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 the nerve endings. Often the pathology is accompanied by a deterioration in blood circulation, which causes disruptions in the nutrition of the brain and internal organs.
Osteochondrosis - what is it?
Osteochondrosis is a type of recurrent disease that occurs in a chronic form and is accompanied by the 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 causes 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.
According to 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 with physical exertion.
There is also stiffness in movement. In addition, the clinical picture is characterized by the presence of vertebral-type signs: headache, changes in blood pressure, deterioration of visual function, hearing, and so on.
Development Mechanism
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 gel-like substance. In the process of development of the human body and its growth, the processes of reducing the vascular bed in the intervertebral discs proceed actively. Nutrients are supplied in a diffuse way, which manifests itself in the spontaneous stabilization of the concentration. This feature becomes a cause of difficulty in the complete restoration of the cartilage that has suffered damage or excessive pressure on the spine.
Pathological abnormalities become more noticeable due to violations of the hormonal background and human nutrition. Cartilage tissue begins to lack nutrients necessary for its normal development. Therefore, the disturbances appear in the form:
- decrease in strength and elasticity;
- changes to consistency parameters and configuration properties.
Against the background of the flattening of the intervertebral discs, the formation of radial cracks in the fibrous rings occurs. 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 tissue related to the annulus fibrous and ligaments.
When tissues are broken down by the immune system, larger amounts of immunoglobulins are produced. This provokes the development of the process of aseptic inflammation, edema is formed in the area where the joint facets are located. They also spread to adjacent soft tissues.
Due to the stretching of the joint capsules, the intervertebral discs lose the ability to fix the vertebrae. Such instability of the position of the spinal structure increases the risk of pinching the nerve roots or pinching the 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 can worsen with a reduced tone of the skeletal muscles of the spine. Due to the irrational and asymmetrical work of the muscles, destruction of cartilage tissues can occur with prolonged preservation of the non-physiological position of the body. This violation is the result of wearing heavy bags on the same shoulder, using soft mattresses and high pillows.
The process of destruction of the 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;
- diseases of an infectious nature, even in chronic form;
- spinal injuries in the form of compression fractures, bruises;
- regular and prolonged hypothermia of the body;
- systemic and degenerative-dystrophic diseases - gouty, psoriatic, rheumatoid arthritis, osteoporosis, arthrosis;
- 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, posture problems, flat feet - these defects increase the load on the spine, as depreciation will be insufficient;
- obesity;
- genetic predisposition;
- regular stress exposure.
Symptoms
The main clinical sign of osteochondrosis of any localization (cervical, thoracic or lumbosacral) is pain syndrome. With a relapse, the pain penetrates, radiating to neighboring areas of the body. Even with a slight movement, it increases. This forces the patient to put the torso in a forced position to minimize discomfort and pain:
- with cervical osteochondrosis, it will be preferable to turn not a head, but the whole body;
- when the thoracic form of the disease is present, it is difficult for the patient to take a deep breath, and therefore, in order to exclude acute pain in the chest, try to minimize the depth and frequency of breathing;
- in patients with a type of lumbar disease, difficulties arise when sitting, standing upright, moving, as the nerve of the spinal position is pinched.
Typically, patients complain of persistent dull 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 spinal muscles or osteoarthritis.
Aching and pressing pains occur due to compensatory tension in the muscle tissues. This condition is necessary to stabilize the area of spinal motion. A constant mild or moderate pain can manifest itself with a significant elongation of the intervertebral disc, resulting in aseptic inflammatory changes.
Osteochondrosis of a separate localization is characterized by special symptoms:
- With cervical osteochondrosis, pain is felt in the cervical area, in the upper limbs. Pain in the head and numbness of 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 health.
- The thoracic localization is manifested by acute and 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, crunching of the vertebrae.
- Patients with lumbar osteochondrosis complain of pain in the back and lower limbs with greater intensity during movement. Disorders in the functioning of the organs of the genitourinary system, problems with male potency, dysfunctional ovarian disorder are often diagnosed. During remission, pain may subside. However, the impact of a provocative factor leads to its renewal.
- When mixed osteochondrosis occurs, symptoms can occur in several areas at the same 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 supplying its cells with an oxygen component. When it is squeezed, food is limited and thus the patient has coordination problems, headaches, tinnitus and high blood pressure.
Consequences if left untreated
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 the posterior direction. This causes a rupture of the posterior ligament of the longitudinal type, which results in instability of the position of the disc, 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 canal area.
With the manifestation of pathological abnormalities in the vertebral structures, the back of the brain begins to contract, the patient develops discogenic myelopathy. The symptomatology of this condition is associated with numbness and weakness in certain muscle groups of the upper and lower limbs. Paresis, muscle atrophy and tendon reflexes occur. In some cases, there are problems with emptying the bladder, with the intestines.
Herniated discs are dangerous because they crush the arteries that feed the spinal cord. The result of this pathology is the formation of ischemic zones, where nerve cells have suffered damage and death. The manifestation of the neurological effect is expressed in malfunctions of motor function, a decrease in the degree of tactility and a disturbance of trophism.
Diagnosis of the disease
The initial diagnosis is made on the basis of the patient's complaints and existing 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 referred to laboratory diagnostics, which will help clarify the diagnosis or refute it.
Search methods used include:
- Radiography- provides a comprehensive examination of the spine with an assessment of the state of the vertebrae, existing disorders in the form of growths, curvatures. The specialist will be able to determine the intervals of the intervertebral type, the state of the holes. To accurately identify osteochondrosis, localized in the chest or cervical area, a two-stage radiographic examination is performed. In the first stage, the patient lies on his side, and in the second directly on his back.
- The tomography method using MRI or CTprovides highly informative data, which helps to examine the vertebrae in detail without interference in the form of the organs that cover them. The image shows the nerves and the vascular system. MRI helps identify the signs of many spinal diseases and the location of the damage. With CT, hernias are visualized, possible deviations in the structure of the spine are determined.
- Laboratory examinationto evaluate the condition of the blood and its main parameters. It 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. Proper diagnosis of the problems helps to effectively treat osteochondrosis. At the same time, the disease itself in the early stages of development is masked by symptoms of other diseases.
Therapeutic process
Osteochondrosis is treated conservatively or with surgery. The choice depends on the severity of the condition, 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 destruction process and increasing the duration and stability of remission.
For symptomatic therapy, chondroprotectors based on chondroitin sulfate or glucosamine are used.
The efficacy of the therapeutic process with the use of chondroprotectors has been clinically confirmed on the basis of long-term tests. If you take these funds for a long time from 3 months, then there is a partial restoration of the cartilage and other elements of the connecting type - the ligamentous 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 of the glucocorticosteroid group, muscle relaxants. You can count on a decrease in the drug load on the patient.
The effectiveness of chondroprotectors is determined by the regularity of their intake. Otherwise, there will be no result. Ineffectiveness is also recorded in the treatment of 3rd degree osteochondrosis, accompanied by significant destruction of the cartilage.
The following groups of drugs can be used for pain relief:
- Non-steroidal anti-inflammatory drugshelps to eliminate inflammatory soft tissue disorders caused by spinal displacement. NSAIDs are effective in reducing pain, swelling and stiffness.
- Means of the glucocorticosteroid group- usually blocks are used in conjunction with an anesthetic. They are able to relieve pain, restore the immune mechanism and provide an anti-exudative effect.
- Muscle relaxants.They are effective in fighting muscle spasms due to nerve entrapment. They help relax the skeletal muscles and block reflexes of the polysynaptic spinal type with an antispasmodic effect.
- External remedies with a warming effect.Irritation of subcutaneous tissue receptors with activation of blood flow is provided by special gels and ointments. These drugs have analgesic and anti-edematous effects.
It is possible to eliminate the vertebrogenic symptoms, manifested following the localization of the pathology in the cervical or thoracic area, with the aid of medical devices to activate the blood flow. Nootropics and drugs are also prescribed to improve microcirculation. In some cases, it may be necessary to take antidepressants and drugs with anticonvulsants.
Physical therapy is also used during the treatment of osteochondrosis. UHF therapy, magnetotherapy, laser therapy, reflexology, massage, physical therapy, hirudotherapy, as well as swimming and yoga procedures can be prescribed. If conservative treatment is ineffective, the operation is performed using microdiscectomy, puncture disc enhancement, laser reconstruction, or implant replacement.