The term osteochondrosis itself is derived from two words: osteo - bone and chondrue - cartilage. Simply put, it is the ossification of the cartilage. Although this interpretation is fundamentally wrong. Some in their delusions go even further and are convinced that osteochondrosis is the deposit of salts in the joints. In addition, it is table salt that is believed to be consumed in large quantities for the diet.
Pathogenesis
In reality, everything turns out a little differently. And harder. And table salt, if it plays a role in the occurrence of osteochondrosis, is very indirect. Osteochondrosis is based on the degeneration and degeneration of the articular cartilage. This is not an independent disease, but a pathological process that can be noted almost anywhere there is connective cartilage tissue.
Yet osteochondrosis in the overwhelming case affects the spine. Why is that? The fact is that between the vertebrae there is a kind of pads - intervertebral (intervertebral) discs. The physiological role of these discs is to cushion and protect the vertebral bodies from premature wear due to mechanical stresses. The disc consists of an internal liquid pulpy nucleus surrounded by a fibrous ring and an upper and lower plate.
The disc undergoes enormous mechanical stress, causing permanent damage to its structures at the cellular level. In humans, these processes are too pronounced - this is our compensation for standing walking. To prevent the disk from being completely "erased", it must constantly regenerate itself, that is, rebuild itself. It is the balance of damage regeneration processes that determines the normal structure of the intervertebral disc. Another curious detail is that the supply of blood and nutrients to the intervertebral discs takes place not through the blood vessels, which are invaded by growth in childhood, but in a diffuse way, from the bone tissue of the vertebral bodies. . Again, the payment for the ability to move on two limbs, not four.
As a result, the intervertebral discs are easily injured in anatomical and physiological terms. Any negative process in the body leads to an imbalance in the damage-regeneration balance and the development of dystrophy and degeneration of the discs. A structurally defective disc is no longer able to withstand the appropriate mechanical stresses. Under excessive pressure from the overlying vertebrae, the discs are moved in different directions, usually to the sides and back. This process is called a herniated disc.
The bone tissue of the vertebrae, which has lost its cartilage lining, also undergoes mechanical wear. Due to constant trauma on the surface of the anterior edge of the vertebral bodies, pathological bone growths are formed - osteophytes. Spondylosis develops. Due to degeneration and displacement of the disc, the intervertebral spaces decrease, the spinal canal narrows, and the roots of the spinal nerves in the so-called foraminal foramina are violated.
Causes
The causes, or etiological factors, of osteochondrosis are diverse. They can be both local, that is to say due to the pathology of the spine itself, and general disorders at the level of the organism. Any pathology leading to a violation of the structure of the spine or metabolic disorders can be considered the cause of osteochondrosis. In this regard, there are:
- Changes in the configuration of the spine (scoliosis, pathological lordosis or kyphosis).
- Other defects of the musculoskeletal system are flat feet, a narrow shoulder girdle, abnormalities in the structure of the pelvis.
- Injury to the spine.
- Low immunity.
- Metabolic disorders - osteoporosis, obesity, diabetes mellitus, thyroid disease.
- Diseases of the cardiovascular system - atherosclerosis, hypertension.
- Digestive disorders leading to insufficient absorption of nutrients from the gastrointestinal tract.
- Heredity.
It should be noted that the above pathological conditions do not necessarily lead to osteochondrosis. This requires constant exposure to certain predisposing factors - hypothermia, malnutrition, sedentary lifestyle or, on the contrary, excessive physical exertion.
Symptoms
Osteochondrosis itself is an asymptomatic process. And, at the same time, the signs of degeneration of the intervertebral discs are various. How? 'Or' What? The fact is that the clinical manifestations of osteochondrosis are based on its complications - herniated discs, spondylosis, sciatica, narrowing of the spinal canal.
In addition, the clinic is very variable depending on the predominant location of the process in the cervical, thoracic or lumbosacral spine. The last section is most often affected, since it is the lower back that exercises the most physical activity. Signs of osteochondrosis of the lumbosacral region:
- Pain (lumbodynia, lumbago, sciatica).
- Restriction of movement in the lower back and lower limbs (intermittent claudication).
- Here, disorders of the sensitivity of the type of paresthesia - numbness, burning, crawling.
- Pathological tension of the lumbar muscles.
- In the absence of treatment, disorders of the function of the pelvic organs.
Cervical osteochondrosis is observed somewhat less frequently than lumbosacral. However, this pathology is also quite common. In addition to the typical signs of pain (neck pain), decreased sensitivity and movement of the upper extremities, cervical osteochondrosis due to insufficient blood supply to the brain has its own characteristics. These characteristics are manifested:
- Insomnia.
- Headache, dizziness.
- Periodic nausea.
- General weakness, rapid fatigue.
- Blood pressure fluctuations.
- Sometimes toothache.
- Behavioral reactions in the form of tearing, irritability.
The thoracic region with osteochondrosis is relatively rarely affected. Patients in this case are people who are forced to sit in a fixed uncomfortable position by profession - students, schoolchildren, programmers, office workers. Symptoms of osteochondrosis in this case will be as follows:
- Pain and paresthesia in the chest.
- Dyspnea.
- Heartbeat feeling.
- Restriction of movement in the thoracic spine.
Diagnostic
From all this it is clear that osteochondrosis is a chameleon disease. Due to the similarity of signs, it is easy to confuse it with stroke, hypertension, myocardial infarction, angina, neurotic disorders. That is why, in order to make the correct diagnosis, a complex and complete diagnosis is necessary in order to correctly determine the symptoms and treatment of osteochondrosis.
This diagnosis, in addition to the traditional questioning and clarification of patient complaints, should include special medical examination and research methods. These methods include x-ray of the spine, ultrasound of internal organs. Recently, magnetic and computed resonance imaging have been used successfully to diagnose osteochondrosis.
Processing
Therapeutic tactics for osteochondrosis involve the use of:
- Medications.
- Massage.
- Physiotherapy procedures.
- Physiotherapy (exercise therapy).
- Manual therapy.
- Acupuncture.
Medicines for osteochondrosis are primarily aimed at relieving pain and eliminating inflammatory processes in the nerve roots. In various combinations, these drugs are widely used in the form of ointments, injections, tablets for the treatment of osteochondrosis. It should be remembered that these drugs have a negative effect on the liver, stomach and intestines. By this, they can worsen metabolic disorders in osteochondrosis. They relieve the pain of the blockade well with local anesthetics. True, the effect of these funds is short-lived and in no way affects the course of osteochondrosis as a whole.
It is possible to improve metabolic processes locally and in the body with the help of drugs such as chondroprotectors, immunostimulants and vitamins with minerals. Chondroprotectors are used in tablets, ointments and ampoules. Among the fortifying agents, vitamins C, group B, in combination with minerals are used. In this regard, calcium preparations are most preferred. Indeed, contrary to some erroneous claims, the basis of osteochondrosis is not excess, but just calcium deficiency.
After successfully relieving the exacerbation, physiotherapy procedures, massage and exercise therapy are presented. As physical procedures, calcium electrophoresis, hydrocortisone phonophoresis, amplipulse, and paraffin therapy are used. All of these measures are aimed at eliminating pain and inflammation of nerve roots, ligaments and muscles. Massage for osteochondrosis is carried out according to the generally accepted method. The massage area is chosen depending on the location of the osteochondrosis. Expansion of range of motion is achieved with the help of exercise therapy. At first, in the phase of exacerbation, there are practically no dynamic loads. The patient is constantly in an optimal posture. At this point, it is desirable to wear immobilization devices - a lumbar corset, a Shant's collar. As the exacerbation decreases, the volume and duration of movements during exercise therapy increase.
Recently, in the treatment of osteochondrosis, non-traditional methods of treatment have been received - acupuncture, manual therapy, osteopathy. Acupuncture is an effect on special biologically active points located along the spine, on the atria, on the hands and on the feet. With manual therapy, the normal position of the vertebrae and intervertebral discs is restored through the manual action of the hands of a specialist. And during osteopathy, the structural integrity of the musculoskeletal system is ensured by specific techniques. In the absence of the effect of conservative measures for the treatment of osteochondrosis, persistent pain, complications, surgery is indicated. The pathologically displaced disc is removed. Currently, for this purpose, a microdiscectomy is performed - the endoscopic removal of a displaced disc.