Diagnosis of osteochondrosis symptoms, treatment

Herniation of intervertebral discs occurs more often in osteochondrosis associated with aging due to the dryness and fragility of the fibrous ring.But this is only one of the risk factors.Others include:

• Heavy load on the lumbar region due to excess body weight.
• Muscle weakness.
• Heredity.
• A sedentary lifestyle and, as a result, constant compression of the spinal structures.
• Smoking.
• Great physical activity.

According to medical statistics, this disease occurs many times more often in men than in women.

What are the most common causes of the disease:

• Injuries from traffic accidents or falls.
• Lifting heavy objects with irregular load distribution.
• Scoliosis or lordosis, which leads to increased stress on certain areas of the spine.
• Hip dysplasia.
• Chronic diseases, including spinal tuberculosis, neoplasms, syphilis.
• Metabolic disorders (hereditary and acquired).

All these factors cause wear and tear of the cartilage and bones of the spine.And this is the main cause of intervertebral hernia.

Stages of disease development

Without proper treatment, the disease progresses and the condition of the damaged spinal discs worsens.There are four stages of disease development:

1. Prolapse.The intervertebral disc has moved quite a bit, no more than two millimeters.The nucleus pulposus does not protrude beyond the vertebral body.
2. Lumbar bulge.The rim of the disc extends beyond the vertebral body for a distance of up to 1.5 mm, but no displacement of the nucleus is observed.
3. Extrusion.The sail protrudes beyond the vertebral body.
4. Sequestration.The nucleus practically falls out and hangs over the vertebrae in the shape of a drop.At this stage, there is a risk of rupture of the fibrous ring and leakage of liquid secretion.

In the first stage of the disease, almost nothing bothers the person;sometimes there is pain in the lower back, but it passes quickly.As the disease progresses, the health condition worsens, the symptoms become more painful and alarming.If the diagnosis is not made in time and the treatment is not started, the consequences are possible: paralysis of the legs and serious disorders of the nervous system.

How is a lumbosacral hernia manifested?

Intervertebral hernia can be manifested by the following symptoms:

• Pain in the lumbar region.
• Pain when walking, radiating in the region of the thighs.
• Numbness of the feet, toes, area on the surface of the lower leg and thigh.
• A feeling of heaviness in the legs.
• Stiffness of movement.

In order not to be late in seeking medical help, it is worth analyzing the symptoms of the disease more carefully.They can be divided into three groups.

Pain syndrome

Lumbosacral herniated pain is a key symptom.Already in the first stage, there is pain in the area of the damaged disc, especially after an injury.They may intensify or subside and then reoccur.More often than not, the sacral region doesn't even hurt, it hurts, especially during physical activity or prolonged sitting.If a person lies on the healthy side and bends the leg, the pain disappears completely.This condition can last for several months.

If you seek medical help in time, it is not difficult to get rid of the problem.It is enough to say goodbye to bad habits and do the physical therapy recommended by your doctor.

Each day the affected area will increase and the condition of the disc will worsen.The transition to the second stage of the disease is signaled by increased pain.Now it is felt not only in the sacral region, but covers the entire lower back, radiates to the cervical region, to every spinal muscle, buttocks, thighs, legs, feet and toes.Discomfort is manifested during physical activity, even minor - coughing or sneezing.

Spinal syndrome

Increased pain in the second phase is accompanied by constant back muscle spasms.This leads to even greater discomfort for the patient.He cannot move freely, straighten his back or stretch.The gait of such a person becomes uncertain, he constantly leans in the direction opposite to the patient and bends over.

Due to impaired coordination of movements, the quality of life of a person deteriorates.He cannot perform well the tasks assigned to him at work, and active rest becomes unrealistic due to constant pain.

Radicular syndrome

If the hernia is left unattended by a doctor, the progressive disease leads to compression of the spinal roots, as a result of which they die, and the access of blood to the tissues of the damaged disc is almost impossible.Symptoms characteristic of serious stages of the disease appear:

• Weakening of the leg muscles.The patient cannot squat, stretch or jump.It is also difficult for him to climb the stairs.
• Numbness of the affected area and surrounding areas.The skin becomes insensitive and pale, there is a sensation of goosebumps and burning.Patients complain of hyperhidrosis in the painful area and legs or, on the contrary, excessive dryness of the skin.
• Lumbago.The patient suffers from shooting in the lumbar region with acute, sharp pain, which increases with every movement.Without treatment, it leads to the destruction of the hip and knee joints.
• Noticeable thinning of the affected leg, which leads to asymmetry of posture.
• Disorder of the pelvic organs.Urological and gynecological problems worsen, libido disappears, diarrhea and urinary incontinence are possible.

In severe cases of spinal hernia there is a risk of paralysis, disability and even death.

Diagnosis of pathology

If a person has severe lumbar pain, it is necessary to make an appointment with a neurologist.He will perform an examination with medical tests:

• Detection of reflexes from the tendons of the lower extremities.
• Leg raise test.
• Determination of sensitivity to heat or cold, pain and vibration in the legs, thighs, buttocks, abdomen and back.

After that, the doctor will refer the patient to a magnetic resonance or CT scan of the lumbar region.Tomographic techniques will obtain a three-dimensional image of the affected area.It can be used to determine the location and size of the hernia and the stage of the disease.

If there is a risk of damage to the spinal cord, electromyography, neurography and contrast myelography are additionally prescribed.With the help of these studies, the doctor will determine whether emergency surgery is necessary.

Treatment of intervertebral hernia

Vertebral hernia is treated with conservative and surgical methods.The choice of technique depends on the stage of disease development, the presence of concomitant diseases and contraindications.

Conservative therapy

The therapeutic course is primarily aimed at alleviating pain and alleviating the patient's condition.

What medicines can the doctor prescribe:

1. Medicines that relieve pain and inflammation.In case of deterioration - in the form of injections.When the acute pain subsides (usually three to four days is enough), oral drugs with a similar effect are prescribed.
2. Novocaine blockade with the addition of corticosteroids.This method can relieve pain for two weeks at a time.A cycle of injections into different areas of the damaged disc is usually carried out.
3. Centrally acting muscle relaxants.They reduce muscle activity, relieve painful spasms.
4. Vitamin-mineral complexes with an emphasis on elements of group B. They slightly relax muscles, help tissue regeneration and the conduction of nerve impulses.

After pain relief, the use of medication is reduced.The disease is treated with physical therapy and physiotherapy.

Physiotherapy treatment methods are also chosen depending on the patient's condition.it could be:

• Treatment with heat or electric current.
• Electrophoresis with anti-inflammatory drugs.
• Acupuncture and acupressure.
• Hirudotherapy.
• Hydromassage.

Regular massage is allowed only in cases where there is no pain syndrome.A more effective physiotherapeutic treatment is manual therapy with postisometric relaxation.

Doctors strongly recommend patients who smoke to give up cigarettes.

Nutritional correction is also important, especially for overweight patients.You will have to exclude fatty, salty dishes, sweets and alcohol from the menu.A gentle diet with plenty of vegetables and dairy products will help the body to better tolerate the treatment, as well as to get rid of the pounds that burden the back.

Surgical intervention

Conservative treatment usually lasts about two months.If it does not give the desired result, a decision is made to change the therapeutic tactics or to operate.The latter is prescribed for severe pain, loss of sensation in the legs and dysfunction of the pelvic organs.Depending on the complexity of the situation, the operation is performed in the following ways:

• Endoscopic method.Three micro-incisions are made on the affected area.A camera is inserted into one to broadcast to the monitor.After the other two, the protrusion of the hernia is removed with miniature instruments.
• Percutaneous discectomy.The damaged core is removed through a puncture in the spinal disc and replaced with an artificial substance.
• Laser reconstruction.It is performed in the form of a puncture using a special needle without cutting the tissue.Laser radiation heats the disc structures and stimulates cell regeneration, and also relieves pain.

In severe cases, it is possible to replace the vertebrae - replacement of the injured organ with an implant.

After complex surgical interventions, rehabilitation will be required.The operated person will have to wear a corset and will not be able to take a sitting position for about three months.The further rehabilitation period includes therapeutic exercises and physiotherapy.

Preventive techniques

Like any other disease, intervertebral hernia is easier to prevent than to treat.What you need to do to keep your spinal discs healthy:

1. Accurately calculate loads if your job involves them or you are a professional athlete.
2. Correct body weight (its index should not exceed 30).
3. Choose a good mattress so that you can sleep in the right position (preferably on your back).
4. Do mild physical exercises, swimming, fitness.
5. Include exercises in the morning exercises to strengthen the muscular corset of the spine.
6. Leave the cigarettes.
7. Eat well.

If following these rules becomes a habit, there is a risk of getting herniated vertebrae just as a result of an accident.

Disc herniation has serious consequences, and the treatment of advanced cases is very long.To avoid surgical intervention and complications, if you experience back pain, you should visit a neurologist.

Osteochondrosis

The term osteochondrosis itself is derived from two words: osteo - bone and chondr - cartilage.Simply put, it is the ossification of cartilage.Although this interpretation is fundamentally wrong.Some people go even further in their delusions and are convinced that osteochondrosis is the deposition of salt in the joints.Moreover, table salt, which is allegedly consumed in large quantities in food, is deposited.

Pathogenesis

In reality, everything happens somehow differently.And harder.And table salt, if it has any role in the development of osteochondrosis, is very indirect.Osteochondrosis is based on dystrophy and degeneration of articular cartilage.This is not an independent disease, but a pathological process that can occur almost anywhere where there is connective cartilage tissue.

But still, osteochondrosis in most cases affects the spine.Why is that so?The fact is that between the vertebrae there are special spacers - intervertebral (intervertebral) discs.The physiological role of these discs is to cushion and protect the vertebral bodies from premature wear due to mechanical stress.The disc consists of an internal liquid nucleus pulposus surrounded by anulus fibrosus and upper and lower end plates.

The disc experiences enormous mechanical stress, which leads to permanent damage to its structures at the cellular level.In humans, these processes are too pronounced - this is our price for walking upright.In order to prevent the disk from being completely "erased", it must be constantly regenerated, i.e. restored.It is the balance of damage and 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 done through the blood vessels that heal in childhood, but diffusely, from the bone tissue of the vertebral bodies.Again, the price is for the ability to move on two limbs, not four.

Because of this, intervertebral discs are easily injured in an anatomical and physiological sense.Any negative process in the body leads to an imbalance of damage-regeneration, and to the development of dystrophy and degeneration of discs.A structurally defective disc is no longer able to withstand the appropriate mechanical loads.Under excessive pressure on the upper vertebrae, the discs move in different directions, usually to the side and back.This process is called a herniated disc.

The bone tissue of the vertebrae, which has lost its cartilage, is also subject to mechanical wear.Due to constant trauma, pathological bone growths - osteophytes - are formed on the front marginal surface of the vertebral bodies.Spondylosis develops.As a result of degeneration and displacement of the disc, there is a reduction of the intervertebral spaces, narrowing of the spinal canal, pinching of the roots of the spinal nerves in the so-calledforaminal openings.

Reasons

The causes, ie etiological factors of osteochondrosis are different.They can be local, i.e. caused by the pathology of the spine itself, and general disorders at the level of the organism.The cause of osteochondrosis can be considered any pathology that leads to disorders of the spine structure or metabolic disorders.In this regard, the following stand out:

• Changes in the configuration of the spine (scoliosis, pathological lordosis or kyphosis)
• Other defects of the musculoskeletal system - flat feet, narrow shoulder girdle, anomalies of the pelvic structure
• Spinal injuries
• Weak immunity
• Metabolic disorders – osteoporosis, obesity, diabetes mellitus, thyroid gland diseases
• Diseases of the cardiovascular system - atherosclerosis, hypertension
• Digestive disorders that lead to insufficient absorption of nutrients from the gastrointestinal tract
• Heredity.

It should be noted that the above pathological conditions do not necessarily lead to osteochondrosis.This requires constant exposure to certain predisposing factors - hypothermia, poor diet, sedentary lifestyle or, on the contrary, excessive physical exertion.

Symptoms

Osteochondrosis itself is an asymptomatic process.At the same time, the signs of intervertebral disc degeneration are varied.How come?The fact is that the clinical manifestations of osteochondrosis are based on its complications - disc herniations, spondylosis, radiculitis, narrowing of the spinal canal.

In addition, the clinical picture is very variable depending on the dominant localization of the process in the cervical, thoracic or lumbosacral spine.The last part is most often affected, because it is the lower back that takes the maximum physical load.Signs of osteochondrosis of the lumbosacral region:

• Pain (lumbago, lumbago, sciatica)
• Limitation of movement in the lower back and lower extremities (intermittent claudication)
• There are also sensory disorders such as paresthesia - numbness, tingling, crawling
• Pathological tension of the lumbar muscles
• In the absence of treatment - pelvic organ dysfunction.

Cervical osteochondrosis is observed somewhat less frequently than lumbosacral osteochondrosis.However, this pathology also occurs quite often.In addition to the typical signs of pain (cervicalgia), reduced sensitivity and movement in the upper extremities, cervical osteochondrosis due to impaired blood flow to the brain has its own characteristics.These characteristics manifest themselves:

• Insomnia
• Headache, dizziness
• Periodic nausea
• General weakness, fatigue
• Blood pressure fluctuations
• Occasional toothache
• Behavioral reactions in the form of crying, irritability.

The thoracic region is relatively rarely affected by osteochondrosis.Patients in this case are people who, due to their occupation, are forced to sit in a fixed, uncomfortable position - students, schoolchildren, programmers, office workers.Symptoms of osteochondrosis in this case will be as follows:

• Chest pain and paresthesias
• Shortness of breath
• The feeling of a heartbeat
• Limitation of movement in the thoracic spine.

Diagnostics

It is clear from everything that osteochondrosis is a chameleon disease.Due to the similarity of symptoms, it can easily be confused with cerebrovascular infarction, hypertension, myocardial infarction, angina pectoris and neurotic disorders.That is why a comprehensive comprehensive diagnosis is necessary to correctly determine the symptoms and treatment of osteochondrosis.

This diagnosis, in addition to traditional research and clarification of the patient's complaints, should include a medical examination and special research methods.These methods include radiography of the spine and ultrasound of internal organs.Recently, computer and magnetic resonance imaging have been successfully used to diagnose osteochondrosis.

Treatment

Therapeutic tactics for osteochondrosis include the use of:

• Medicines
• Massage
• Physiotherapy procedures
• Therapeutic physical education (physical therapy)
• Manual therapy
• Acupuncture.

Treatment of osteochondrosis with drugs is mainly aimed at alleviating pain and eliminating inflammatory processes in the nerve roots.NSAID drugs are used for this purpose.In various combinations, these drugs have found wide application in the form of ointments, injections and tablets for the treatment of osteochondrosis.We should not forget that these drugs have a negative effect on the liver, stomach and intestines.In this way, they can worsen metabolic disorders in osteochondrosis.Blockades with local anesthetics relieve pain well.True, the effect of these drugs is short-lived and in no way affects the course of osteochondrosis as a whole.

Metabolic processes at the local and organism level can be improved with the help of drugs such as chondroprotectors, immunostimulants, and vitamins and minerals.Chondroprotectors are used in tablets, ointments and ampoules.Of the general strengthening agents, vitamins C and group B are used in combination with minerals.In this sense, calcium preparations are the most preferable.Indeed, contrary to some erroneous claims, the basis of osteochondrosis is not an excess, but rather a lack of calcium.

After the successful removal of the exacerbation, physiotherapeutic procedures, massage and exercise therapy are indicated.Electrophoresis with calcium, phonophoresis with hydrocortisone, amplipulse and paraffin treatment are used as physical procedures.All these measures are aimed at eliminating pain and inflammation in nerve roots, ligaments and muscles.Massage for osteochondrosis is performed according to generally accepted methods.The area for massage is selected depending on the localization of osteochondrosis.Extending the range of motion is achieved with the help of exercise therapy.Initially, in the acute phase, there are practically no dynamic loads.The patient is always in the optimal position.At this time it is recommended to wear immobilization devices - lumbar corset, Shants cervical collar.As the deterioration subsides, increase the volume and duration of movement during physical therapy sessions.

Recently, non-traditional treatment methods are used in the treatment of osteochondrosis - acupuncture, manual therapy, osteopathy.Acupuncture is an action on special biologically active points located along the spine, on the ears, on the hands and feet.With manual therapy, the normal position of the vertebrae and intervertebral discs is restored by the manual influence of the specialist's hands.And during osteopathy, the structural integrity of the musculoskeletal system is ensured by special techniques.In the absence of the effect of conservative measures for the treatment of osteochondrosis, persistent pain and complications, surgical intervention is indicated.A pathologically displaced disc is removed.Currently, microdiscectomy is performed for this purpose - endoscopic removal of a displaced disc.