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Treatment of osteochondrosis

Severe pain caused by osteochondrosis

Osteochondrosis-age-related changes in spinal dystrophy associated with tissue aging. 80% of pathology is related to genetic data, and the rest is the influence of external factors.

Osteochondrosis-Mainly human diseases, the development of which is promoted by the following factors:

  • Increased lifespan. Over time, metabolism slows down, tissue nutrition is destroyed, and destructive regulatory systems begin to defeat constructive regulatory systems
  • Walk upright. Standing on his feet, the man received uneven loads on different parts of the spine and was able to perform more exercises-twisting and stretching. Abnormal scoliosis-scoliosis-uneven load on the muscles and small joints of the spine. This increases the possibility of disease formation, even in the department of low mobility and rib protection of the vertebrae-thoracic osteochondrosis
  • accelerate. Rapid growth makes bones, muscles and cartilage more fragile. The number and popularity of blood vessels are not enough to provide them with oxygen and essential substances
  • Lack of sufficient physical activity. There are two extremes-sedentary work and full-driving exercises or excessive stress in the gym, when the disc and cartilage wear out faster
  • Improper nutrition. Fast carbohydrates dominate, lack of protein, and the use of carbonated beverages results in the body not having enough high-quality building materials to maintain tissue health
  • smokes. Causes long-term vasospasm-destruction of tissue nutrients, acceleration of degenerative processes
  • Urbanization, a large number of surrounding traumas cause spinal injury, secondary osteochondrosis

Types of osteochondrosis

Through localization

  • Cervical osteochondrosis
  • Thoracic spine injury
  • Lumbar osteochondrosis
  • Common osteochondrosis-combination of cervical and lumbar spine, thoracic and lumbar spine, lumbosacral, etc.

The most common changes in the most movable parts are the cervical and lumbar spine. The pain point is the transition from the active lumbar area to the fixed sacrum area.

By stage

  • Initial-small changes in the center of the intervertebral disc, nuclear compaction, cartilage cracks appear
  • The progression of the disease-the cracks deepen, the height of the intervertebral disc decreases, and the diameter of the intervertebral foramina decreases. Compression of spinal nerve roots can cause pain and muscle spasms. Osteochondrosis of the spine is not only manifested as changes in the intervertebral discs-due to the violation of the ratio between the vertebrae, the cartilage on the surface of the facet joints is unevenly erased, and the joints and arthritis develop
  • Complex osteochondrosis-symptoms: further degradation of cartilage-the cartilage ring connecting two adjacent vertebrae is broken. A part of the nucleus protrudes through the free space and squeezes the root, the spinal cord-forming a herniated disc. A more serious problem is the separation of the shedding part-isolating the hernia. Severe pain, impaired sensitivity, and movement disorders in the area of the compressed nerve
  • Organisms respond to increased load and excessive activity through the growth of bone tissue-the appearance of osteophytes. They can stabilize the spine, but reduce the range of motion. Bone hooks stimulate muscle receptors and compress nearby blood vessels. For cervical osteochondrosis, this can cause symptoms of "vertebral arteries"-dizziness, tinnitus, dotted flashes in front of the eyes

Cervical osteochondrosis

With the advent of mobile phones and computersCervical osteochondrosisEven in adolescents: Due to muscle tension, the head being in an unnatural position for a long time can overload the vertebrae, intervertebral discs and joints.

Cervical osteochondrosis-symptoms

  • Neck pain extends to the back of the head and upper back
  • Sometimes headaches associated with cervical osteochondrosis resemble migraines-one-sidedness of symptoms, intolerance to sounds and bright lights, strong pulsations in the temples, bright flashes in front of the eyes
  • Frequent headaches that do not respond well to traditional pills
  • Blood pressure drop of antihypertensive drugs
  • Dizzy, suddenly turning his head
  • Numbness of the fingers, especially after sleeping, the skin has a creeping sensation
  • Restricted neck movement, crunching when trying to move. The patient must turn his entire body to see what is behind him
  • Sweaty upper body
  • The tight muscles of the neck and shoulder straps can be detected by palpation.

If sureCervical osteochondrosis, The initial treatment can prevent serious complications-compression of the vertebral artery, hypoxia in the brain, compression of the spinal cord.

The manifestations of thoracic osteochondrosis

Changes in the chest area occur less frequently, leading to factors-back injuries, scoliosis, previous spine diseases (tuberculous, nonspecific spondylitis, body hemangioma).

Symptoms of chest lesions:

  • Back pain-pain, tugging, worse after standing for a long time or sitting in an uncomfortable position. However, due to constant complaints of pain, other possible causes must be ruled out-pneumonia, pleurisy, tumor, intercostal neuralgia of different nature, herpes zoster before the appearance of air bubbles
  • Difficulty breathing, shortness of breath, inability to breathe deeply
  • Sternal osteochondrosis is sometimes similar to the onset of angina pectoris-if a person is treated by a cardiologist for a long time, the problem lies in the diseased intervertebral disc

Lumbar and lumbosacral osteochondrosis

In the structure of various types of osteochondrosis, these departments are confident leaders, accounting for more than half of all diagnosed cases. The reason is that the greatest load falls on this area of the body, whether standing or sitting. Body weight, under the condition of improper weight lifting, long time in a bent position-the nucleus pulposus of the intervertebral disc is in a compressed state and is pressed into the vertebral body through the cartilage plate-forming a Schmorl hernia. Overwork and muscle spasm destroy the small vertebraeThe relative position of the joints-articular cartilage is erased and mobility is reduced.

Several vicious cycles develop at the same time: muscle spasm causes pain-pain reflexively increases the contraction of muscle fibers, acute pain forces a person to restrict movement and avoid damaged areas-the strength of the muscle frame and the support of the spine are weakened, which increases itsUnstable, progression of lumbar osteochondrosis.

Turning point in mobileLumbar spineIf the fixed sacrum is fused into a whole, the fifth lumbar vertebra is in danger of slipping off the surface of the sacrum. This squeezes the nerve bundles and leads to nerve root syndrome.

Lumbar osteochondrosis symptoms

  • Low back pain, especially sitting and standing. After the rest, the horizontal position improves. As the course of the disease is prolonged, the pain is habitual, sore, and tugging
  • Sudden low back pain when changing physical condition, lifting weights, or heavy load. The patient was trapped in the location where he was attacked, it was difficult to straighten up and start to move. Low back pain is usually related to spinal nerve root compression, which develops acutely
  • The pain transitions to the hip area and the legs. The sciatic nerve, the largest nerve in the human body, is a direct continuation of the spinal cord. Therefore, patients with lumbar osteochondrosis often worry about sciatica.
  • Because nerve fibers control the tension of muscles and blood vessels and regulate tissue nutrition, the part of the trunk responsible for the diseased nerves will change. Limbs feel colder than healthy limbs. As the course of the disease prolongs, muscle atrophy, dryness and swelling of the skin will be obvious. Local immunity is reduced-any scratches, cuts, abrasions, etc. are easy to become the entrance of infection
  • The failure of sensory fibers leads to a violation of sensitivity-surface and deep layers. Patients may suffer burns or frostbite because they do not feel dangerous changes in temperature.
  • Very scary symptoms-numbness of the skin in the perineum and loss of control of the pelvic organs. The patient does not feel a full bladder or the need to empty the bowel. Over time, urine and feces begin to excrete on their own and cannot be retained. In this case, the treatment of osteochondrosis of the spine and its complications is performed by surgery in an emergency.

Diagnosis of osteochondrosis

It is performed by a neurologist or orthopedic doctor after the therapist has ruled out the pathology of the internal organs.

  • Experts find out the main complaints, their appearance, development, effects of medications on pain intensity, rest, changes in life rhythm
  • A mandatory external examination is performed when the patient takes off the underwear-it is necessary to compare the skin condition and color of symmetrical parts of the body, the tone of the tissue, the response to various stimuli: pain, touch, cold or heat. Symptoms of tension are identified, indicating muscle tension and irritation of their tendons and outer membrane-fascia
  • The nerve hammer will reveal the uniformity and symmetry of the reflex
  • The neurologist records the amount of active (independent) and passive (performed by the doctor) movement in the joints, the ability to turn the head, the upper part of the body without involving the lower spine

If necessary, send for additional inspection

  • Thermal imaging diagnosis
  • ENMG (Neuroelectromyography): Radiography. In order to obtain the necessary information, it is done in at least two projections-direct and lateral. The pictures will tell about the state of bone tissue, the severity of osteoporosis, the size and safety of the vertebral body, and will reveal osteophytes. The damaged disc is determined by the width and uniformity of the intervertebral fissure. The unevenness of the upper and lower boundaries of the body can make people suspect that it is a Schmorl hernia. In order to clarify the nature of changes in the bone structure of the spine, it is recommended to use computed tomography. Multi-spiral examination allows three-dimensional modeling of the vertebrae. If necessary, MRI is prescribed in order to find out the condition of soft tissues-muscles, ligaments, intervertebral discs.

It must be remembered that the results of the research must be compared with the complaints and changes found during the inspection. It can detect signs of osteochondrosis of the spine and even disc herniation without any serious measures.

Treatment of spine osteochondrosis

Remove the acute manifestations of the disease

  • Severe pain and intense muscle tension reinforce each other, and the deterioration cannot be allowed to subside. Therefore, the first is to relieve pain.
  • Prescribe non-steroidal anti-inflammatory drugs in injections, muscle relaxants-muscle relaxants
  • If these measures are not enough, blockade of painkillers and hormones

Radiofrequency denervation

It is recommended to stay in bed for a few days

After the symptoms subsided, start to move, gradually increase the range of activity and load. At this time, active kneading and massage are not advisable, because complications may occur.

Osteochondrosis: treatment without deterioration

When the patient's condition is stable, the usual sluggishness still existsOsteochondrosis, The treatment consists of several parts:

  • drug. All anti-inflammatory and painkillers in tablets, capsules and ointments are the same. Doctors choose specific drugs based on the patient's condition, lifestyle, concomitant diseases, and the advantages of one or another component of osteochondrosis. A course of B vitamins will improve the transmission of nerve impulses and normalize tissue nutrition. While maintaining the increased muscle tone, muscle relaxants will continue to be used. There is no panacea, an injection that can restore the spine and cartilage to its original state. Medications can relieve symptoms and improve mobility and performance. But they cannot completely stop the progression of the disease.
  • physiotherapy. It is used to deliver drugs directly to the painful area (electrophoresis), heating (paraffin wax, infrared radiation). Exposure to therapeutic current can relax muscles and improve the function of nerve fibers. After several courses of treatment, the pain was relieved and the mobility was restored. Not suitable for active inflammation
  • Manual operation, massage, acupuncture, acupressure. Relieve cramps by stretching and relaxing muscles. If only the upper muscles are affected during the massage, the manual therapy penetrates deeper, so the requirements for experts are higher. Be sure to do MRI first to find out the anatomical features of a specific patient
  • Spinal traction. The vertebrae move away from each other, the normal distance between them is restored, and the compression of the nerves is reduced. The operation has contraindications, so only a doctor can prescribe it
  • physiotherapy. The most effective treatment. The only thing to note is that it must be used for life. Advantages-it provides activity, improves mood, increases tissue tension. The best way is a set of exercises recommended by the doctor, elementary yoga asanas, Pilates, and swimming. They proceed smoothly, without sudden and traumatic movements, stretch the tissue, and gradually increase the amplitude
  • Proper nutrition and get rid of bad habits
  • Providing adequate nutrient supply for tissues, good vascular conditions, and adequate blood supply for the vertebrae and surrounding structures are measures to prevent the progression of osteochondrosis. Proper nutrition can normalize weight and reduce spine pressure

Surgical treatment of spinal osteochondrosis.Modern clinics have a large number of minimally invasive interventions:

  • Treatment and diagnostic blockade
  • Radiofrequency ablation
  • Cold plasma and laser nucleoplasty
  • Endoscope to remove herniated disc
  • Microdiscectomy

Radiofrequency thermal ablation of small joints

The special needle is placed exactly on one side of the intervertebral joint, where the median branch of the Lyushka nerve passes. The electrode is installed in the needle, and the needle tip can be heated to 80 degrees for 90 seconds. This can cause nerves to coagulate. The pain disappeared.

Cold plasma nucleoplasty

Through the needle inserted into the intervertebral disc, a special cold plasma electrode is applied to the intervertebral disc tissue. The pressure in the intervertebral disc is reduced, and the hernia (protrusion) is pulled inward.

Microdiscectomy

Intervertebral disc herniation can compress adjacent nerve roots and blood vessels, causing extreme pain and various disorders of the innervation of the limbs. If the effect of conservative treatment no longer exists, then surgical removal of the herniated disc is the only possible solution for many patients. The operation is performed under anesthesia using microsurgery equipment and instruments through a 2-3 cm incision. The operation time is 45-60 minutes. In 95% of patients, the pain syndrome was significantly reduced or disappeared immediately after surgery. The next day, the patient could walk and was soon discharged from the hospital.

Endoscope to remove the herniated disc:

Removal of hernias or free lying spacers through the lateral intervertebral foramen. To place the tube, make a 5 mm incision in the skin. The muscles, fascia, and ligaments are not damaged, they are pushed apart using a tube retractor system of increasing diameter. The operation hardly bleeds and only lasts 40-50 minutes. Patients can resume their usual treatment regimen after three weeks. The risk of complications is small.

When complications occur, large disc herniation, spinal nerve roots and spinal cord are severely compressed, decompression and stabilization operations are performed. If there are signs of sudden loss of sensitivity, movement, or pelvic dysfunction, the patient should be taken to a neurosurgeon immediately. The sooner the oppression is eliminated, the more thorough the recovery will be, and the person will soon return to a normal life. In this case, the purpose of surgical treatment is to decompress the compressed nerve structure and stabilize the affected segment. This is a hemilateral or laminectomy. The fixation consists of the combination of a transpedicular system and an intervertebral fusion cage to provide 360-degree fusion. The interspinous process stabilization of the vertebrae is widely used. There are several interspinous process implants today. Microdiscectomy combined with interspinous process stabilization, especially in the elderly, can significantly improve the effectiveness of long-term results and reduce the possibility of recurrence of a herniated disc.