The term osteochondrosis itself is derived from two words: osteo - bone and chondrue - cartilage. Simply put, it is cartilage ossification. Although this interpretation is fundamentally wrong. Some in their illusions go even further, and are certain that osteochondrosis is the deposition of salts in the joints. Moreover, it is table salt that is supposed to be consumed in large quantities for food.
Pathogenesis
In reality, everything happens a little differently. And harder. And table salt, if it plays any role in the onset of osteochondrosis, is very indirect. Osteochondrosis is based on degeneration and degeneration of the articular cartilage. This is not an independent disease, but a pathological process that can be observed almost anywhere where there is cartilage connective tissue.
However, osteochondrosis in the vast majority affects the spine. Why is she? The fact is that between the vertebrae there is a kind of pads - intervertebral discs (intervertebral). The physiological role of these discs is to protect and safeguard the vertebral bodies from premature wear due to mechanical stress. The disc consists of an inner fluid pulposus nucleus surrounded by an annulus fibrosus and an upper and lower end plate.
The disk is subjected to extreme mechanical stress, leading to permanent damage to its structures at the cellular level. In humans, these processes are very pronounced - this is our payoff for moving forward. To prevent the disk from being "erased" completely, it must be constantly regenerated, that is, rebuilt 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 is carried out not through blood vessels, which are overloaded in childhood, but diffusely, from the bone tissue of the vertebral bodies. Again, payment for the ability to move on two limbs, not four.
Because of this, the intervertebral discs are easily damaged anatomically and physiologically. Any negative process in the body leads to an imbalance in the damage-regeneration balance and to the development of dystrophy and degeneration in the discs. A structurally defective disc is no longer able to withstand proper mechanical stress. Under excessive pressure from the upper vertebrae, the discs move in different directions, usually to the sides and back. This process is called a disc herniation.
The vertebral bone tissue, which has lost cartilage lining, is also subject to mechanical wear. Due to the constant trauma to the surface of the anterior edge of the vertebral bodies, pathological growths of bones are formed - osteophytes. Spondylosis develops. Due to degeneration and displacement of the disc, the intervertebral spaces shrink, the spinal canal narrows, and the roots of the spinal nerves in the so-called foramina foramina are damaged.
Causes
The causes or etiological factors of osteochondrosis are different. They can be local, ie due to the pathology of the spine itself and general disorders at the organism level. Any pathology leading to a violation of the structure of the spine or metabolic disorders can be considered as 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, narrow shoulder girdle, abnormalities in the structure of the pelvis.
- Spinal cord injury.
- Weak immunity.
- Metabolic disorders - osteoporosis, obesity, diabetes mellitus, thyroid diseases.
- Diseases of the cardiovascular system - atherosclerosis, hypertension.
- Digestive disorders leading to insufficient absorption of nutrients from the gastrointestinal tract.
- Inheritance.
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, a sedentary lifestyle or, conversely, excessive physical exertion.
Symptoms
Osteochondrosis itself is an asymptomatic process. And, at the same time, the signs of intervertebral disc degeneration are different. How so? The fact is that the clinical manifestations of osteochondrosis are based on its complications - disc herniation, spondylosis, sciatica, narrowing of the spinal canal.
Moreover, the clinic is highly variable depending on the predominant localization of the process in the cervical, thoracic, or lumbosacral spine. The last part is most often affected, as it is the lower back that receives the maximum physical activity. Signs of osteochondrosis of the lumbosacral region:
- Pain (lumbodynia, lumbago, sciatica).
- Restriction of movement in the lower back and lower extremities (intermittent claudication).
- Here, disorders of sensitivity of the type of paresthesia - numbness, burning, crawling crawling.
- Pathological tension of the lumbar muscles.
- In the absence of treatment, disorders of pelvic organ function.
Osteochondrosis of the cervix is observed somewhat less frequently than lumbosacral. However, this pathology is also quite common. In addition to the typical signs of pain (cervical pain), decreased sensitivity and movements in the upper extremities, cervical osteochondrosis due to impaired 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.
- Occasional toothache.
- Behavioral reactions in the form of tears, nervousness.
The thoracic region with osteochondrosis is affected relatively rarely. Patients in this case are persons forced to sit in a fixed position uncomfortable by profession - students, schoolchildren, programmers, office workers. The symptoms of osteochondrosis in this case will be as follows:
- Chest pain and paresthesia.
- Dyspnea.
- Feeling of heartbeat.
- Restriction of movement in the thoracic spine.
Diagnosing
From all this it is clear that osteochondrosis is a chameleon disease. Due to the similarity of the signs, it is easy to confuse with cerebrovascular accident, hypertension, myocardial infarction, angina pectoris, neurotic disorders. This is why, to make an accurate diagnosis, a comprehensive comprehensive diagnosis is needed to accurately determine the symptoms and treatment of osteochondrosis.
This diagnosis, in addition to the traditional questions and clarification of patients' complaints, should include a medical examination and special research methods. These methods include x-ray of the spine, ultrasound of internal organs. Recently, computed tomography and magnetic resonance imaging have been used successfully to diagnose osteochondrosis.
Treatment
Therapeutic tactics for osteochondrosis include the use of:
- Barna.
- Massage.
- Physiotherapy procedures.
- Physiotherapy (exercise therapy).
- Manual therapy.
- Acupuncture.
Medicines for osteochondrosis are mainly 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 not be forgotten that these drugs have a negative effect on the liver, stomach and intestines. With this, they can aggravate metabolic disorders in osteochondrosis. They relieve blockage pain 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 physically with the help of drugs such as chondroprotectors, immunostimulants and mineral vitamins. Chondroprotectors are used in tablets, ointments and ampoules. Among the strengthening agents are used vitamins C, group B, in combination with minerals. In this regard, calcium supplements are the most preferred. Indeed, contrary to some erroneous statements, the basis of osteochondrosis is not an excess, but only a lack of calcium.
After successful relief of irritation, physiotherapy procedures, massage and exercise therapy are indicated. Calcium electrophoresis, hydrocortisone phonophoresis, amplipulus, paraffin therapy are used as physical procedures. All of these measures are aimed at eliminating pain and inflammation in the nerve roots, ligaments and muscles. Massage for osteochondrosis is performed according to the generally accepted method. The massage area is chosen depending on the localization of osteochondrosis. The expansion of the range of motion is achieved with the help of exercise therapy. At first, in the deterioration phase, there are virtually no dynamic loads. The patient is constantly in an optimal position. At this time, it is desirable to wear immobilizing equipment - a lumbar corset, Shants neck collar. As the deterioration decreases, the volume and duration of movements during exercise therapy increases.
Recently, in the treatment of osteochondrosis, non-traditional methods of treatment have been accepted - acupuncture, manual therapy, osteopathy. Acupuncture is an effect on specific biologically active points located along the spine, kidneys, hands and feet. With manual therapy, the normal position of the vertebrae and intervertebral discs is restored through the manual action of a specialist's hands. And in the course of osteopathy, the structural integrity of the musculoskeletal system is ensured using 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, microdiscectomy is performed - endoscopic removal of a displaced disc.