, as a result of which they begin to lose elasticity and reduce the degree of flexibility, and at that time the disc itself becomes quite flat. The distance between the two discs decreases, while it compresses the nerve endings and blood vessels and causes severe pain. The place of compression of the nerve node begins to swell, which leads to increased pain and even greater injury.
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 mobility of muscles and organs are disrupted. For example, the most common osteochondrosis is cervical osteochondrosis accompanied by back pain, nausea, dizziness, visual impairment, and frequent 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 endangered category of people are those who have seriously disturbed metabolism and hormonal levels of the body, as well as people who have disorders of a vascular-venous nature. This is due to the fact that these diseases cause a disorder of disc oxygenation. If timely healing measures are not taken, the edges of the affected intervertebral disc, which is compacted, will anatomically protrude beyond the boundaries of the spinal column, 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 in places 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, like our hair. Major 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. 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 also be triggered by various factors:
- injuries, bruises;
- spinal muscle dystrophy;
- bending and curvature of the spine;
- weightlifting;
- extended stay in one position;
- metabolic disease;
- lack of trace elements and vitamins - manganese, magnesium, zinc and vitamins D and F;
- hereditary predisposition;
- physical overload;
- inactive lifestyle;
- background radiation;
- frostbite;
- congenital dystrophies;
- asymmetric work of the spinal column muscles;
- stress, depression.
These causes of osteochondrosis are just assumptions of scientists, direct factors that cause the disease, science has not yet found, and we are talking only about risk factors.
The first perioddevelopment - characterized by early placement of the intradiscal nucleus pulposus (the nucleus pulposus of the eccentric intervertebral disc, located along the dorsal part of the spine).
Another periodcharacterized by the appearance of spinal segment instability. Pathological substrates are represented by the fibrous nucleus of the affected disc with degenerative processes of take-off and fragmentation of the posterior longitudinal ligament, pathological movements between the vertebrae develop.
The third perioddevelopment of the disease - total damage to the intervertebral disc, with the appearance of a "disc herniation" - dislocation 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 deep disability.
Types of osteochondrosis
The evolution of osteochondrosis is slow, with worsening caused by spinal injuries, exercise, carrying weights, etc. The clinic depends on the location of the lesion.
Osteochondrosis of the cervical spinehas local and distant symptoms of advanced forms - with loud dominance of the roots, that is, contributes to the development of severe radicular pain. Symptoms of osteochondrosis in the cervical spine are accompanied by varying degrees of dysfunction, which is sometimes manifested in a sudden limitation of cervical spine mobility and functional blocks. Headaches can be traction and paroxysmal in nature with irradiation to the interscapular region or shoulder. In the acute period, patients are diagnosed with attacks of neck pain that interfere with and impede the movement of the head and neck. With severe discomfort, the pain syndrome may be accompanied by dizziness, insomnia, pain, loss of appetite, depression, eye and throat diseases.
Osteochondrosis of the chest. . . Clinical manifestations are due to local lesions and the process of destruction of the nerve root structure. 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, all the way to atrophy of the right verbal muscle. Chest pain can manifest as diffuse, intercostal, and neuralgic. Palpation enhances the axial rotation of the vertebral body. The disorders correspond to the level of root irritation from Thl1 to Thl2 and can manifest as angina pectoris, which is reflected in liver and gastrointestinal tract dysfunctions. Disorders of the genitourinary system and genital area often occur. Patients notice sensory disorders such as paresthesias, superficial and deep sensitivity is significantly reduced.
Lumbar osteochondrosis. . . They are characterized by abdominal reflexes and dysfunction of the lower extremities. During the development of neurological disorders, dysfunction of the muscles in the legs and pelvic organs can occur. Osteochondrosis is characterized by the assessment of damage to the sitting process. The more advanced the stage of development of the lumbar spine lesion, the shorter the period of time 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 back of the 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 (for example, the Achilles reflex is absent), muscle wear, muscle tone disorders, autonomic disorders (paleness, redness of the skin, trophic changes on the nails, hypothermia of the skin on the distal extremities), sphincter dysfunction and sexual dysfunction are also characteristic.
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 radiographic images show abnormalities in the early stages of disease development.
However, if the symptoms are severe, and the disease is already in the second or third phase, defects can be seen on one or more intervertebral discs. Osteophytes between the vertebrae and joints can penetrate them.
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 nucleus 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 in the diagnosis. This examination is performed using a contrast agent, which is injected into one or more discs. 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
Whenever possible, doctors prefer non-surgical treatment. The most important thing in non-surgical treatment is to alleviate pain and other discomforts so that the patient can continue with 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 a problem. If the symptoms are severe, a few days of bed rest may be prescribed.
When the spine is moved, 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 appointments provide serious relief from osteochondrosis.Osteopathic doctornot only diagnoses the 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 to resume normal activities for extended periods of time. If symptoms continue to limit the patient's activity, a conventional physician may suggest an epidural steroid injection.
Steroids are powerful anti-inflammatory drugs that help relieve pain and inflammation. Nonsteroidal anti-inflammatory injections are injected into the area around the spinal root of the spine. This place is called the epidural space. Some doctors inject the steroid themselves. However, it is most often combined with other medications. Basically, steroids are prescribed only when other medications 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 goal of the exercise program is to improve flexibility and is useful for training the abdominal and back muscles to allow movement with the least pain.
Surgery
People with osteochondrosis problems usually do not need surgical treatment. In fact, only 1-3% is operable. Surgeons prescribe non-surgical treatment, namely craniosacral osteopathy, as rehabilitation therapy, at least 3 months before considering surgery. If after 3 months of non-surgical treatment there are no results, only then are there reasons that indicate 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 surgery by cutting on the lumbar region. Some tiles need to be removed before removing the disc herniation.
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.
Connect
It is an intervention that connects two or more bones into one, preventing wear and tear on the ends of the bones and joints.
Rehabilitation
The doctor may recommend that the patient see 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 positions and movements that relieve pain. Heat, cold, ultrasound, and electrical stimulation may be prescribed to relieve pain and muscle cramps. Massage or specialized forms of soft tissue mobilization can also be used. These procedures help the patient to perform movements with ease.
Typically, adjusting the treatment helps 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 advised through 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 themselves and their loved ones. Finally, 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 remedy is prevention. . .
Prevention of osteochondrosis
Prevention is quite simple - it's 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. Adherence to these rules is enough to never face the above mentioned problem and avoid terrible symptoms and lifelong treatment.