The term osteochondrosis itself comes 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 confident that osteochondrosis is the deposition of salts in the joints. Also, it is table salt that is supposed to be consumed in large quantities for food.
pathogenesis
In reality, everything happens a little differently. It is more difficult. And table salt, if it plays a role in the onset 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 noticed almost anywhere where connective cartilage tissue is present.
However, osteochondrosis in the overwhelming case affects the spine. Because? The fact is that between the vertebrae there are 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 stress. The disc consists of an internal liquid nucleus pulposus surrounded by a fibrous ring and an upper and lower end plate.
The disc undergoes tremendous mechanical stress, which leads to permanent damage to its structures at the cellular level. In humans, these processes are too pronounced - this is our payment for walking upright. 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 is not effected through the blood vessels, which grew in childhood, but diffusely, from the bone tissue of the vertebral bodies. Again, the payment for the ability to move on two limbs, not four.
For this reason, 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 in the discs. A structurally defective disc is no longer able to withstand the correct mechanical stress. 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, is also subject to 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 due to the pathology of the spinal column itself, and general disorders at the level of the organism. Any pathology that leads 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, narrow shoulder girdle, anomalies in the structure of the pelvis.
- Spine injury.
- Weak 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.
- 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. Why? The fact is that the clinical manifestations of osteochondrosis are based on its complications: herniated discs, spondylosis, sciatica, narrowing of the spinal canal.
Furthermore, the clinic is highly variable depending on the predominant localization of the process in the cervical, thoracic or lumbosacral spine. The last section is most often affected, since it is the lower back that takes on the greatest physical activity. Signs of osteochondrosis of the lumbosacral region:
- Pain (low back pain, low back pain, sciatica).
- Restriction of movement in the lower back and lower limbs (intermittent claudication).
- Here, sensitivity disorders of the type of paresthesia: numbness, burning, creeping chills.
- Pathological tension of the lumbar muscles.
- In the absence of treatment, disturbances in 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 movements of the upper limbs, cervical osteochondrosis due to impaired blood supply to the brain has its own characteristics. These features manifest themselves:
- Insomnia.
- Headache, dizziness.
- Periodic nausea.
- General weakness, rapid fatigue.
- Fluctuations in blood pressure.
- Occasionally toothache.
- Behavioral reactions in the form of crying, irritability.
The thoracic region with osteochondrosis is relatively rarely affected. Patients in this case are people forced to sit in an uncomfortable position fixed by the occupation: students, schoolchildren, programmers, office workers. Symptoms of osteochondrosis in this case will be as follows:
- Chest pain and paraesthesia.
- Dyspnea.
- Sensation of heartbeat.
- Movement restriction in the thoracic spine.
Diagnostics
From all this it is clear that osteochondrosis is a chameleon disease. Due to the similarity of the signs, it is easy to confuse it with cerebrovascular accident, hypertension, myocardial infarction, angina pectoris, neurotic disorders. That is why, in order to make the correct diagnosis, a comprehensive complex diagnosis is required to correctly determine the symptoms and treatment of osteochondrosis.
This diagnosis, in addition to the traditional questions and clarifications on patient complaints, should include a medical examination and special research methods. These methods include x-ray of the spine, ultrasound of internal organs. Recently, MRI and computerized resonance have been used successfully to diagnose osteochondrosis.
Treatment
Therapeutic tactics for osteochondrosis involves the use of:
- Medicines.
- Massage.
- Physiotherapy procedures.
- Physiotherapy (physical 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 block pain 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 the most preferred. Indeed, contrary to some erroneous claims, the basis of osteochondrosis is not an excess, but only a calcium deficiency.
After successfully relieving the exacerbation, physiotherapy, massage and physical therapy procedures are shown. As physical procedures, calcium electrophoresis, hydrocortisone phonophoresis, amplipulse, paraffin therapy are used. All these measures are aimed at eliminating pain and inflammation in the nerve roots, ligaments and muscles. Massage for osteochondrosis is carried out according to the generally accepted method. The massage zone is selected based on the localization of osteochondrosis. Expansion of the range of motion is achieved with the help of physical therapy. At first, in the phase of exacerbation, there are practically no dynamic loads. The patient is constantly in optimal posture. At this time, it is preferable to wear immobilization devices: a lumbar corset, Shants neck collar. As the exacerbation subsides, the volume and duration of movements during physical 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 auricles, hands and 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 in the course of osteopathy, the structural integrity of the musculoskeletal system is ensured through specific techniques. In the absence of the effect of conservative measures for the treatment of osteochondrosis, persistent pain, complications, surgical intervention is indicated. The pathologically displaced disc is removed. Currently, for this purpose, microdiscectomy is performed - endoscopic removal of a displaced disc.