Osteochondrosis

The term osteochondrosis itself consists of two words: osteo - bone and chondrue - cartilage. Simply put, it is the ossification of cartilage. Although this interpretation is fundamentally wrong. Some go even further in their dreams and are convinced that osteochondrosis is a deposition of salts in the joints. In addition, it is a common table salt consumed for food.

Pathogenesis

In reality, everything is a little different. And more difficult. And table salt, if it plays any role in the formation of osteochondrosis, is very indirect. Osteochondrosis is based on degeneration and degeneration of joint cartilage. It is not an independent disease, but a pathological process that can be observed almost everywhere in the presence of connective cartilage tissue.

However, in a large case, osteochondrosis affects the spine. Why is that? The fact is that there is a kind of cushion between the vertebrae - intervertebral (intervertebral) discs. The physiological role of these discs is to protect the vertebral bodies from premature wear due to mechanical stress. The disc consists of a ring fibrosus and an internal fluid nuclear pulposus surrounded by an upper and lower end plate.

The disc is subjected to great mechanical stress, which causes permanent damage to its structures at the cellular level. In humans, these processes are very pronounced - this is our payment for a steep walk. To prevent the disk from being completely "erased", it must constantly regenerate, ie rebuild itself. It is the balance of damage-regeneration processes that determines the normal structure of the intervertebral disc. Another interesting detail is that the supply of blood and nutrients to the intervertebral discs is not diffuse through the blood vessels that grew in childhood, but diffusely from the bone tissue of the vertebral bodies. Again, pay for the ability to move on two legs, not four.

For this reason, intervertebral discs are easily damaged anatomically and physiologically. Any negative process in the body leads to damage to the balance of damage, the development of dystrophy and degeneration of the discs. A structurally defective disk can no longer withstand the required mechanical stress. Under the excessive pressure of the upper vertebrae, the discs move in different directions, usually to the sides and back. This process is called disc herniation.

The bone tissue of vertebrae that have lost their cartilage lining is also subject to mechanical wear. Pathological bone growths occur as a result of constant trauma on the anterior margin of vertebral bodies - osteophytes. Spondylosis develops. Due to degeneration and displacement of the disc, the intervertebral spaces are reduced, the spinal canal is narrowed, and the roots of the spinal nerves in the so-called foraminal openings are damaged.

Reasons

The causes or etiological factors of osteochondrosis are different. They can be both local, ie the pathology of the spine itself, as well as general disorders at the level of the organism. Any pathology that causes structural disorders of the spine or metabolic disorders can be considered the cause of osteochondrosis. In this regard, there are:

• Changes in the configuration of the spine (scoliosis, pathological lordosis or kyphosis).
• Other defects of the musculoskeletal system are straight legs, narrow shoulder girdle, anomalies in the pelvic structure.
• Spinal cord injury.
• Weak immunity.
• Metabolic disorders - osteoporosis, obesity, diabetes mellitus, thyroid disease.
• Diseases of the cardiovascular system - atherosclerosis, hypertension.
• Digestive disorders that cause insufficient absorption of nutrients from the gastrointestinal tract.
• Heredity.

It should be noted that the above pathological conditions do not necessarily cause osteochondrosis. This requires certain predisposing factors - hypothermia, nutrition, sedentary lifestyle or, conversely, constant exposure to excessive physical force.

Symptoms

Osteochondrosis itself is an asymptomatic process. And at the same time, the symptoms of intervertebral disc degeneration are different. How? The fact is that the clinical manifestations of osteochondrosis are based on its complications - disc herniation, spondylosis, sciatica, narrowing of the spinal canal.

Moreover, the clinic is very variable depending on the predominant localization of the process in the cervical, thoracic or lumbosacral spine. The last part is the most affected, because it is the waist with maximum physical activity. Symptoms of lumbar-sacral osteochondrosis:

• Pain (lumbodynia, lumbago, sciatica).
• Restriction of movement in the lower back and lower extremities (intermediate claudication).
• Sensitivity disorders of the paresthesia type - numbness, burning, crawling.
• Pathological tension of the lumbar muscles.
• In the absence of treatment, disorders of the pelvic organs.

Cervical osteochondrosis is slightly less common than lumbosacral. However, this pathology is also very common. In addition to the typical symptoms of pain (cervical), cervical osteochondrosis has its own characteristics due to decreased sensitivity and movement in the upper extremities, disruption of blood supply to the brain. These features manifest themselves:

• Insomnia.
• Headache, dizziness.
• Periodic nausea.
• General weakness, fatigue.
• Fluctuations in blood pressure.
• Sometimes toothache.
• Behavioral reactions in the form of tears, irritation.

The thoracic region with osteochondrosis is relatively rarely affected. In this situation, patients are those who are forced to sit in a constant state of anxiety with the profession - students, schoolchildren, programmers, office workers. In this case, the symptoms of osteochondrosis will be as follows:

• Chest pain and paresthesia.
• Shortness of breath.
• Feeling of heartbeat.
• Restriction of movement in the thoracic spine.

Diagnostics

From all this it is clear that osteochondrosis is a disease of the chameleon. Due to the similarity of the signs, it is easy to confuse it with cerebrovascular accident, hypertension, myocardial infarction, angina pectoris, neurotic disorders. Therefore, a comprehensive diagnosis is needed to correctly diagnose the symptoms and treatment of osteochondrosis in order to make a correct diagnosis.

This diagnosis should include traditional examination and clarification of patient complaints, as well as medical examination and specific research methods. These methods include radiography of the spine, ultrasound of the internal organs. Recently, computed tomography and magnetic resonance imaging have been used successfully to diagnose osteochondrosis.

Treatment

Therapeutic tactics for osteochondrosis include:

• Medications.
• Massage.
• Physiotherapy procedures.
• Physiotherapy (exercise therapy).
• Manual therapy.
• Acupuncture.

Medications for osteochondrosis are mainly aimed at relieving pain and inflammatory processes in the nerve roots. In various combinations, these drugs are widely used in the form of ointments, injections, tablets for the treatment of osteochondrosis. It should not be forgotten that these drugs have a negative effect on the liver, stomach and intestines. Thus, they can aggravate metabolic disorders in osteochondrosis. With local anesthesia, the pain of the blockade is well relieved. However, the effect of these drugs is short-lived and in no way affects the course of osteochondrosis as a whole.

With the help of drugs such as chondroprotectors, immunostimulants, minerals and vitamins, it is possible to improve metabolic processes at the local and body levels. Chondroprotectors are used in tablets, ointments and ampoules. Among the strengthening substances, along with minerals, vitamins C and B group are used. In this regard, calcium supplements are the most preferred. Indeed, contrary to some misconceptions, the basis of osteochondrosis is not an excess, but simply a lack of calcium.

After successful exacerbation, physiotherapy procedures, massage and exercise therapy are indicated. Electrophoresis with calcium, phonophoresis with hydrocortisone, amplipulse, paraffin therapy are used as physical procedures. All these measures are aimed at eliminating pain and inflammation in the nerve roots, ligaments and muscles. Massage for osteochondrosis is performed according to the generally accepted method. The massage area is selected depending on the localization of osteochondrosis. Expansion of the range of motion is achieved with the help of exercise therapy. Initially, there are virtually no dynamic loads during the ignition phase. The patient is always in optimal condition. In this case, it is desirable to wear immobilization devices - a waist corset, a neck collar of Chants. As the severity decreases, the volume and duration of exercise increase during exercise therapy.

Recently, non-traditional treatments for osteochondrosis - acupuncture, manual therapy, osteopathy have been adopted. Acupuncture is the treatment of specific biologically active points along the spine, ears, hands and feet. With manual therapy, the normal position of the vertebrae and intervertebral discs is restored with the hand movements of a specialist's hands. In the course of osteopathy, the structural integrity of the musculoskeletal system is ensured using special methods. In the absence of the effect of conservative measures for the treatment of osteochondrosis, persistent pain, complications, surgery are indicated. Pathologically displaced disc is removed. Currently, a microdiscectomy is performed for this purpose - endoscopic removal of the displaced disc.