Excessive tension in the back muscles causes a lot of discomfort and pain.Osteochondrosis, which causes disruption of the structure of the vertebrae and intervertebral discs, leads to severe pinching of nerve endings.Often the pathology is accompanied by a deterioration in blood circulation, which causes disruptions in the nutrition of the brain and internal organs.
Osteochondrosis – what is it?
Osteochondrosis is a relapsing disease that occurs chronically and is accompanied by the destruction of the vertebrae and intervertebral discs.Its tissues are ruptured, which causes a decrease in their elasticity with a subsequent change in shape.There is a gradual decrease in the intervertebral space.This causes a loss of spinal stability in areas where the pathology develops.
The processes of pathological tissue destruction occur against the background of compressed nerve endings that are directed from the area where the spinal cord is located.As a result, the back muscles are in constant tension.In this situation, patients complain of back pain and other symptoms.
Based on the peculiarities of the location of the spinal structures that were affected by degenerative changes, the cervical, thoracic and lumbosacral varieties of the pathological process are distinguished.The main sign of the development of osteochondrosis is pain, the intensity and severity of which usually increases during physical activity.
There is also stiffness in movements.Also, the clinical picture is characterized by the presence of vertebral-type signs - headaches, changes in blood pressure, deterioration of visual, auditory function, and so on.
Development mechanism
The development of osteochondrosis is due to the fact that the nucleus pulposus begins to lose its hydrophilic qualities.This semi-liquid structure contains connective tissue fibers and chondroitin, a gelatinous substance.During the development of the human body and its growth, processes of reducing the vascular bed in the intervertebral discs are actively occurring.Nutrients are supplied diffusely, which manifests itself in spontaneous concentration stabilization.This characteristic causes difficulties in the complete restoration of cartilage that has suffered damage or excessive pressure in the spine.
Pathological deviations become more pronounced due to disturbances in hormonal levels and human nutrition.Cartilage tissue begins to lack nutrients necessary for normal development.Therefore, disorders manifest themselves in the form of:
- decreased strength and elasticity;
- changes to consistency parameters and configuration properties.
Against the background of flattening of intervertebral discs, radial cracks form in the fibrous rings.As a result, the intervertebral distance is reduced and the joints begin to shift.Over time, pathological changes cover the connective tissues related to the fibrous rings and ligaments.
As tissue breaks down, the immune system produces immunoglobulins in greater quantities.This provokes the development of the process of aseptic inflammation and swelling forms in the area where the facet joints are located.They also spread to nearby soft tissue.
Due to the stretching of the joint capsules, the intervertebral discs lose their ability to fix the vertebrae.This instability in the position of the spinal structure increases the risk of nerve root compression or blood vessel compression.This feature is characteristic, for example, of cervical osteochondrosis, which is accompanied by intense verbal symptoms.
Reasons for the development of the disease
The condition of the intervertebral discs can worsen with a decrease in the tone of the skeletal muscles of the spine.Due to irrational and asymmetrical muscle work, when a non-physiological body position is maintained for a long time, destruction of cartilaginous tissue may occur.This violation occurs as a result of carrying heavy suitcases on the same shoulder, using soft mattresses and high pillows.
The process of destruction of intervertebral discs is accelerated by the action of a number of negative factors of an external and internal nature.These include:
- disturbances in the functioning of the endocrine mechanism and metabolic disorders;
- pathologies of an infectious nature, including chronic ones;
- damage to the spine in the form of compression fractures, bruises;
- regular and prolonged hypothermia of the body;
- diseases of systemic and degenerative-dystrophic type - gouty, psoriatic, rheumatoid arthritis, osteoporosis, osteoarthritis;
- smoking and alcohol abuse, which disrupt the state of the vascular system, impair blood circulation and cause a lack of nutrients in the cartilage;
- insufficient physical development, problems with posture, flat feet - these defects increase the load on the spine, as shock absorption will be insufficient;
- obesity;
- genetic predisposition;
- exposure to regular stress.
Symptoms
The main clinical sign of osteochondrosis of any location (cervical, thoracic or lumbosacral) is pain.In case of relapse, the pain is penetrating, radiating to nearby areas of the body.Even with slight movement it intensifies.This forces the patient to give the body a forced position to minimize discomfort and pain:
- with cervical osteochondrosis, it would be preferable to turn not just one head, but the entire body;
- when the thoracic form of the disease is present, the patient has difficulty breathing deeply and therefore, to avoid sharp chest pain, tries to minimize the depth and frequency of breathing;
- Patients with the lumbar type of the disease have difficulty sitting, staying upright and moving around, as the spinal nerve is compressed.
Typically, patients complain about the presence of constant, uncomfortable pain and a feeling of stiffness in their movements in the morning when they wake up.In this case, differential diagnosis will be needed to help eliminate the risks of developing myositis caused by inflammation of the skeletal muscles of the spine or osteoarthritis.
Aching, pressing pains occur due to compensatory tension in muscle tissue.This condition is necessary to stabilize the spinal movement area.Mild or moderate constant pain may also appear with significant stretching of the intervertebral disc, resulting from aseptic inflammatory changes.
Osteochondrosis of a specific localization is characterized by special symptoms:
- In cervical osteochondrosis, pain is felt in the cervical region, in the upper limbs.There is pain in the head and numbness in the fingers.If the disease manifests itself in a severe form, compression of the vertebral artery may occur.In this case, the patient begins to complain of a significant deterioration in health.
- The thoracic location is manifested by sharp, aching pains in the back;there is visceral pain syndrome in the cardiac region, right hypochondrium and abdomen.Patients complain of numbness, skin paresthesia, difficulty breathing and crushing of the vertebrae.
- Patients with lumbar osteochondrosis complain of pain in the back and lower extremities with increasing intensity when moving.Disorders in the functioning of the genitourinary system, problems with male potency and dysfunctional ovarian disorders are often diagnosed.During remission, the pain may decrease.However, exposure to a provoking factor leads to its resumption.
- When mixed osteochondrosis appears, symptoms can appear in several areas simultaneously.This condition is characterized by a more severe course of the disease.
It must be remembered that the displacement of the vertebrae and the formation of osteophytes cause compression of the vertebral artery.Nourishes the brain by providing oxygen to cells.When squeezed, nutrition is limited and therefore the patient experiences coordination problems, headaches, tinnitus and high blood pressure.
Consequences if not treated
The reason for the complicated course of osteochondrosis is the relatively rapid formation of hernias in the intervertebral discs.Its appearance is associated with a posterior displacement of the vertebral structure.This provokes a rupture of the posterior longitudinal ligament, resulting in instability of the position of the disc and protrusion of its individual sections into the spinal canal area.A hernia ruptures when the disc with the nucleus pulposus penetrates the canal area.
When pathological abnormalities occur in the vertebral structures, the spinal cord begins to be compressed and the patient develops discogenic myelopathy.Symptoms of this condition are associated with numbness and weakness in certain muscle groups of the upper and lower extremities.Paresis, muscle atrophy and impaired tendon reflexes appear.In some cases, problems arise with emptying the bladder and bowels.
The formation of intervertebral hernias is dangerous due to compression of the arteries that nourish the spinal cord.The result of this pathology is the formation of ischemic zones where nerve cells are damaged and killed.The manifestation of the neurological effect is expressed in disturbances in motor function, a decrease in the degree of touch and trophic disorders.
Diagnosis of the disease
The initial diagnosis is made based on the patient's complaints and existing symptoms.The specialist examines the condition of the spine in different positions, asking the patient to be at rest or in movement.At the next stage, the patient is sent for laboratory diagnostics, which will help clarify or refute the diagnosis.
Research methods used include:
- Radiography– provides a complete examination of the spine with an assessment of the condition of the vertebrae, existing disorders in the form of growths, curvatures.The specialist will be able to determine the intervertebral spaces and the condition of the holes.To accurately identify osteochondrosis located in the thoracic or cervical region, a two-stage X-ray examination is performed.In the first stage, the patient lies on their side and, in the second, directly on their back.
- Tomography method using MRI or CTprovide highly informative data, which helps to study the vertebrae in detail without interference from the organs that cover them.The image shows the nerves and vascular system.MRI helps identify signs of many spinal diseases and the location of damage.Computed tomography visualizes hernias and determines possible deviations in the structure of the spine.
- Laboratory examinationassess the state of the blood and its main parameters.It allows you to clarify the diagnosis and determine the possibility of developing concomitant diseases.
In many cases, as a result of examinations, doctors diagnose the presence of certain underlying diseases that are potentially dangerous due to their complications.We are talking, for example, about hernias, protrusions, radiculitis.Correct diagnosis of problems helps to treat osteochondrosis more effectively.At the same time, the disease itself in the early stages of development disguises itself as symptoms of other diseases.
Therapeutic process
Osteochondrosis is treated conservatively or surgically.The choice depends on the severity of the disease, its neglect, the level of tissue deterioration and the causes of its occurrence.
It is important to remember that it is not possible to completely cure osteochondrosis, as there are no medications that can help completely restore discs and vertebrae.The therapeutic effect is aimed at inhibiting the destruction process and increasing the duration and stability of remission.
For symptomatic therapy, chondroprotectors are used, based on chondroitin or glucosamine sulfate.
The effectiveness of the therapeutic process with chondroprotectors has been clinically confirmed based on long-term tests.If you take these drugs for a long time (from 3 months), partial restoration of cartilage and other connective-type elements - the ligamentous-tendon apparatus, bursa will be observed.
The accumulation of glucosamine and chondroitin in the region of the intervertebral discs leads to an analgesic, anti-edematous and anti-inflammatory effect.Therefore, there is a real opportunity to optimize the dosage of NSAIDs, glucocorticosteroids and muscle relaxants.You can count on a reduction in the patient's medication burden.
The effectiveness of chondroprotectors is determined by the regularity of their use.Otherwise there will be no result.Ineffectiveness is also recorded in the treatment of osteochondrosis of the 3rd degree, accompanied by significant destruction of cartilage.
The following groups of medicines can be used to relieve pain:
- Nonsteroidal anti-inflammatory drugshelp eliminate inflammatory disorders in soft tissues caused by vertebral displacement.NSAIDs are effective in reducing pain, swelling and stiffness.
- Medicines from the glucocorticosteroid group– blocks are usually used in conjunction with an anesthetic.They are capable of relieving pain, restoring the functioning of the immune mechanism and providing an anti-exudative effect.
- Muscle relaxants.They are effective in combating muscle spasms due to nervous shock.They help relax skeletal muscles and block polysynaptic spinal type reflexes with an antispasmodic effect.
- External products with a heating effect.Irritation of subcutaneous tissue receptors with activation of blood flow is provided by special gels and ointments.These medications have analgesic and anti-edematous effects.
Symptoms of the vertebrogenic type, which appear due to the localization of the pathology in the cervical or thoracic region, can be eliminated by medical means to activate blood flow.Nootropics and medications to improve microcirculation are also prescribed.In some cases, it may be necessary to take antidepressants, as well as pharmaceutical medications with anticonvulsant effects.
During the treatment of osteochondrosis, they also resort to physiotherapy.UHF therapy, magnetic therapy, laser therapy, reflexology, massage, exercise therapy, hirudotherapy, as well as swimming and yoga can be prescribed.If conservative treatment is ineffective, surgery is performed using microdiscectomy, disc enhancement puncture, laser reconstruction or implant exchange.