Treatment of symptomatic diagnosis of Osteochondrosis

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

• Heavy load on the lumbar region due to overweight.
• Weakness of the muscular apparatus.
• Descendants.
• An inactive lifestyle and, consequently, constant compression of the vertebral structure.
• Smoking.
• Great physical activity.

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

What are the most common causes of the disease:

• Injuries due to road accidents or falls.
• Lifting heavy objects with incorrect load distribution.
• Scoliosis or lordosis, which leads to increased pressure on certain areas of the spine.
• Dysplasia of the hip joint.
• Chronic diseases, including spinal tuberculosis, neoplasms, syphilis.
• Metabolic disorders (hereditary and acquired).

All of these factors cause the cartilage and bones of the spine to wear out and weaken. And this is the leading cause of intervertebral hernias.

Stages of disease development

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

1. Prolapse. The intervertebral disc has shifted slightly, no more than two millimeters. The nucleus pulposus does not protrude beyond the vertebral body.
2. Lumbar protrusion. The edges of the disc extend beyond the vertebral body to a distance of up to 1. 5 mm, but displacement of the nucleus is not observed.
3. Extrusion. The nucleus protrudes beyond the vertebral body.
4. Sequestration. The nucleus can be said to fall and hang above the vertebrae in the form of droplets. At this stage, there is a risk of rupture of the fibrous annulus and leakage of fluid secretions.

In the first stage of the disease, a person hardly worries about anything, sometimes there is back pain, but they quickly pass. With the progression of the disease, the health condition also worsens, the symptoms become more painful and alarming. If the diagnosis is not made in a timely manner and treatment is not initiated, the consequences may be: paralysis of the legs and serious disorders of the nervous system.

How is a lumbosacral hernia real?

An intervertebral hernia can present itself with the following symptoms:

• Pain in the lumbar region.
• Pain when walking, radiating to the thigh area.
• Numbness of the feet, fingers, areas on the lower surface of the feet and thighs.
• Feeling heavy in the legs.
• Stiffness of movement.

In order not to be too late to seek medical help, it is beneficial to analyze the symptoms of the disease more carefully. They can be divided into three groups.

Pain syndrome

Pain with a lumbosacral spinal hernia is the main symptom. Even in the first stage, there is pain in the damaged disc area, especially after injury. They can increase or decrease, and then resurface. More often, the sacral area is not painful, but painful, especially with prolonged physical exertion or sedentary work. If a person lies on a healthy side and bends the legs, the pain will disappear completely. This condition can last for several months.

With timely treatment for medical help, getting rid of the problem is easy. It’s enough to just say goodbye to bad habits and do the physiotherapy exercises recommended by your doctor.

Every day, the affected area will increase, and the condition of the disc tissue will worsen. The transition to the second stage of the disease is marked by an increase in pain. It is now felt not only in the sacral area, but covers the entire lower back, radiating to the cervical area, to every muscle of the spine, buttocks, thighs, legs, feet and toes. Discomfort manifests itself with physical activity, although not significant - coughing or sneezing.

Vertebral syndrome

Increased pain in the second stage is accompanied by constant spasm of the back muscles. This leads to greater discomfort for the patient. He could not move freely, straighten his back, stretch. The gait of such a person becomes erratic, he always leans to the opposite side of the patient, bending over.

Due to movement coordination disorders, the quality of human life is deteriorating. He is unable to perform well -established tasks at work, and active rest due to constant pain becomes unrealistic.

Radicular Syndrome

If the hernia is left unattended by a doctor, the progressive disease leads to compression of the spinal root, as a result of which it dies, and access of blood to the damaged disc tissue is almost impossible. Symptoms characteristic of a serious stage of the disease appear:

• Weakness of leg muscles. Patients should not squat, stretch, jump. Going up the stairs is difficult for him.
• Numbness of the affected area and the surrounding area. The skin becomes insensitive and pale, there is a feeling of chills and tingling. Patients complain of hyperhidrosis in the affected area and feet, or, conversely, excessive skin dryness.
• Lumbago. The patient developed lumbago in the lumbar region with acute, sharp pain, which increased with any movement. If left untreated, it leads to destruction of the hip and knee joints.
• Significant thinning of the aching leg, leading to asymmetric posture.
• Disorders of the pelvic organs. Urological and gynecological diseases worsen, libido disappears, diarrhea, urinary incontinence are possible.

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

Pathological diagnosis

If a person has severe back pain, he or she should make an appointment with a neurologist. He will conduct an examination with a medical test:

• Reflex identification of the lower leg tendons.
• Leg lift test.
• Determination of sensitivity to heat or cold, pain and vibration on the entire 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 help of tomographic techniques, a three -dimensional picture 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 this study, the doctor will determine whether immediate surgical intervention is needed.

Treatment of herniated discs

Vertebral hernias are treated conservatively and surgically. The choice of technique depends on the stage of disease development, the presence of concomitant diseases and contraindications.

Conservative therapy

The therapeutic course is aimed primarily at relieving pain and alleviating the patient’s condition.

What pharmaceuticals can be prescribed by a doctor:

1. Medicines that relieve pain and inflammation. In case of exacerbation - in the form of injections. When acute pain is relieved (usually three to four days is enough), oral medications with similar effects are prescribed.
2. Novocaine blockade with the addition of corticosteroids. The same method is able to stop the pain for two weeks at a time. Typically, a course of blockage is carried out by injection into different parts of the damaged disc.
3. Relax the central action muscles. They reduce muscle activity by relieving painful cramps.
4. Vitamin-mineral complexes with an emphasis on the elements of group B. They slightly relax the muscles, help tissue regeneration and the conduction of nerve impulses.

After relief of the pain syndrome, pharmaceutical intake is reduced. Treatment of the disease is due to physical therapy and physiotherapy.

Physiotherapy treatment methods are also chosen depending on the patient’s condition. This can be:

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

Regular massage is allowed only in the absence of pain syndrome. A more effective physiotherapy treatment is manual therapy with post -isometric relaxation.

Doctors strongly recommend smoking patients to quit smoking.

Dietary adjustments are also important, especially for overweight patients. Fatty, flavorful dishes, sweets and alcohol should be excluded from the menu. A frugal diet with plenty of vegetables and fermented dairy products will help the body to withstand treatment better, as well as get rid of the pounds that weigh on the back.

Surgical intervention

Conservative treatment usually lasts about two months. If it does not give the desired result, a decision is made to change therapeutic tactics or perform surgery. The latter is prescribed for severe pain, loss of sensitivity of the legs, dysfunction of the pelvic organs. Depending on the complexity of the situation, the operation is performed in the following ways:

• Endoscopic methods. Three micro -slices were made in the affected area. A camera is inserted into one for broadcasting to the monitor. Through the other two, the hernia protrusion was removed using small instrumentation.
• By percutaneous discectomy method. The damaged nucleus is removed through a puncture in the vertebral disc and replaced with artificial material.
• With laser reconstruction. It is carried out in the form of a puncture using a special needle without dissecting the tissue. Laser radiation heats the disc structure and stimulates cell regrowth, as well as relieving pain.

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

After a complex surgical intervention, rehabilitation will be required. The person being operated on will have to wear a corset and will not be able to take a sitting position for about three months. Further recovery periods involve the practice of therapeutic gymnastics and physiotherapy.

Prevention techniques

Like any other disease, herniated discs are easier to prevent than to treat. Things you need to do to keep your spinal discs healthy:

1. Calculate the load accurately if your job is related to it, or if you are a professional athlete.
2. Correct weight (index should not exceed 30).
3. Choose a good mattress to sleep in the correct position (preferably on your back).
4. Engage in gentle physical education, swimming, fitness.
5. Include exercise in the morning workout to strengthen the spinal muscular corset.
6. Quit smoking.
7. Eat well.

If adherence to this rule becomes the norm, then there is a risk of getting a spinal hernia simply as a result of an accident.

Herniated discs are dangerous with serious consequences, and treatment of further cases is very lengthy. To avoid surgery and complications, if you experience a painful sensation in the back, you should see a neurologist.

Osteochondrosis

The term osteochondrosis itself comes from two words: osteo - bone, and chondrue - cartilage. In short, it is the ossification of cartilage. Although this interpretation is fundamentally wrong. Some in their delusion go further, and are convinced that osteochondrosis is the deposition of salt in the joints. Moreover, it is table salt that is supposedly consumed in large quantities.

Pathogenesis

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

However, osteochondrosis in rare cases affects the spine. Why is that? The fact is that between the vertebrae there is a kind of spacer - intervertebral disc (intervertebral). The physiological role of this disc is to protect and shield the vertebral body from premature wear due to mechanical stress. The disc consists of an internal fluid pulposus nucleus surrounded by a fibrous annulus and upper and lower end plates.

The disk experiences extraordinary mechanical stress, which leads to permanent damage to its structure at the cellular level. In humans, this process is all too obvious - this is our payment for walking upright. To prevent a disk from being "erased" completely, it must always be regenerated, that is, restored. It is the balance of the damage regeneration process that determines the normal structure of the intervertebral disc. Another curious detail is that the supply of blood and nutrients to the intervertebral disc is done not through blood vessels, which grow in childhood, but extensively, from the bone tissue of the vertebral body. Again, payment for the ability to walk with two members, not four.

Therefore, the intervertebral disc is easily injured in anatomical and physiological terms. Any negative process in the body leads to an imbalance in the regeneration of damage, and to the development of dystrophy and degeneration in the disc. Structurally damaged discs can no longer withstand proper mechanical stress. Under excessive pressure from the vertebrae above it, the disc is displaced in different directions, usually to the side and back. This process is called disc herniation.

The vertebral bone tissue, which has lost its cartilage layer, also suffers from mechanical wear. Due to constant trauma to the anterior edge surface of the vertebral body, pathological bone growth is formed - osteophytes. Spondylosis develops. Due to degeneration and displacement of the disc, the intervertebral space is reduced, the spinal canal narrows, and the spinal nerve roots are violated in the so -called. foraminal hole.

cause

The causes, or etiological factors, of osteochondrosis are various. They can be both local, i. e. caused by the pathology of the spine itself, and general disorders at the level of the organism. Any pathology that leads to a violation of the structure of the spine or to metabolic disorders can be considered a cause of osteochondrosis. In this case, there are:

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

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, an inactive lifestyle, or, conversely, excessive physical exercise.

symptoms

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

In addition, the clinic is highly variable depending on the primary localization of the process in the cervical, thoracic or lumbosacral spine. The last part is most often affected, because the lower back is doing maximum physical activity. Signs of lumbosacral osteochondrosis:

• Pain (lumbodynia, lumbago, sciatica)
• Restriction of movement in the lower back and lower legs (intermittent claudication)
• Here, sensitivity disorders of the paresthesia type - numbness, burning, creeping
• Pathological tension of the lumbar muscles
• If left untreated, pelvic organ dysfunction.

Cervical osteochondrosis is observed somewhat less frequently than lumbosacral. However, this pathology is also quite common. In addition to the typical signs of pain (cervicalgia), decreased sensitivity and movement in the upper legs, cervical osteochondrosis due to disruption of blood supply to the brain has its own characteristics. These features are shown:

• Insomnia
• Headache
• Periodic nausea
• General weakness, rapid fatigue
• Fluctuations in blood pressure
• Occasional toothache
• Behavioral reactions in the form of tears, irritation.

The thoracic area with osteochondrosis is affected relatively rarely. The patient in this case is a person who is forced to sit in a fixed position that is uncomfortable by the job - students, school students, programmers, office workers. The symptoms of osteochondrosis in this case are as follows:

• Pain and paresthesia in the chest
• Dyspnea
• Feeling of heartbeat
• Restriction of movement in the thoracic spine.

Diagnostics

From all this it is clear that osteochondrosis is a chameleon disease. Due to the similarity of symptoms, it is easy to confuse it with cerebrovascular accident, hypertension, myocardial infarction, angina pectoris, neurotic disorders. That is why, to make a correct diagnosis, a comprehensive complex diagnosis is needed to properly determine the symptoms and treatment of osteochondrosis.

This diagnosis, in addition to traditional questions and clarification of patient complaints, should include medical examination and special research methods. These methods include X-rays of the spine, ultrasound of internal organs. Recently, computed magnetic resonance imaging has been successfully used to diagnose osteochondrosis.

Treatment

Therapeutic tactics for osteochondrosis involve the use of:

• Medications
• massage
• Physiotherapy procedures
• Physiotherapy (exercise therapy)
• Manual therapy
• Acupuncture.

Medications for osteochondrosis are primarily aimed at relieving pain and at the elimination of inflammatory processes in the nerve roots. For this purpose, NSAIDs are used. In various combinations, these drugs are widely used in the form of ointments, injections, tablets for the treatment of osteochondrosis. It should not be forgotten that these drugs have negative effects on the liver, stomach and intestines. By doing this, they can exacerbate metabolic disorders in osteochondrosis. They relieve blockage pain well with local anesthetics. True, the effect of these funds is short -term, and in no way affects the course of osteochondrosis as a whole.

It is possible to improve metabolic processes at the local level and the body with the help of drugs such as chondroprotectors, immunostimulants, and vitamins with minerals. Chondroprotectors are used in tablets, ointments and ampoules. Among the strengthening agents, vitamin C, group B, in combination with minerals are used. In this case, Calcium supplies are the most preferred. Indeed, contrary to some misconceptions, the basis of osteochondrosis is not an excess, but simply a lack of Calcium.

After successful relief of severity, physiotherapy, massage, and exercise therapy are indicated. Electrophoresis with calcium, phonophoresis with hydrocortisone, amplipulse, paraffin therapy were used as physical procedures. All of these measures are aimed at eliminating pain and inflammation in the nerve roots, ligaments and muscles. Massage for osteochondrosis is carried out according to generally accepted methods. The massage zone selected depends on the localization of the osteochondrosis. Expansion of range of motion is achieved with the help of exercise therapy. Initially, in the deterioration phase, there is almost no dynamic load. The patient is always in optimal posture. At this time, it is desirable to wear a crippling device - lumbar corset, neck collar Shants. When exacerbations are removed, the amount and duration of movement during exercise therapy increases.

Recently, in the treatment of osteochondrosis, non -traditional treatment methods have been accepted - acupuncture, manual therapy, osteopathy. Acupuncture is the effect on special biological active points located along the spine, on the earlobes, on the hands and on the feet. With manual therapy, the normal position of the vertebrae and intervertebral discs is restored through the manual action of a specialist’s hands. And in the course of osteopathy, the structural integrity of the musculoskeletal system is ensured using certain techniques. If there is no effect of conservative measures for the treatment of osteochondrosis, persistent pain, complications, surgery is indicated. Pathologically displaced discs are removed. Currently, for this purpose, microdiscectomy is performed - the endoscopic removal of the transplanted disc.