Osteochondrosis Symptom Diagnostic Treatment

Herniated intervertebral discs are more common in age-related osteochondrosis due to the dryness and fragility of the annulus fibrosus. But this is only one of the risk factors. Others include:

• Heavy load in the lumbar region due to being overweight.
• Weakness of the muscular apparatus.
• Inheritance.
• A sedentary lifestyle and, as a result, a constant compression of the vertebral structures.
• Of smoking.
• Great physical activity.

According to medical statistics, this disease occurs in men much more often than in women.

What are the most common causes of the disease?

• Injuries from traffic accidents or falls.
• Lifting heavy objects with incorrect load distribution.
• Scoliosis or lordosis, which cause increased stress in certain areas of the spine.
• Hip joint dysplasia.
• Chronic diseases, including tuberculosis of the spine, neoplasms, syphilis.
• Metabolic disorders (inherited and acquired).

All of these factors cause the cartilage and bones of the spine to wear down and weaken. And this is the main reason for intervertebral hernia.

Stages of disease development.

Without proper treatment, the disease progresses and the condition of the damaged spinal discs worsens. There are four stages in the development of the disease:

1. Prolapse. The intervertebral disc has moved quite a bit, no more than two millimeters. The nucleus pulposus does not protrude beyond the vertebral body.
2. Lumbar bulgeThe edge of the disc extends beyond the vertebral body for a distance of up to 1. 5 mm, but displacement of the nucleus is not observed.
3. Extrusion. The nucleus protrudes beyond the vertebral body.
4. Kidnapping. The nucleus practically falls off and hangs over the vertebra in a teardrop shape. At this stage, there is a risk of rupture of the fibrous ring and loss of fluid secretion.

At the first stage of the disease, a person is almost not worried about anything, sometimes there are back pains, but they quickly pass. With the development of the disease, the state of health also worsens, the symptoms become more painful and alarming. If the diagnosis is not made in time and treatment is not started, the consequences are possible: paralysis of the legs and serious disorders of the nervous system.

How does a lumbosacral hernia manifest?

An intervertebral hernia can manifest itself with the following symptoms:

• Pain in the lumbar region.
• Pain when walking, radiating to the thigh region.
• Numbness of the feet, fingers, surface areas of the lower leg and thigh.
• Feeling of heaviness in the legs.
• Stiffness of movement.

In order not to delay in seeking medical help, it is worth taking a closer look at the symptoms of the disease. They can be divided into three groups.

Pain syndrome

Pain with a lumbosacral spine hernia is a key symptom. Even in the first stage, there is pain in the area of the damaged disc, especially after an injury. They can increase or decrease and then reappear. More often, the sacral region does not even hurt, but it hurts, especially with physical exertion or prolonged sedentary work. If a person lies on a healthy side and bends the leg, the pains completely disappear. This condition can last for several months.

With timely medical help treatment, it is easy to get rid of the problem. Just say goodbye to bad habits and perform the physical therapy exercises recommended by your doctor.

Every day, the affected area will increase, and the condition of the disc tissues will worsen. The transition to the second degree of the disease is indicated by increased pain. Now it is felt not only in the sacral region, but it covers the entire lower back, radiating to the cervical region, to each spinal muscle, buttocks, thighs, legs, feet and fingers. Discomfort manifests itself with physical activity, even insignificant - coughing or sneezing.

Vertebral syndrome

Increased pain in the second stage is accompanied by constant spasms of the back muscles. This leads to even greater discomfort for the patient. He cannot move freely, straighten his back, stretch. The gait of such a person becomes uncertain, he always leans to the side opposite the patient, bends over.

Due to the lack of coordination of movements, the quality of human life deteriorates. You are unable to perform your assigned tasks well at work and active rest due to constant pain becomes unrealistic.

Root syndrome

If doctors do not take care of a hernia, a progressive disease leads to compression of the spinal roots, as a result of which they die, and access of blood to the tissues of the damaged disc is almost impossible. Characteristic symptoms of severe stages of the disease appear:

• Weakening of the leg muscles. The patient is unable to squat, stretch, or jump. Even climbing the stairs is difficult for him.
• Numbness of the affected area and surrounding areas. The skin becomes numb and pale, there is a feeling of goose bumps and tingling. Patients complain of hyperhidrosis in the affected area and legs or, conversely, excessive dryness of the skin.
• Lumbago. The patient suffers from lumbago in the lumbar region with sharp, sharp pain, increasing with any movement. If left untreated, it leads to the destruction of the hip and knee joints.
• A noticeable thinning of the sore leg, leading to posture asymmetry.
• Alteration of the pelvic organs. Urological and gynecological ailments are aggravated, libido disappears, diarrhea, urinary incontinence is possible.

In severe cases of spinal hernia, there is a risk of paralysis, disability, and even death.

Pathology diagnosis

If a person has severe low back pain, they should make an appointment with a neurologist. You will perform an exam with medical tests:

• Identification of reflexes of the tendons of the lower extremities.
• Leg lift test.
• Determination of sensitivity to heat or cold, pain and vibration on the entire surface of the legs, thighs, buttocks, abdomen and back.

The doctor will then refer the patient for an MRI or CT scan of the lumbar spine. With the help of tomographic techniques, a three-dimensional image of the affected area will be obtained. It can be used to determine the location and size of the hernia, the stage of the disease.

If there is a risk of spinal cord injury, electromyography, neurography, and contrast myelography are also prescribed. With the help of these studies, the doctor will determine if urgent surgical intervention is necessary.

Herniated disc treatment

A vertebral hernia is treated both conservatively and surgically. The choice of technique depends on the stage of development of the disease, the presence of concomitant diseases and contraindications.

Conservative therapy

The therapeutic course is primarily aimed at relieving pain and alleviating the patient's condition.

What pharmaceutical products can a doctor prescribe?

1. Medicines that relieve pain and inflammation. In case of exacerbation, in the form of injections. When acute pain is relieved (usually three or four days is enough), oral medications are prescribed with a similar effect.
2. Novocaine blockade with the addition of corticosteroids. A similar method can stop pain for two weeks at a time. Usually a course of blockages is carried out with injections in different parts of the damaged disc.
3. Central action muscle relaxants. They reduce muscle activity by relieving painful cramps.
4. Complexes of vitamins and minerals with an emphasis on the elements of group B. They slightly relax the muscles, help the regeneration of tissues and the conduction of nerve impulses.

After pain syndrome relief, drug intake decreases. Treatment of the disease is due to physical therapy and physical therapy.

Physiotherapy treatment methods are also selected based on the patient's condition. This could be:

• Treatment with heat or electric shock.
• Electrophoresis with anti-inflammatory drugs.
• Acupuncture and acupressure.
• Hirudotherapy.
• Hydromassage.

Normal massage is allowed only if there is no pain syndrome. A more effective physical therapy treatment is manual therapy with posisometric relaxation.

Doctors strongly advise smoking patients to quit smoking.

Nutritional adjustments are also important, especially for overweight patients. Fatty, salty dishes, sweets and alcohol should be excluded from the menu. A moderate diet with plenty of vegetables and fermented dairy products will help the body better withstand the treatment, as well as shed the pounds on the back.

Surgical intervention

Conservative treatment usually lasts about two months. If it does not give the desired result, the decision is made to change the therapeutic tactic or to perform surgery. The latter is prescribed for severe pain, loss of sensation of the legs, dysfunctions of the pelvic organs. Depending on the complexity of the situation, the operation is carried out in the following ways:

• Endoscopic method. Three micro-incisions are made in the affected area. One camera is inserted into another to transmit to the monitor. Through the other two, the hernia bulge is removed using miniature instrumentation.
• By the percutaneous discectomy method. The damaged nucleus is removed by puncturing the spinal disc and replaced with an artificial substance.
• By laser reconstruction. It is done in the form of pricks with a special needle without dissecting tissue. The laser radiation heats the disc structures and stimulates cell regeneration, in addition to relieving pain.

In difficult cases, the endoprosthesis of the vertebral discs is possible, replacing the injured organ with an implant.

After complex surgical interventions, rehabilitation will be required. The person operated on must wear a corset and will not be able to sit for about three months. The additional rehabilitation period involves the practice of therapeutic gymnastics and physical therapy.

Preventive techniques

Like any other medical condition, herniated discs are easier to prevent than to cure. What you need to do to keep your spinal discs healthy:

1. Calculate loads accurately if your job is related to them or if you are a professional athlete.
2. Correct body weight (your index should not exceed 30).
3. Choose a good mattress to sleep in the correct position (preferably on your back).
4. Participate in soft physical education, swimming, fitness.
5. Include exercises in your morning exercises to strengthen the spinal muscle corset.
6. Put down the cigarettes.
7. Eat well.

If following these rules becomes a habit, there is a risk of getting a spinal hernia only as a result of an accident.

A herniated disc is dangerous with serious consequences and the treatment of advanced cases is very long. To avoid surgeries and complications, if you have painful sensations in your back, you should consult a neurologist.

Osteochondrosis

The term osteochondrosis itself is derived from two words: osteo - bone and chondrosis - cartilage. Simply put, it is the ossification of the cartilage. Although this interpretation is fundamentally wrong. Some in their delusions go even further and trust that osteochondrosis is the deposit of salts in the joints. Also, it is table salt that is supposedly consumed in large quantities.

Pathogenesis

In reality, everything happens a little differently. And harder. And table salt, if it plays a role in the appearance of osteochondrosis, is very indirect. Osteochondrosis is based on dystrophy and degeneration of articular cartilage. This is not an independent disease, but rather a pathological process that can be observed almost anywhere where there is connective cartilage tissue.

Still, osteochondrosis in the overwhelming case affects the spine. Why is that? The fact is that between the vertebrae there is a kind of spacers - intervertebral (intervertebral) discs. The physiological function 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 an annulus fibrosus and an upper and lower end plate.

The disc undergoes tremendous mechanical stress, causing permanent damage to its structures at the cellular level. In humans, these processes are too pronounced - this is our pay for walking upright. To prevent the disk from being "erased" completely, it must be constantly regenerated, that is, restored. It is the balance of the 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 carried out through the blood vessels, which grow too large in childhood, but diffusely, from the bone tissue of the vertebral bodies. Again, the payment for the ability to walk on two limbs, not four.

Due to this, the intervertebral discs are easily injured anatomically and physiologically. Any negative process in the body leads to an imbalance in the regeneration of damage and the development of dystrophy and degeneration in the discs. A structurally defective disc can no longer withstand adequate mechanical stress. Under excessive pressure from the overlying vertebrae, the discs shift 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 suffers mechanical wear. Due to constant trauma to the surface of the anterior border 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 are infringed on the so-called. Foraminal holes.

Causes

The causes or etiological factors of osteochondrosis are diverse. They can be both local, that is, caused by the pathology of the spine itself and general disorders at the organism level. Any pathology that leads 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: flat feet, narrow shoulder girdle, pelvic abnormalities
• Spinal 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 effort.

Symptoms

Osteochondrosis itself is an asymptomatic process. And at the same time, the signs of degeneration of the intervertebral disc are diverse. How is that? 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 symptoms are highly variable depending on the predominant location of the process in the cervical, thoracic or lumbosacral spine. The last section is the most affected, since it is the lower back that performs 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, the sensitivity disorders of the paresthesia type: 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 seen less frequently than lumbosacral. However, this pathology is also quite common. In addition to the typical signs of pain (neck pain), decreased sensation and movements in the upper extremities, cervical osteochondrosis due to poor blood supply to the brain has its own characteristics. These characteristics are manifested:

• 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 infrequently affected. Patients in this case are people forced to sit in an uncomfortable fixed position by occupation: students, schoolchildren, programmers, office workers. The symptoms of osteochondrosis in this case will be as follows:

• Pain and paresthesia in the chest.
• Dyspnoea
• Feeling of heartbeat.
• Restriction of movement in the thoracic spine.

Diagnosis

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 pectoris, neurotic disorders. That is why, in order to make the correct diagnosis, a comprehensive and complex diagnosis is required to correctly determine the symptoms and treatment of osteochondrosis.

This diagnosis, in addition to the traditional questioning and clarification of patient complaints, must include a medical examination and special investigation methods. These methods include X-rays of the spine, ultrasound of internal organs. Recently, computerized and magnetic resonance imaging have been used successfully to diagnose osteochondrosis.

Treatment

Therapeutic tactics for osteochondrosis involve the use of:

• Medicines
• Massage
• Physiotherapy procedures
• Physical therapy (exercise therapy)
• Manual therapy
• Acupuncture.

Medication for osteochondrosis is primarily aimed at relieving pain and eliminating inflammatory processes in the nerve roots. For this purpose, NSAID drugs are used. 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. By doing this, they can aggravate metabolic disorders in osteochondrosis. They alleviate the pain of the block 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. Chondroprotectants are used in tablets, ointments, and ampoules. Among the fortifying agents, vitamins C, group B, are used in combination with minerals. In this regard, calcium preparations are most preferred. In fact, contrary to some erroneous claims, the basis of osteochondrosis is not an excess, but only a deficiency of calcium.

After successfully relieving the exacerbation, physical therapy, massage and exercise therapy are shown. Calcium electrophoresis, hydrocortisone phonophoresis, amplipulse, 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 carried out according to the generally accepted method. The massage zone is selected depending on the location of the osteochondrosis. Expansion of range of motion is accomplished with the help of exercise therapy. At first, in the exacerbation phase, there are practically no dynamic loads. The patient is constantly in an optimal posture. At this time, it is desirable to use immobilizing devices - a lumbar corset, Shants neck. As the exacerbation subsides, the volume and duration of movements during exercise therapy increase.

Recently, in the treatment of osteochondrosis, non-traditional treatment methods have been received: acupuncture, manual therapy, osteopathy. Acupuncture is an effect on special biologically active points located along the spine, in 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 in the course of 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 - endoscopic removal of a displaced disc.