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, an increase in the axial load on the intervertebral discs and ligaments of the spine creates conditions for their microtraumatization. . Degenerative-dystrophic processes of the cartilage tissue of the vertebrae, intervertebral discs and ligaments develop - doctors collectively call all this polysegmental osteochondrosis.
With age, the natural aging of the intervertebral discs occurs, they are strengthened under the influence of vibration, jerking movements, heavy lifting and falls. The development and exacerbation of osteochondrosis is facilitated by various back injuries, physical exertion, poor physical fitness, poor posture and curvature of the spine, flat feet and excess weight.
Causes of osteochondrosis
- hereditary tendency;
- metabolic disorders in the body;
- overweight, poor diet (deficiency of fluid);
- age-related changes;
- spinal injuries;
- poor posture, scoliosis, flat feet;
- sedentary lifestyle;
- heavy lifting work;
- excessive loading of the spine due to walking in high heels and pregnancy in women, etc.
The main symptoms of general osteochondrosis
- constant aching pain in the back, numbness in the limbs;
- increased pain with sudden movements, physical activity or lifting heavy loads;
- decreased range of motion, muscle spasms;
With cervical chondrosis, a person will be worried about pain in the arms, shoulders and headaches; It is possible to develop vertebral artery syndrome with complaints of noise in the head, dizziness, flashing "dots", colored spots in front of the eyes, throbbing headache.
With osteochondrosis of the thoracic spine: 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, spreading to the sacrum, legs, and sometimes the pelvic organs.
Cervical osteochondrosis. Localization of osteochondrosis in the neck region is quite common. Cervical spine is more often in people engaged in monotonous work - designers, programmers, secretaries, dentists, etc. suffers. As a rule, the development of cervical osteochondrosis is facilitated by driving a car and working at a computer for a long time. 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 darkens and blood pressure rises. A channel for the so-called vertebral artery passes through the transverse processes of the cervical vertebra. It is directed into the cranial cavity and nourishes the brain. Displacement of the vertebrae causes spasm of the vertebral artery, and in severe cases, compression. Thus, the blood supply to certain parts of the brain is disturbed.
When osteochondrosis worsens, there may also be radicular symptoms: the pain spreads to the hands, sometimes to individual fingers, they become numb and constantly cold. The reason for this is the violation of the passage of impulses along the nerve fiber. With the numbness of a certain finger, a neurologist can judge the displacement of a certain vertebra. The clinical picture of osteochondrosis of the cervical spine is characterized by various symptoms, which are related to the physiological characteristics of this segment.
The thoracic spine is rarely affected by osteochondrosis. One of the main reasons for development
Lumbosacral osteochondrosis. Osteochondrosis of the back occurs most often. This is explained by the fact that the lower back (lumbar vertebra), as a rule, carries the main load. Often, lumbar osteochondrosis can be complicated by intervertebral hernia of the lumbar vertebra. The main symptoms and signs of lumbar osteochondrosis include: back pain (lower back pain has been bothering people for many years and is characterized by cyclicity, worsening in the autumn-winter period), limitation of mobility, pain in the legs. Very often, with lumbar osteochondrosis, there is a sharp (lumbago) or aching pain in the legs that affects a certain part of the leg (for example, the back or side). In addition to pain, there may be an increase or decrease in the sensitivity of the skin of the feet to touch or pain - these symptoms of osteochondrosis are explained by compression of the spinal cord roots.
The most common cause of osteochondrosis in the lumbar-sacral region is traumatic (compression fracture or chronic injury). The sciatic nerve originates from nerve roots in the lumbar region. When a nerve is pinched, the pain radiates along the nerve trunk: to the buttock, below the knee, sometimes to the calf or heel. Significant disturbances in the nutrition of the nerve trunk are possible, then the foot becomes numb. Symptoms of sensitivity disorders are very persistent, sometimes the numbness lasts for a long time. When the sciatic nerve is compressed, a person begins to bend to the healthy side in order to maximize the vertebrae in the affected part of the body and thereby reduce compression of the root. The first clinical manifestations with osteochondrosis of the lumbar-sacral spine are pain in the back and legs.
Treatment
Pain syndrome with osteochondrosis usually occurs as a type that eliminates exacerbation. Moreover, if the pain lasts more than 3 months, doctors talk about chronic pain. It increases the level of anxiety in patients and makes them prone to depression. As the pathogenesis of pain changes, standard treatment regimens become ineffective. 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. Also, eliminate acute pain in a timely and effective manner to prevent its chronicity.
Acute pain develops when 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 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-relieving and anti-inflammatory effects. Diclofenac is widely used to relieve acute pain in osteochondrosis.
A new drug containing diclofenac is of great interest. It is a fast-dissolving, buffer-stabilized package. This release form is quickly absorbed and the therapeutic effect is comparable to the injection form and develops within 5-20 minutes. The new drug has a high speed of action and a long-lasting effect.
The drug is used in a dose of 50-100 mg, the daily dose of the drug should not exceed 150 mg per day. The daily dose should be divided into 3 doses.
The effect of diclofenac potassium in the form of a packet was compared with the injection form of diclofenac in a clinical study. The results showed that the packet form of diclofenac potassium was superior to the injectable form. It seems that the new drug will greatly expand the possibilities of painkiller therapy for doctors in our country.
The effect of pain on the muscle component includes the following: post-isometric relaxation, massage and therapeutic exercises, including exercises to strengthen the muscle 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, hydrocortisone phonophoresis, etc. ).
Prevention
The main methods of prevention of osteochondrosis are: physical activity, a properly equipped workplace that eliminates long-term 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 initial stage of the disease. Physical rehabilitation should be carried out comprehensively.