Osteochondrosis is a degenerative-destructive lesion of the spine, which includes the loss of vertebrae, articular apparatus, ligament apparatus and intervertebral discs. This disease is quite commonly common in all countries - from 45 to 85% of the population suffers from this disease. The onset of osteochondrosis occurs in patients over 30-35 years, however, cases of an early onset of the disease are known. Men and women get sick with approximately the same frequency.
Causes
There is no unified cause of osteochondrosis development. There are a large number of predisposing causal factors. The main ones are as follows:
Spinal damage (fractures, bruises, displacements);
Hereditary predisposition;
Foot diseases that cause an overload of the spine - this includes flat feet, different foot deformity, valgus deformation of the foot;
Wearing tight and unpleasant shoes for a long time (also causes spinal cord overload);
Overweight and overweight;
Age -related changes;
Sedentary lifestyle;
Athletes who suddenly abandon their training and classes;
Metabolic disorders;
Spinal cord (kyfosis, lordosis, scoliosis);
Professional features - weight lifting, frequent curves and body insults, work in an unpleasant body position;
Frequent and prolonged hypothermia;
Stress;
A specific climate, both in the place of residence and in the workplace - low air temperatures and high humidity.
When exposed to one or more causal factors, the development of the disease begins. It is a habit to divide it into four main stages:
First stage. There is a decrease in the amount of moisture at the essence of the intervertebral disc, it becomes flat, the distance between the vertebrae decreases. The jump is covered with small cracks.
The second phase. Due to the reduction of the distance between the vertebrae, the muscles and the ligamental apparatus of the vertebrae occurs. This leads to the pathological mobility of vertebral bodies, to their displacements.
The third stage. Due to the progressive processes in the spine, the squeezing of the intervertebral discs occurs, the vertebra subluxation occurs.
Fourth stage. Between the vertebrae, bone points (osteophytes) appear, which are aimed at eliminating the mobility of the vertebrae, preventing displacements. Over time, there are so many of them that the affected beads completely lose their mobility. In this case, there is a trauma of blood vessels and nerves that pass near the vertebrae and remove from the spinal column.
In the early and final stages of clinical manifestation (pain) disease, the patient does not have.
ClaSSIFICaTION
There are many classifications of osteochondrosis. Every doctor chooses more acceptable for himself. The following classifications are most commonly used:
Classification for spinal loss:
Cervical osteochondrosis;
Chest osteochondrosis;
Lumbar osteochondrosis;
Crowning of osteochondrosis;
Wide osteochondrosis (common) - affects 2 or more spine.
Classification by the degree of change in the intervertebral disc (radiological stages):
0 Stage - there is no difference in disk;
First stage - small changes, including maximum internal tears;
2 stages - severe disk changes preserving the outer surface;
Stage 3-Disku is completely affected (cracks with spread to the outer surface, squeezing the disk from under the bodies of the vertebrae, etc. ).
Classification according to clinical manifestations and the degree of damaged spine function:
The first stage - the functioning of the spine has not changed, the patient feels a slight pain in the lesions;
2 stages - the functioning of the spine is disturbed (subluxuses of the vertebral bodies occur, extension disk, pinching of ners), pain in the site of destruction intensifies;
Stage 3 - the back is deformed, the hernia of the intervertebral discs occurs, significant pain;
Phase 4 - The patient is difficult to move, the mobility of the spine decreases, the pain during the slightest movement. The patient is given disability.
Symptoms of osteochondrosis
Symptoms of osteochondrosis depend on the field of spine damage and the degree of disorders that occur in it.
For the enlarged clinical appearance of cervical back osteochondrosis, the following signs are characteristic:
Violation of visual acuity;
Dizziness;
Tinnitus in the ears;
Flossial "flies" in front of the eyes and the appearance of colored spots;
Hearing loss;
Headaches in the Napa region, temporary and parietal, intensifying when moving the cervical spine;
Loss of consciousness;
Snoring;
Fierce voice or its weakening;
Numbness and loss of sensitivity to the skin of the face, neck and hands;
Teeth destruction;
Blood pressure board.
For osteochondrosis of the spine of the chest, the following symptoms are characteristic:
Heart pain, which lasts for a long time, painting or pressing, often sharp, sewn, sharp, patients may indicate a specific point of pain;
Numbness of the skin in the chest, abdomen and spine;
Back pain, especially between shoulder blades, strongly expressed;
Pain when raising your hands;
Pain with a sharp, deep spirit, and later join when you bring out;
Pain, discomfort and difficulty during the slope of the body in any direction.
The following symptoms are characteristic of lumbar and sacral back osteochondrosis:
Pain in the lumbar and sacral back area (lumbalgia), which can give to one or both feet, intensifying with any movement of the spine in the affected area;
The legs freeze at a comfortable temperature for other parts of the body;
Almost constant tension in the back muscles, especially the lumbar region;
A feeling of numbness, crawling of goose and tingling on the skin of the feet and buttocks;
Varicose veins in the legs;
Violation of power in men;
Increased sweating;
Fading the skin on the legs;
Irregular menstruation in women.
With prolonged and neglected osteochondrosis, when vertebra vertebrae affected with each other, the patient is only disturbed by the inability of movements in a particular spine, the pain, as a rule, is completely reduced or removed.
Troubleshooting
First of all, the doctor conducts a study and examination of the patient, creating a preliminary diagnosis. For confirmation, additional exam methods are assigned. With osteochondrosis, they are only instrumental, because the laboratory (tests) will not indicate any confirmative change.
The main diagnostic methods include the following:
Exam X -Ray. Allows you to determine the degree of damage to the vertebrae, their location, bone formations. By indirect methods, you can determine the condition of the bone channels and intervertebral discs;
Calculated tomography (CT). Allows you to determine the condition of the intervertebral discs, their structure and shape, the deformation of the vertebrae and the compression of the nerve endings and the roots;
Magnetic resonance imaging (MRI) images. Allows you to determine smaller violations on your back and is described in cases where controversial issues remain the post of CT;
Ultrasound procedure. Allows you to identify the rate of blood flow to the vessel that feeds the spinal cord and other organs;
Myelography. Spinal cord radiography method using a contrast. Allows you to identify intervertebral hernias.
The treatment of osteochondrosis
Conservative treatment
In the treatment of osteochondrosis, conservative methods of treatment are mainly used. In this case, the approach to each patient must be individual and complex. Conservative treatment methods can be divided into 4 main groups:
Drug treatment;
Physiotherapy;
Bath treatment;
Diet (basics of proper food).
Treatment of osteochondrosis drugs
The medicines used in the treatment of osteochondrosis should be used during periods of irritation. They contribute to a decrease in symptoms, and also affect several causal factors in the development of the disease. The main groups of medicines used in the treatment of osteochondrosis:
NSAID. Josteroidal anti -inflammatory drugs have anesthetic, anti -inflammatory effects, and also reduce the elevated temperature of the affected spinal tissue and its structures. With pronounced symptoms, the first days of deterioration of the disease are described in the form of injections. The frequency of use is 1-2 times a day. After that, they move to the forms of medication tablets with a 10-30-day treatment scale, if necessary. The frequency of acceptance is from 1 to 4 times daily. Also, along with tablets and injections, driving or creams are shown, which are applied to the skin in the spine area 1-3 times daily.
Musorelaxants. Preparations of this group make a great deal with the increase in muscle tone, relaxing the muscle fibers transversely and alleviating the patient's condition. On average, the course of treatment is about 1 month. With severe symptoms, treatment begins with drug injection forms. The dose should begin with minimal, gradually increasing until the therapeutic effect is achieved, after which it is also gradually decreasing to complete cancellation.
Some other groups are used as additional medicines:
Vitamins. Accelerate tissue restoration processes, normalize nerve conductivity, accelerate metabolism, etc. Almost always these medicines for osteochondrosis are prescribed in the form of injections, and for 10 days. These are vitamins B1, B2, B6, E.
Blood preparations. These medicines normalize the blood flow to the veins and arteries, restore the tone of the vascular muscles and restore metabolism. Most often the forms of release of tablets are used. The duration of treatment with these agents is from 1 to 3 months. Also, in extreme cases, the injection of the drug is possible for the first 5-10 days, with the subsequent transition to the tablets.
Glucocorticosteroids. They have anti -inflammatory, decongestant effects, increase the work of NSAIDs and muscle relaxants. Depending on the severity of the patient's condition, they are prescribed in the form of injections intramuscularly either inside, or in the form of tablets for oral administration. The course of treatment is individually selected, from several days to several weeks. Removal of the medicine should be done with a gradual dose decrease.
Biogenic stimulants. Accelerate metabolism, stimulate tissue restoration, reduce inflammation and swelling of the tissue and much more. It is most often used in injection and somewhat less common in the form of tablets or other forms for oral administration. The course of treatment can range from 1 week to 2-3 months, depending on the severity of the disease.
Physiotherapeutic treatment of osteochondrosis
Physiotherapeutic measures, combined with medicines, allow you to accelerate recovery processes and also extend the period of prayer when used outside the irritation. There are many methods of physiotherapy and most of them are well practiced in the treatment of osteochondrosis:
Electrophoresis. Depending on the drug used in this procedure, an analgesic effect is obtained. Metabolism improved and normalization of blood flow to the affected tissues.
Acupuncture (acupuncture). With the help of special needles best and their effects on the active points located on the patient's skin, an analgesic effect is achieved, the recovery and metabolic processes are stimulated, and the inflammation decreases.
Magnetotherapy. Reduces pain, swelling and inflammation of the tissues, accelerates nerve conductivity, normalizes metabolic processes
Manual therapy. Mobility has returned to the spine joints, the pain syndrome decreases.
Massage normalizes muscle tone, eliminates back pain, restores nerve conductivity.
Exercise therapy. Restoring spine mobility, a decrease in pain, restoration of the usual lifestyle, strengthening the muscle frame of the back, relaxing the back muscles, accelerating metabolism.
Pulling of the spine. Spine mobility has been restored, prevents the progression of the disease and the development of complications and anesthesia.
Laser therapy. Improves blood supply, stimulates tissue regeneration, reduces pain and inflammation, reduces swelling of the spine.
Thermotherapy. The anesthetic effect, normalization of blood flow and lymph through the blood vessels, a decrease in inflammation in the tissues, acceleration of cartilage restoration.
Mudreat (peloid therapy). Reduces back pain, reduces muscle spasm, slightly reduces inflammation processes, improves blood supply and metabolism.
A patient can be prescribed for 1 physiotherapeutic event and their complex. It depends on the severity of the osteochondrosis process and the accompanying pathologies. The duration of the treatment flow on average is 10-15 days. It is recommended to repeat 3-4 times a year. Thus, it is possible to reduce the frequency of irritation and the degree of advancement of osteochondrosis several times.
