Osteochondrosis: the stage, the symptoms of spine treatment

Author: N.Zemereva practicing therapist.
April 2019

Synonyms: degenerative and destructive pathology of the musculoskeletal system, the pathology of the musculoskeletal system.

ICD-10 code: M42.

Osteohondroz - rachiopathy degenerative-destructive nature, which affects the intervertebral discs, ligaments and articular apparatus, as well as the vertebral bodies. Pathology provokes instability and the curvature of the vertebrae with the development of acute pain. Treatment involves removal of inflammatory syndrome by receiving NSAIDs and chondroprotective processes for slowing bone destruction.

Osteochondrosis arises due to the destruction of bone and collagen structures. In addition, accompanying pathology disorders of mineral metabolism, due to which the bone loses strength. This leads to a shift of the intervertebral discs, violation of the integrity of joints and vertebrae. The disease tends to progression. In the absence of therapy progresses osteochondrosis that promotes disruption of blood flow, the appearance of headaches. In some cases the damage may lead to a hernia.

How common is low back pain

The disease is common. According to the WHO this pathology affects from 45 to 85% of the world population. Osteochondrosis develops mostly in people from 30-35 years. In some cases, the disease is formed and in individuals at an earlier age. Women and men are affected equally often.

Species and stage of osteochondrosis

Photo: refer to the corresponding spine vertebrae

Classification of osteochondrosis in the level of the spinal column parts of lesions:

• polisegmantarny (common);
• sacral;
• lumbar;
• breast;
• cervical.

Classification according to radiographic changes:

• Stage 0 - no change of the intervertebral disc.
• Stage 1 - predominantly internal traumatization disc with minor modifications.
• Stage 2 - significant lesions inside of the disk while maintaining the outer surface.
• Stage 3 - the entire disc defeat: propagation of cracks on the outer surface of the disk, which may lead to its extrusion in the intervertebral space.

Classification according to functional and clinical manifestations:

• Stage 1 - the functional activity of the affected segment is stored in the site of the lesion indicated a slight soreness.
• Stage 2 - as a result of vertebral subluxations, pinched nerves and disc protrusion begins to break the spine functioning. Amplified pain at the lesion.
• Step 3 - as a result of spinal deformity appear herniated intervertebral discs. Pain become more intense.
• Stage 4 - the patient almost loses the ability to move. The mobility of the spinal segment is virtually absent, found significant muscle tension. Noted disability.

Clinical stage osteochondrosis

With the development of the pathological process brings a number of changes, characterized by certain symptoms.

Preclinical stage osteoarthritis (grade 1).

• There have been minor changes. Pain appear and become more pronounced when bending and bends felt fatigue and stress of the back muscles. For correction of the course enough chondroprotectors and regular exercise therapy system.

Clinical stage osteoarthritis (grade 2).

• Detected instability between the vertebrae. The pain becomes intense radiating to the arms, shoulders or lower limbs, increasing with pan and tilt. This is due to a decrease in the height of the intervertebral disc. Patients reported fatigue, confusion, headaches and decreased performance. Treatment includes pharmacological agents, ointments, physiotherapy and physical therapy correction system.

Formation of herniation (Grade 3).

• The pain becomes more intense and is manifested not only in the place of destruction, but also in places of possible irradiation. The muscles begin to lose their dynamic force, limb numbness exposed. Hernias of intervertebral discs. Reduced mobility of the spine. Patients concerned about weakness and dizziness. It is necessary to address the issue of prompt intervention.

The destruction of the intervertebral disc (4 degree).

• Wheels start to be replaced by connective tissue. Defeat can capture several vertebral segments. The degree of destruction in them may vary. There discoordination movements gain headaches and dizziness, tinnitus appearance.

Causes of

The main causes of degenerative disc disease.

• Overweight.
• Eating disorders: lack of foods containing calcium and vitamin D.
• Incorrect posture and the associated pathology of the musculoskeletal system (flat feet, rheumatism, scoliosis, lordosis and kyphosis).
• Hypodynamy: sedentary work, lack of physical activity.
• Traumatic injury to the spinal division.
• Excessive exercise, traumatic tissue.
• Genetic predisposition to develop the disease.
• Incorrect tab tissues of the musculoskeletal system.

There are a significant number of risk factors for the formation of degenerative disc disease, which in the presence of a predisposition may trigger onset of the disease.

The main ones are the following:

• Prolonged and frequent overcooling.
• Age-related degeneration of tissues.
• Diseases of the arch, which leads to overloading of the spinal column.
• Metabolic disorders (age-related loss of glucosamine and chondroitin compounds).
• Chronic overload of the spine during prolonged wearing uncomfortable and tight shoes.
• Occupational risk factors (work in a forced position, body jerks and frequent turns, lifting weights).
• Properties microclimate: a combination of high humidity and low temperature.
• Abrupt cessation of sporting activities and a decrease in physical activity.
• Frequent stress, nervous tension that causes spasmodic muscle activity, deforming the vertebral segment.

pathology development

the above factors cause excessive strain on the vertebrae. This leads to muscle spasms. Systemic circulatory disturbances occur, the efficiency of metabolic processes disrupted - formed degenerative changes.

The intervertebral discs are deformed and become thinner, beginning to extend beyond the spinal column.

There are four basic stages of development of osteochondrosis.

• Step One. It reduces the amount of moisture contained in the nucleus of an intervertebral disc. He flattened, resulting in reduced spaces between the vertebrae. Cartilage begins to be covered small cracks. Typically, in a first step of forming pain patient no disease.
• Step Two. With the reduction of the intervertebral space starts to spasm and ligamentous muscular system. This contributes to excessive mobility of the spinal segment, its displacement.
• Step three. As a result of the progression of the degeneration process occurs protrusion (squeezing) of the disc, subluxations of the vertebral bodies.
• Step Four. The intervertebral space begin to form osteophytes (bony spines). They stabilized somewhat pathologically movable vertebral segment, prevent sprains. Over time, their number increases significantly. This leads to almost complete loss of mobility of the spine. Simultaneously start injure nerves and vessels located near the vertebrae.

Symptoms of osteoarthritis of different departments

Cimptomatika osteochondrosis has a strict correlation with the lesion area of ​​the spinal segment and the degree of injury severity.

The defeat of the cervical spine

In addition to pain in the neck, patients often note the following non-specific symptoms:

• Decrease in visual acuity.
• Ringing and tinnitus.
• Dizziness.
• The appearance of colored spots before his eyes and flashing "flies".
• The rise in blood pressure.
• Reduction of hearing acuity.
• Nighttime sleep apnea (snoring).
• Paresthesia (sensitivity violation) in the upper limbs, neck and facial skin.
• Changing the power to vote.
• Bouts of fainting.
• Headaches in the parietal, temporal and occipital areas. Amplified during movement.

thoracic spine defeat

• Pain between pronounced blades.
• Tenderness on deep and sharp intake of breath.
• Paresthesia (numbness) of the skin of the back, abdomen and chest.
• Difficulties during lifting of the upper extremities.
• Pain in the heart for a long time. By the nature of sharp, stabbing, sharp, with a particular point of pain, which may indicate the patient.
• Difficulty slopes.

Osteochondrosis of the lumbar and sacral spine

• Lumbodynia - pain in the lumbar and sacral spine, radiating to the lower extremities. May be aggravated by movements in the affected segment.
• Hyperhydrosis (sweating).
• Cold sensation in the lower extremities of the body at a comfortable temperature.
• Constant voltage muscular corset of the lumbar.
• Tingling and pins and needles in the legs.
• Change potency in men.
• Irregular menstrual cycle in women.

In the long osteoarthritis affected segments tend to fuse together. In this case, the main symptoms - difficulty of mobility and pain is reduced significantly.

Especially in women and men

There were no significant differences for degenerative disc disease in men and women does not exist. It differs only more vegetative symptoms on a background of the lumbar lesions. In men, the process may be accompanied by sexual dysfunction in women - menstrual irregularities. At the time of menopause, women may be more pronounced symptoms of cervical degenerative disc disease. This is due to the effects of hormonal dysfunction, which causes further vasoconstriction.

With what could be mistaken for low back pain

• Ankylosing spondylitis spondylitis. Characterized by the gradual upward lesions of the spine with fusion of the spinal segments. It leads to a lack of mobility.
• Rheumatism. Usually accompanied by a lesion of the heart valves and major joints.
• Rheumatoid arthritis. In addition to lesions of small joints of the hands and feet can be detected kidney damage.
• Urolithiasis disease, adnexitis. The pain may radiate to the lumbar spine. To clarify the diagnosis requires holding ultrasound.
• Coronary heart disease. necessary to carry Holter in order to avoid strokes, reminiscent of pain in the thoracic osteochondrosis.

survey

• Clinical survey and medical examination. It allows you to set the symptoms, to exclude comorbidities and pick up the necessary diagnostic tests.
• X-ray of the spine. It allows you to set the behavior of the vertebral bodies, to assess the degree of narrowing of the joint space, the existence and size of osteophytes.
• MRI (Magnetic Resonance Imaging) renders the bone structure, hernial protrusion intervertebral discs.
• CT (computed tomography) less informative resolution than MRI. It is difficult to establish the presence and size of the herniation.
• Duplex ultrasonic scanning. The method is used when the need to identify atherosclerotic vascular lesions. Estimated rate of blood flow and the presence of constrictions angialnogo bed.
• Myelography - retgenografichesky method research primneniem contrast agent. It allows you to establish the existence of a hernia.

Research Methods in osteochondrosis mostly instrumental, as laboratory diagnosis does not reveal significant changes. For differential diagnosis with several pathologies rheumatological profile (rheumatic fever, ankylosing spondylitis, rheumatoid arthritis, osteoporosis) is recommended to perform a number of surveys: KLA, ESR, CRP, urea, rheumatoid factor, SLA-O, fibrinogen, calcium concentration blood.

therapies

drug therapy

It includes pain killers and anti-inflammatories in the form of injections and tablets. Topically applied ointments and creams. Their number is chosen in relation to the severity of pain. By the base of NSAIDs include:

• nimulid,
• celecoxib,
• eterekoksib,
• meloxicam.

Analgesics:

• deksalgin,
• Amelotex,
• ketorol,
• Ksefokam.

ointments:

• ibuprofen,
• artrafik,
• aertal,
• nimulid.

Hondroptrotektory

• Preferred combination preparations with a combination of glucosamine and chondroitin. Chondroitin restores the articular surface, promoting the regeneration of bone tissue, glucosamine helps to regenerate ligament apparatus. These drugs require a course of reception of at least 3 months, 2 times a year.

Physiotherapy

Technique employs a laser correction, electrophoresis and phonophoresis, magnetic, low-frequency currents. This helps reduce pain in the affected segment of the spine and extend the possibility of functional activity.

Physiotherapy

• Well-chosen training system strengthens ligaments and muscular system. This prevents the formation of hernial protrusion and subluxations development. it normalizes metabolism in the intervertebral discs and improves the local blood circulation.

Extension (traction) of the spinal column

• Skeletal hood by modern equipment is used outside the period of exacerbation. This helps preserve the elasticity of ligament apparatus and the distance between vertebrae. This measure makes it possible to maintain the elasticity of muscular frame back.

Photo: stretching back osteochondrosis

Massage

• Eliminates spasmodic activity of muscles of the spine. This leads to a decrease in pain symptoms, normalize blood circulation and leads to the strengthening of the musculoskeletal system (muscles and ligaments).

Reflexology

• It reduces the focal pain symptoms by acting on certain reflex zones.

To achieve the clinical effect requires the regular use of these methods in combination.

Surgical treatment of degenerative disc disease

It is used in case of failure of conservative therapy.

Preferably microsurgical treatment in the presence of intervertebral hernia.

Removal of the affected disk replacing it with an implant. This allows you to restore the intervertebral spacing and eliminate the symptoms of osteoarthritis.

Complications and prognosis

• Migraine attacks.
• Narrowing (stenosis) of the spinal canal.
• Vascular dystonia - increased activity of the sympathetic nervous system, which leads to high blood pressure spikes.
• Sciatica - inflammation of the nerve endings.
• Sciatica - pain in the lower limbs and buttocks, associated with the defeat of the sciatic nerve.
• Lumbago - severe pain in the lumbar region.
• Hernia SHmorlja - the displacement of the intervertebral disc in the cavity of the vertebra.

When integrated approach: the combination pharmaceutical techniques physiotherapeutic correction and physical therapy techniques can significantly reduce the progression of the disease.

prevention

• Maintaining proper posture.
• Avoidance of physical inactivity.
• Preventing injury to the spinal division, lifting weights.
• Acquisition of orthopedic bedding.
• When an awkward position during operation it is recommended to wear a special corset.
• Perform physiotherapy exercises aimed at maintaining the activity of the back muscles.
• Izbegatnie hypothermia.