Common osteochondrosis

Since the human body walks upright, the spine, as an axial structure, bears the main load. This is why processes of degeneration and malnutrition are quite common consequences of human life. One of the most common disorders of the musculoskeletal system is osteochondrosis, which causes severe discomfort and may lead to disability. This article will discuss the most severe form of this pathology - common osteochondrosis.

General characteristics

Osteochondrosis is a degenerative disease of the spine that most commonly affects the thoracic, lumbar, and cervical regions. This pathology is directly related to age. The disease is more common in people over 40, but there has been a recent trend among younger people. Common osteochondrosis is different in that it can affect multiple parts of a department or multiple departments simultaneously. Due to the gradual progression of degenerative processes in the bone tissue and ligamentous apparatus of the spine, the vertebrae become mobile and put pressure on nerves and blood vessels. Common symptoms of osteochondrosis are associated with this, but it is important to note that the disease may be asymptomatic for a period of time.

important! The pathology requires multidisciplinary control because it affects not only the musculoskeletal system but also the nervous system as well as the internal organs. In addition to the spine itself, pathological processes can affect other parts of the skeleton.

Etiology and pathogenesis

There are many reasons why osteochondrosis is widespread. Some of these are related to congenital bone defects, others to insufficient loading during strenuous activities. Particularly common factors affecting clinical manifestations are:

• Injuried;
• flatfoot;
• Clubfoot - a deformation of the foot (varus, varus, or valgus, depending on the position of the heel);
• Work related to weightlifting;
• Performing exercise without warming up or warming up muscles;
• Work at low temperatures.

Hypothermia is considered a predisposing factor because cold temporarily changes the molecular structure of soft tissues, reduces the intensity of blood circulation, reduces the conductivity of nerve impulses and metabolism, and thus reduces the function of the immune system. Other causes disrupt the biomechanics of the spine and cause rapid wear of the discs.Pain in generalized osteochondrosis may be the result of osteophytes or disc deformation. The pain is usually radicular, that is, associated with posterior nerve root compression.Common osteochondrosis can easily mimic other diseases. When the chest area is damaged, pain occurs in the heart area and is mistaken for an ischemic process; when the lumbar area is damaged, it is mistaken for radiculitis.

symptom

Clinical manifestations depend on the site affected and the combination of those affected.When the cervical spine is affected, the following characteristics appear:

• Unstable blood pressure;
• Headache;
• lack of coordination;
• hand pain;
• Numbness in upper body and arms.

For pathologies of the chest area:

• intercostal neuralgia;
• Stiffness in arms and neck;
• Internal organ dysfunction.

If the lumbar area is affected:

• combustion;
• urinary tract disorders;
• spasms; spasms;
• Pain when walking.

Based on the above, it is easy to conclude that the pathology affects not only the spine and large joints, but also the autonomic nervous system. The latter is associated with disruption of internal organ function. Common multilevel osteochondrosis sometimes worsens. In this case, the performance will be more intense. When diseases from several departments are combined, the symptoms will correspond.

complication

Osteochondrosis can be conditionally divided into moderate osteochondrosis, which is a natural process of spinal wear and tear due to life activities, and severe osteochondrosis, which is most often characterized by complications.Moderate osteochondrosis is easily treated with conservative treatment. If it is not possible to completely stop the inevitable aging process, then it is quite possible to significantly slow it down. Complications that can result from severe osteochondrosis are as follows.

1. Spondyloarthropathy.
2. Intervertebral disc degeneration.
3. Spinal stenosis.

important! Intervertebral discs act as shock absorbers, reducing friction between vertebrae. Degenerative processes in these structures can lead to disc herniation and disc herniation. The protrusion can cause root pressure and pain.

Spondyloarthropathy is the degeneration of the facet joints that connect adjacent vertebrae. In other words, such joints are called facet joints. When articular cartilage is damaged, painful contact occurs between vertebrae. As the facet joints degenerate, bone growth most often occurs, leading to spondylosis.Stenosis is a narrowing (in this case, of the spinal canal). Typically, stenosis is the result of pathology such as intervertebral hernia or spondylosis. Bone growth and herniation compress the entry and exit points of the nerve roots.The clinical manifestations of severe osteochondrosis are the result of complications:

• chronic pain in the spine;
• Friction of bone surfaces;
• rigidity;
• sudden muscle weakness;
• Reduced response;
• Tingling in the extremities;
• radiating pain;
• Sciatica symptoms.

Sciatica is caused by pressure on the sciatic nerve.

Classification

There are four degrees of osteochondrosis. Classification is based on collected medical history and with the help of instrumental diagnostic methods. The main criteria for this classification are pain and neurological symptoms.

1. Class I - Pain easily relieved by medication.
2. Degree II - Characterized by long-term pain and deformity of the spine with moderate neurological symptoms.
3. Grade III - generalized pain with significant neurological symptoms.
4. Degree IV - persistent pain, multiple neurologic deficits. Disorders of nerve impulse conduction. Paralysis and paresis.

If widespread dysplastic osteochondrosis is present, the patient is assigned a disability status. Disabilities can be divided into three groups based on the patient's general condition and the degree and intensity of clinical manifestations.Types of disability in osteochondrosis.<头>

group	describe
First group	Loss of function of the spine. Patients are unable to move independently and care for themselves.
Second Group	The patient is able to move around and perform small tasks, but the condition often worsens. The surgery is contraindicated or useless for some reason. Or surgery has been performed, but the results were ineffective.
The third group	The patient has the ability to take care of himself. Pain and vestibular symptoms were present, but exacerbations were moderate and cyclical.

Disability groups are assigned by doctors based on a number of studies assessing work ability.

diagnosis

When going to the doctor, a diagnosis will consist of several parts. The first and most important is the collection of medical records based on subjective information provided by the patient. Since osteochondrosis has a genetic component, family history needs to be taken into account. The specialist asks about the place of work, living conditions and the course of the disease itself, and the patient must describe exactly what is bothering him. The best results are achieved through good feedback between patient and doctor.The next method is objective research, conducted by experts themselves or using instrumental methods. The doctor will check the range of motion in the neck and extremities, which may be significantly reduced due to pain and stiffness. He uses palpation to record the degree of muscle spasm and the degree of curvature of the spine. Attention should be paid to neurological examination, with which diminished reflexes can be traced. This symptom may be the result of pinched or damaged nerves.Instrumental methods for diagnosing common osteochondrosis include:

1. X-ray of the entire spine, divided into two projections.
2. MRI is used to evaluate ligaments and nerve tissue.
3. Electrophysiological studies that test nerve impulse conduction.

X-rays are effective in determining the presence of bone growth (osteophytes), spinal stenosis, and the presence of other conditions caused by osteochondrosis, such as scoliosis.Computed tomography can also be used in conjunction with MRI. Using a CT scan, you can determine how much pressure the bone spur is putting on the nerve. Generalized multisegmental osteochondrosis is diagnosed if other pathologies causing vertebral destruction (such as tuberculosis) are excluded and multiple segments of one or more sectors are affected.There are other diagnostic methods. These include:

1. Bone scan.
2. Discography.
3. Myelography.

Bone scans can detect conditions such as osteoarthritis, fractures, or infections. The method is radionuclide and is suitable for differential diagnosis and identification of possible complications.During a discogram, a contrast agent is injected into the nucleus pulposus of the disc. This method is effective in determining whether a herniated disc is present.Myelography is also a comparative study method. Contrast material is injected into the spinal canal and images are recorded using X-rays or CT. Using this method, you can determine the condition of the spinal cord, the presence of stenosis and compression.

treat

Treatment is based on the following mechanisms.

1. Slows down the degenerative process by improving the supply of nutrients to the structures of the musculoskeletal system.
2. The spine is stable.
3. Eliminate compressed nerve fibers.
4. Relieve symptoms.

Pharmacological treatment uses the following drugs:

• NSAIDs to relieve inflammation and pain;
• Anilides relieve pain in the initial stages;
• Topical analgesics in ointment form;
• Muscle relaxants reduce muscle spasms and increase range of motion;
• B vitamins improve nerve tissue conductivity;
• Chondroprotectant, reduces the rate of progression of degenerative processes by integrating active substances (chondroitin sulfate and glucosamine) into chondrocytes. As a result, metabolism normalizes and clinical manifestations decrease. This medicine has been used for a long time. People who are pregnant, breastfeeding, or have gastrointestinal diseases need special consultation. An absolute contraindication is phenylketonuria;
• Antispasmodics relieve smooth muscle spasms and thereby reduce the manifestations of osteochondrosis in internal organs;
• Antioxidants;
• Antidepressants can eliminate the psychosomatic components of the disease. They interfere with the transmission of nerve impulses from the central nervous system to the brain. Promotes the production of endorphins, which can help resolve chronic insomnia caused by persistent pain.
• Neuropathy drugs eliminate damage to nerve endings.
• Opioids are used to treat unbearable pain and conditions where other painkillers are ineffective.

The following are used as invasive medical procedures:

• Steroids are injected into the epidural space. Steroids are powerful anti-inflammatory drugs. They can relieve inflammation in the nerve roots and help relieve pain caused by radiculopathy. The procedure is complex. Qualified experts are needed;
• Inject into facet joints. The injectable medication causes local numbness and pain relief.

It's important to understand this! Taking medications is not intended to eliminate the disease—no medications can completely eliminate osteochondrosis, which is a chronic condition. Medications are prescribed simply to relieve symptoms.

Medications are prescribed by the attending physician. Patients are informed of the possible side effects of each drug and then decide for themselves which treatment option to choose.For symptoms that suggest osteochondrosis, contact a chiropractor, orthopedic surgeon, and neurologist. High-quality medical care will include close collaboration between these specialists and with their patients.

physiotherapy

Physiotherapy is used as a set of complementary therapeutic measures to improve blood circulation and metabolism of the affected tissues. For widespread osteochondrosis, the following approaches may be used.

1. Electrophoresis (based on the movement of colloidal particles under the influence of an external electric field).
2. Phonophoresis (a combination of ultrasound and medication).
3. Magnetic therapy (using static magnetic fields).
4. UHF therapy (Ultra High Frequency Therapy).
5. Electrical muscle stimulation (stimulation of nerves and muscles).
6. Acupuncture (acupuncture).
7. Laser exposure.

In addition to physical therapy, manual therapy and physical therapy are actively used. Professional massage can bring long-term relief. Therapeutic exercise should not be performed during an exacerbation of the disease as this may lead to complications. During remission, moderate physical activity can maintain muscle tone and thus spinal tone. Exercises are performed under the supervision of a trainer and prescribed by the attending physician. You cannot warm the spine during an exacerbation, but you can wear a corset, but only for a few hours. In other cases, wearing a corset for more than a few hours is not the best option as it can cause muscle atrophy.Manual therapy can increase clearance of compressed nerves and reduce neurological symptoms. Alternatives are leeches and vacuum massage. These methods are designed to improve blood circulation in the affected area. Hygienic spa treatments are helpful. The water program is particularly preferred.

Surgery

When treating osteochondrosis, experts prefer conservative treatment, however, to obtain appropriate results requires a lot of time, patience and strict compliance with patient recommendations. Invasive methods are only needed if conservative treatments fail. Usually the surgery is palliative. This means that surgery is only to relieve symptoms and relatively improve the quality of life, rather than to completely cure (to be fair, conservative treatment cannot completely eliminate the disease, but the patient's ability to accept non-invasive treatment is a sign of good prognosis).There are two types of surgery: decompression and stabilization. The first is designed to relieve nerve compression, and the second is designed to stabilize the spine. The following operations are classified as decompression operations.

1. Facetectomy – Removal of facet joints to relieve pressure.
2. Foraminotomy increases the lumen of the spinal canal that is narrowed by osteophytes.
3. A laminectomy is the removal of the back part of the vertebrae, which may be deformed by osteochondrosis.
4. Laminotomy - Removal of fragments from the back of the vertebral body to enlarge the spinal canal.

These procedures require a posterior approach, but if an intervertebral hernia occurs, the surgical approach will be anterior.Anterior decompression surgery is performed as follows.

1. Discectomy – Removal of an intervertebral disc.
2. Corpectomy – removal of the entire vertebral body and adjacent discs.

Stability operations include:

1. Spinal fusion is a method of fusing the vertebrae.
2. Artificial disc.

Stabilization surgery is required after discectomy.

Surgery is rarely performed because of the risk of serious complications.

Complications include:

• recurrence of pain;
• false alliance;
• Infect;
• Phlebitis of extremities;
• Violation of urination;
• Transplant-induced pain;
• Embedded fastener failure.

The postoperative period lasts for several months. Sutures healed 2 weeks after surgery. If complications are discovered, a doctor should be consulted immediately.After surgery, rehabilitation sessions will be conducted to speed up the healing process and restore full working ability.

general advice

Proper nutrition can help prevent the recurrence of common osteochondrosis exacerbations. Proper nutrition is crucial to maintaining a stable weight, as excess weight can put additional stress on the spine. In this case, the diet should be complete, fortified and rich in calcium, magnesium and potassium. It is necessary to limit coffee intake as it leach calcium from the body. Visiting the swimming pool is useful. You should avoid staying in one position all the time.If the condition worsens frequently and you lack the discipline to strictly follow the recommendations, it is better to go to the hospital for a complete course of treatment under the supervision of a doctor.

You cannot self-administer medications.

Let's summarize

Often, extensive osteochondrosis develops after incomplete healing of a "single" osteochondrosis. This fact suggests that if any discomfort occurs, you should contact your doctor immediately and do not expect the pain to go away on its own. In this case, it will be easier to prevent the development of other conditions and even easier to treat the underlying cause.