In the life of a modern person, an imbalance between active physical activity and static loads leads to a decrease in the tone of the back muscles, therefore, the increase in the axial load on the intervertebral discs and the 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 call all this collective polysegmental osteochondrosis.
With age, the natural aging of the intervertebral discs occurs, which is intensified under the influence of vibrations, jerking movements, heavy lifting and falling. The development and worsening of osteochondrosis is facilitated by various back injuries, physical overload, poor physical fitness, poor posture and curvature of the spine, flat feet and excess weight.
Causes of osteochondrosis
- hereditary predisposition;
- metabolic disorders in the body;
- overweight, poor diet (lack of fluids);
- age-related changes;
- spinal cord injuries;
- poor posture, scoliosis, flat feet;
- sedentary lifestyle;
- work that involves heavy lifting;
- spine overload as a result of walking with high heels and pregnancy in women, etc.
The main symptoms of common osteochondrosis
- constant pain pain in the back, a feeling of numbness in the limbs;
- increased pain with sudden movements, physical activity or heavy lifting;
- decreased range of motion, muscle spasm;
With cervical chondrosis, a person will be bothered by 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 before the eyes in combination with a throbbing headache.
With osteochondrosis of the thoracic spine: pain in the chest (like a "pin" in the chest), in the area of the heart and other internal organs; with 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. The cervical spine suffers more often in people who do monotonous work - designers, programmers, secretaries, dentists, etc. As a rule, the development of cervical osteochondrosis is facilitated by driving and long-term computer work. The main signs and symptoms of cervical osteochondrosis include: headache, dizziness, pain in the arms and chest, lumbago, numbness of the tongue. With cervical osteochondrosis, the head often hurts and feels dizzy, vision becomes dark and blood pressure rises. A channel for the so-called vertebral artery passes through the transverse processes of the cervical vertebrae. It is directed into the cranial cavity and feeds the brain. Displacement of the vertebrae leads to spasm of the vertebral artery, and in severe cases, compression. Thus, the blood supply to certain parts of the brain is interrupted.
With an exacerbation of osteochondrosis, radicular symptoms may also be present: the pain radiates to the hand, sometimes to individual fingers, they are constantly numb and cold. The reason for this is an interruption in the passage of impulses along the nerve fiber. Based on the numbness of a particular finger, a neurologist can judge the displacement of a particular vertebra. The clinical picture of osteochondrosis of the cervical spine is characterized by a number of symptoms, which is due to 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 more often. This is explained by the fact that the lower back (lumbar vertebrae), as a rule, carries the main load. More often, lumbar osteochondrosis can be complicated by an intervertebral hernia of the lumbar spine. The main symptoms and signs of lumbar osteochondrosis include: pain in the lower back (pain in the lower back bothers a person for many years and is characterized by cyclicity, worsening in the autumn-winter period), limited mobility, pain infoot. Very often, with lumbar osteochondrosis, there is acute pain (lumbago) or pain in the leg, affecting a certain part of the leg (for example, in 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 the compression of the roots of the spinal cord.
The most common cause of osteochondrosis in the lumbosacral region is traumatic (compression fracture or chronic injury). In the lumbar region, the sciatic nerve is formed by nerve roots. When a nerve is pressed, the pain spreads along the nerve trunk: in the buttock area, under the knee, sometimes in the calf 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 continues for a long time. When the sciatic nerve is compressed, a person begins to limp, bending to the healthy side in order to maximize the vertebrae in the affected part of the body and thereby reduce compression of the root. With osteochondrosis of the lumbosacral spine, the first clinical manifestations are pain in the lower back and leg.
Treatment
Pain syndrome with osteochondrosis usually appears as a type of worsening that removes. Moreover, if the pain lasts more than 3 months, doctors talk about chronic pain. It increases the level of anxiety in patients and pushes them towards a depressed mood. Standard treatment regimens become ineffective as the pathogenesis of pain changes. In such cases, neurologists add to the treatment medications from the group of antidepressants, which are included in the standard treatment of chronic pain. This whole process can take a long time.
Therefore, it is necessary to eliminate the risk factors for osteochondrosis and modify the lifestyle. And also timely and effectively relieve acute pain to prevent its chronicity.
Acute pain develops when tissues are 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 the 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 release form 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 a dose of 50 to 100 mg, the daily dose of the drug should not exceed 150 mg/day. The daily dose should be divided into 3 doses.
The effect of diclofenac potassium in sachet form was compared with the injectable form of diclofenac in a clinical study. The results showed the superiority of diclofenac potassium in sachet form over the injection form. It seems that the new drug will significantly expand the possibilities of analgesic therapy for doctors in our country.
Influence on the muscular 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. ).
Preventing
The main methods of preventing osteochondrosis are: physical activity, a properly equipped workplace that eliminates prolonged postural tension, timely relief of acute pain and regular exercise therapy.
The successful treatment of patients with osteochondrosis depends on the proper management of restorative measures, especially in the early stage of the disease. Physical rehabilitation should be carried out comprehensively.