In the life of a modern person, an imbalance between active physical activity and static loads leads to a decrease in the tone of the back muscles, therefore, an increase in the axial load on the intervertebral discs and ligamentous apparatus of the spine creates conditions for their microtraumatization. The so-called degenerative-dystrophic processes of the cartilaginous tissue of the vertebrae, intervertebral discs and the ligamentous apparatus develop - doctors collectively call all this polysegmental osteochondrosis.
With age, natural aging of intervertebral discs occurs, intensifying under the influence of vibrations, sudden movements, lifting weights and falls. The development and exacerbation of osteochondrosis is facilitated by various back injuries, physical overload, poor physical fitness, poor posture and curvature of the spine, flat feet and excess weight.
Causes of osteochondrosis
- hereditary predisposition;
- metabolic disorders in the body;
- excess weight, poor diet (lack of fluids);
- age-related changes;
- spinal injuries;
- poor posture, scoliosis, flat feet;
- sedentary lifestyle;
- work involving heavy lifting;
- overload of the spine as a result of walking in high heels and pregnancy in women, etc.
The main symptoms of common osteochondrosis
- constant back pain, feeling of numbness in the limbs;
- increased pain with sudden movements, physical activity or heavy lifting;
- decreased range of motion, muscle spasms;
With cervical chondrosis, the person will be bothered by pain in the arms, shoulders and headaches; It is possible to develop the so-called vertebral artery syndrome, in which there are complaints of noises in the head, dizziness, bright "spots", colored spots before the eyes combined with a throbbing headache.
With osteochondrosis of the thoracic spine: pain in the chest (like a "stake" in the chest), in the region of the heart and other internal organs; with osteochondrosis of the lumbosacral spine: pain in the lower back, radiating to the sacrum, legs and sometimes to the pelvic organs.
Cervical osteochondrosis. The location of osteochondrosis in the neck region is quite common. The cervical spine suffers most often in people who perform monotonous work - designers, programmers, secretaries, dentists, etc. As a rule, the development of cervical osteochondrosis is facilitated by driving and prolonged work at the computer. The main signs and symptoms of cervical osteochondrosis include: headache, dizziness, pain in the arms and chest, low back pain, numbness in the tongue. With cervical osteochondrosis, the head often hurts and feels dizzy, vision becomes dark, and blood pressure rises. A channel for the so-called vertebral artery passes through the transverse processes of the cervical vertebrae. It is directed to the cranial cavity and nourishes the brain. Displacement of the vertebrae leads to spasm of the vertebral artery and, in severe cases, compression. Thus, the blood supply to certain parts of the brain is interrupted.
When osteochondrosis worsens, radicular symptoms may also be present: pain radiates to the hand, sometimes to individual fingers, they become numb and are constantly cold. The reason for this is a violation of the passage of impulses along the nerve fiber. By the numbness of a specific finger, a neurologist can assess the displacement of a specific vertebra. The clinical picture of osteochondrosis of the cervical spine is characterized by a variety of symptoms, which is due to the physiological characteristics of this segment.
The thoracic spine is rarely affected by osteochondrosis. One of the main reasons for the developmentthoracic osteochondrosisIt is a curvature of the spine (scoliosis). Typically, the reasons for the development of thoracic osteochondrosis are formed at school. The thoracic spine is the least mobile, so the signs and symptoms of thoracic osteochondrosis are very different from the symptoms of cervical or lumbar osteochondrosis. In most cases, the main difference between thoracic osteochondrosis is the absence of sharp pain and the presence of only dull, aching pain in the back. The main symptoms and signs of thoracic osteochondrosis include: chest pain, numbness, tingling sensation in the chest area, pain in the heart, liver and stomach. Often, thoracic osteochondrosis is disguised as other diseases (for example, myocardial infarction, peptic ulcer, gastritis). The pain associated with osteochondrosis of the thoracic spine is long-lasting, similar to intercostal neuralgia. Sometimes the pain can radiate under the shoulder blade, which makes you suspect a heart attack. The difference between "heart" pain and intercostal neuralgia is that in osteochondrosis the patient has a normal electrocardiogram, there are no symptoms such as intense pallor, bluish skin, cold sweat, etc.
Lumbosacral osteochondrosis. Osteochondrosis of the lumbar spine occurs most often. This is explained by the fact that the lower back (lumbar vertebrae), as a rule, bears the main load. Most often, lumbar osteochondrosis can be complicated by an intervertebral hernia of the lumbar spine. The main symptoms and signs of lumbar osteochondrosis include: low back pain (low back pain has been bothersome for many years and is characterized by cyclicity, worsening in the autumn-winter period), limited mobility, pain in the legs. Often, with lumbar osteochondrosis, sharp (lumbago) or aching pain in the legs occurs, affecting a certain part of the leg (for example, in the back or side). In addition to pain, there may be an increase or decrease in the sensitivity of the skin on the legs to touch or pain - these symptoms of osteochondrosis are explained by compression of the roots of the spinal cord.
The most common cause of osteochondrosis in the lumbosacral region is traumatic (compression fracture or chronic injury). In the lower back, the sciatic nerve is formed from nerve roots. When a nerve is pinched, the pain spreads along the nerve trunk: to the buttock region, under the knee, sometimes to the calf or heel. Significant disturbances in the nutrition of the nerve trunk are possible, and then the leg becomes numb. Symptoms of sensory impairment are very persistent, sometimes the numbness persists for a long time. When the sciatic nerve is compressed, the person begins to limp, leaning towards the healthy side to maximize the vertebrae in the affected part of the body and thus reduce root compression. In osteochondrosis of the lumbosacral spine, the first clinical manifestations are pain in the lower back and legs.
Treatment
Treatment for osteochondrosisIt is carried out mainly using conservative methods aimed at eliminating pain, dysfunction of the spinal roots and preventing the progression of dystrophic changes in the spinal structures.
Pain syndrome in osteochondrosis often occurs as an exacerbation-remission type. Furthermore, if the pain lasts more than 3 months, doctors call it chronic pain. It increases the anxiety level in patients and leads them to depressed mood. Standard treatment regimens become ineffective as the pathogenesis of pain changes. In these cases, neurologists add medications from the antidepressant group to the treatment, which are part of the standard treatment for chronic pain. This entire process can take a long time.
Therefore, it is necessary to eliminate risk factors for osteochondrosis and modify your lifestyle. And it also relieves acute pain timely and effectively to prevent its chronicity.
Acute pain develops when tissue is damaged and inflamed. Therefore, the main group of medications used in treatment are non-steroidal anti-inflammatory drugs (NSAIDs). Pain occurs when nociceptors are irritated by products of arachidonic acid metabolism.
The most popular NSAID was and remains diclofenac. This medication has been used for many years and is considered the "gold standard" for pain relief and anti-inflammatory effects. Diclofenac is widely used to relieve acute pain in osteochondrosis.
A new drug containing diclofenac is of great interest. This is a fast-dissolving, buffer-stabilized sachet. This release form is quickly absorbed and the therapeutic effect is comparable to the injectable form and develops within 5 to 20 minutes. The new medicine has a high speed of action and a long-lasting effect.
The medicine is used in a dosage of 50 to 100 mg, the daily dose of the medicine should not exceed 150 mg/day. The daily dose must be divided into 3 doses.
The effect of diclofenac potassium in a sachet was compared with the injectable form of diclofenac in a clinical study. The results showed the superiority of diclofenac potassium in sachet form over injectable form. It appears that the new drug will significantly expand the possibilities of analgesic therapy for doctors in our country.
The impact on the muscular component of pain involves: post-isometric relaxation, massage and therapeutic exercises, including exercises to strengthen the muscular corset or stretch spasmodic muscles, and the use of muscle relaxants. These methods can be combined with reflexology and other physiotherapeutic procedures (DDT, SMT, electrophoresis with local anesthetics, phonophoresis with hydrocortisone, etc. ).
Prevention
The main methods of preventing osteochondrosis are: physical activity, a properly equipped workplace that eliminates prolonged postural tension, timely relief of acute pain and regular exercise therapy.
The successful treatment of patients with osteochondrosis depends on the appropriate management of restorative measures, especially in the initial phase of the disease. Physical rehabilitation must be carried out comprehensively.