In the life of a modern person, an imbalance between active physical activity and static loads leads to a decrease in the tone of the back muscles, therefore, the increasing axial load on the intervertebral discs and ligamentous apparatus of the spine creates conditions for their microtraumatization. The so-called degenerative-dystrophic processes of the cartilaginous tissue of the vertebrae, intervertebral discs and ligamentous apparatus develop - doctors call all this collectively polysegmental osteochondrosis.
With age, natural aging of the intervertebral discs occurs, intensifying under the influence of vibration, jerking movements, heavy lifting and falls. The development and exacerbation of osteochondrosis is facilitated by various back injuries, physical overload, poor physical fitness, poor posture and curvature of the spine, flat feet and excess weight.
Causes of osteochondrosis
- hereditary predisposition;
- metabolic disorders in the body;
- overweight, poor diet (lack of fluids);
- age-related changes;
- spinal injuries;
- poor posture, scoliosis, flat feet;
- sedentary lifestyle;
- work involving heavy lifting;
- overload of the spine as a result of walking in high heels and pregnancy in women, etc.
The main symptoms of common osteochondrosis
- constant aching pain in the back, a feeling of numbness in the limbs;
- increased pain with sudden movements, physical activity, or heavy lifting;
- decreased range of motion, muscle spasms;
With cervical chondrosis, a person will be bothered by pain in the arms, shoulders, and headaches; It is possible to develop the so-called vertebral artery syndrome, in which there are complaints of noise in the head, dizziness, flashing "spots", colored spots before the eyes in combination with a throbbing headache.
With osteochondrosis of the thoracic spine: pain in the chest (like a "stake" in the chest), in the area of the heart and other internal organs; with osteochondrosis of the lumbosacral spine: pain in the lower back, radiating to the sacrum, legs, and sometimes to the pelvic organs.
Cervical osteochondrosis. Localization of osteochondrosis in the neck area is quite common. The cervical spine suffers more often in people who do monotonous work - designers, programmers, secretaries, dentists, etc. As a rule, the development of cervical osteochondrosis is facilitated by driving and long-term work at the computer. The main signs and symptoms of cervical osteochondrosis include: headache, dizziness, pain in the arms and chest, lumbago, numbness of the tongue. With cervical osteochondrosis, the head often hurts and feels dizzy, the vision becomes dark, and the blood pressure rises. A canal for the so-called vertebral artery passes through the transverse processes of the cervical vertebrae. It is directed into the cranial cavity and nourishes the brain. Displacement of the vertebrae leads to spasm of the vertebral artery, and in severe cases, to compression. Thus, the blood supply to certain parts of the brain is disrupted.
When osteochondrosis worsens, radicular symptoms may also be present: pain radiates to the hand, sometimes to individual fingers, they become numb, and become constantly cold. The reason for this is a disruption in the passage of impulses along the nerve fiber. By the numbness of a particular finger, a neurologist can judge the displacement of a particular vertebra. The clinical picture of osteochondrosis of the cervical spine is characterized by a variety of symptoms, which is due to the physiological characteristics of this segment.
The thoracic spine is rarely affected by osteochondrosis. One of the main reasons for the developmentthoracic osteochondrosisis a curvature of the spine (scoliosis). Usually, the reasons for the development of thoracic osteochondrosis are formed from school. The thoracic spine is the least mobile, so the signs and symptoms of thoracic osteochondrosis are very different from the symptoms of cervical or lumbar osteochondrosis. In most cases, the main difference between thoracic osteochondrosis is the absence of acute pain and the presence of only dull, aching pain in the back. The main symptoms and signs of thoracic osteochondrosis include: chest pain, numbness, a crawling sensation in the chest area, pain in the heart, liver, and stomach. Very often, thoracic osteochondrosis is disguised as other diseases (for example, myocardial infarction, peptic ulcer, gastritis). The pain associated with osteochondrosis of the thoracic spine is long-lasting, similar to intercostal neuralgia. Sometimes the pain may radiate under the shoulder blade, which makes one suspect a heart attack. The difference between "heart" pain and intercostal neuralgia is that with osteochondrosis the patient has a normal electrocardiogram, there are no symptoms such as severe pallor, bluish skin, cold sweat, etc.
Lumbosacral osteochondrosis. Osteochondrosis of the lumbar spine occurs most often. This is explained by the fact that the lower back (lumbar vertebrae), as a rule, bears the main load. Most often, lumbar osteochondrosis can be complicated by an intervertebral hernia of the lumbar spine. The main symptoms and signs of lumbar osteochondrosis include: lower back pain (lower back pain has bothered a person for many years and is characterized by cyclicality, worsening in the autumn-winter period), limited mobility, pain in the legs. Very often, with lumbar osteochondrosis, there is acute (lumbago) or aching pain in the legs, affecting a certain part of the leg (for example, at the back or side). In addition to pain, there may be an increase or decrease in the sensitivity of the skin of the legs to touch or pain - these symptoms of osteochondrosis are explained by pinching of the spinal cord roots.
The most common cause of osteochondrosis in the lumbosacral region is traumatic (compression fracture or chronic injury). In the lumbar region, the sciatic nerve is formed from nerve roots. When a nerve is pinched, the pain spreads along the nerve trunk: to the buttock area, under the knee, sometimes to the calf or heel. Significant disturbances in the nutrition of the nerve trunk are possible, then the leg goes numb. Symptoms of sensory impairment are very persistent, sometimes numbness persists for a long time. When the sciatic nerve is pinched, a person begins to limp, leaning towards the healthy side in order to maximize the vertebrae on the affected part of the body and thereby reduce compression of the root. With osteochondrosis of the lumbosacral spine, the first clinical manifestations are pain in the lower back and leg.
Treatment
Treatment for osteochondrosisIt is mainly carried out using conservative methods aimed at eliminating pain, dysfunction of the spinal roots and preventing the progress of dystrophic changes in the structures of the spine.
Pain syndrome with osteochondrosis usually occurs as an exacerbation-remitting type. Moreover, if the pain lasts for more than 3 months, doctors talk about chronic pain. It increases the anxiety level in patients and inclines them to a depressed mood. Standard treatment regimens become ineffective as the pathogenesis of pain changes. In such cases, neurologists add to treatment drugs from the group of antidepressants, which are part of the standard treatment for chronic pain. This entire process can take a long time.
Therefore, it is necessary to eliminate risk factors for osteochondrosis and modify lifestyle. And also timely and effectively relieve acute pain to prevent its chronicity.
Acute pain develops when tissue is damaged and inflamed. Therefore, the main group of drugs used in treatment are non-steroidal anti-inflammatory drugs (NSAIDs). Pain occurs when nociceptors are irritated by products of arachidonic acid metabolism.
The most popular NSAID was and remains diclofenac. This drug has been used for many years and is considered the "gold standard" for pain relief and anti-inflammatory effects. Diclofenac is widely used to relieve acute pain in osteochondrosis.
A new drug containing diclofenac is of great interest. This is a rapidly dissolving, buffer-stabilized sachet. This form of release is quickly absorbed, and the therapeutic effect is comparable to the injection form and develops within 5 to 20 minutes. The new drug has a high speed of action and a long lasting effect.
The medicine is used in a dosage of 50 to 100 mg, the daily dose of the drug should not exceed 150 mg/day. The daily dose should be divided into 3 doses.
The effect of diclofenac potassium in sachet form was compared with the injectable form of diclofenac in a clinical study. The results showed the superiority of diclofenac potassium in sachet form over the injection form. It seems that the new drug will significantly expand the possibilities of analgesic therapy for doctors in our country.
The impact on the muscle component of pain involves: post-isometric relaxation, massage and therapeutic exercises, including exercises to strengthen the muscle corset or stretch spasmodic muscles, and the use of muscle relaxants. These methods can be combined with reflexology and other physiotherapeutic procedures (DDT, SMT, electrophoresis with local anesthetics, hydrocortisone phonophoresis, etc. ).
Prevention
The main methods for preventing osteochondrosis are: physical activity, a properly equipped workplace that eliminates prolonged postural tension, timely relief of acute pain, and regular exercise therapy.
Successful treatment of patients with osteochondrosis depends on proper management of restorative measures, especially at the early stage of the disease. Physical rehabilitation should be carried out comprehensively.