Excessive tension in the back muscles causes a lot of discomfort and pain. Osteochondrosis, which causes a violation of the structure of the vertebrae and intervertebral discs, leads to severe pinching of nerve endings. Often the pathology is accompanied by deterioration of blood circulation, which causes disturbances in the nutrition of the brain and internal organs.
Osteochondrosis - what is it?
Osteochondrosis is a type of recurrent disease, which proceeds in a chronic form and is accompanied by destruction of the vertebrae with intervertebral discs. Their tissues are disturbed, which causes a decrease in the degree of their elasticity, followed by a change in shape. There is a gradual decrease in the intervertebral space. This leads to a loss of stability of the spine in the areas of development of the pathology.
The processes of pathological destruction of tissues occur against the background of pinched nerve endings, which are directed from the area where the spinal cord is located. As a result, the back muscles are in constant tension. In such a situation, patients complain of back pain and other symptoms.
Based on the peculiarities of the localization of the structures of the spine, which were covered by degenerative changes, the cervical, thoracic and lumbosacral types of the pathological process are distinguished. The main symptom of the development of osteochondrosis is pain, the intensity and severity of which usually increases during physical exertion.
There is also a stiffness in the movement. In addition, the clinical picture is characterized by the presence of signs of a vertebral type - headache, changes in blood pressure, deterioration of visual function, hearing, etc.
Mechanism of development
The development of osteochondrosis is associated with the fact that the nucleus pulposus begins to lose its hydrophilic qualities. This semi-liquid structure contains connective tissue fibers and chondroitin, a gelatinous substance. In the process of development of the human body and its growth, the processes of reducing the vascular bed in the intervertebral discs actively continue. The nutrients are supplied in a diffuse manner, which manifests itself in a spontaneous stabilization of the concentration. This characteristic becomes the reason for the difficulties in the complete restoration of the cartilage that has suffered damage or excessive pressure on the spine.
Pathological abnormalities become more striking due to violations of the hormonal background and human nutrition. Cartilage tissue begins to lack the nutrients necessary for its normal development. Therefore, the disorders appear as:
- decrease in strength and elasticity;
- changes to consistency settings and configuration properties.
Against the background of the flattening of the intervertebral discs, radial cracks are formed in the fibrosus ring. As a result, the intervertebral distance is reduced, and the facet joints begin to move. Over time, the pathological changes cover the types of connective tissues related to the fibrous rings and ligaments.
As tissues are degraded by the immune system, increased amounts of immunoglobulins are produced. This provokes the development of the aseptic inflammation process, edema is formed in the area where the facet joints are located. They also spread to adjacent soft tissues.
Due to stretching of the joint capsules, the intervertebral discs lose their ability to attach the vertebrae. Such instability of the position of the spinal structure increases the risk of pinching nerve roots or constricting blood vessels. This feature is typical, for example, of cervical osteochondrosis, which is accompanied by intense verbal symptoms.
Causes of the disease
The condition of the intervertebral discs may worsen with a decrease in the tone of the skeletal muscles of the spine. Due to the irrational and asymmetric work of the muscles, the destruction of cartilage tissue can occur with prolonged preservation of the non-physiological position of the body. This violation is the result of carrying heavy bags on the same shoulder, using soft mattresses and high pillows.
The process of destruction of intervertebral discs is accelerated due to the action of a number of negative factors of an external and internal nature. These include:
- disorders of the endocrine mechanism and metabolic disorders;
- pathologies of an infectious nature, including in chronic form;
- injuries of the spine in the form of compression fractures, bruises;
- regular and prolonged hypothermia of the body;
- systemic and degenerative-dystrophic diseases - gouty, psoriatic, rheumatoid arthritis, osteoporosis, osteoarthritis;
- smoking and alcohol abuse, which disrupts the state of the vascular system, impairs blood circulation and causes a lack of nutrients in the cartilage;
- insufficient physical development, postural problems, flat feet - these defects increase the load on the spine, since the cushioning will be insufficient;
- obesity;
- genetic predisposition;
- exposure to regular stress.
Symptoms
The main clinical sign of osteochondrosis of any location (cervical, thoracic or lumbosacral) is pain syndrome. In the event of a relapse, the pain is penetrating, radiating to areas near the body. Even with a slight movement, it intensifies. This forces the patient to put the torso in a forced position to minimize discomfort and pain:
- with cervical osteochondrosis, it will be better to turn not one head, but the whole body;
- when there is a thoracic form of the disease, it is difficult for the patient to breathe deeply, and therefore, in order to exclude sharp pain in the chest, he tries to minimize the depth and frequency of thebreathing;
- in patients with some type of lumbar disease, difficulty occurs when sitting down, taking an upright position, moving, because the nerve of the spine is pinched.
Usually, patients complain of dull, persistent pain and a feeling of stiffness in movement in the morning after waking up. In this case, a differential diagnosis will be needed to help rule out the risks of developing myositis caused by inflammation of the skeletal muscles of the spine or osteoarthritis.
Painful and pressing pains occur due to compensatory tension in muscle tissue. This condition is necessary to stabilize the area of motion of the spine. Mild or moderate constant pain may appear with severe stretching of the intervertebral disc and result from aseptic inflammatory changes.
Osteochondrosis of a distinct localization is characterized by specific symptoms:
- With cervical osteochondrosis, pain is felt in the cervical area, in the upper limbs. Pain in the head and numbness in the fingers are observed. If the disease manifests itself in a severe form, pinching of the vertebral artery may occur. In this case, the patient begins to complain of a significant deterioration in his health.
- Chest localization is manifested by a sharp aching pain in the back, visceral pain syndrome is present in the heart region, right hypochondrium and abdomen. Patients complain of numbness, paresthesia of the skin, shortness of breath, cracking of the vertebrae.
- Patients with lumbar osteochondrosis complain of pain in the back and lower limbs with increased intensity during movement. Often, disturbances in the functioning of the genitourinary system, problems with male potency and dysfunctional ovarian disorder are diagnosed. During remission, the pain may decrease. However, the impact of a provoking factor leads to its renewal.
- When mixed osteochondrosis occurs, symptoms may appear in more than one area at a time. This condition is characterized by a more severe course of the disease.
It should be remembered that the displacement of the vertebrae and the formation of osteophytes cause compression of the vertebral artery. It nourishes the brain by providing its cells with an oxygen component. When in a hurry, food is limited and as a result the patient has problems with coordination, headaches, tinnitus, and high blood pressure.
Consequences if not treated
The reason for the complicated course of osteochondrosis is the relatively rapid formation of hernias in the intervertebral discs. Their appearance is associated with the displacement of the vertebral structure in a posterior direction. This provokes a rupture of the posterior ligament of a longitudinal type, as a result of which there is an instability of the position of the disc, a protrusion of its individual sections in the region of the spinal canal. Rupture of the hernia occurs when a disc with a nucleus pulposus enters the area of the canal.
With the manifestation of pathological abnormalities in the vertebral structures, the back of the brain begins to tighten, the patient develops discogenic myelopathy. Symptoms of this disease are associated with numbness and weakness in certain muscle groups of the upper and lower extremities. Paresis, muscle atrophy, and tendon reflexes occur. In some cases, there are problems with emptying the bladder, intestines.
Herniated discs are dangerous by squeezing the arteries that supply the spinal cord. The result of this pathology is the formation of ischemic areas, where nerve cells have suffered damage and death. The manifestation of a neurological effect is manifested by dysfunctions of motor function, a decrease in the degree of tactility and a disorder of trophism.
Diagnosis of diseases
The initial diagnosis is made on the basis of the patient's complaints and symptoms. The specialist studies the condition of the spine in different positions, suggesting that the patient is at rest or in motion. At the next stage, the patient is directed to laboratory diagnostics, which will help to clarify the diagnosis or refute it.
Search methods used include:
- Radiography- provides a comprehensive examination of the spine with an assessment of the condition of the vertebrae, existing disorders in the form of growths, curvatures. The specialist will be able to determine the intervertebral type intervals, the state of the holes. To accurately identify osteochondrosis, localized in the chest or cervical region, a two-step x-ray examination is performed. In the first stage, the patient lies on his side and in the second, directly on his back.
- MRI or CT tomography methodgives very informative data, which allows the vertebrae to be studied in detail without interference in the form of covering organs. The photo shows the nerves and the vascular system. MRI helps identify the signs of many diseases of the spine and the location of damage. With CT, hernias are visualized, possible deviations in the structure of the spine are determined.
- Laboratory examinationto assess the condition of the blood and its main parameters. Allows you to clarify the diagnosis and determine the possibility of developing concomitant diseases.
In many cases, after examinations, doctors diagnose the presence of certain underlying diseases, potentially dangerous for their complications. We are talking, for example, of hernias, protrusion, radiculitis. Correct diagnosis of the problems helps to effectively treat osteochondrosis. At the same time, the disease itself in the early stages of development is disguised as symptoms of other diseases.
Therapeutic process
Osteochondrosis is treated conservatively or surgically. The choice depends on the severity of the disease, its neglect, the level of tissue deterioration and the causes.
It is important to remember that it is not possible to completely cure osteochondrosis, as there are no drugs to help fully restore the discs and vertebrae. The therapeutic effect is focused on inhibiting the destructive process and increasing the duration and stability of remission.
For symptomatic treatment, chondroprotectors are used, based on chondroitin sulfate or glucosamine.
The effectiveness of the therapeutic process with the use of chondroprotectors has been clinically confirmed by long-term tests. If you take these funds for a long time from 3 months, there is a partial restoration of cartilage and other elements of the connection type - the ligament-tendon apparatus, bursa.
The accumulation of glucosamine and chondroitin in the area of the intervertebral disc leads to the manifestation of analgesic, anti-edematous and anti-inflammatory effects. Therefore, there is a real opportunity to optimize the dosage of NSAIDs, drugs from the group of glucocorticosteroids, muscle relaxants. You can count on a decrease in the patient's drug load.
The effectiveness of chondroprotectors is determined by the regularity of their intake. Otherwise, there will be no result. Inefficiency is also recorded in the treatment of osteochondrosis of the 3rd degree, accompanied by significant destruction of cartilage.
The following groups of medicines can be used for pain relief:
- Nonsteroidal anti-inflammatory drugshelp eliminate inflammatory soft tissue disorders caused by spinal displacement. NSAIDs are effective in reducing pain, swelling, and stiffness.
- Means of the glucocorticosteroid group- blockages are usually used with an anesthetic. They are able to relieve pain, restore the immune mechanism and provide an anti-exudation effect.
- Muscle relaxants.They are effective in combating muscle spasms due to nerve entrapment. They help relax skeletal muscles and block polysynaptic spinal reflexes with an antispasmodic effect.
- External means with a warming effect.Irritation of receptors of the subcutaneous tissue with the activation of blood flow is provided by special gels and ointments. These drugs are characterized by analgesic and anti-edematous effects.
Symptoms of the vertebrogenic type, which are manifested as a result of localization of the pathology in the cervical or thoracic area, can be eliminated with the help of medical devices to activate blood circulation. Nootropics and drugs are also prescribed to improve microcirculation. In some cases, it may be necessary to take antidepressants, as well as pharmaceuticals containing anticonvulsants.
During the treatment of osteochondrosis, physiotherapy is also used. The procedures of UHF therapy, magnetotherapy, laser therapy, reflexology, massage, exercise therapy, hirudotherapy, as well as swimming and yoga can be prescribed. If conservative treatment is ineffective, the operation is performed by microdiscectomy, recovery of the puncture disc, laser reconstruction or implant replacement.