Osteochondrosis is a chronic disease of articular cartilage in which degenerative-dystrophic disorders occur in them. Pathology can develop in any joint, but the vertebrae most often suffer. With such dystrophic changes in the disk, the outer fibrous ring weakens and damage occurs: protrusion (bulging of the pulp of the disk) and intervertebral hernia (drooping of the pulpous nucleus of the disk into the spinal canal).
This diagnosis was first made 100 years ago. In such a short period, pathology has become so widespread that it is considered a disease of the century. After 30 years, every second person has vertebral problems, and this is not just about the elderly. Osteochondrosis is "getting younger", it is often diagnosed even in adolescents and youths - at 15-20 years old. In these cases, complications occur after 35-40 years. In 70% of cases, pain in the spine is caused by osteochondrosis. The development of pathology is gradual.
Anatomical features of the spine
Between the vertebral bodies is an intervertebral disc. In its center is a gelatinous core with high elasticity. It is surrounded by a fibrous ring (very dense). The function of the disc is that it connects the vertebral bodies. They, in turn, have processes of the upper and lower, forming joints between the vertebrae.
Vertebral movements go around the discs. During tilting and straightening, the discs are squeezed slightly forward or backward, respectively. Degeneration violates this process.
Another function of the disc is spring. It redistributes the load exerted on the spine. It can be compared with a robust and reliable hydrostatic system, which is capable of heavy loads. During degeneration, disk height and resistance to stress are markedly reduced.
In addition, the strength of the spine is provided by the ligaments. They hold the spine in a certain position.
Muscles provide not only movement, but also maintain a constant normal configuration of the spinal column. Normally, the spine has 4 bends: cervical and lumbar lordosis (forward bend), thoracic and sacral kyphosis (backward bend). If the posture is impaired, osteochondrosis develops faster.
Nerve endings and blood supply
Spinal roots are bundles of nerve fibers that exit through the intervertebral foramen. Along with them come the spinal arteries. In osteochondrosis, when the height of the discs is less than normal, the lumen of these holes decreases, and nerves and arteries are compressed. A similar condition provokes inflammation.
Why does osteochondrosis most often develop in the cervical and lumbar spine?
Osteochondrosis affects the most mobile parts of the spine - the cervical and lumbar. In the thoracic region, the vertebrae are connected by ribs and do not possess mobility. The terminal spine is a fusion of bones, and there are no displacements.
Pathogenesis
Osteochondrosis is more often observed among lovers of a passive lifestyle. In this case, the spine is in an unnatural position for a long time, the posture is disturbed, the muscles work asymmetrically. Also, insufficient warm-up, carrying bags on the shoulder, and the use of soft pillows and mattresses contribute to this. There is degradation of the spinal muscles, the nutrition of cartilage tissue suffers. This is the root cause of osteochondrosis.
After injuries and loads, it becomes difficult for tissues to recover. Cartilage not only loses its elasticity and strength, it changes its consistency and shape.
Causes
The development and exacerbation of osteochondrosis contribute to overload static and dynamic, back injuries, exposure to vibrations.
Causes of an early illness:
- lack of physical fitness;
- scoliosis and poor posture;
- flat feet and obesity.
Main reasons:
- hereditary predisposition;
- impaired metabolism;
- malnutrition;
- physical inactivity;
- weight lifting and excessive physical activity;
- prolonged uncomfortable posture for the spine;
- wearing high heels and pregnancy;
- professional sports (upon termination of training);
- stress
- smoking.
Disease classification
Degrees of osteochondrosis:
- At the first stage, diagnosis is difficult due to the severity of symptoms. They are too blurry: general malaise, discomfort in the back. All this is sluggish and looks like overwork. The detection of pathology is usually random.
- The second stage of osteochondrosis - pain appears, as the process of destruction of the cartilage starts. If untreated, the intervertebral fissures narrow and the nerve endings begin to compress. With them, lymph vessels and arteries are compressed. Pain is still relieved by analgesics. Patients see a doctor.
- The third stage - changes in the spine become fixed. Various curvatures of the spine occur, there is no complete cure, but it is possible to minimize the destruction.
- The fourth stage is the fossil of the joints. Often the patient is disabled. Irreversible changes in the spine lead to the fact that pain occurs with the slightest movement. The cartilage is compacted, the vertebra moves and osteophytes appear - the growth of bone tissue.
Symptomatic manifestations
The course of the disease is characterized by exacerbations and remissions. Exacerbations are provoked by physical exertion. Patients noted aching back pain, aching and numbness in the arms and legs. With movements, the pain intensifies. If treatment is not carried out, the muscles atrophy and the person loses weight.
Cervical Osteochondrosis (SHOX)
It makes up 50% of all types of osteochondrosis. It is expressed by pains in the neck, shoulders, arms, numbness of the fingers, migraine attacks for up to 10 hours in a row.
Perhaps the development of SPA syndrome (vertebral artery syndrome), which occurs against the background of brain hypoxia due to pinching of the vertebral artery. This is expressed by vestibular disorders in the form of noise in the head, flickering spots and flies in front of the eyes, a pulsating burning headache.
What to do with osteochondrosis of the cervical spine and how to eliminate pain? The main method is the use of non-steroidal anti-inflammatory drugs. As an addition, physiotherapy, wearing a Shants collar is shown.
The causes of headache in osteochondrosis are compression of the occipital nerves and increased intracranial pressure. Dizziness joins this.
What to do - dizzy with cervical osteochondrosis? You can do self-massage - knead the painful area with your hands in a circle. Begin and end the massage with warming strokes.
Forms of Cervical Osteochondrosis
SHOH can be classified by the localization of pain:
- cervicalgia - only in the neck;
- cervicocranialgia - in the neck and head;
- cervicobrachialgia - in the neck and shoulder girdle, arm;
- sciatica - damage to nerve roots and blood vessels.
What to do with osteochondrosis of the cervical spine with these symptoms? Complex treatment is necessary at the first signs of the development of pathology. It includes not only medicines, but also massage, , exercises, etc.
Thoracic osteochondrosis
With thoracic ostechondrosis, pain first appears in the back and between the shoulder blades. Later it spreads to the shoulder girdle, chest, lower back. By nature it is burning or stitching, makes breathing difficult due to its intensity.
Pain in the chest increases with physical exertion, prolonged stay in one uncomfortable position. Patients often note that at night during sleep, the back seems to be "squeezed by ticks."
A very clear symptom is a violation of skin sensitivity, vascular disorders (spasm of the vessels of the legs). Paresthesias appear in the legs in the form of goosebumps, tingling sensations, the skin turns pale and colder.
Characterized by pain in the heart, which intensifies during exertion. They resemble an attack of angina pectoris, occur directly in the heart.
Osteochondrosis of the lumbar spine
Lumbar osteochondrosis also occupies 50% of all diagnosed pathologies.
A disease appears in the lumbar as follows:
- Dull, pulling pains are easily provoked by a prolonged stay in an uncomfortable position, physical overload, hypothermia. They are localized from the lower back to the tips of the toes. Often, because of pain, it is difficult for the patient to straighten out.
- Lumbago - lumbar backache - severe pain during physical exertion, especially when lifting a load. Lasts hours or days.
- Violation of skin sensitivity - decreases or rises in the lower back, buttocks, legs.
- Paresthesia - the muscles weaken, their tone decreases, the result is atrophy.
- Vascular disorders - with pain and changes in atmospheric pressure, the skin of the legs turns pale, turns blue and becomes cold. The pains are itchy, stitching.
With lumbosacral osteochondrosis, pelvic disturbances join these symptoms:
- frequent urination;
- urinary incontinence or retention;
- problems with erection in men.
Another specific symptom is coccygodynia, damage to the tailbone.
A common or expanded osteochondrosis of the spine is a lesion of 2 or more parts of the spinal column. It occurs in 12% of patients. The most severe form.
Complications
Complications of osteochondrosis include: protrusion, disc herniation (intervertebral hernia), kyphosis, radiculitis, spinal stenosis.
Osteochondrosis leads to muscle atrophy and disability. Protrusion - protrusion of the pulpous nucleus. After it in the subsequent intervertebral hernia occurs. In parallel, the patient has an increase in osteophytes.
When squeezing the vertebral arteries, hypoxia of the brain, arrhythmias, and swallowing and breathing disorders develop. Hearing and vision, coordination of movement, etc. also deteriorate.
Treatment
The main ones in the diagnosis are X-ray, CT, MRI. Osteochondrosis is not completely cured. Only prolongation of remissions, adherence to progressive dystrophic changes and leveling of symptoms are possible.
Conservative Therapy Methods
A conservative treatment is complex. Successful as a rehabilitation after surgery.
It is based on medication, hardware therapy (exercise therapy, massage, spinal traction (traction), , manual therapy, kinesiotherapy, underwater hydromassage, physiotherapy), diet. Surgical intervention is prescribed according to indications.
What to do with breast osteochondrosis:
- physiotherapy - stimulation of the body with magnets, vibration and electricity;
- laser and ultrasound treatment;
- Ural federal district;
- vacuum therapy;
- electrophoresis.
Active treatment lasts 1-3 months with a conservative method, the rehabilitation period takes almost a year.
What to do with osteochondrosis of the lumbar with exercise therapy? Exercise therapy, kinesitherapy consists in creating moderate doses of loads that relieve compression of the nerve roots, strengthen the muscle corset, increase range of motion and improve posture, preventing complications.
What to do with osteochondrosis of the cervical spine yet? Exercises; only it is important to remember that with this pathology it is impossible to touch the neck. This can compress blood vessels and nerves even more.
Daily exercises are simple:
- With your head tilted forward, with your woven fingers you need to push on the forehead, then alternately on the back of the head, left and right temple.
- Sitting on a chair straight, slowly tilt your head back and push the chin from the bottom up. Then try to reach the chest with the chin, head down. Hands at this time are on the back of the head and gently press on the head. After that, move your shoulders up and down.
Massage is a dosed mechanical manual action on the soft tissues with friction, pressure, vibration, which is performed by the masseur. This is another answer to the question: what to do with breast osteochondrosis? Massage effectively relieves muscle spasm, pain, improves blood circulation. The movements of the masseur should be careful and smooth.
Manual therapy is a more rigid, individually selected action by the hands on muscles, ligaments and bones. It not only helps relieve pain, but also restores the function of the affected joints. It is also used to correct posture.
If there are pains with osteochondrosis, what to do - the doctor decides. In addition to the methods described above, spinal traction (traction) or autogravity therapy (creating traction that provides spinal traction in a specific area using special equipment) is effective. At the same time, the spine restores its anatomically correct shape.
Preparations for osteochondrosis
Pain in osteochondrosis - what to do, what means to use:
- NSAIDs are non-steroidal anti-inflammatory drugs: Ketonal, Diclofenac, Ibuprofen, Ketoprofen, Nimesulide, Indomethacin, Milgamma, Ibuprofen, Ketorolac.
- Vitamins of group B, D, E, A, C; calcium, phosphorus.
- Vasodilator drugs to improve microcirculation (Xanthinol nicotinate, Pentoxifylline, Actovegin, Trental), etc.
What to do - headache with osteochondrosis? In this case, nonsteroids and analgesics (Baralgin, Analgin), muscle relaxants help.
Vitamins
If you feel dizzy with osteochondrosis - what should I do? In this case, vitamins of group B help well. They activate the immune system, strengthen bones, and prevent osteophytes from growing.
Chondroprotectors
They must accumulate in the body, so they must be taken for at least 3 months. In large doses, they are hepato- and enterotoxic, therefore, patients are recommended to take probiotics in parallel.
What to do with osteochondrosis of the spine for pain? In this case, analgesic injections help, but this is only a symptomatic effect. Their use is justified for severe pain, when other means are not at hand.
Antispasmodics
The most effective ones are Midokalm, Sirdalud (Tizanidine), Baclofen, etc. These drugs relieve pain by eliminating muscle spasm. Effective as an injection.
What to do with exacerbation of osteochondrosis? In such cases, blockades are placed - an anesthetic is injected into the affected area. This is the most effective way to get rid of acute pain. The procedure is exclusively medical. The blockade is only an ambulance, but not a cure.
Ointments for osteochondrosis
What to do with osteochondrosis? For local exposure, ointments, creams and gels of various effects are used:
- Anti-inflammatory - Nurofen, Voltaren gel, Ketonal, Ibuprofen ointment, etc.
- Warming and painkillers - Nikoflex, Capsikam, Finalgon, etc.
- Complex - "Dolobene" or "Fitobene".
- Homeopathic - “Sabelnik”, “Zhivokost”, “Target T”, “Traumeel”, “Shungit”, etc.
With cervical osteochondrosis, ointments do not help.
Surgery
Indications for surgery:
- complications of osteochondrosis in the form of disc hernias, subluxations of the vertebrae, spondylolisthesis;
- pelvic disturbances;
- ponytail syndrome - pinching of the nerve bundle of the terminal spinal cord;
- constant pain, frequent exacerbations, impaired sensation and movement.
Types of operations for osteochondrosis
For the treatment of osteochondrosis, several types of operations are used:
- Foraminotomy - expansion of the intervertebral foramen.
- Laminotomy is an expansion of the spinal canal.
- Discectomy - removal of the intervertebral disc and replacing it with an artificial one.
- Corpectomy - complete removal of the vertebra and the installation of a bone graft instead.
- Fusion - the creation of a fixed connection of the vertebrae with each other.
IRT
This method consists in exposing the active points to needles. The production of intrinsic endorphins with analgesic properties is stimulated. The success of the treatment depends on the skill of the acupuncturist.
What to do with pain of cervical osteochondrosis? To resort to the help of . Acupuncture normalizes hormonal levels, especially the production of cortisol, a powerful analgesic.
Bed for the patient
What to do with osteochondrosis for sleep? It is recommended to choose orthopedic mattresses and pillows, as the muscles and spine should completely relax. To do this, sleep should be in the fetal position. With cervical osteochondrosis, the patient’s head should be on a small pillow, and the shoulder rests on a hard mattress.
What to do with lumbar osteochondrosis? You should sleep on your back with a roller under your knees. You can’t sleep on your stomach. The bed and mattress should be even.
What can not be done with osteochondrosis? It is strictly forbidden to use a hydromat, feather bed, soft pillows and bed, to sleep on a cot.
Can osteochondrosis be cured at home?
What to do with osteochondrosis at home? At home, you can only follow a diet. Unfortunately, at home there are no special medical equipment and simulators, often there are psychological problems. Such treatment is unlikely to be complete.
Prevention Methods
What to do with osteochondrosis? The most effective way is to observe the proper diet and gymnastics. In order not to harm the spine, you can not carry a load heavier than 15 kg. For hard work, wear a corset.
Physical activity is important, you should do gymnastics in the morning and visit the pool weekly.
A massage course, even with full health, must be done once a year. It is necessary to deal with excess weight, giving a load on the spine column. Important control of posture in schoolchildren and hardening of the body.