In the life of a modern person, an imbalance between active physical activity and static loads leads to a decrease in the tone of the back muscles, therefore, an increase in the axial load on the intervertebral discs and apparatus spinal ligament creates the conditions for its microtraumatization. . The so-called degenerative-dystrophic processes of the cartilaginous tissue of the vertebrae, intervertebral discs and the ligamentous apparatus develop; Doctors collectively call all this polysegmental osteochondrosis.
With age, natural aging of the intervertebral discs occurs, which intensifies under the influence of vibrations, sudden movements, heavy lifting and falls. The development and exacerbation of osteochondrosis is facilitated by various back injuries, physical overload, poor physical fitness, poor posture and curvature of the spine, flat feet and excess weight.
Causes of osteochondrosis
- hereditary predisposition;
- metabolic disorders in the body;
- overweight, poor diet (lack of fluids);
- age-related changes;
- spinal injuries;
- poor posture, scoliosis, flat feet;
- sedentary lifestyle;
- jobs that involve lifting heavy objects;
- spinal overload as a result of walking in high heels and pregnancy in women, etc.
The main symptoms of common osteochondrosis.
- constant pain in the back, feeling of numbness in the extremities;
- increased pain with sudden movements, physical activity, or lifting heavy objects;
- decreased range of motion, muscle spasms;
With cervical chondrosis, a person will be bothered by pain in the arms, shoulders and headaches; It is possible to develop the so-called vertebral artery syndrome, in which there are complaints of noises in the head, dizziness, flickering "spots", colored spots before the eyes in combination with a throbbing headache.
With osteochondrosis of the thoracic spine: pain in the chest (like a "stake" in the chest), in the area of the heart and other internal organs; with osteochondrosis of the lumbosacral spine - pain in the lower back, radiating to the sacrum, legs, and sometimes to the pelvic organs.
Cervical osteochondrosis. The location of osteochondrosis in the neck area is quite common. The cervical spine suffers most often in people who do monotonous jobs: designers, programmers, secretaries, dentists, etc. As a rule, the development of cervical osteochondrosis is facilitated by driving and prolonged work at the computer. The main signs and symptoms of cervical osteochondrosis include: headache, dizziness, pain in the arms and chest, lumbago, numbness of the tongue. With cervical osteochondrosis, you often have a headache and feel dizzy, vision becomes dark, and blood pressure rises. A channel for the so-called vertebral artery passes through the transverse processes of the cervical vertebrae. It goes to the cranial cavity and nourishes the brain. Displacement of the vertebrae causes spasm of the vertebral artery and, in severe cases, compression. Therefore, the blood supply to certain parts of the brain is disturbed.
When osteochondrosis worsens, radicular symptoms may also occur: the pain radiates to the hand, sometimes to individual fingers, they become constantly numb and cold. The reason for this is a disruption in the passage of impulses along the nerve fiber. By the numbness of a particular finger, a neurologist can judge the displacement of a particular vertebra. The clinical picture of osteochondrosis of the cervical spine is characterized by a variety of symptoms, due to the physiological characteristics of this segment.
The thoracic spine is rarely affected by osteochondrosis. One of the main reasons for the developmentthoracic osteochondrosisIt is a curvature of the spine (scoliosis). Usually, the causes of the development of thoracic osteochondrosis are formed at school. The thoracic spine is the least mobile, so the signs and symptoms of thoracic osteochondrosis are very different from the symptoms of cervical or lumbar osteochondrosis. In most cases, the main difference between thoracic osteochondrosis is the absence of acute pain and the presence of only a dull, aching pain in the back. The main symptoms and signs of thoracic osteochondrosis include: chest pain, numbness, tingling sensation in the chest area, pain in the heart, liver and stomach. Very often, thoracic osteochondrosis disguises itself as other diseases (for example, myocardial infarction, peptic ulcer, gastritis). The pain associated with osteochondrosis of the thoracic spine is long-lasting, similar to intercostal neuralgia. Sometimes the pain can radiate below the shoulder blade, raising the suspicion of a heart attack. The difference between "heart" pain and intercostal neuralgia is that with osteochondrosis the patient has a normal electrocardiogram, there are no symptoms such as intense paleness, bluish skin, cold sweat, etc.
Lumbosacral osteochondrosis. Osteochondrosis of the lumbar spine occurs most often. This is explained by the fact that the lumbar area (lumbar vertebrae), as a rule, bears the main load. Very often, lumbar osteochondrosis can be complicated by an intervertebral hernia of the lumbar spine. The main symptoms and signs of lumbar osteochondrosis include: low back pain (low back pain has bothered a person for many years and is characterized by a cyclical character, worsening in the autumn-winter period), limited mobility, pain in the legs . Very often, with lumbar osteochondrosis, sharp pain (lumbago) or aching pain occurs in the legs that affects a certain part of the leg (for example, on the back or side). In addition to pain, there may be an increase or decrease in sensitivity of the skin of the legs to touch or pain; These symptoms of osteochondrosis are explained by pinching of the roots of the spinal cord.
The most common cause of osteochondrosis in the lumbosacral region is traumatic (compression fracture or chronic injury). In the lumbar region, the sciatic nerve forms from nerve roots. When a nerve is pinched, the pain spreads along the trunk of the nerve: to the buttock area, below the knee, and sometimes to the calf or heel. Major disturbances in the nutrition of the nerve trunk may occur, and then the leg becomes numb. Symptoms of sensory impairment are very persistent, sometimes numbness persists for a long time. When the sciatic nerve is pinched, a person begins to limp, leaning toward the healthy side to maximize the vertebrae in the affected part of the body and thus reduce root compression. With osteochondrosis of the lumbosacral spine, the first clinical manifestations are pain in the lower back and leg.
Treatment
Treatment for osteochondrosisIt is carried out mainly by conservative methods aimed at eliminating pain, dysfunction of the spinal roots and preventing the progress of dystrophic changes in the spinal structures.
Pain syndrome with osteochondrosis usually occurs as a remitting type of exacerbation. Additionally, if the pain lasts more than 3 months, doctors speak of chronic pain. It increases the level of anxiety in patients and inclines them towards a depressed mood. Standard treatment regimens become ineffective as the pathogenesis of pain changes. In such cases, neurologists add medications from the group of antidepressants to the treatment, which are included in the standard treatment of chronic pain. This whole process can take a long time.
Therefore, it is necessary to eliminate the risk factors for osteochondrosis and modify the lifestyle. And also timely and effectively relieve acute pain to prevent its chronicity.
Acute pain develops when tissue becomes damaged and inflamed. Therefore, the main group of drugs used in treatment are non-steroidal anti-inflammatory drugs (NSAIDs). Pain occurs when nociceptors are irritated by products of arachidonic acid metabolism.
The most popular NSAID was and remains diclofenac. This medication has been used for many years and is considered the "gold standard" for pain relief and anti-inflammatory effects. Diclofenac is widely used to relieve acute pain in osteochondrosis.
Of great interest is a new drug that contains diclofenac. This is a buffer-stabilized sachet that dissolves quickly. This release form is rapidly absorbed and the therapeutic effect is comparable to that of the injectable form and develops within 5 to 20 minutes. The new drug has a high speed of action and a long-lasting effect.
The drug is used in doses of 50 to 100 mg, the daily dose of the drug should not exceed 150 mg/day. The daily dose should be divided into 3 doses.
In a clinical study, the effect of diclofenac potassium in sachet form was compared with that of the injectable form of diclofenac. The results showed the superiority of diclofenac potassium in sachet form over the injectable form. It seems that the new drug will significantly expand the possibilities of analgesic therapy for doctors in our country.
The impact on the muscular component of pain involves: post-isometric relaxation, massage and therapeutic exercises, including exercises to strengthen the muscle corset or stretch spasmodic muscles, and the use of muscle relaxants. These methods can be combined with reflexology and other physiotherapeutic procedures (DDT, SMT, electrophoresis with local anesthetics, phonophoresis with hydrocortisone, etc. ).
Prevention
The main methods of preventing osteochondrosis are: physical activity, a properly equipped workplace that eliminates prolonged postural tension, timely relief of acute pain, and regular exercise therapy.
Successful treatment of patients with osteochondrosis depends on the proper management of restorative measures, especially in the early stages of the disease. Physical rehabilitation must be carried out comprehensively.