Spondyloarthrosis usually ill older people, but there is a trend towards the emergence of pathology and young people in recent years. Osteoarthritis of the facet joints can cause severe pain, dizziness, pain, "lumbago" from the waist to the thigh and the other negative symptoms that significantly impair quality of life. If untreated, the disease can even lead to disability.
What it is?
Spondylarthrosis - a disease of the spine (osteoarthritis), which affects the facet joints in all the parts.
Characterized by pain, enhanced by movements or stresses on the body of the patient, and weaken during complete rest. It is considered a disease of age and 90% of the 100 forms in people age 65 years and older. Yet, unfortunately, this pathology occurs in the young 30-year-old patients.
Causes of spondyloarthrosis
Our spine, as well as many other structures, graduated increase to 20-25 years. After that it slowly at first, and then - more and more, develop degenerative changes. It decreases the amount of moisture in the articular cartilage, which is less strong and elastic, sclerosing - replaced by connective tissue. In addition, the reduced production of joint synovial fluid. All this leads to a decrease in the volume of spinal movements - developing spine spondiloartroz.
Movement disorders entail congestion in the tissues of the intervertebral joints, surrounding ligaments and muscles. As a result of this further worsens the power of joint tissues, and a vicious circle. The important role played in the formation of spondyloarthrosis osteochondrosis. In this case, the pathological state of intervertebral disc height is reduced, due to which increases the load on the facet joints, and cartilage wear. Subsequently increasing mechanical pressure on the bone of the vertebrae. This changes their structure, on the surface of the vertebral bodies formed edge pathological bony growths. Develops deforming spondiloartroz.
Doctors vertebrologists distinguish several main reasons for the development of spondyloarthrosis:
- Instability of the vertebrae;
- The constant improvement of the load on the spine (sedentary work, professional sports, flat, working with weights);
- spinal injury (most often formed due spondylarthrosis subluxation of the spine joints);
- Abnormalities of the spine (the presence of additional 6th lumbar vertebra, merging into a fixed block 5 th lumbar vertebra with the sacrum, asymmetrical spinal processes are not fully formed and the vertebral arch etc.).
Also, there are a number of predisposing factors that increase the risk of developing this disease:
- Age after age 65;
- Autoimmune diseases;
- The presence of diabetes mellitus, gout;
- Violation of the regime and balanced diet;
- Women after menopause;
- Hereditary predisposition to diseases of the spine.
Spondylarthrosis develops gradually and begins with atrophic changes in the cartilage of the joints. With degenerative processes in the cartilage and lost their elasticity (from the center to the periphery) occur over disease is a destruction of cartilage cells. Further, there is reduction in the size of the cartilage and as a result, exposure of the articular surfaces on bone joints components. It is replaced bone connective tissue (sclerosis) and having minor inflammation in the joints. This happens due to the fact that the destructive cartilage crumbles into small fragments and these fragments fall into the synovial fluid. Edge portions of bone joint surfaces begin to grow and form osteophytes.
Stage of the disease and classification
Spondylarthrosis divided into three groups, depending on the location of the process:
- Tservikoartroz - spondiloartroz cervical spine;
- Dorsartroz - thoracic spine spondiloartroz;
- Lyumboartroz - spondiloartroz lumbar spine.
By considering the formation of 4 stages of development phase:
- First. The initial process is not accompanied by any symptoms. At this stage, there is a loss of plasticity spinal disc disorders in bundles, as well as the splash shells. Found usually accidentally during normal prophylactic medical examination.
- Second. At this stage begin to show pain in the back, fatigue, mobility disorders vertebra.
- Third. To have added progressive disease inflammatory processes affecting the bone of the joint plane, begin to form small osteophytes, ligamentous apparatus work is disrupted.
- Fourth. In the lesion of the spine motor function does not work, there is ankylosis, spondylosis, osteophytes have large dimensions, manifested disorders of the nervous and vascular systems. This phase of the disease is irreversible.
Depending on the severity of a pathologic process spondiloartroz further divided into several types:
- Deforming - the deformation form osteophytes vertebrae;
- Degenerative - is the destruction of articular surfaces in place with edges of the spine and joints in the vertebral arches, and the destruction of the intervertebral disc structure;
- Ankylosing - is known as ankylosing spondylitis, it affects many human joints, significantly deforming them;
- Dugootroschaty - processes occur in the joints between the spine and ribs and in the joints dugootroschatyh;
- Unkovertebralny - located between the spinous processes on the rear surface of between 1 and 2 cervical vertebrae;
- Dysplastic - manifest violation of the full structure of the joints, their deformation;
- Polysegmental - affects both 2 and a spine.
Spondyloarthrosis clinical picture depends on the pathological process localization. If the damage of different parts of the spine, the patient feels specific symptoms.
Symptomatology spondyloarthrosis poyasnochno - sacral spine:
- violation of joint mobility;
- violated the patient's gait, posture;
- marked weakness in the muscles;
- discomfort occurs in the lumbar spine, gives to the buttocks, thighs, even the perineum.
The clinical picture of the thoracic spine spondyloarthrosis:
- substantially limits the mobility in the thoracic human spine;
- people complain of morning stiffness of the thoracic spine;
- notes crunch during sharp dvizheniyzh;
- the patient feels uncomfortable with the sharp change of weather, during exercise. Constant pain accompanies the patient if spondiloartroz develops in 3-4 stage.
If there is a lesion of the cervical spine:
- discomfort is felt when turning the neck, sudden inclination of the head;
- tinnitus, headaches, insomnia, fatigue;
- aching with a sharp change in weather, particularly severe discomfort observed during high humidity;
- pain is observed not only in the neck, extend to the scapula, shoulders, neck, even the chest. Pain occurs only after physical exertion or in the morning (the body for a long time there were no traffic).
Since both osteochondrosis and spondylarthritis very linked and anatomical localization, and risk factors, these processes can run concurrently. The differences between them can be set only by using imaging techniques such as X-ray.
In the event that after the MRI is performed, it gives the opportunity to explore the long spinal cords, which are often involved in the pathological process.
How to treat spondiloartroz?
Treatment spondyloarthrosis lumbosacral held conservative and surgical methods.
- Conservative eliminate pain and inflammation followed by the appointment of drugs and procedures that restore damaged tissue.
- The surgical technique is applied in extreme cases, as the medical and physiotherapy effectively enough, and after back surgery has a risk of complications.
spondyloarthrosis Drug therapy includes certain preparations, they can be included in two large groups:
- Fast-acting agent. Their use leads to the minimization of pain symptoms. These include analgesics, non-steroidal anti-inflammatory drugs, tramadol.
- Slow release agents. Their action is aimed at restoring the structure of cartilage vertebral joints. These include chondroitin sulfate, glucosamine, diacerein, soya or avocado unsaponifiable compound.
Fast-acting drugs are designed to reduce the symptoms of the disease:
- Analgesics. They are first-line agents for the relief of pain. These include paracetamol. Assign it not more than 4 g / day. Relatively harmless drug in the use of it for two years.
- Opioid painkillers. Assign with no effect of the previous groups. Tramadol administered 50-200 mg per day. Opiates should be short-lived.
- Corticosteroids. Corticosteroids administered with the progression of disease with significant restriction of motion in the joints.
- NSAIDs. Most often used in practice. Appointment they should be in the absence of the desired effect of paracetamol. In the appointment of this group of funds is necessary to rely on comorbidities. This group of drugs has many side effects to the cardiovascular, digestive system, the kidneys. Acceptance of these drugs in spondyloarthrosis should begin only in the period of increased pain.
Slow acting formulations exhibit chondroprotective properties. Representatives of this group:
- Chondroitin sulfate and glucosamine are components of articular cartilage. For the manifestation of the effect of these drugs-Chondroprotectors need to reach high concentrations in the synovial fluid of joints. Trade names of these drugs: struktum, terafleks Dona, hondromed et al.
- Unsaponifiable compounds soya and avocado promote the synthesis of substances that stimulate the production of collagen by chondrocytes. These drugs reduce pain impulses.
Timing the therapeutic effect vary from 2 to 8 weeks.
Methods of treatment without tablets
As for non-drug techniques, these include:
- Acupuncture, which allows to eliminate muscle spasm and affect the blood flow to the affected area.
- Psychotherapy. Necessary to correct the mental state of patients spondyloarthrosis, which often have to deal with debilitating pain.
- Kinesiotherapy - teaching method, through which the patient can independently engage in physical therapy at home during periods of remission and exacerbation subsided.
- Physiotherapy - used even in the acute phase - but not at the peak of pain. This includes a variety of techniques, ranging from the electrophoresis and ending with the magneto. Treatment selects the physician.
- Manual therapy eliminates functional problems in the affected segment, muscle tension, helps to improve the local microcirculation.
- Massage - is responsible for the normalization of supply of tissues due to the acceleration of metabolism, restoration of blood and lymph circulation. With deep massage can block pain impulses from the peripheral nervous system. Improvement of trophism allows you to quickly remove the decomposition products.
Each procedure is assigned a doctor who assesses the pre-condition of the spine and excludes / confirms the presence of systemic diseases that may be a contraindication for any of the procedures.
Contraindications for spondyloarthrosis
Once you have passed the course of treatment, the doctor is obliged to introduce you with contraindications when spondyloarthrosis. Perform these simple recommendations necessary to prevent deterioration of the status of your spine. It is necessary to remember:
- We need to avoid hypothermia;
- not to make any sudden movements and jerks;
- You can not lift weights;
- It can not be a long time to be in the same position;
- if to be a long trip, take advantage of an orthopedic corset.
But do not overdo it by wearing orthotic devices and other devices. With long-term use in patients observed weakening of muscles of the trunk, there is static disorders of the spine, as well as pain. Experts strongly advised to engage in physical therapy, walk more and pay attention to the cross-country skiing.
Preventive measures at risk spondyloarthrosis include the following activities that should be carried out and the condition of remission:
- Massage. From time to time you need to take massage courses.
- Physical Education. Sometimes a simple lack of charging and light exercise to improve the situation. Experts recommend to go swimming.
- Dieting. diseases of the spine sometimes caused by excess weight.
To what doctor to treat symptoms spondyloarthrosis? Everything depends on the form of the disease. If it was caused by a trauma, it is best to be recorded to the traumatologist. If there is inflammatory in nature, there will rheumatologist. If the cause is unknown, the experts recommend to go to a neurologist, who deals with all spinal pathologies.