Osteochondrosis — degenerative changes, the effects on the intervertebral discs, joints, ligaments and other tissues to form spine-Motor Segment (PDS). In this disease, the band primarily relates to washers, and secondary to other areas of the spine and the musculoskeletal system. It is believed that the greatest incidence of this disease occurs in relatively young people and people of middle age, with a tendency to decrease in elderly and senile age.
In the composition of the vertebral-motor Segment consists of two adjacent vertebra, the upper and the niinamesai. Between them the intervertebral disc, joints, articular and spinous processes is located. The adjacent vertebrae, between the transverse processes form a joint connection (boat based, or facet joints). Spinous and transverse projections of the surrounding vertebrae attached to the bands. This design together with the wheels for agility and stability of the spine.
The causes of the emergence of osteochondrosis is not defined still. But the fact that he frequently, in the case of certain professional groups of adults, suggests that the leading cause for the emergence of this disease, lack of exercise is. As a result of muscle stress, reducing muscle physical effort, and replace them in the static parts of the body, which by nature need to be articulated (neck, loin) occurs, the weakening of the spring and stabilizing functions of muscles.
Degenerative changes in the spine occur:
- excess static or dynamic load on the spine (e.g., weight lifting);
- a hereditary predisposition;
- the confirmed injuries of the spine in the past.
In the case of the detection of similar symptoms, contact your doctor. You do not engage in self-medication is dangerous for your health!
Symptoms of osteochondrosis
The main symptom of osteoarthritis — pain-myofascial syndrome, i.e., painful muscle spasms, a consequence, a muscular dysfunction.
Talk about the causes of pain, pain to distinguish the pathology of the structures of the spine (in contrast, vertebral pain syndromes), pain or other origin (nevertebralnah pain). Depending on what type of pain identified, depends on the choice of treatment methods.
Types of back pain:
1. Nociceptive — due to the fact that the peripheral pain receptors effect a variety of precipitating factors (injury or inflammation) in the case of the integrity of all parts of the nervous system. For such pain, the constant pain and the improvement of the sensitivity to pain in places the tissue damage is characterized by the formation of zones.
2. Neuropathic pain — occurs as a result of the pathological stimulation of neurons in the peripheral or Central nervous system, responsible for the response to physical damage to the organism. Often a characteristic feature of neuropathic pain, reduction of muscle strength and violation of the sensitivity, is reflected in particular by the fact that the Patient experiences pain in response to nabolese stimuli.
3. Dysfunctional (psychogenic) — occurs in consequence of changes in the functional state of the nervous system, or the changed perception of the people. Often there is an improvement in rest after strenuous activity.
4. Mixed — a combination of several varieties of pain that previously described.
Usually the pain in the back are associated with irritation of the pain receptors, muscles, joints and ligaments, and it is a pain in the nociceptive character. The Patient feels in the place of origin (local pain) or distance (radiating pain). Neuropathic pain in the back of the rule with the fact that in the process Karasek cerebrovascular involved spinal nerve or Ganglion. This pain chronic.
Reflected pain in the back can cause diseases of the internal organs (in other words, the Vice Regency of pain).
Taking into account the causes of degenerative disc disease, the clinical appearance of the disease forms associated herniated disc or degenerative (pathological) changes in the spine (for example, osteoarthritis of the intervertebral joints or formation of osteophytes).can be
4 the most important clinical syndrome, which can lead to any of the above options:
- local local pain;
- diffused (reflex pain), associated with damage of the musculoskeletal (fascial) structures;
- radicular syndromes (radiculopathy), caused to roots by irritation or compression of the Monte Spino-cerebral nerves;
- Myelopathy – pain, as a result of the compression of the spinal cord or its vessels.
The pathogenesis of osteochondrosis
The basis for the development of degenerative disc disease is a number of pathophysiological mechanisms. The disease develops as a result of degenerative processes, which have their origin at a very young age, as well as aseptic inflammation, dystonia, spasm.
In the case of occurrence of changes in the spine intervertebral disc at the beginning of damage to the sheath around the nerve fibers (demyelination), then damage occurs in transverse processes of nerve cells (axonopathy), the local reduction in blood flow (ischaemia) and venous congestion. The totality of these processes aggravated the Situation, and if no timely treatment leads to the emergence of a peripheral or Central sensitization.
Most of the time it is the defeat of the liquid ring and the nucleus pulposus and the annulus fibrosus of the intervertebral disc. Mechanical loads cause the elastic fibrous ring of the disc loses its elasticity and there is a protrusion. Then through the cracks of the annulus fibrosus of the loss of the land, liquid ring and the nucleus pulposus of the spine occurs, i.e., the supernatant disc replace disc herniation.
A herniated disc means a solid education that maintains connection of the disc with the body, but sometimes a loss of its fragments in the spinal canal (secretion of the disc).
Classification and stages of development of osteochondrosis
In terms of localization, you assign the following types of the disease:
- Lumbalgia — pain in the lumbar spine (lumbosacral) awarded;
- * Sciatica — pain in the back, radiating into the legs;
- Lumbago — low back pain, i.e., acute, strong pain in the loin;
- torakalgiya — pain in the chest;
- cervicalgia, cervicobrachialgia — pain in the neck and upper limbs.
Classification of stages of development of osteochondrosis:
Level 1: reduces the amount of moisture, the intervertebral disc loses its resilient and elastic properties, and the loads remain unchanged. As a result, the hard disk is reduced in height, flattened, bulging.
2 stage: if the pathology continues to develop in the fibrous Ring of red marked the emergence of cracks, and because Putin finds in it smooth-made the height of the Disk is already reduced, then the result of this instability of the whole vertebral body Segment.
3 Phase: formation of Crack in the cartilage tissue of the annulus fibrosus. They are a part of a liquid core and formation of the intervertebral disc prolapse seeps. Such changes often can be the spine in the lumbar and neck.
For the first time in the presence of a hernia of the intervertebral disc to be in pain when the irritation of the pain receptors in the outer layers of the Anulus fibrosus and the posterior longitudinal ligament appears.
Complications of osteochondrosis
- Symptom Of Lumbago. In the early stages appearance celebrated periodic pain as a reaction to an action, such as, for example, the result of the violent movement, lifting the heavy, heavy burden (longer hikes), persistence in obezbijede Position. This type of pain is known, and is described as a "attack is". Otherwise a rare event in the activation of the movement, and almost does not manifest itself in a static condition. In this type of pain, no serious consequences, and he himself is in the course of the week.
- Lumbodynia. This type of pain has the property, for colds, with intense symptoms during the journey. Not a response to the load on the spine, in the stationary state is not finished, although decreases, so that nagging feeling.
- * Sciatica. Pain is in the neighboring departments. Lumbar osteochondrosis is characterized by irrationalism pain in the leg -, chest — in the area of the Hand or of the heart; cervical migraine manifested.
- Cramps. You will often the three-headed muscle of the lower leg. Among other things, marked in red, the emergence of a very strong pain to the touch in the area of the back or the legs.
- Kokcigodiniâ. Irradiiruet in the area of the tailbone or groin. Pain, pain, burning, sterledeva character, which can drastically limit the physical activity of the patient
Diagnosis of osteochondrosis
Diagnosis of degenerative disc disease involves several steps:
1. History. In this Phase, investigates complaints of the patient and the history of the disease. In the conversation with the patient is clear, where basically unpleasant sensations, their intensity, duration, factors that are provoked by an increased sensation of pain and promote to relieve pain. In addition, if you have a diagnostic clarification of the history of the disease: emergence, discomfort, and stiffness; identify possible causes for their occurrence is an important point; collect information about the previously held treatment and their effectiveness, is an Information about the last exacerbation and the type of course. For the diagnosis is also important to find out under what conditions the Patient lives and works, what reasons life style and bad habits has suffered, what illnesses and injuries, a more and more important and the consideration of the hereditary factor.
2. During the physiological inspection is the evaluation of the Position of the body of the patient, his gait and movements; the skin (in terms of redness, skin rash, desquamation), is a comparison of the symmetrical parts of the body healthy side and painful; it is the determination of the amplitude of the movements (bending, circular movements of the trunk, the circumference of the rotary movements in various areas of the spine); undetectable painful Phase for the determination of the temperature of the skin, presence of cramps in the muscles, swelling, painful seals; Palpation of the deep and superficial layers of the muscles to the condition of the muscles (muscle tone, increase or decrease its volume); with the tapping with a special Hammer or with the fingers defined area of the irradiation of pain; with the help of a needle tingling sensation determines the sensitivity to pain; at the end of a series of special techniques is to find out the symptoms of tension, the arrangement of the edge.
3. Radiography. For a better information content is the research of individual departments of the spine separately. Is made in two oblique projections in two mutually perpendicular planes (frontal and side). In some cases, you can define a functional x-rays, if the Patient is in flexion, extension, or lateral tilt. For special reasons, for more qualitative results, the study was carried out, with the introduction of contrast medium into the spinal canal, in the sleepy or A. vertebralis, in the damaged intervertebral disc or spine: angiography, discography, myelography, pneumonologia.
The most important radiological signs of osteoarthritis, consider:
- pathological mobility of the vertebral body;
- Balance Your Body;
- Calcification of the disc (salt deposits);
- a uniform narrowing of the slot in the lumbar and cervical departments and in the area of the thoracic spine are wedge-shaped constriction;
- the formation of osteophytes (regional growths);
- Education on the border with the measures taken, the window gasket (regional sclerosis).
5. Magnetic resonance imaging (MRI) is based on the fact that electromagnetic waves are valid, the generate a Signal, which is characteristic for each substance. He processed on a Computer and translated into the graphics. With this method, you can check exactly blood vessels, neural processes, and the intervertebral discs without the harmful effects of ionizing radiation on the body.
Forecast. Prevention
As practice, at most a manifestation of the osteochondrosis forms, when properly conducted therapy, the approval is given within 6 weeks.
However, incorrectly chosen treatment or self-treatment can lead to the pain syndrome in a chronic Form, and will contribute to the aggravating changes in the spine in the future.
If the pain in the back or the limbs, consult especially necessary, a qualified expert, in order to have a correct diagnosis and adequate treatment destination.
The most effective and efficient method for the treatment of most forms of back pain on drug injection and therapy as well as acupuncture. Physiotherapy, including laser therapy, Massage, spinal Manipulation, have a low unstable and effect, and in some cases it may be contraindicated not contraindicated.
Modern methods of treatment of degenerative disc disease are based on the principle of continuity of treatment: that is to say, quick and safe relief Episode of acute pain to design preventative methods. To be recommended for the prevention of the emergence and development of osteochondrosis weight loss (if overweight), and regular physical activity, especially.
Regular activities with the technique of dynamic neuromuscular stabilization (Yoga, Pilates-in the framework of the aerobic load), pain is the Basis of the Rehabilitation and prevention of back, promotes the strength and endurance of the muscles of the spine.