In the life of a modern person, the imbalance between active physical activity and static loads leads to a decrease in the tone of the back muscles, therefore, the increasing axial load on the intervertebral discs and the ligamentous apparatus of the spine creates conditions for their microtraumatization. . The so-called degenerative-dystrophic processes of the cartilage tissue of the vertebrae, intervertebral discs and ligamentous apparatus develop - doctors call all this together polysegmental osteochondrosis.
With age, there is a natural aging of the intervertebral discs, which is intensified 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 training, poor posture and curvature of the spine, flat feet and excess weight.
Causes of osteochondrosis
- hereditary predisposition;
- metabolic disorders in the body;
- overweight, improper nutrition (lack of fluids);
- age-related changes;
- spine injuries;
- bad posture, scoliosis, flat feet;
- sedentary lifestyle;
- work involving heavy lifting;
- overloading of the spine as a result of walking in high heels and pregnancy in women, etc.
The main symptoms of simple osteochondrosis
- constant pain in the back, a feeling of numbness in the limbs;
- increased pain with sudden movements, physical activity or lifting weights;
- decreased range of motion, muscle spasms;
With cervical chondrosis, a person will be bothered by pain in the arms, shoulders and headache; It is possible to develop the so-called vertebral artery syndrome, in which there are complaints of noise in the head, vertigo, flashing "spots", colored spots in front of the eyes in combination with a throbbing headache.
With osteochondrosis of the chest: pain in the chest (like a "stake" in the chest), in the area 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. Localization of osteochondrosis in the neck area is quite common. The cervical spine suffers more often in people who are engaged in 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, lumbago, numbness of 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 into the cranial cavity and nourishes the brain. Displacement of the vertebrae leads to spasm of the vertebral artery, and in severe cases to compression. This disrupts the blood supply to certain parts of the brain.
When osteochondrosis is aggravated, root symptoms may also appear: the pain radiates to the hand, sometimes to individual fingers, they become numb and constantly cold. The reason for this is a violation of the passage of impulses along the nerve fibers. By the numbness of a certain finger, the neurologist can assess the displacement of a certain vertebra. The clinical picture of osteochondrosis of the cervical spine is characterized by a variety of symptoms, which is due to the physiological features of this segment.
The thoracic spine is rarely affected by osteochondrosis. One of the main reasons for the development
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, carries the main load. Most often, lumbar osteochondrosis can be complicated by intervertebral hernia of the lumbar spine. The main symptoms and signs of lumbar osteochondrosis include: pain in the lower back (pain in the lower back has bothered a person for many years and is characterized by cyclicity, worsening in the autumn-winter period), limited mobility, pain in the legs. Very often, with lumbar osteochondrosis, there is a sharp (lumbago) or painful pain in the legs, affecting a certain part of the leg (for example, the back or the side). In addition to pain, there may be an increase or decrease in the sensitivity of the skin of the legs to touch or pain - these symptoms of osteochondrosis are explained by pinching of the roots of the spinal cord.
The most common cause of osteochondrosis in the lumbosacral region is trauma (compression fracture or chronic injury). In the lumbar region, the sciatic nerve is formed by nerve roots. When a nerve is pinched, the pain spreads along the nerve trunk: to the buttock area, below the knee, sometimes to the calf or heel. Significant disturbances in the nutrition of the nerve trunk are possible, after which the leg becomes numb. Symptoms of sensory damage are very persistent, sometimes the numbness lasts for a long time. When the sciatic nerve is compressed, a person begins to limp, bending to the healthy side to maximize the vertebrae of the affected part of the body and thus reduce compression of the root. In osteochondrosis of the lumbosacral spine, the first clinical manifestations are pain in the lower back and legs.
Treatment
The pain syndrome in osteochondrosis usually manifests itself as a remitting type of exacerbation. Also, if the pain lasts more than 3 months, doctors talk about chronic pain. It increases the level of anxiety in patients and predisposes them to a depressed mood. Standard treatment regimens become ineffective as the pathogenesis of pain changes. In such cases, neurologists add to the treatment drugs from the group of antidepressants, which are included in the standard treatment of chronic pain. This whole process can take a long time.
Therefore, it is necessary to eliminate the risk factors for osteochondrosis and change the lifestyle. And also timely and effective relief of acute pain to prevent its chronicity.
Sharp pain develops when the tissue is damaged and inflamed. Therefore, the main group of drugs used in treatment are non-steroidal anti-inflammatory drugs (NSAIDs). Pain occurs when nociceptors are irritated by the products of arachidonic acid metabolism.
The most popular NSAID was and remains diclofenac. This drug 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 causing great interest. This is a fast-dissolving, buffer-stabilized sachet. This form of release is absorbed quickly, and the therapeutic effect is comparable to the injection form and develops within 5 to 20 minutes. The new drug has a high speed of action and a long-lasting effect.
The drug is used in a dose of 50 to 100 mg, the daily dose of the drug should not exceed 150 mg / day. The daily dose should be divided into 3 doses.
The effect of diclofenac potassium in the form of a sachet was compared with the injectable form of diclofenac in a clinical study. The results show the superiority of diclofenac potassium in the form of a sachet over the injection form. It seems that the new medicine will significantly expand the possibilities of analgesic therapy for doctors in our country.
The impact on the muscle component of pain includes: postisometric relaxation, massage and therapeutic exercises, including exercises to strengthen the muscle corset or stretch spasmodic muscles and use of muscle relaxants. These methods can be combined with reflexotherapy and other physiotherapeutic procedures (DDT, CMT, electrophoresis with local anesthetics, phonophoresis with hydrocortisone, etc. ).
Prevention
The main methods of preventing osteochondrosis are: physical activity, an appropriately equipped workplace that eliminates prolonged postural tension, timely relief of acute pain, and regular exercise therapy.
Successful treatment of patients with osteochondrosis depends on the correct management of restorative measures, especially in the early stage of the disease. Physical rehabilitation must be carried out comprehensively.