Osteochondrosis is a disorder that self-limits bone development. More precisely, osteochondrosis is an aseptic ischemic necrosis. The psychosomatics of osteochondrosis (Louise Hay detailed all the influencing factors) further.
Starting events in the pathogenesis of osteochondrosis have not yet been found, but the data indicate ischemic necrosis of the ossification center. This may be caused by a primary vascular event resulting from a traumatic event or multiple injuries. And there may be psychosomatic causes of osteochondrosis.
It may contain one pineal gland or many, and even sashamoids are not spared this (both with Syndrome Larsen and with the first metasarzal sesamoids). The main processes, apparently, are the same for isolated and multiple diseases.
Incomplete healing or complete rejection of treatment can lead to chronic pain and even disability later in life. More on the symptoms and treatment of osteochondrosis of the cervical spine next.
Symptoms
The following symptoms are characteristic of all types of osteochondrosis:
- Uncertain etiology.
- The clinical picture of progression.
There are also such models of the disease:
- Normal pineal gland injured (e.g., elbow of a jug with osteochondritis of dissection of capitilla).
- Mildly dyschondrotic pineal gland caused by external stimuli (for example, Perthes disease).
- Severely affected dyschondrotic pineal gland, subjected to normal stress (for example, the pineal gland of the femur in Gaucher disease).
There are pathogenetic factors that require further research on the subject: altered collagen-proteoglycan ratio, biochemical abnormalities (for example, altered expression of matrix metalloproteinases [MMP] such as MMP-1, MMP-3 and MMP-13), and overexpression of glycosaminoglycans and aggrecan as a result of altered mechanics that exacerbate cartilage damage.
Psychosomatics of diseases osteochondrosis
It may appear not only for physiological reasons, but also because of psychosomatic reasons.
The human body is highly susceptible to psychological pressure. More than half of the diseases that appear in people, these are most often not real diseases, but stress loads, worries, nervousness. Psychosomatic conditions and osteochondrosis are tightly connected.
Osteochondrosis of the neck
The cervical spine connects the thinking part with the acting. The reasons for the psychosomatics of cervical osteochondrosis is that a confident person always keeps his head high. While an insecure person, on the contrary, squeezes it into himself, which destroys the tissue of the cartilaginous parts. The psychosomatics of osteochondrosis of the cervical spine is treated only with the help of a change in worldview and thoughts.
Breast osteochondrosis
The psychosomatics of osteochondrosis of the thoracic region is that a person is in a bad mood. This includes sadness and loss of spirit. Because of them, a person begins to hunch.
Osteochondrosis of the lower back
The psychosomatics of lumbar osteochondrosis appears in those women who have a burden of family worries. Also, the appearance of the disease is affected by a strong self-doubt. All this together leads to painful sensations.
Classification
Early classifications of osteochondrosis divide them into pressure, traction and atavistic types (Burroughs classification) or compression, tension and atavistic types (Hoff classification). These systems were inadequate. Siffer proposed a classification that divides osteochondrosis into articular, nonarticular, and physical types. This scheme is largely accepted in our time.
Joint osteochondrosis has the following characteristics:
- The primary involvement of articular and epiphyseal cartilage and the lower endochondral center of ossification is Freiberg's disease.
- Secondary involvement of articular and epiphyseal cartilage due to ischemic necrosis of the podzolic bone - Perthes disease, Köhler disease, osteochondritis dissection.
Osteochondrosis occurs in the following places:
- The trend is Osgood-Schlatter syndrome, Monde-Felix disease.
- Ligamentous ligaments - the vertebral ring.
Focal osteochondrosis includes the following:
- Long bones - Tibia vara (Blount disease).
- Scheuermann's disease.
Related Violations
Scientists have found that the main disorders of the genitourinary system are associated with Perthes disease. The risk of inguinal hernia is increased by 8 times in patients with this disease. Slip of the pineal gland of the femur can occur in patients with Scheuermann's disease.
Considerable attention was paid to the occurrence of growth retardation with osteochondrosis. The rationale for evidence of this association includes a decrease in urinary deoxypyridinoline and glycosaminoglycan excretion, as well as a low level of insulin-like growth factor (IGF) in plasma -1. These changes cause a violation of collagen metabolism. In the future, this change may be associated with the pathogenesis of osteochondrosis in syndromic terms.
Probable reasons
In addition to the psychosomatics of osteochondrosis, there are other reasons. The oldest, most controversial and, therefore, the least common of them are social deprivation, malnutrition and passive effects on smoke (unknown industrial factor). Studies that suggested these factors as causes were geographically specific, and their results may have been recognized as an etiological error.
Main reasons
Factors that are considered the most likely causes of osteochondrosis - individually or in various combinations (with multifactorial disease) - are:
- Genetic predisposition.
- Environmental factors.
- Acute or repeated injury.
- Embolism.
- Deficiency of copper (trace element).
- Infection.
- Mechanical factors.
Regarding the genetic predisposition, Blount disease is known to be inherited in an autosomal dominant sample. However, inheritance characteristics of other potentially inherited disorders (e.g., Scheuermann's disease) still exist.
An area worthy of further study is the genetic predisposition, which causes a hypercoagulable state due to a lack of tissue factor pathway inhibitor (TFPI). Others include protein S fibrinolysis defects, protein C deficiency, and resistance to activated protein C. Similarly, there is no consensus on inherited thrombophilia disorders due to mutations in the prothrombin genes (mutation G20210A), Leiden factor V (mutation G1691A), methylenetetrahydrofolate reductase ( mutation C677T) or anticardiolipin antibodies.
As for both genetic predisposition and environmental factors, exposure to second-hand smoke may be associated with the development of Perthes disease as a result of the G-455-A polymorphism of the beta-fibrinogen gene.
Deficiencies in trace elements (e.g. copper and zinc) have been suggested as probable causes based on animal studies.
The infection, which once seemed to be unanimously discredited as the cause of osteochondrosis, has now shown that it causes or enhances the disease process. Its effect may be direct or associated with autoimmune mechanisms.
Certain mechanical factors may be associated with the development of specific diseases, such as Osgood-Schlatter disease and Sindin-Larsen-Johansson disease. Examples of such factors are the long patella (Grelsamer type II) and the extensor device and the external torsion of the tibia. Various authors have suggested that Osgood-Schlatter syndrome is traumatic in nature and that it is not associated with ischemic necrosis.
Related factors
Factors associated with osteochondrosis have also been identified. These include hormonal imbalances (hypothyroidism), sickle cell anemia, Gaucher disease and mucopolysaccharidoses, tetany due to magnesium deficiency and cystic fibrosis. Nevertheless, all these conditions are currently well-established diseases in themselves and, according to the authors, should not be associated with osteochondrosis.
Treatment
After understanding the symptoms of osteochondrosis of the cervical spine, treatment and epidemiology will be discussed further.
Since osteochondrosis is a self-limiting disease, the result of treatment is usually good. Most often, in fact, the syndrome goes unnoticed. However, when osteochondrosis is not limited to conservative treatment or surgery, the patient's prognosis is usually disappointing. In these cases, patients may need urgent interventions or joint replacements later in life to control secondary changes. Patients should be properly informed and educated before such interventions are undertaken.
Epidemiology
The frequency with which osteochondrosis affects different sites is different. Because they are self-limiting disorders, they often remain undiagnosed; therefore, accurate documentation is difficult. Perthes disease is considered the most common disabling osteochondrosis, but not the most common of all types. Some species are so rare that the doctor may never encounter them for the entire period of his practice.
A large number of osteochondrosis occurs after the appearance of the bone core in the patient, because at this moment the pineal gland, most often the cartilage, grows very quickly, so it is incredibly susceptible to injuries of various types and strengths. Exceptions to this general statement include pain in dissecting osteochondrosis, Scheuermann's disease, Osgood-Schlatter, which mainly occur during the period of very rapid growth of adolescents.
Freiberg's disease is more common among women and adolescents. These are pains of osteochondrosis of the elbow joint (head). All other possible and investigated types of osteochondrosis are most often found in men. The delay in the appearance and maturation of the growth center in boys may explain this difference. Also, a high level of activity additionally injures the fragile bones of a child or adolescent.
Some of the very common and well-studied osteochondrosis have certain racial and ethnic differences in the frequency and prevalence in the world. For example, the Perthes disease previously mentioned in this article is rare among people of African or Chinese descent. While Blount's disease is very common on the African continent, but the same disease is quite rare in Western Europe, as well as in North America.