Among chronic human diseases, spinal pathologies do not occupy the last place in medical practice. Pain in the spinal column, periodically occurring, and then disappearing for a period of time, is familiar to many people on the planet. Often people neglect the trip to a specialist to find out the cause of the origin of pathological conditions. But in vain. Not taken in time measures lead to the appearance in the body of irreversible phenomena that significantly reduce the quality of life of the patient. For such pathologies, and DDZP.
Diagnosis "DZDP" - what is it?
Degenerative dystrophic disease of the spine (DDD) is a pathology of the peripheral parts of the nervous system, which belongs to the group of the most common chronic human diseases, has a recurrent nature and often leads to disability.
The most common disease occurs in people of working age. Unfortunately, to date, there is no generally accepted point of view on the origin of DZDP. What does it mean? There are no sufficient and effective methods for detecting and treating the disease.
It is believed that the occurrence of pathology occurs for several reasons:
- due to local overload of the vertebral motor segments (PDS);
- due to decompensation in trophic systems.
Due to the fact that DZDP is a disease that lasts for years, the changes occurring in the patient's body become irreversible. Therefore, the complete recovery of the patient in most cases is impossible. Therapeutic measures are aimed only at restoring normal spinal function and eliminating the clinical manifestations of the disease.
The reason for everything is osteochondrosis
The disease leads to a malfunction of the motor segments of the spine, which entails consecutive disturbances in the functioning of the entire human body. How does this happen? It is believed that osteochondrosis acts as a trigger for the occurrence of DDZP. What is this pathology? In medical practice of the CIS countries, osteochondrosis is commonly called dystrophic changes in the cartilage structures of the spinal column. The cause of osteochondrosis are:
- genetic predisposition
- disorders of vascular nutrition of the discs,
- lack of exercise
- poorly organized workplace (uncomfortable chair or table),
- physical work with lifting weights,
- overweight.
A gradual change in the structure of cartilage leads to a decrease in the mobility of the vertebrae, a reduction in the distance between them, and a disturbance in the nutrition of tissues adjacent to the spine. If the running process cannot be stopped, vertebral or extravertebral syndrome develops. There are 4 reasons why this syndrome is formed:
- compression - the disease begins to appear due to mechanical overload of the motor segments of the spine, leading to compression of the nerve roots;
- dysfixation - pathology occurs due to a weakening of the fixation of the motor segments of the spine;
- dyshemic cause - pathology occurs against the background of a violation of microcirculation of tissues adjacent to the intervertebral disc at the site of damage to the spine;
- aseptic-inflammatory cause - pathology occurs against the background of the inflammatory process in the motor segments of the spine.
Spinal structure
The spine is a collection of vertebrae, each of which is formed by the body and the arch. The vertebrae are located one above the other and form a pillar, in the central part of which the spinal canal passes - a kind of tunnel pierced by nerves and blood vessels.
The vertebrae are separated by cartilage - intervertebral discs consisting of a fibrous ring and a pulpous nucleus. The ring takes on part of the load attributable to the disk. In a young body, the pulp nucleus is 90% water, however, over time, the fluid content in it decreases. The pulpous nucleus is a shock absorber that changes its shape under the action of a load, thereby ensuring the mobility of the spine and protecting it from destruction.
The spinal column from all sides is strengthened by ligaments and muscle corset. Strong muscles and ligaments reduce the load on the discs and joints. However, over the years, under the influence of various factors, a decrease in the elasticity of cartilage tissue occurs. The mechanism of the formation of painful conditions is launched.
How does the pathological process arise
Violation of posture, excess weight, weight lifting, prolonged stay in the wrong uncomfortable position and other factors lead to the fact that the fluid content begins to decrease in the disk, the elasticity of the cartilaginous structure disappears. Under the influence of the above factors, the load on the fibrous ring increases, its fibers break. In places of rupture, an inflammatory process occurs, scar tissue is formed.
When scarring is widespread, the blood vessels supplying the intervertebral discs overlap. Gradually, the height of the disc decreases, as a result of which the distance between adjacent vertebrae decreases, the ligaments stretch and sag, and the load on the intervertebral joints increases. As a result, cartilage is destroyed. The mechanism for the formation of DZDP is launched. What does it mean? The fibers of the fibrous ring under pressure go beyond the vertebral body, the edges of the vertebra soldered to them also change their correct position, bone outgrowths are formed - osteophytes. The intervertebral disc is clamped, while spinal mobility is sharply reduced. Often, pain occurs during this.
A hernia of the intervertebral disc can also cause the development of pathology. Hernia is the part of the pulpous nucleus that breaks through the
fibrous ring, extends beyond it and puts pressure on the nerve roots of the spinal cord.
The concept and classification of dorsopathies
Pathological conditions of the spine, which are not associated with a disease of internal organs and are accompanied by pain, are combined into a separate group of diseases called dorsopathy. In accordance with international standards, all types of dorsopathy are divided into three groups:
- deforming dorsopathies - these include spinal column deformities due to changes in the intervertebral discs: this group includes kyphosis, scoliosis, lordosis, spondylolisthesis, osteochondrosis;
- spondylopathy - these include all traumatic and inflammatory spondylopathies;
- other dorsopathies - manifestations of pain in the neck, body, or even limbs that are not the result of displacement of the discs or impaired function of the spinal cord.
Depending on the place of occurrence of the pathology, there are: DDZP of the thoracic and lumbosacral spine, as well as DDZP of the cervical spine. What is it, we will understand a little later. A characteristic feature of the pathology is that the symptoms of the disease in each of the areas of localization, on the one hand, are very similar, on the other hand, have their own distinctive features.
Types of remote sensing
Often pathological conditions occur in the lumbar spine. According to most doctors, the main reason for this is the upright man, for which he, in fact, pays. Of course, the disease does not occur from scratch, but is formed under the influence of a number of factors (poor nutrition, disruption of the lymphatic system in the tissues of the intervertebral discs, etc.).
- DDZP of the cervical spine. What it is? As a rule, this is dorsopathy that occurs in the neck, front of the chest, in the hands. Some patients note burning aching pain between the shoulder blades, similar to the manifestations of angina pectoris. With cervical dorsopathy, there is an increase in pain when turning or tilting the head. With pathology of the thoracic spine, chest pains may occur.
- DDZP of the lumbar spine. May be accompanied by impaired sensitivity of the groin and inner thighs. Pain can occur simultaneously in both legs; manifested by a decrease in sensitivity in the lower back and sensitivity of the big toes. Shooting pain, decreased sensitivity of the lower leg, pain in the foot, paralysis of the lower leg and buttocks, loss of pelvic function - all these are symptoms of dorsopathy of the lumbar spine or DDZP of the lumbosacral spine.
Therapeutic measures
Manifestations of the pathological process in the spine depend on the stage of development of the disease, as well as on the area and extent of the lesion. The main manifestation of the pathology is pain. As noted above, the cause of pain can be muscle cramps, nerve roots of the spinal cord squeezed by an intervertebral hernia, etc. Often the pain occurs not only in the spine, but also transmitted to other parts of the body. In addition to pain in the affected area, a decrease in sensitivity, as well as muscle weakness, is possible.
Therapy for degenerative-dystrophic disease of the spine can slow down the course of the disease and improve the quality of life of the patient. A set of therapeutic measures is aimed at:
- stop the pain
- slow down the destruction of cartilage,
- improve blood circulation of soft tissues surrounding the spine,
- reduce compression of the vertebrae on each other,
- to restore the patient's motor ability.
Therapeutic methods include the use of medications, physiotherapy, physiotherapy.
DDZP: treatment with medicines
The manifestation of pain can be eliminated by taking anti-inflammatory non-steroidal drugs, such as Ibuprofen, Ketoprofen, Diclofenac. The use of these drugs, however, is often associated with the occurrence of side effects. In this case, you can resort to taking selective agents - this is Lornoxicam, Nimesulide, Meloxicam.
In the event of congestion in the muscles and impaired circulation, they resort to the use of a solution of lidocaine in combination with steroid hormones. This measure helps relieve acute pain.
It is possible to partially alleviate the condition and eliminate the pain syndrome with the help of a medical anesthetic patch (Dorsaplast, Nanoplast, etc.). In addition to the fact that the patch relieves pain, it also provides an anti-inflammatory effect - it affects the affected area with a magnetic field. Use the patch is recommended both during exacerbation for quick relief of pain, and courses. The product does not contain steroids, it is very comfortable to use: the patch does not constrain movements, has no smell, does not leave marks on the skin and clothes.
Physiotherapy and Orthopedic Corsets
Along with the use of medications in the treatment of DDDZ, orthopedic corsets are actively used, which reduce pain by fixing the damaged segment of the spine. If the pathological process affects the cervical spine, use a Shants collar. The product not only has a warming effect, but also temporarily reduces the mobility of the spine in the affected area, relieves muscle spasm, provides favorable conditions for the restoration of damaged structures.
For pathology of the thoracic spine, semi-rigid correctors are used, which correctly distribute the load throughout the spine, unloading the affected area. If the problem occurs in the lower back, use the lumbosacral corsets. Often resort to the use of orthopedic insoles, removing part of the shock load from the spine.
Physiotherapeutic procedures also help relieve pain. These include: electrophoresis, massage, UHF, ultrasound therapy, magnetotherapy.
Stop Cartilage Destruction
As mentioned above, therapy for DDDZ is not only aimed at eliminating pain. With this diagnosis, it is very important to stop the process of destruction of cartilage tissue. For this, there is a whole range of medications - chondroprotectors. These include: "Chondroitin sulfate", "Glucosamine", etc. Often, drugs are taken together to enhance the effect. In such a situation, an accurate dosage of medications is necessary. As a rule, the daily dose of Glucosamine is 1000-1500 mg, Chondroitin Sulfate is 1000 mg.
Blood circulation in the tissues of the affected area can be improved with the help of antiplatelet agents and angioprotectors, which include Pentoxifylline, Actovegin. B vitamins (for example, "Neuromultivit") help balance metabolic processes in the body.
During the rehabilitation period, they often resort to the procedure for stretching the spine, which helps to increase the distance between the vertebrae and reduce their influence on each other. It is also important to constantly maintain motor activity, strengthen the muscle corset through physiotherapy exercises.
Diagnostics
To date, the technique for identifying degenerative-dystrophic diseases of the spine cannot be called perfect and reliable. Like any other disease, the diagnosis of DDDZ begins with a medical examination. The doctor, when talking with the patient, determines the location of the pain, identifies factors that can exacerbate the pain syndrome (for example, a change in the location of the body). The specialist also finds out from the patient the presence of spinal injuries and related diseases.
Next, the doctor examines the paravertebral muscles by palpation. This allows you to detect the presence of muscle tension or prolapse of the vertebra. Laboratory diagnosis involves examining the patient’s blood and is carried out in order to establish the presence or absence of infectious processes in the body.
Of course, the most informative method for diagnosing pathology is spinal X-ray, computed tomography (CT) and magnetic resonance
imaging (MRI). Electroneuromyography (ENMG) allows you to determine the cause of nerve damage.