Osteochondrosis

Osteochondrosis is a degenerative-destructive lesion of the spine, which includes the defeat of the bodies of the vertebrae, articular apparatus, ligamentous apparatus and intervertebral discs. This disease is common enough evenly in all countries - from 45 to 85% of the population suffers from this disease. The beginning of osteochondrosis occurs in patients over 30-35 years old, however, cases of an earlier onset of the disease are known. Men and women get sick with approximately the same frequency.

Causes

There is no unified cause of development of osteochondrosis. There are a large number of predisposing causal factors. The main ones are as follows:

• Spinal injuries (fractures, bruises, dislocations);
• Hereditary predisposition;
• Foot diseases causing a spine overload - this includes flat feet, varous deformation of the foot, valgus deformation of the foot;
• Wearing close and uncomfortable shoes for a long time (also causes overload of the spine);
• Overweight and obesity;
• Age -related changes;
• Sedentary lifestyle;
• Athletes who abruptly abandon their training and classes;
• Metabolic disorders;
• Spinal curvature (kyphosis, lordosis, scoliosis);
• Professional features - weight lifting, frequent turns and jerks of the body, work in an uncomfortable body position;
• Frequent and prolonged hypothermia;
• Stress;
• A specific climate, both at 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 customary to divide it into four main stages:

• The first stage. There is a decrease in the amount of moisture in the core of the intervertebral disc, it becomes more flat, the distance between the vertebrae decreases. The cartilage is covered with minor cracks.
• The second stage. Due to the reduction in the distance between the vertebrae, the muscle and ligamentous apparatus of the vertebrae occurs. This leads to pathological mobility of the vertebral bodies, to their displacements.
• The third stage. Due to progressive processes in the spine, squeezing (protrusion) of the intervertebral discs, subluxation of the vertebrae occurs.
• The fourth stage. Between the vertebrae, bone spikes (osteophytes) appear, which are aimed at eliminating the mobility of the vertebrae, the prevention of dislocations. Over time, there are so many of them that the affected vertebrae completely lose their mobility. In this case, there is a trauma of blood vessels and nerves passing near the vertebrae and leaving the spinal column.

At the first and last stages of the disease of clinical manifestations (pain), the patient does not have.

Classification

There are a lot of classifications of osteochondrosis. Each doctor chooses the most acceptable for himself. The following classifications are most often used:

Classification on the defeat of the spine:

• Cervical osteochondrosis;
• Thoracic osteochondrosis;
• Lumbar osteochondrosis;
• Crowning osteochondrosis;
• Extensive (common) osteochondrosis - affects 2 or more spine.

Classification by the degree of change in the intervertebral disc (radiological stages):

• 0 stage - there is no disk change;
• 1st stage - minor changes, including maximum internal tears;
• 2 stages - severe changes in the disk while maintaining the outer surface;
• Stage 3-the entire disk is completely affected (cracks with spread to the outer surface, squeezing the disk from under the bodies of the vertebrae, etc. ).

Classification by clinical manifestations and degree of impaired spinal functioning:

• 1st stage - the functioning of the spine is not changed, the patient feels a slight pain at the lesion;
• 2 stages - the functioning of the spine is disturbed (subluxuses of the vertebral bodies occur, disk protrusion, pinching of nerves), pain at the destruction site intensifies;
• Stage 3 - the spine is deformed, hernias of intervertebral discs occur, significant pain;
• Stage 4 - the patient is difficult to move, the mobility of the spine decreases, pain during the slightest movement. The patient is given disability.

Symptoms of osteochondrosis

Symptoms of osteochondrosis depends on the area of damage to the spine and on the degree of disorders occurring in it.

For the expanded clinical picture of osteochondrosis of the cervical spine, the following signs are characteristic:

• Violation of visual acuity;
• Dizziness;
• Tinnitus;
• Flickering "flies" in front of the eyes and the appearance of colored spots;
• Hearing loss;
• Headache in the nape, temporal and parietal region, intensifying when moving the cervical spine;
• Loss of consciousness;
• Snore;
• Hoarse of the voice or its weakening;
• Numbness and loss of sensitivity on the skin of the face, neck and hands;
• Dental destruction;
• Board of blood pressure.

For osteochondrosis of the thoracic spine, the following symptoms are characteristic:

• Pain in the heart, lasting for a long time, aching or pressing, often sharp, stitching, sharp, patients can show a specific point of pain;
• Numbness of the skin in the chest, abdomen and back;
• Pain in the spine, especially between the shoulder blades, strongly expressed;
• Pain when raising hands;
• Pain with a sharp and deep breath, and later join when exhaling;
• Pain, discomfort and difficulties during tilts of the body in any direction.

The following symptoms are characteristic of osteochondrosis of the lumbar and sacral spine:

• Soreness in the area of the lumbar and sacral spine (lumbalgia), which can give in one or both legs, intensifying with any movement of the spine in the affected area;
• Legs freeze at a comfortable temperature for other parts of the body;
• Almost constant tension in the muscles of the back, especially the lumbar region;
• A feeling of numbness, crawling goosebumps and tingling on the skin of legs and buttocks;
• Varicose veins on the legs;
• Violation of potency in men;
• Increased sweating;
• Pallor of the skin on the legs;
• Irregular menstruation in women.

With prolonged and neglected osteochondrosis, when the affected vertebrae fuse with each other, the patient is worried only by the impossibility of movements in a particular spine, pain, as a rule, decreases or leaves completely.

Diagnostics

First of all, the doctor conducts a survey and examination of the patient, establishing a preliminary diagnosis. For confirmation, additional examination methods are assigned. With osteochondrosis, they are only instrumental, because laboratory (tests) will not show any confirming changes.

The main diagnostic methods include the following:

• X -ray examination. Allows you to determine the degree of damage to the vertebrae, their location, bone formations. By indirect methods, you can determine the condition of bone channels and intervertebral discs;
• Computed tomography (CT). Allows you to determine the condition of the intervertebral discs, their structure and shape, deformation of the vertebrae and compression of the nerve endings and roots;
• Magnetic resonance imaging (MRI). Allows you to determine smaller violations in the spine and is prescribed in cases where controversial issues remain the post of CT;
• Ultrasound procedure. Allows you to identify the degree of blood flow in the vessels that feed the spinal cord and other organs;
• Myelography. The method of radiography of the spine using a contrast matter. Allows you to identify intervertebral hernias.

Treatment of osteochondrosis

Conservative treatment

In the treatment of osteochondrosis, conservative methods of treatment are primarily used. In this case, the approach to each patient should be individual and complex. Conservative methods of treatment can be divided into 4 main groups:

• Drug treatment;
• Physiotherapy;
• Spa treatment;
• Diet (basics of proper nutrition).

Drug treatment of osteochondrosis

Medicines used in the treatment of osteochondrosis must be used during periods of exacerbations. They contribute to a decrease in symptoms, and also affect some causal factors in the development of the disease. The main groups of drugs used in the treatment of osteochondrosis:

• NSAID. Nonsteroidal anti -inflammatory drugs have anesthetic, anti -inflammatory effects, and also reduce the elevated temperature of the affected tissues of the spine and its structures. With pronounced symptoms, the first days of exacerbation of the disease are prescribed in the form of injections. The frequency of use is 1-2 times a day. After that, they switch to tablet forms of drugs with a treatment rate of 10-30 days, if necessary. The frequency of admission is from 1 to 4 times a day. Also, together with tablets and injections, ointments or creams are shown, which are applied to the skin in the area of the spine 1-3 times a day.
• Musorelaxants. Preparations of this group do a great cope with increased muscle tone, relaxing transversely broken muscle fibers and facilitating the patient's condition. On average, the course of treatment is about 1 month. With severe symptoms, treatment begins with injection forms of drugs. The dosage must begin with minimal, gradually increasing until the therapeutic effect is achieved, after which also gradually reducing to complete cancellation.

Several more groups are used as additional medicines:

• Vitamins. Accelerate tissue restoration processes, normalize nervous conductivity, accelerate metabolism, etc. Almost always these drugs for osteochondrosis are prescribed in the form of injections, courses for 10 days. These are vitamins B1, B2, B6, E.
• Blood preparations. These drugs normalize blood flow in the veins and arteries, restore the muscle tone of blood vessels, and restore metabolism. Most often, tablet forms of release 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 tablets.
• Glucocorticosteroids. They have anti -inflammatory, decongestant effects, enhance 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 or intra -fast, or in the form of tablets for oral administration. The course of treatment is selected individually, from several days to several weeks. The abolition of the drug should take place with a gradual decrease in dosage.
• Biogenic stimulants. Accelerate metabolism, stimulate tissue restoration, reduce inflammation and swelling of tissues and much more. Most often used in injection form 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 remission when used outside of exacerbations. There are a lot of physiotherapy methods and most of them are well practiced in the treatment of osteochondrosis:

• Electrophoresis. Depending on the drug that is used in this procedure, an analgesic effect is obtained. The metabolism improved and the normalization of blood flow in the affected tissues.
• Acupuncture (acupuncture). With the help of special finest needles and their effects on active points located on the skin of the patient, an analgesic effect is achieved, recovery and metabolic processes are stimulated, and inflammation decreases.
• Magnetotherapy. Reduces pain, swelling and inflammation of tissues, accelerates nervous conductivity, normalizes metabolic processes
• Manual therapy. Mobility is restored in the joints of the spine, the pain syndrome is reduced.
• Massage. Normalizes muscle tone, eliminates back pain, restores nervous conductivity.
• Exercise therapy. Restoring the mobility of the spine, a decrease in pain, restoration of the usual lifestyle, strengthening the muscular frame of the back, relaxation of the back muscles, acceleration of metabolism.
• The traction of the spine. The mobility of the spine is restored, prevents the progression of the disease and the development of complications, and anesthetizes.
• Laser therapy. Improves blood supply, stimulates tissue regeneration, reduces pain and inflammation, reduces swelling of the spine.
• Thermotherapy. Anesthetic effect, normalization of blood flow and lymph through blood vessels, a decrease in inflammation in the tissues, acceleration of the restoration of cartilage.
• Mudreing (peloid therapy). Reduces pain in the spine, reduces muscle spasm, slightly reduces inflammation processes, improves blood supply and metabolism.

One patient can be prescribed for 1 physiotherapeutic event and their complex. It depends on the severity of the process of osteochondrosis and on the accompanying pathologies. The duration of the course of treatment on average is 10-15 days. It is recommended to repeat 3-4 times during the year. Thus, it is possible to reduce the frequency of exacerbations and the rate of progression of osteochondrosis several times.