Diagnosis and treatment of osteochondrosis symptoms

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 on the lumbar region due to excess weight.
• Weakness of the muscular apparatus.
• Heredity.
• Sedentary lifestyle and consequent constant compression of vertebral structures.
• To smoke.
• Great physical activity.

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

What are the most common causes of the disease:

• Injuries caused by road accidents or falls.
• Lifting heavy objects with incorrect load distribution.
• Scoliosis, or lordosis, causes increased stress in certain areas of the spine.
• Dysplasia of the hip joints.
• Chronic diseases, including tuberculosis of the spine, neoplasms, syphilis.
• Metabolic disorders (hereditary and acquired).

All these factors cause erosion and weakening of the cartilage and bones of the spine. And this is the main cause of 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 changed slightly, no more than two millimeters. The pulposus nucleus does not extend beyond the vertebral body.
2. Waist protrusion. The edge of the disc extends to a distance of 1. 5 mm from the vertebral body, but no displacement of the nucleus is observed.
3. Extrusion. The nucleus extends beyond the vertebral body.
4. Sequestration. The nucleus practically falls and hangs over the vertebrae in the form of a drop. At this stage, there is a risk of rupture of the annulus fibrosus and leakage of fluid secretion.

In the early stages of the disease, a person is not worried about almost anything, sometimes there is back pain, but it passes quickly. As the disease progresses, the health condition worsens, and the symptoms become more painful and disturbing. 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 lumbar-sacral hernia manifest itself?

An intervertebral hernia can present with the following symptoms:

• Pain in the lower back.
• Pain while walking, spreads to the thigh area.
• Alignment of the feet, toes, lower legs and areas on the surface of the thighs.
• Feeling of heaviness in the legs.
• Stiffness of movement.

It is worth analyzing the symptoms of the disease more carefully so as not to delay in seeking medical help. They can be divided into three groups.

Pain syndrome

Pain with a lumbar-sacral hernia is the main symptom. Even in the first stage, there is pain in the area of the damaged disc, especially after the injury. They may increase or decrease, and then reappear. More often the sacral region does not even hurt, but it hurts especially with physical force or prolonged sedentary work. If a person stretches to a healthy side and bends his leg, the pain is completely reduced. This situation can last for several months.

It is easy to get rid of the problem with timely treatment for medical care. It is enough to say goodbye to bad habits and do physiotherapy exercises recommended by your doctor.

Every day the affected area will grow and the condition of the disc tissues will worsen. The transition to the second degree of the disease is marked by an increase in pain. Now it is felt not only in the sacral region, but covers the entire lower back, spreading to the cervical region, every spinal muscle, hips, thighs, legs, feet and toes. Anxiety manifests itself in physical activity, even insignificant - coughing or sneezing.

Vertebral syndrome

In the second stage, increased pain is accompanied by constant spasms of the back muscles. This is an even greater concern for the patient. He can move freely, straighten his back, and cannot lie down. The gait of such a person is indeterminate, always bends to the opposite side of the patient.

The quality of human life deteriorates due to the coordination of movements. He is not able to perform the tasks set at work well, and active rest is unrealistic due to constant pain.

Radicular syndrome

If the hernia is left unattended by doctors, a progressive disease can lead to compression of the spinal roots, resulting in their death, and blood flow to the tissues of the damaged disc is almost impossible. Symptoms characteristic of severe stages of the disease appear:

• Weakening of leg muscles. The patient can not squat, lie down, jump. Even the stairs are difficult for him to climb.
• Coherence of the affected area and surrounding areas. The skin becomes sensitive and pale, there are gas shoots and tingling sensation. Patients complain of hyperhidrosis in the affected area and legs, or, conversely, excessive dryness of the skin.
• Lumbaqo. The patient suffers from lumbago in the lumbar region with sharp, sharp pain that increases with any movement. If left untreated, it can lead to the destruction of the hip and knee joints.
• Significant thinning of the painful leg, causing asymmetry of posture.
• Disorders of the pelvic organs. Urological and gynecological diseases are aggravated, libido disappears, diarrhea, urinary incontinence are possible.

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

Diagnosis of pathology

If a person has severe back pain, he should make an appointment with a neurologist. He will be examined by medical tests:

• Determination of reflexes from 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, hips, abdomen and back.

The doctor will then send the patient for an MRI or CT scan of the lower back. A three-dimensional image of the affected area will be obtained with the help of tomographic equipment. With its help, you can determine the location and size of the hernia, the stage of the disease.

If there is a risk of spinal cord injury, additional electromyography, neurography and contrast myelography are prescribed. With the help of these tests, the doctor will determine whether emergency surgery is needed.

Treatment of disc herniations

Spinal hernias are 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 medications can the doctor prescribe:

1. Medications to relieve pain and inflammation. In case of exacerbation - in the form of injections. When acute pain is relieved (usually three to four days is enough), oral medications with similar effects are prescribed.
2. Novocaine blockade with the addition of corticosteroids. A similar method is able to stop the pain for two weeks at a time. Usually, a course of blockage is performed by injecting various parts of the damaged disc.
3. Centrally effective muscle relaxant. They reduce muscle activity by relieving pain cramps.
4. Vitamin-mineral complexes with an emphasis on the elements of the B group. They relax the muscles a little, help to regenerate tissues and conduct nerve impulses.

After the pain syndrome is eliminated, the intake of medications decreases. Treatment of the disease is associated with physical therapy and physiotherapy.

Physiotherapy treatments are also selected depending on the patient's condition. It can be:

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

Normal massage is allowed only in the absence of pain syndrome. A more effective physiotherapy treatment is hand therapy with post-isometric relaxation.

Doctors strongly advise smokers to quit smoking.

Nutritional adjustment is also important, especially for overweight patients. Fatty, tasty foods, sweets and alcohol should be excluded from the menu. A careful diet with plenty of vegetables and fermented dairy products will help the body better tolerate treatment, but also get rid of the weight that weighs on the back.

Surgical intervention

Conservative treatment usually lasts about two months. If you do not get the desired result, it is decided to change the therapeutic tactics or to perform surgery. The latter is prescribed for severe pain, loss of sensation in the legs, dysfunction 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. A camera is included in the camera to broadcast to the monitor. Through the other two, the protrusion of the hernia is removed using miniature tools.
• By percutaneous discectomy. The damaged nucleus is removed through a puncture in the spinal disc and replaced with an artificial substance.
• With laser reconstruction. It is performed in the form of a puncture using a special needle without tearing the tissue. Laser radiation heats disc structures and stimulates cell regeneration, as well as relieves pain.

In difficult cases, endoprosthetics of vertebral discs are possible - replacement of the damaged organ with an implant.

Rehabilitation will be required after complex surgeries. The person undergoing the operation will have to wear a corset and will not be able to hold a sitting position for about three months. The next rehabilitation period covers the practice of therapeutic gymnastics and physiotherapy.

Preventive methods

Like any other disease, hernias are easier to prevent than to treat. What you need to do to keep your spinal discs healthy:

1. If your job involves them or you are a professional athlete, calculate the loads accurately.
2. Proper body weight (its index should not exceed 30).
3. Choose a good mattress to sleep in the right position (it is better in the back).
4. Do gentle physical training, swimming, fitness.
5. Include morning workouts to strengthen your spinal muscle corset.
6. Quit smoking.
7. Eat well.

If you become accustomed to following these rules, then there is a risk of developing a spinal hernia only as a result of an accident.

Herniated discs are dangerous with serious consequences, and the treatment of advanced cases is very long. To avoid surgery and complications, you should consult a neurologist if you have back pain.

Osteochondrosis

The term osteochondrosis itself comes from two words: osteo - bone and chondrue - cartilage. Simply put, it is the ossification of cartilage. Although this interpretation is fundamentally wrong. Some go even further in their dreams and are convinced that osteochondrosis is a deposition of salts in the joints. In addition, it is eaten in large quantities.

Pathogenesis

In reality, everything is a little different. And more difficult. And table salt, if it plays any role in the onset of osteochondrosis, is very indirect. The basis of osteochondrosis is dystrophy and degeneration of articular cartilage. It is not an independent disease, but a pathological process that can be observed almost everywhere in the presence of connective cartilage tissue.

However, in a large case, osteochondrosis affects the spine. Why is that? The fact is that there is a kind of space between the vertebrae - intervertebral discs. The physiological role of these discs is to protect the vertebral bodies from premature wear due to mechanical stress. The disc consists of an annular fibrosus and an internal fluid nuclear pulp surrounded by an upper and lower end plate.

The disc is subjected to great mechanical stress, which causes permanent damage to its structures at the cellular level. These processes are very pronounced in humans - this is our payment for a steep walk. To prevent the disk from being completely "erased", it must be constantly restored, ie restored. It is the balance of damage-recovery processes that determines the normal structure of the intervertebral disc. An interesting detail is that the supply of blood and nutrients to the intervertebral discs is not diffuse from the bone tissue of the vertebral bodies, but through the blood vessels that grew in childhood. Again, pay for the ability to walk on two legs, not four.

For this reason, intervertebral discs are easily damaged anatomically and physiologically. Any negative process in the body leads to a violation of the balance of damage and regeneration, the development of dystrophy and degeneration of the discs. A structurally defective disk can no longer withstand the required mechanical stress. Under the excessive pressure of the vertebrae on it, the discs move in different directions, usually to the sides and back. This process is called disc herniation.

The bone tissue of vertebrae that have lost their cartilage lining is also subject to mechanical wear. Pathological bone growths occur on the anterior surface of vertebral bodies due to constant trauma - osteophytes. Spondylosis develops. Due to degeneration and displacement of the disc, the intervertebral spaces are reduced, the spinal canal is narrowed, and the roots of the spinal nerves are so-called damaged. foraminal holes.

Reasons

The causes or etiological factors of osteochondrosis are different. They can both be local, that is. causes pathology of the spine itself and general disorders at the body level. Any pathology that causes structural disorders 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 - straight legs, narrow shoulder girdle, pelvic anomalies
• Spinal cord injury
• Weak immunity
• Metabolic disorders - osteoporosis, obesity, diabetes mellitus, thyroid disease
• Diseases of the cardiovascular system - atherosclerosis, hypertension
• Digestive disorders that cause insufficient absorption of nutrients from the gastrointestinal tract
• Heredity.

It should be noted that the above pathological conditions do not necessarily cause osteochondrosis. This requires certain predisposing factors - hypothermia, nutrition, sedentary lifestyle or, conversely, constant exposure to excessive physical force.

Symptoms

Osteochondrosis itself is an asymptomatic process. And at the same time, the symptoms of intervertebral disc degeneration are different. How? 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 very variable depending on the localization of the process in the cervical, thoracic or lumbosacral spine. The last part is most affected because it is the lower back that has the most physical activity. Symptoms of lumbar-sacral osteochondrosis:

• Pain (lumbodynia, lumbago, sciatica)
• Restriction of movement in the lower back and lower extremities (intermediate claudication)
• Here paresthesia-type sensory disorders - numbness, burning, crawling.
• Pathological tension of the lumbar muscles
• In the absence of treatment, disorders of the pelvic organs.

Cervical osteochondrosis is slightly less common than lumbosacral. However, this pathology is also very common. In addition to the typical symptoms of pain (cervical), cervical osteochondrosis has its own characteristics due to decreased sensitivity and movement in the upper extremities, disruption of blood supply to the brain. These features manifest themselves:

• Insomnia
• Headache, dizziness
• Periodic nausea
• General weakness, fatigue
• Fluctuations in blood pressure
• Sometimes toothache
• Behavioral reactions in the form of tears, irritation.

The thoracic region with osteochondrosis is relatively rarely affected. In this situation, patients are forced to sit in a constant state of anxiety with the profession - students, schoolchildren, programmers, office workers. In this case, the symptoms of osteochondrosis will be as follows:

• Chest pain and paresthesia
• Shortness of breath
• The feeling of a heartbeat
• Restriction of movement in the thoracic spine.

Diagnostics

From all this it is clear that osteochondrosis is a disease of the chameleon. Due to the similarity of the signs, it is easy to confuse it with cerebrovascular accident, hypertension, myocardial infarction, angina pectoris, neurotic disorders. Therefore, a comprehensive diagnosis is required to correctly diagnose the symptoms and treatment of osteochondrosis in order to make a correct diagnosis.

In addition to the traditional interrogation and clarification of patient complaints, this diagnosis should include medical examination and special research methods. These methods include spinal radiography and ultrasound of the internal organs. Recently, computed tomography and magnetic resonance imaging have been used successfully to diagnose osteochondrosis.

Treatment

Therapeutic tactics for osteochondrosis include:

• Medications
• Massage
• Physiotherapy procedures
• Physiotherapy (exercise therapy)
• Manual therapy
• Acupuncture.

Medications for osteochondrosis are mainly aimed at relieving pain and inflammatory processes in the nerve roots. NSAIDs are used for this purpose. In various combinations, these drugs are widely used in the form of ointments, injections, tablets for the treatment of osteochondrosis. It should be noted that these drugs have a negative effect on the liver, stomach and intestines. Thus, they can aggravate metabolic disorders in osteochondrosis. With local anesthesia, the pain of the blockade is well relieved. However, the effect of these drugs is short-lived and in no way affects the course of osteochondrosis as a whole.

With the help of drugs such as chondroprotectors, immunostimulants, minerals and vitamins, it is possible to improve metabolic processes at the local and body levels. Chondroprotectors are used in tablets, ointments and ampoules. Among the strengthening substances, along with minerals, vitamins C and B group are used. In this regard, calcium supplements are the most preferred. In fact, contrary to some misconceptions, the cause of osteochondrosis is not an excess, but simply a lack of calcium.

After successful exacerbation, physiotherapy, massage and exercise therapy are indicated. Electrophoresis with calcium, phonophoresis with hydrocortisone, amplipulse, paraffin therapy are used as physical procedures. All these measures are aimed at relieving 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 selected depending on the localization of osteochondrosis. Expansion of the range of motion is achieved with the help of exercise therapy. Initially, there are virtually no dynamic loads during the ignition phase. The patient is always in optimal condition. In this case, it is desirable to wear immobilization devices - a waist corset, a collar of Chants. When aggravation is eliminated, the volume and duration of movements increase during exercise therapy.

Recently, non-traditional treatments have been adopted in the treatment of osteochondrosis - acupuncture, manual therapy, osteopathy. Acupuncture is the treatment of specific biologically active points along the spine, ears, hands and feet. With manual therapy, the normal position of the vertebrae and intervertebral discs is restored with the hand movement of a specialist's hand. In the course of osteopathy, the structural integrity of the musculoskeletal system is ensured using special methods. In the absence of the effect of conservative measures for the treatment of osteochondrosis, persistent pain, complications, surgery are indicated. Pathologically displaced disc is removed. Currently, a microdiscectomy is performed for this purpose - endoscopic removal of the displaced disc.