Diagnosis Treatment of Osteochondrosis Symptoms

Herniated intervertebral discs are most frequently manifested in age-related osteochondrosis due to dryness and fragility of the annulus fibrosus. But this is just one of the risk factors. Others include:

• Heavy load on the lower back due to being overweight.
• Weakness of the muscular apparatus.
• Heredity.
• A sedentary lifestyle and, as a result, constant compression of the vertebral structures.
• Smoking.
• Great physical activity.

According to medical statistics, this disease occurs in men many times more often than in women.

What are the most common causes of the disease:

• Injuries caused by road accidents or falls.
• Lifting heavy objects with incorrect load distribution.
• Scoliosis or lordosis, leading to increased stress in certain areas of the spine.
• Hip joint dysplasia.
• Chronic diseases including spinal tuberculosis, neoplasms, syphilis.
• Metabolic disorders (hereditary and acquired).

All of these factors cause the cartilage and bones in the spine to wear out and weaken. And this is the main reason for intervertebral hernia.

Stages of disease development

Without proper treatment, the disease progresses and the condition of the damaged spinal discs worsens. There are four stages in the development of the disease:

1. Prolapse. The intervertebral disc has changed a lot, no more than two millimeters. The nucleus pulposus does not project beyond the vertebral body.
2. Lumbar protrusion. The edge of the disc extends beyond the vertebral body for a distance of up to 1. 5 mm, but displacement of the nucleus is not observed.
3. Extrusion. The nucleus projects beyond the vertebral body.
4. Kidnapping. The nucleus practically falls and hangs over the vertebra in the form of a drop. At this stage, there is a risk of rupture of the fibrous annulus and extravasation of fluid secretion.

In the first stage of the disease, the person hardly worries about anything, sometimes he has back pain, but it goes away quickly. With the development of the disease, the health condition also worsens, the symptoms become more painful and alarming. If the diagnosis is not made in time and the treatment is not initiated, the consequences are possible: paralysis of the legs and serious illnesses of the nervous system.

How does a lumbosacral hernia manifest?

An intervertebral hernia may present with the following symptoms:

• Pain in the lower back.
• Pain when walking, radiating to the thigh region.
• Numbness of feet, fingers, surface areas of leg and thigh.
• Feeling of heaviness in the legs.
• Rigidity of movement.

In order not to be late in seeking medical help, it is worth analyzing the symptoms of the disease more carefully. They can be divided into three groups.

pain syndrome

Pain with herniated lumbosacral spine is an important symptom. Even in the first stage, there is pain in the area of the damaged disc, especially after the injury. They can increase or decrease and then reappear. Most of the time, the sacral region doesn't even hurt, but it does, especially with physical exertion or prolonged sedentary work. If the person lies down on the healthy side and bends the leg, the pain will completely subside. This condition can last for several months.

With timely treatment for medical help, it is easy to get rid of the problem. Just say goodbye to bad habits and do the physical therapy exercises recommended by your doctor.

Every day, the affected area will enlarge and the condition of the disc tissues will worsen. The transition to the second degree of the disease is signaled by increased pain. It is now felt not only in the sacral region, but covers the entire lower back, radiates to the cervical region, to each spinal muscle, buttocks, thighs, legs, feet and toes. Discomfort manifests itself with physical activity, even minor - coughing or sneezing.

spinal syndrome

The increase in pain in the second stage is accompanied by constant spasms of the back muscles. This leads to even greater discomfort for the patient. He cannot move freely, straighten his back, stretch. The walk of such a person becomes uncertain, he always leans away from the patient, sloppy.

Due to poor coordination of movements, the human quality of life deteriorates. He cannot do well the tasks set out at work, and active rest due to constant pain becomes unrealistic.

root syndrome

If a hernia is left unattended, progressive disease causes compression of the spinal roots, resulting in their death, and accessing blood to the damaged disc tissues is nearly impossible. The characteristic symptoms of severe stages of the disease appear:

• Weakening of the leg muscles. The patient cannot crouch, stretch, jump. Even climbing the stairs is difficult for him.
• Numbness of the affected area and surroundings. The skin becomes numb and pale, there is a tingling and tingling sensation. Patients complain of hyperhidrosis in the affected area and legs or, conversely, excessive dryness of the skin.
• Lumbago. The patient suffers from lumbago in the lower back with sharp, sharp pain that increases with any movement. If left untreated, it can lead to destruction of the hip and knee joints.
• Noticeable emaciation of the painful leg, which leads to posture asymmetry.
• Rupture of Organs pelvic organs. Urological and gynecological diseases are aggravated, libido disappears, diarrhea, urinary incontinence are possible.

In severe cases of spinal hernia, there is a risk of paralysis, disability and even death.

pathology diagnosis

If a person has severe back pain, they need to make an appointment with a neurologist. He will undergo an exam with medical exams:

• Identification of reflexes in the tendons of the lower extremities.
• Leg lift test.
• Determination of sensitivity to heat or cold, pain and vibration across the surface of the legs, thighs, buttocks, abdomen and back.

The doctor will then refer the patient for an MRI or CT scan of the lumbar spine. With the aid of tomographic techniques, a three-dimensional image of the affected area will be obtained. It can be used to determine the location and size of the hernia, the stage of the disease.

If there is a risk of spinal cord injury, electromyography, neurography, and contrast myelography are also prescribed. With the help of these studies, the doctor will determine whether urgent surgical intervention is needed.

Herniated Disc Treatment

A vertebral hernia is treated conservatively and surgically. The choice of technique depends on the stage of disease development, presence of concomitant diseases and contraindications.

conservative therapy

The therapeutic course is mainly aimed at alleviating pain and alleviating the patient's condition.

What pharmaceutical products a doctor can prescribe:

1. Medicines that relieve pain and inflammation. In case of exacerbation - in the form of injections. When the acute pain is relieved (usually three to four days is sufficient), oral medications with a similar effect are prescribed.
2. Novocaine blockade with the addition of corticosteroids. A similar method is able to stop the pain for two weeks at a time. Typically, a blockage course is performed with injections into different parts of the damaged disc.
3. Centrally acting muscle relaxants. They reduce muscle activity, relieving pain cramps.
4. Vitamin-mineral complexes with an emphasis on group B elements. They lightly relax the muscles, aid in tissue regeneration and in the conduction of nerve impulses.

After pain syndrome relief, medication intake decreases. The treatment of the disease is done through physiotherapy and physiotherapy.

Physiotherapeutic treatment methods are also selected depending on the patient's condition. This can be:

• Treatment with heat or electric shock.
• Electrophoresis with anti-inflammatory drugs.
• Acupuncture and acupressure.
• Hirudotherapy.
• Whirlpool.

Normal massage is allowed only if there is no pain syndrome. A more effective physical therapy treatment is manual therapy with post-isometric relaxation.

Doctors strongly recommend that smoking patients give up smoking.

Nutritional adjustments are also important, especially for overweight patients. Fatty, savory, sweet and alcoholic dishes should be excluded from the menu. An economical diet with plenty of vegetables and fermented dairy products will help the body to better support the treatment, in addition to getting rid of the pounds that weigh on your back.

Surgical intervention

Conservative treatment usually lasts for about two months. If it does not give the desired result, one chooses to change the therapeutic approach or perform surgery. The latter is prescribed for severe pain, loss of sensation in the legs, dysfunction of Organs pelvic organs. Depending on the complexity of the situation, the operation is done in the following ways:

• Endoscopic method. Three microincisions are made in the affected area. A camera is inserted into one to transmit to the monitor. Through the other two, the hernia protrusion is removed using miniature instruments.
• By the percutaneous discectomy method. The damaged nucleus is removed through a puncture in the vertebral disc and replaced with an artificial substance.
• By laser reconstruction. It is performed in the form of punctures with a special needle, without tissue dissection. Laser radiation heats disc structures and stimulates cell regeneration, in addition to relieving pain.

In difficult cases, vertebral disc endoprosthesis is possible - replacing the injured organ with an implant.

After complex surgical interventions, rehabilitation will be necessary. The operated person must wear a corset and cannot sit for about three months. The subsequent rehabilitation period involves the practice of therapeutic gymnastics and physiotherapy.

preventive techniques

Like any other disease, a herniated disc is easier to prevent than cure. What you need to do to keep your spinal discs healthy:

1. Accurately calculate loads if your work is related to them or if you are a professional athlete.
2. Correct body weight (your index should not exceed 30).
3. Choose a good mattress to sleep in the correct position (preferably on your back).
4. Practice moderate physical education, swimming and fitness.
5. Include morning exercises to strengthen the spinal muscular corset.
6. Give up on cigarettes.
7. Eat well.

If following these rules becomes a habit, there is a risk of having a spinal hernia just as a result of an accident.

A herniated disc is dangerous, with serious consequences, and the treatment of advanced cases is very long. To avoid surgery and complications, if you experience painful sensations in your back, you should consult a neurologist.

osteochondrosis

The term osteochondrosis itself is derived from two words: osteo - bone and chondrue - cartilage. Simply put, it's cartilage ossification. Although this interpretation is fundamentally wrong. Some in their delusions go even further and are confident that osteochondrosis is the deposition of salts in the joints. Furthermore, it is table salt that is supposed to be eaten in large quantities.

pathogenesis

In fact, everything happens a little differently. It's harder. And table salt, if it has any role in the onset of osteochondrosis, is very indirect. Osteochondrosis is based on dystrophy and degeneration of articular cartilage. This is not an independent disease, but a pathological process that can be seen almost anywhere there is connective cartilage tissue.

Still, osteochondrosis, in general, affects the spine. Why is that? The fact is that between the vertebrae there is a kind of spacer - intervertebral (intervertebral) discs. The physiological role of these discs is to cushion and protect the vertebral bodies from premature wear due to mechanical stress. The disc consists of an inner fluid nucleus pulposus surrounded by a fibrous ring and an upper and lower endplate.

The disk undergoes tremendous mechanical stress, causing permanent damage to its structures at the cellular level. In humans, these processes are very pronounced - this is our payment for walking upright. To prevent the disk from being completely "erased", it must be constantly regenerated, that is, restored. It is the balance of damage regeneration processes that determines the normal structure of the intervertebral disc. Another curious detail is that the supply of blood and nutrients to the intervertebral discs is not provided by blood vessels, which grew too large in childhood, but diffusely, from the bone tissue of the vertebral bodies. Again, payment for the ability to walk on two limbs, not four.

Because of this, the intervertebral discs are easily damaged anatomically and physiologically. Any negative process in the body leads to an imbalance in the regeneration of damage and the development of dystrophy and degeneration in the discs. A disc with a structural defect is no longer able to withstand adequate mechanical stress. Under excessive pressure from the overlapping vertebrae, the discs are displaced in different directions, usually to the sides and posteriorly. This process is called a herniated disc.

The bone tissue of the vertebrae, which has lost its cartilaginous coating, also undergoes mechanical wear. Due to constant trauma to the surface of the anterior edge of the vertebral bodies, pathological bone growths are formed - osteophytes. Spondylosis develops. Due to degeneration and displacement of the disc, the intervertebral spaces shrink, the spinal canal narrows, and the spinal nerve roots are infringed on calls. foraminal holes.

causes

The causes, or etiological factors, of osteochondrosis are diverse. They can be local, that is, caused by the pathology of the spine itself and general disturbances at the level of the organism. Any pathology that leads to a violation of the spinal structure or metabolic disturbances can be considered to be the cause of osteochondrosis. In this regard, there are:

• Changes in spine configuration (scoliosis, pathological lordosis or kyphosis)
• Other musculoskeletal system defects - flat feet, narrow shoulder girdle, pelvic anomalies
• spinal injury
• weak immunity
• Metabolic disorders - osteoporosis, obesity, diabetes mellitus, thyroid disease
• Diseases of the cardiovascular system - atherosclerosis, hypertension
• Digestive disorders leading to insufficient absorption of nutrients from the gastrointestinal tract
• Heredity.

It should be noted that the above pathological conditions do not necessarily lead to osteochondrosis. This requires constant exposure to certain predisposing factors - hypothermia, malnutrition, a sedentary lifestyle or, conversely, excessive physical exertion.

Symptoms

Osteochondrosis itself is an asymptomatic process. And, at the same time, the signs of intervertebral disc degeneration are diverse. As well? The fact is that the clinical manifestations of osteochondrosis are based on its complications - herniated discs, spondylosis, sciatica, narrowing of the spinal canal.

Furthermore, the clinic varies greatly depending on the predominant location of the process in the cervical, thoracic or lumbosacral spine. The last section is the most affected as it is the lower back that performs maximum physical activity. Signs of osteochondrosis of the lumbosacral region:

• Pain (lumbodynia, lumbago, sciatica)
• Restriction of movement in the lower back and lower limbs (intermittent claudication)
• Here, sensitivity disorders of the type of paresthesia - numbness, burning, crawling
• Pathological tension of the lumbar muscles
• In the absence of treatment, disturbances in the function of Organs pelvic organs.

Cervical osteochondrosis is seen slightly less frequently than lumbosacral. However, this pathology is also quite common. In addition to the typical signs of pain (cervicalgia), decreased sensation and movement in the upper extremities, cervical osteochondrosis due to insufficient blood supply to the brain has its own characteristics. These features are manifested:

• Insomnia
• headache, dizziness
• Periodic nausea
• General weakness, rapid fatigue
• Fluctuations in blood pressure
• Occasionally, toothache
• Behavioral reactions in the form of crying, irritability.

The thoracic region with osteochondrosis is affected relatively rarely. Patients in this case are people forced to sit in a fixed awkward position due to occupation - students, students, programmers, office workers. The symptoms of osteochondrosis, in this case, will be as follows:

• Chest pain and paresthesia
• dyspnea
• Feeling of heartbeat
• Restriction of movement in the thoracic spine.

Diagnosis

For all these reasons, it is clear that osteochondrosis is a chameleon disease. Due to the similarity of the signs, it is easy to confuse it with stroke, hypertension, myocardial infarction, angina pectoris, neurotic disorders. Therefore, to make the correct diagnosis, a comprehensive and complex diagnosis is necessary to correctly determine the symptoms and treatment of osteochondrosis.

This diagnosis, in addition to the traditional questioning and clarification of patients' complaints, must include a medical examination and special research methods. These methods include X-rays of the spine, ultrasound of internal organs. Recently, computerized imaging and magnetic resonance imaging have been used successfully to diagnose osteochondrosis.

Treatment

Therapeutic tactics for osteochondrosis involve the use of:

• Medicines
• Massage
• physiotherapy procedures
• Physiotherapy (exercise therapy)
• Manual therapy
• Acupuncture.

The medicine for osteochondrosis has as its main objective the relief of pain and the elimination of inflammatory processes in the nerve roots. For this, NSAID drugs are used. In various combinations, these drugs are widely used in the form of ointments, injections, pills for the treatment of osteochondrosis. It should not be forgotten that these medications have negative effects on the liver, stomach and intestines. By doing this, they can aggravate metabolic disturbances in osteochondrosis. They alleviate blockage pain well with local anesthetics. It is true that the effect of these funds is short-lived and in no way affects the course of osteochondrosis as a whole.

It is possible to improve metabolic processes at the local and body level with the help of medications such as chondroprotectors, immunostimulants and vitamins with minerals. Chondroprotectors are used in pills, ointments and ampoules. Among the fortifying agents, vitamins C, group B, are used in combination with minerals. In this regard, calcium preparations are most preferred. In fact, contrary to some erroneous statements, the basis of osteochondrosis is not an excess, but just a deficiency of calcium.

After successfully relieving the exacerbation, physical therapy, massage, and exercise therapy are shown. Calcium electrophoresis, hydrocortisone phonophoresis, amplipulse, paraffin therapy are used as physical procedures. All of these measures aim to eliminate pain and inflammation in the nerve roots, ligaments and muscles. Massage for osteochondrosis is performed according to the generally accepted method. The massage zone is selected depending on the location of the osteochondrosis. Expansion of range of motion is achieved with the help of exercise therapy. In the beginning, in the exacerbation phase, there are practically no dynamic loads. The patient is constantly in an ideal posture. At this time, it is desirable to use immobilization devices - a lumbar corset, necklace of Shants around the neck. As the exacerbation is removed, the volume and duration of movements during exercise therapy increases.

Recently, in the treatment of osteochondrosis, non-traditional methods of treatment have been received - acupuncture, manual therapy, osteopathy. Acupuncture is an effect on special biologically active points located along the spine, atria, hands and feet. With manual therapy, the normal position of the vertebrae and intervertebral discs is restored by the manual action of a specialist's hands. And in the course of osteopathy, the structural integrity of the musculoskeletal system is guaranteed through specific techniques. In the absence of the effect of conservative measures for the treatment of osteochondrosis, persistent pain, complications, surgery is indicated. The pathologically displaced disc is removed. Currently, for this purpose, microdiscectomy is performed - endoscopic removal of a displaced disc.