The term osteochondrosis itself comes from two words: osteo - bone and chondrue - cartilage. Simply put, this is cartilage ossification. Although this interpretation is fundamentally wrong. Some go even further in their delusions and are convinced that osteochondrosis is the deposition of salts in the joints. In addition, table salt is thought to be consumed in large quantities for food.
Pathogenesis
In fact, everything happens a little differently. And harder. And table salt, if it plays any role in the appearance of osteochondrosis, is very indirect. Osteochondrosis is based on degeneration and degeneration of articular cartilage. This is not an independent disease, but a pathological process that can be observed almost everywhere where there is connective cartilage tissue.
However, osteochondrosis predominantly affects the spine. Why so? The fact is that between the vertebrae there is 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 inner fluid pulpal nucleus surrounded by a fibrous ring and an upper and lower end plate.
The disk undergoes a huge mechanical load, which leads to permanent damage to its structures at the cellular level. In humans, these processes are very pronounced - this is our payment for upright walking. In order to prevent the complete "erasure" of the disc, it must be constantly regenerated, ie self-constructed. It is the balance of damage-regeneration processes that determines the normal structure of the intervertebral disc. Another interesting detail is that the blood and nutrient supplyintervertebral discs are carried out not through blood vessels that have grown in childhood, but diffusely, from the bone tissue of the vertebral bodies. Again, the payment for the ability to move two limbs, not four.
Therefore, the intervertebral discs are easily injured anatomically and physiologically. Every negative process in the body leads to an imbalance in the balance of damage-regeneration and to the development of dystrophy and degeneration in the discs. A structurally defective disk is no longer able to withstand the correct mechanical stress. With excessive pressure from the upper vertebrae, the discs move in different directions, usually laterally and posteriorly. This process is called a disc herniation.
The bone tissue of the vertebrae, which has lost its cartilage sheath, also undergoes mechanical wear. Due to constant trauma to the anterior marginal surface of the vertebral bodies, pathological bone growths - osteophytes - are formed. Spondylosis develops. Due to degeneration and displacement of the disc, the intervertebral spaces shrink, the spinal canal narrows and the roots of the spinal nerves in the so-called foraminal openings are damaged.
Reasons
The causes or etiological factors for osteochondrosis are different. They can be both local, ie due to pathology of the spine itself, and general disorders at the body level. Any pathology leading to a violation of the structure of the spine or to metabolic disorders can be considered a 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, abnormalities in the structure of the pelvis.
- Spinal cord injury.
- Weak immunity.
- Metabolic disorders - osteoporosis, obesity, diabetes, thyroid disease.
- Diseases of the cardiovascular system - atherosclerosis, hypertension.
- Digestive disorders leading to insufficient absorption of nutrients from the gastrointestinal tract.
- Heredity.
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, sedentary lifestyle or, conversely, excessive exercise.
Symptoms
Osteochondrosis itself is an asymptomatic process. At the same time, the signs of intervertebral disc degeneration are varied. How so? The fact is that the clinical manifestations of osteochondrosis are based on its complications - disc herniation, spondylosis, sciatica, narrowing of the spinal canal.
In addition, the clinic is very variable depending on the predominant localization of the process in the cervical, thoracic or lumbosacral spine. The last part is most often affected, as the lower back takes on maximum physical activity. Signs of osteochondrosis of the lumbosacral region:
- Pain (lumbodia, lumbago, sciatica).
- Restriction of movement in the lower back and lower limbs (intermittent claudication).
- Sensitivity disorders of the type of paresthesia are observed here - tingling, burning, crawling crawling.
- Pathological tension of the lumbar muscles.
- In the absence of treatment, disorders of pelvic function.
Cervical osteochondrosis is slightly less common than lumbosacral. However, this pathology is also quite common. In addition to the typical signs of pain (cervicalgia), decreased sensitivity and movements in the upper extremities, cervical osteochondrosis due to impaired 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.
- Sometimes a toothache.
- Behavioral reactions in the form of tearfulness, irritability.
The thoracic region with osteochondrosis is relatively rarely affected. Patients in this case are people forced to sit in a fixed awkward position in the profession - students, pupils, programmers, office workers. The symptoms of osteochondrosis in this case will be as follows:
- Chest pain and paresthesia.
- dyspnea.
- Feeling of palpitations.
- Restriction of movement in the chest.
Diagnosis
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, in order to make a correct diagnosis, a comprehensive diagnosis is needed to correctly determine the symptoms and treatment of osteochondrosis.
This diagnosis, in addition to the traditional questioning and clarification of patients' complaints, should include a medical examination and special examination methods. These methods include X-ray of the spine, ultrasound of internal organs. Recently, computed tomography and magnetic resonance imaging have been used successfully to diagnose osteochondrosis.
Treatment
Therapeutic tactics for osteochondrosis include the use of:
- Medicines.
- Massage.
- Physiotherapeutic procedures.
- Physiotherapy (exercise).
- Manual therapy.
- Acupuncture.
The drug for osteochondrosis is aimed primarily 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 be remembered that these drugs have a negative effect on the liver, stomach and intestines. Thus, they may exacerbate metabolic disorders in osteochondrosis. They relieve the pain of blockade with local anesthetics. It is true that the effect of these funds is short-lived and in no way affects the course of osteochondrosis in general.
It is possible to improve metabolic processes at the local and body level with the help of drugs such as chondroprotectors, immunostimulants, vitamins and minerals. Chondroprotectors are used in tablets, ointments and ampoules. Among the tonics are used vitamins C, group B, in combination with minerals. In this regard, calcium preparations are most preferred. In fact, contrary to some misconceptions, the basis of osteochondrosis is not an excess, but simply a deficiency of calcium.
After successful relief of the exacerbation, physiotherapy procedures, massage and exercise therapy are indicated. Calcium electrophoresis, hydrocortisone phonophoresis, amplipulse, paraffin therapy are used as physical procedures. All these measures are aimed at eliminating pain and inflammation in the nerve roots, ligaments and muscles. The massage for osteochondrosis is performed according to the generally accepted method. The massage area is chosen depending on the location of osteochondrosis. The expansion of the range of motion is achieved with the help of exercise therapy. In the beginning, in the phase of exacerbation, there are practically no dynamic loads. The patient is constantly in optimal position. At this time it is desirable to wear immobilizers - lumbar corset, collar on the neck of the trench. As the exacerbation subsides, the volume and duration of movements during exercise therapy increase.
Recently, in the treatment of osteochondrosis, non-traditional methods of treatment have been obtained - acupuncture, manual therapy, osteopathy. Acupuncture is an effect on special biologically active points located along the spine, on the earlobes, on the hands and feet. In 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 with specific techniques. In the absence of the effect of conservative measures for the treatment of osteochondrosis, constant pain, complications, surgery is indicated. The pathologically displaced disc is removed. Microdiscectomy is currently being performed for this purpose - endoscopic removal of a displaced disc.