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 the increasing axial load on the intervertebral discs and the ligamentous apparatus of the spine creates conditions for their microtraumatization. The so-called degenerative-dystrophic processes of the cartilage tissue of the vertebrae, intervertebral discs and the ligamentous apparatus develop - doctors collectively call this all polysegmental osteochondrosis.
With increasing age, the intervertebral discs naturally age, which increases under the influence of vibrations, jerky movements, heavy lifting and falls. The development and aggravation of osteochondrosis is promoted 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 nutrition (dehydration);
- age-related changes;
- spinal injuries;
- poor posture, scoliosis, flat feet;
- sedentary lifestyle;
- working with heavy lifting;
- Overload on the spine due to walking in high heels and pregnancy in women, etc.
The main symptoms of common osteochondrosis
- constant aching pain in the back, numbness in the limbs;
- increased pain with sudden movements, physical activity, or heavy lifting;
- limited range of motion, muscle cramps;
With cervical chondrosis, a person is plagued 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 noise in the head, dizziness, flashing "spots", colored spots in front of 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, affecting the sacrum, legs and sometimes onthe pelvic organs radiate.
Cervical osteochondrosis. The localization of osteochondrosis in the neck area is quite common. The cervical spine suffers more often in people who perform monotonous work - designers, programmers, secretaries, dentists, etc. As a rule, the development of cervical osteochondrosis is promoted by driving a car and prolonged work at a 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, the head often hurts and dizziness, vision becomes dark and blood pressure rises. A channel for the so-called vertebral artery runs through the transverse processes of the cervical vertebrae. It is directed into the cranial cavity and nourishes the brain. Displacement of the vertebrae leads to spasm of the vertebral artery and, in severe cases, compression. This disrupts the blood supply to certain parts of the brain.
If osteochondrosis worsens, radicular symptoms may also appear: the pain radiates to the hand, sometimes to individual fingers, they become numb and there is constant cold. The reason for this is a disruption in the transmission of impulses along the nerve fiber. Based on the numbness of a particular finger, a neurologist can assess the displacement of a particular vertebra. The clinical picture of osteochondrosis of the cervical spine is characterized by a variety of symptoms that are due to the physiological characteristics of this segment.
The thoracic spine is rarely affected by osteochondrosis. One of the main reasons for the developmentBreast osteochondrosisis a curvature of the spine (scoliosis). Usually the reasons for the development of thoracic osteochondrosis are identified 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 that there is no acute pain and only dull, aching pain occurs in the back. The main symptoms and signs of thoracic osteochondrosis include: chest pain, numbness, a tingling sensation in the chest area, pain in the heart, liver and stomach. Very often, thoracic osteochondrosis is disguised as another disease (e. g. myocardial infarction, stomach ulcer, gastritis). The pain associated with osteochondrosis of the thoracic spine is long-lasting, similar to intercostal neuralgia. Sometimes the pain radiates below the shoulder blade, which can raise suspicion of a heart attack. The difference between "cardiac" pain and intercostal neuralgia is that with osteochondrosis the patient has a normal electrocardiogram and there are no symptoms such as severe pallor, bluish skin, cold sweat, etc.
Lumbosacral osteochondrosis. Osteochondrosis of the lumbar spine is the most common. This is because the lower back (lumbar vertebra) usually bears the brunt of the load. Most often, lumbar osteochondrosis can be complicated by an intervertebral fracture of the lumbar spine. The main symptoms and signs of lumbar osteochondrosis include: lower back pain (lower back pain has plagued a person for many years and is characterized by cyclicity, which worsens in the autumn-winter period), limited mobility, pain in the legs. Very often, lumbar osteochondrosis causes acute (lumbago) or aching pain in the legs that affects a specific part of the leg (e. g. back or side). In addition to pain, there may be an increase or decrease in the sensitivity to touch or pain of the skin of the legs - these symptoms of osteochondrosis are explained by the 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 is formed from nerve roots. When a nerve is pinched, the pain spreads along the nerve trunk: to the buttock area, below the knee, sometimes to the calf or heel. Significant disturbances in the nutrition of the nerve trunk are possible, which then leads to numbness in the leg. The symptoms of sensory impairment are very persistent, and sometimes the numbness lasts for a long time. When the sciatic nerve is pinched, the person begins to limp and leans toward the healthy side to maximize the vertebrae on the affected body part, thereby reducing compression of the root. With osteochondrosis of the lumbosacral spine, the first clinical manifestations are pain in the lower back and leg.
Treatment
Treatment of osteochondrosisIt is carried out mainly using conservative methods aimed at eliminating pain and dysfunction of the spinal roots and preventing the progression of dystrophic changes in the structures of the spine.
Pain syndrome with osteochondrosis most often occurs as an exacerbation-remission type. If the pain lasts longer than 3 months, doctors speak of chronic pain. It increases patients' anxiety levels and leads to depressed mood. Standard treatment regimens lose their effectiveness when the pathogenesis of pain changes. In such cases, neurologists supplement the treatment with medications from the group of antidepressants, which are part of the standard treatment for chronic pain. This entire process can take a long time.
Therefore, it is necessary to eliminate risk factors for osteochondrosis and make lifestyle changes. And also relieve acute pain in a timely and effective manner to prevent its chronicity.
Acute pain occurs when tissue is damaged and inflamed. The main group of drugs used for treatment are therefore non-steroidal anti-inflammatory drugs (NSAIDs). Pain occurs when nociceptors are irritated by products of arachidonic acid metabolism.
The most popular NSAID was and is diclofenac. This drug has been used for many years and is considered the "gold standard" for pain relief and anti-inflammatory effects. Diclofenac is often used to relieve acute pain in osteochondrosis.
A new drug containing diclofenac is of great interest. This is a fast dissolving, buffer stabilized sachet. This form of release is quickly absorbed, the therapeutic effect is comparable to the injection 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 a dosage 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.
A clinical trial compared the effects of diclofenac potassium sachet form with the injectable form of diclofenac. The results demonstrated the superiority of diclofenac potassium sachet form over the injection form. It seems that the new drug will significantly expand the possibilities of pain therapy for doctors in our country.
The effects on the muscular component of pain include: post-isometric relaxation, massage and therapeutic exercises, including exercises to strengthen the muscular corset or stretch spasmodic muscles, as well as the use of muscle relaxants. These methods can be combined with reflexology and other physiotherapeutic procedures (DDT, SMT, electrophoresis with local anesthetics, hydrocortisone phonophoresis, etc. ).
prevention
The main methods of preventing osteochondrosis are: physical activity, a properly equipped workplace that eliminates persistent postural tension, timely relief of acute pain and regular exercise therapy.
Successful treatment of patients with osteochondrosis depends on the correct implementation of restorative measures, especially in the early stages of the disease. Physical rehabilitation should be carried out comprehensively.