Osteochondrosis is a chronic recurring disease that occurs against the constant destruction background of vertebrae and intervertebral discs.Depending on the location of vertebrates subjected to degenerative changes, they distinguish between breast, lombosacral pathology and the neck.The main symptoms of osteochondrosis are pain, whose severity increases during physical exertion, rigidity of the movements.In the clinical image, there are often vertebral signs: headaches, heels in blood pressure, a decrease in acuity and visual hearing.
The diagnosis is based on the results of instrumental research - radiography, magnetic resonance imaging, CT.In osteochondrosis therapy, medicines from various clinical and pharmacological groups are used.To increase your clinical efficiency, physiotherapeutic and massage procedures are performed.One of the main methods of therapy and prevention is physiotherapy exercises.
The mechanism for the development of the disease
Pathogenesis of osteochondrosis is based on pulposus loss by the core of its hydrophilic properties.This semi -liquid structure consists of connective tissue fiber and jacket.As a person grows, there is a decrease in the vascular canal on each disc between the vertebrae.Nutrient intake occurs diffusely, that is, according to the principle of spontaneous leveling of concentrations.This explains the impossibility of a complete restoration of cartilaginous tissues after injury or excessive physical exertion in the spine spine.
Osteochondrosis processes aggravate changes in hormonal background and an unbalanced diet.The amount of nutrients sufficient for all its operation does not enter the tissue of the cartilage, which causes the following disturbances of its structure and properties:
- Strength and elasticity are lost;
- The form, consistency and change of configuration.
Intervertebral discs are flat and radial cracks are formed in fibrous rings.This causes a reduction in distance between neighboring vertebrae.Gradually, the connective tissues of rings and fibrous ligaments are involved in the pathological process.In response to tissue deterioration, the immune system begins to produce immunoglobulins, which leads to aseptic inflammation and the formation of edema in the joint joint and in the nearby tissues.Joint capsules are stretched;Therefore, intervertebral discs fail to securely fix the vertebrae.And with the instability of intervertebral segments, the likelihood of nerve root violation or blood vessel squeezing increases.This usually occurs with cervical osteochondrosis and causes its pronounced symptoms.
Causes and provocative factors
In the state of intervertebral discs, the small tone of the skeletal muscles of the spinal column affects adversely.Irrational and asymmetrical functioning of the muscles occurs with a prolonged person in a non -physiological position, for example, with a head down while working on the computer.The destruction of cartilaginous tissues can be caused by the constant use of a heavy bag in a shoulder, a dream in a soft mattress and a tall pillow.
The following external and internal negative factors also accelerate the destruction of intervertebral discs:
- endocrine and metabolic disorders;
- infectious, especially chronic pathologies;
- preceding lesions in the spine (compression fractures, bruises);
- frequent hypothermia;
- The presence of systemic or degenerative-degenerative diseases, rheumatoid arthritis, psoriatic, osteoarthritis, osteoporosis.
If a person has bad habits, he is at risk.Smoking and alcohol abuse worsen the state of blood vessels, lead to insufficient blood circulation and nutrient deficiency in disc cartilage tissues.
In the presence of flat feet or club feet, the risk of developing osteochondrosis of any location increases significantly.Such congenital or acquired defects become the reason for increasing the load in the spine, due to the impossibility of ensuring proper depreciation with the support.The factor that predisposes to the emergence of pathology is obesity.
With the deposition of adipose tissues in various parts of the body, support for balance is complicated, which leads to the effects of excessive loads on the intervertebral joints.
Clinical image
The first clinical manifestation of cervical, thoracic or lumbar osteochondrosis is back pain.During the relapses, it is permeating, radiating to the near the body.Lower movement leads to an increase in the severity of pain syndrome.A person's answer is the adoption of a forced position in which the intensity of uncomfortable sensations is minimal:
- People with cervical osteochondrosis prefer to divert their heads, but the whole body;
- With a breast pathology, a person is afraid to breathe in total, as this becomes the cause of acute pain in the thoracic region;
- Patients with lumbar osteochondrosis are difficult to sit, get up and leave due to the violation of the spinal nerve.
Most patients complain to the doctor about stupid constant pain and a sense of restrictions on movements in the morning.This requires additional differential diagnosis to exclude myositis (inflammatory process in the skeletal muscles of the back) and osteoarthritis.The reason for the appearance of painful pain is compensatory stress of muscle tissue to stabilize the affected vertebral engines segment.The constant pain syndrome of weak or medium gravity also occurs due to a significant part of the intervertebral disc and the development of aseptic inflammation.
For osteochondrosis of a certain location, specific symptoms are characteristic.For example, with lumbar pathology, lumboyshialgia usually occurs - an attack of pain in the lower back and back of the thigh.Toracic osteochondrosis is clinically manifested by visceral pain in the heart, the right hypochondrium, stomach, numbness, increased skin sensitivity, vertebra crocnce.But the most pronounced and diverse symptoms are distinguished by a pathology that affects cervical intervertebral discs.
As a result of the displacement of the vertebrae, the formation of osteophytes, the vertebral artery is compressed, which feeds the brain cells, which provides them with oxygen.One person suffers from violation of movement coordination, noise in the ears, headaches and hypertension.
What can be in the absence of treatment
Most complications of osteochondrosis occurs due to intervertebral hernia formation.It is formed when this vertebral structure is displaced, which leads to a rupture of the posterior longitudinal ligament.The disk becomes even more unstable and part of it projects on the cephalorean channel.A hernia is considered an explosion if, in the process of its formation, along with the disc, its purpose core penetrates the channel.
This pathological state of vertebrates predisposes to the compression of the spinal cord and the development of discogenic myelopathy.Clinically, it manifests itself in numbness, the weaknesses of some muscle groups of legs or arms, paresia, muscle atrophy, a change in the tendon's reflexes.Emptying the bladder and (or) intestines can also be observed.As a result of the formation of intervertebral hernia, the arteries that feed the spinal cord are squeezed.Ischemic areas are formed in which all nerve cells were killed.The neurological deficit called occurs - the movements are violated, sensitivity is reduced and Trothy is upset.
Treatment tactics
Osteochondrosis does not lend itself to complete healing, as so far the medicines have not yet been synthesized, whose intake would help restore intervertebral discs and damaged vertebrae.But the therapeutic schemes necessarily include Condroprotectors - Symptomatic Slow Action Agents.Preference is given to drugs with active chondroitin ingredients with sulfate and (or) glucosamine sulfate (hydrochloride).
The clinical effectiveness of these drugs is confirmed by the results of many years of research.With prolonged admission (from 3 months to 2 years), partial regeneration of cartilaginous tissues, as well as other connective tissue structures - ligaments, tendons, bournes occurs.As they accumulate in the intervertebral discs of glucosamine and chondroitin, they begin to exert a pronounced, decongestant and anti -inflammatory analgesic effect.This allows you to reduce the doses of NSAIDs, glucocosteroids, muscle relaxants, thus reducing the pharmacological load in the body.
The medications for the joints are ineffective with irregular use or its use for the treatment of 3rd degree osteochondrosis, when a significant destruction of cartilage tissues is observed.
To eliminate symptoms that usually occur with cervical or mammary osteochondrosis, medications are used to improve blood circulation, nootropic, a drug that improves maze microcirculation used for the pathology of the vestibular apparatus.
If necessary, antidepressants, anticonvulsants are included in therapeutic schemes.
In the treatment of osteochondrosis, physiotherapeutic procedures are used: UHF therapy, magnetotherapy, laser therapy.Reflexotherapy, massage, exercise therapy, hirudotherapy, swimming, yoga are used.With the ineffectiveness of conservative treatment, the patient is shown surgical intervention.Practices are practiced by the disc, their laser reconstruction or implant replacement.