Excessive tension in the back muscles causes a lot of discomfort and pain.Osteochondrosis, which causes a disruption of the structure of the vertebrae and intervertebral discs, leads to severe pinching of nerve endings.Often, the pathology is accompanied by worsening blood circulation, which causes disorders in the nutrition of the brain and internal organs.
Osteochondrosis - what is it?
Osteochondrosis is a relapsing disease that occurs in a chronic form and is accompanied by the destruction of vertebrae and intervertebral discs.Their tissues are disrupted, which causes a decrease in their elasticity with a subsequent change in shape.There is a gradual reduction of the intervertebral space.This causes a loss of stability of the spinal column in the areas where the pathology develops.
The processes of pathological tissue destruction occur against the background of pinched nerve endings that are directed from the area where the spinal cord is located.As a result, the back muscles are in constant tension.In such a situation, patients complain of back pain and other symptoms.
Based on the peculiarities of the localization of the spinal structures that were affected by degenerative changes, cervical, thoracic and lumbosacral variants of the pathological process are distinguished.The main sign of the development of osteochondrosis is pain, the intensity of which usually increases during physical activity.
There is also stiffness in movements.Additionally, the clinical picture is characterized by the presence of signs of the vertebral type - headaches, changes in blood pressure, deterioration of visual function, hearing, etc.
Development mechanism
The development of osteochondrosis is due to the fact that the nucleus pulposus begins to lose its hydrophilic qualities.This semi-fluid structure contains connective tissue fibers and chondroitin, a gelatinous substance.During the development of the human body and its growth, the processes of reduction of the vascular bed in the intervertebral discs actively occur.Nutrients are supplied diffusely, which is manifested by spontaneous concentration stabilization.This characteristic causes difficulty in completely restoring the cartilage that has suffered damage or excessive pressure on the spine.
Pathological deviations are becoming more pronounced due to disturbances in the hormonal level and human nutrition.Cartilage tissue begins to feel the lack of nutrients that are necessary for its normal development.Therefore, disorders manifest in the form of:
- reduced strength and elasticity;
- changes in consistency parameters and configuration properties.
Against the background of the flattening of the intervertebral discs, radial cracks are formed in the fibrous rings.As a result, the intervertebral distance decreases, and the facet joints begin to move.Over time, pathological changes affect the connective tissues attached to the fibrous rings and ligaments.
As the tissue breaks down, the immune system produces immunoglobulins in increased amounts.This causes the development of the process of aseptic inflammation, and swelling is formed in the area where the facet joints are located.They also spread to nearby soft tissues.
Due to the stretching of the joint capsules, the intervertebral discs lose their ability to fix the vertebrae.Such instability of the position of the spinal structure increases the risk of pinching nerve roots or squeezing blood vessels.This feature is characteristic, for example, of cervical osteochondrosis, which is accompanied by intense verbal symptoms.
Reasons for the development of the disease
The condition of the intervertebral discs can be worsened by a decrease in the tone of the skeletal muscles in the spine.Due to the irrational and asymmetric work of the muscles, when the non-physiological position of the body is maintained for a long time, the cartilage tissue can be destroyed.This violation occurs as a result of carrying heavy bags on the same shoulder, using soft mattresses and high pillows.
The process of destruction of intervertebral discs is accelerated by the action of a number of negative factors of an external and internal nature.This includes:
- endocrine mechanism disorders and metabolic disorders;
- pathologies of an infectious nature, including chronic ones;
- damage to the spinal column in the form of compression fractures, bruises;
- regular and long-term hypothermia of the body;
- diseases of systemic and degenerative-dystrophic type - gout, psoriatic, rheumatoid arthritis, osteoporosis, osteoarthritis;
- smoking and alcohol abuse, which impairs the state of the circulatory system, worsens blood circulation and causes a lack of nutrients in the cartilage;
- insufficient physical development, problems with posture, flat feet - these defects increase the load on the spinal column, because shock absorption will be insufficient;
- obesity;
- genetic predisposition;
- exposure to regular stress.
Symptoms
The main clinical sign of osteochondrosis of any localization (cervical, thoracic or lumbosacral) is pain.In case of recurrence, the pain is piercing, spreading to nearby parts of the body.Even with light movement, it intensifies.This forces the patient to impose a forced position on the body to reduce discomfort and pain:
- with cervical osteochondrosis, it would be desirable to turn not only one head, but the whole body;
- when the chest form of the disease is present, it is difficult for the patient to take a deep breath, and therefore, in order to avoid acute chest pain, he tries to minimize the depth and frequency of breathing;
- Patients with the lumbar type of the disease have difficulty sitting down, assuming a vertical position and moving, because the spinal nerve is compressed.
Usually, patients complain of the presence of dull, constant pain and a feeling of stiffness in movements in the morning after waking up.In this case, a differential diagnosis will be required to eliminate the risk of developing myositis caused by inflammation of the skeletal muscles of the spine or osteoarthritis.
Aching and pressing pains are caused by compensatory tension in the muscle tissue.This condition is necessary to stabilize the range of motion of the spine.Constant mild or moderate pain may also occur with significant stretching of the intervertebral disc, resulting from aseptic inflammatory changes.
Osteochondrosis of a certain localization is characterized by special symptoms:
- With cervical osteochondrosis, pain is felt in the cervical area, in the upper limbs.There is pain in the head and numbness of the fingers.If the disease manifests itself in a serious form, pinching of the vertebral artery may occur.In this case, the patient begins to complain of a significant deterioration in health.
- Thoracic localization is manifested by sharp and painful pain in the back;there is a syndrome of visceral pain in the region of the heart, right hypochondrium and abdomen.Patients complain of stiffness, paresthesia of the skin, difficulty breathing and creaking in the vertebrae.
- Patients with lumbar osteochondrosis complain of pain in the back and lower extremities that gets worse when moving.Disorders in the functioning of the genitourinary system, problems with male potency and dysfunctional ovarian disorders are often diagnosed.During remission, the pain may decrease.However, exposure to the provoking factor leads to its reactivation.
- When mixed osteochondrosis occurs, symptoms can appear in several areas at the same time.This condition is characterized by a more severe course of the disease.
It should be remembered that the movement of the vertebrae and the formation of osteophytes cause compression of the vertebral artery.It nourishes the brain, supplying its cells with oxygen.When squeezed, nutrition is limited, so the patient has problems with coordination, headaches, tinnitus and arterial hypertension.
Consequences if not treated
The reason for the complicated course of osteochondrosis is the relatively quick formation of a hernia in the intervertebral discs.Their appearance is associated with the posterior displacement of the vertebral structure.This provokes the rupture of the posterior longitudinal ligament, which results in the instability of the disc position and the protrusion of some of its parts into the area of the spinal canal.The hernia ruptures when the disc with the nucleus pulposus penetrates the area of the canal.
When pathological abnormalities appear in the vertebral structures, the spinal cord begins to be compressed, and the patient develops discogenic myelopathy.Symptoms of this condition are associated with numbness and weakness of certain muscle groups of the upper and lower extremities.Paresis, muscle atrophy and impaired tendon reflexes appear.In some cases, there are problems with emptying the bladder and bowels.
The formation of intervertebral hernias is dangerous due to compression of the arteries that supply the spinal cord.The result of this pathology is the formation of ischemic zones where nerve cells are damaged and killed.Manifestation of the neurological effect is expressed in disorders of motor function, decrease in the degree of tactility and trophic disorders.
Disease diagnosis
The initial diagnosis is made based on the patient's complaints and existing symptoms.The specialist examines the condition of the spinal column in different positions, asking the patient to rest or move.In the next stage, the patient is sent for laboratory diagnostics, which will help clarify the diagnosis or refute it.
Research methods used include:
- Radiography- provides a complete examination of the spinal column with an assessment of the condition of the vertebrae, existing disorders in the form of growths, curvature.The specialist will be able to determine the intervertebral spaces and the condition of the holes.For accurate identification of osteochondrosis localized in the thoracic or cervical region, a two-phase X-ray examination is performed.In the first phase, the patient lies on his side, and in the second - directly on his back.
- Tomography method using MRI or CTthey provide highly informative data, which help to study the vertebrae in detail without disturbing the organs that cover them.The picture shows the nerves and the vascular system.MRI helps to identify the signs of many diseases of the spine and the location of damage.A CT scan visualizes hernias and determines possible deviations in the structure of the spine.
- Laboratory examinationto assess the condition of the blood and its main parameters.It allows you to clarify the diagnosis and determine the possibility of developing concomitant diseases.
In many cases, as a result of the examination, doctors diagnose the existence of certain underlying diseases that are potentially dangerous due to their complications.We are talking, for example, about hernias, protrusions, radiculitis.Correct diagnosis of the problem helps in more effective treatment of osteochondrosis.At the same time, the disease itself in the first stages of development is disguised as symptoms of other diseases.
Therapeutic process
Osteochondrosis is treated conservatively or surgically.The choice depends on the severity of the condition, its neglect, the degree of tissue deterioration and the causes of its occurrence.
It is important to remember that it is not possible to completely cure osteochondrosis, because there are no drugs that help to completely restore the discs and vertebrae.The therapeutic effect is aimed at inhibiting the destruction process and increasing the duration and stability of remission.
Chondroprotectors, based on chondroitin or glucosamine sulfate, are used for symptomatic therapy.
The effectiveness of the therapeutic process using chondroprotectors has been clinically confirmed on the basis of long-term tests.If you take these drugs for a long time (more than 3 months), then a partial restoration of the cartilage and other elements of the connective type - the ligamentous-tendonous apparatus, the bursa - is observed.
Accumulation of glucosamine and chondroitin in the area of the intervertebral discs leads to analgesic, anti-edematous and anti-inflammatory effects.Therefore, there is a real opportunity to optimize the dose of NSAIDs, glucocorticosteroids and muscle relaxants.You can count on reducing the patient's medication burden.
The effectiveness of chondroprotectors is determined by the regularity of their use.Otherwise, there will be no results.Inefficiency was also recorded in the treatment of osteochondrosis of the 3rd degree, accompanied by significant cartilage destruction.
The following groups of drugs can be used to relieve pain:
- Nonsteroidal anti-inflammatory drugsthey help eliminate inflammatory disorders in soft tissues caused by displacement of the vertebrae.NSAIDs are effective in reducing pain, swelling and stiffness.
- Medicines from the group of glucocorticosteroids– blocks are usually used together with an anesthetic.They are able to relieve pain, restore the functioning of the immune mechanism and provide an anti-exudative effect.
- Muscle relaxants.They are effective in the fight against muscle spasms due to nerve impulses.They help relax skeletal muscles and block reflexes of the polysynaptic spinal type with antispasmodic action.
- External products with a warming effect.Special gels and ointments ensure the irritation of subcutaneous tissue receptors with the activation of blood flow.These drugs have analgesic and anti-edematous effects.
Symptoms of the vertebrogenic type, which occur due to localization of pathology in the cervical or thoracic region, can be eliminated by medical means to activate blood flow.Nootropics and drugs to improve microcirculation are also prescribed.In some cases, it may be necessary to take antidepressants, as well as pharmaceutical drugs with anticonvulsant effects.
Physiotherapy is also used during the treatment of osteochondrosis.UHF therapy, magnetotherapy, laser therapy, reflexology, massage, exercise therapy, hirudotherapy, as well as swimming and yoga can be prescribed.If conservative treatment is ineffective, surgery is performed with microdiscectomy, disc valorization puncture, laser reconstruction or implant replacement.