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 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 collectively call it polysegmental osteochondrosis.
Over the years, the natural aging of the intervertebral discs occurs, which intensifies under the influence of vibrations, jerks, lifting heavy loads and falls. Various back injuries, physical overload, poor physical fitness, poor posture and curvature of the spine, flat feet and excess weight contribute to the development and worsening of osteochondrosis.
Causes of osteochondrosis
- hereditary predisposition;
- metabolic disorders in the body;
- overweight, poor nutrition (lack of fluids);
- age changes;
- spinal injuries;
- bad posture, scoliosis, flat feet;
- sedentary lifestyle;
- work involving heavy lifting;
- overloading of the spine as a result of walking on heels and pregnancy in women, etc.
The main symptoms of common osteochondrosis
- constant aching pain in the back, feeling of numbness in the limbs;
- increased pain during sudden movements, physical activity or heavy lifting;
- reduced range of motion, muscle spasms;
With cervical chondrosis, a person will suffer from pain in the arms, shoulders and headaches; It is possible to develop the so-called vertebral artery syndrome, in which there are complaints of noise in the head, dizziness, flashing "spots", colored spots in front of the eyes in combination with a pulsating 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; in 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. Cervical spine suffers more often in people engaged in monotonous work - designers, programmers, secretaries, dentists, etc. As a rule, the development of cervical osteochondrosis is facilitated by driving and long-term work at the computer. The main signs and symptoms of cervical osteochondrosis are: headache, dizziness, pain in the arms and chest, lumbago, numbness of the tongue. With cervical osteochondrosis, the head often hurts and becomes dizzy, vision becomes dark, and blood pressure rises. The channel for the so-called vertebral artery passes through the transverse processes of the cervical vertebrae. It is directed into the cavity of the skull and nourishes the brain. Movement of the vertebrae leads to spasm of the vertebral artery, and in severe cases to compression. Thus, the blood supply to certain parts of the brain is disrupted.
When osteochondrosis worsens, radicular symptoms may also occur: the pain spreads to the hand, sometimes to individual fingers, they become numb and constantly cold. The reason for this is a disturbance in the passage of impulses along the nerve fiber. According to 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 various symptoms, which is a consequence of 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 lumbar spine occurs most often. This is explained by the fact that the lower part of the back (lumbar vertebra), 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 are: pain in the lower back (pain in the lower back torments 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, acute (lumbago) or aching pain in the legs occurs, affecting a certain part of the leg (for example, at the back or on 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 the roots of the spinal cord.
The most common cause of osteochondrosis of the lumbosacral region is traumatic (compression fracture or chronic injury). In the lumbar region, the sciatic nerve is formed from nerve roots. When the nerve is pinched, the pain spreads along the nerve trunk: in the buttock area, under the knee, sometimes to the lower leg or heel. Significant disturbances in the nutrition of the nerve trunk are possible, then the leg becomes numb. Symptoms of sensory impairment are very persistent, sometimes the numbness lasts for a long time. When the femoral nerve is compressed, the person begins to limp, leaning towards the healthy side to maximize the vertebrae on the affected part of the body and thereby reduce root compression. In osteochondrosis of the lumbosacral spine, the first clinical manifestations are pain in the lower back and legs.
Treatment
Pain syndrome in osteochondrosis usually occurs as a type with remitting exacerbation. Moreover, if the pain lasts longer than 3 months, doctors speak of chronic pain. It increases the level of anxiety in patients and induces them to have 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 some time.
Therefore, it is necessary to eliminate the risk factors for osteochondrosis and modify the lifestyle. And also timely and effectively relieve acute pain in order to prevent its chronicity.
Acute pain occurs 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 relief and anti-inflammatory effects. Diclofenac is widely used to relieve acute pain in osteochondrosis.
A new drug containing diclofenac is of great interest. This is a fast-dissolving, buffer-stabilized sachet. This form of release is quickly absorbed, 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 doses of 50 to 100 mg, the daily dose of the drug must not exceed 150 mg/day. The daily dose should be divided into 3 doses.
In a clinical study, the effect of diclofenac potassium in the form of a bag was compared with the injected form of diclofenac. The results showed the superiority of diclofenac potassium in sachet form over the injectable form. It seems that the new drug will significantly expand the possibilities of analgesic therapy for doctors in our country.
The influence on the muscle component of pain includes: 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, regular exercise therapy.
Successful treatment of patients with osteochondrosis depends on the correct management of restorative measures, especially in the early stages of the disease. Physical rehabilitation should be carried out comprehensively.