Do you suggest
Official website Hondrostrong

Treatment of osteochondrosis

Severe pain with osteochondrosis

Osteochondrosis - Dystrophic changes in the spinal column associated with age-related aging of tissues. Pathology 80% is associated with genetic data, the rest is influenced by external factors.

Osteochondrosis- Predominantly human disease, the development of which is facilitated by:

  • Increased life expectancy. Over time, metabolism slows down, tissue nutrition is disrupted, and destructive regulatory systems begin to take precedence over the constructive.
  • Walk upside down. By standing, the person acquired an uneven load on different parts of the spine, being able to perform larger movements - for twisting, stretching. Abnormal lateral curvatures - scoliosis - with uneven load on the muscles and small joints of the spine. This has increased the likelihood of disease formation even in the department where low mobility and the ribs protect the vertebrae - thoracic osteochondrosis.
  • Acceleration. Rapid growth makes bones, muscles and cartilage more vulnerable. The number and distribution of blood vessels is insufficient to supply them with oxygen and essential substances.
  • Lack of adequate physical activity. There are two extremes - sedentary work and movement exclusively in the car or excessive stress in the gym when the discs and cartilage wear out at an accelerated pace.
  • Wrong nutrition. Excess amounts of fast carbohydrates, lack of protein, use of carbonated beverages lead to the fact that the body does not have enough high quality building materials to maintain tissue health.
  • smoke. Causes prolongation of vasospasm - disruption of tissue nutrition, acceleration of degenerative processes.
  • Urbanization, a large number of traumatic objects around causes spinal injuries, secondary osteochondrosis

Types of osteochondrosis

By localization

  • Osteochondrosis of the cervical spine
  • Injury of the thoracic spine
  • Lumbar osteochondrosis
  • Common osteochondrosis - cervical and lumbar, thoracolumbar, lumbosacral and other combinations

The most common changes in the most mobile parts are in the cervix and lumbar region. The painful place is to move the moving lumbar region to a fixed sacral.

According to the stage

  • From - small changes in the center of the disc, compaction of the nucleus, the appearance of cartilage cracks.
  • Disease progression - cracks deepen, disc height decreases, intervertebral diameter decreases. Compression of the spinal nerve roots causes pain, muscle spasm. Osteochondrosis of the spine is manifested not only by changes in the discs - due to the violation of the ratio of the vertebrae to each other, the cartilage on the surfaces of small joints unevenly disintegrates, developing arthrosis and arthritis.
  • Complicated osteochondrosis - Symptoms: Further cartilage degeneration occurs - a rupture of the cartilage ring that connects the two adjacent vertebral bodies. Part of the nucleus emerges in the free space and attaches to the roots, spinal cord - a disc herniation is formed. A more serious problem is the separation of the fallen part - the caught hernia. Suffers from severe pain, hypersensitivity and movement to the side responsible for the compressed nerve
  • The body responds to increased load and excess mobility by the growth of bone tissue - osteophytes appear. They stabilize the spine but reduce the range of motion. Bone hooks irritate muscle receptors and clog nearby vessels. In osteochondrosis of the cervix, it causes symptoms of the "vertebral artery" - dizziness, tinnitus, blinking of spots in front of the eye.

Osteochondrosis of the cervical spine

With the advent of cell phones and computersCervical osteochondrosisEven in adults: its prolonged unnatural position overloads the vertebrae, their discs, and joints with muscle tension.

Cervical osteochondrosis - symptoms

  • Neck pain extends to the back of the head, to the back
  • Sometimes the headache associated with cervical osteochondrosis is mimicry of migraine - unilateral symptoms, intolerance to sounds and bright light, strong pulsation in the temples, dazzling flashes in front of the eyes.
  • Frequent headaches that do not respond well to the usual tablets
  • Drop in blood pressure resistant to antihypertensive drugs
  • Dizziness and dizziness in the eyes with a sudden turn of the head
  • Numbness of the fingers, especially after sleep, a creeping sensation on the skin
  • Restriction of movement in the neck, convulsions when trying to move. Patients have to turn their whole body to see something behind them
  • Upper body sweating
  • Tensed muscles of the neck and shoulder girdle can be detected by palpation.

If identifyingCervical osteochondrosis, Treatment in the early stages prevents severe complications - compression of the vertebral artery by oxygen starvation of the brain, compression of the spinal cord.

Manifestations of thoracic osteochondrosis

Changes in the chest are less common, provoking factors - spinal cord injuries, scoliosis, pre-existing diseases of the spine (tuberculous, nonspecific spondylitis, hemangiomas of the body).

Symptoms of chest injury:

  • Back pain - pain, traction, worse after prolonged standing or sitting in an uncomfortable posture. But with constant complaints of pain, other possible causes should be ruled out - pneumonia, pleurisy, tumors, intercostal neuralgia of various natures, herpes zoster before the appearance of blisters.
  • Shortness of breath, shortness of breath, inability to breathe deeply
  • Osteochondrosis of the chest sometimes mimics angina attacks - a person is treated by a cardiologist for a long time, and the problem is in the diseased intervertebral disc.

Lumbar and lumbosacral osteochondrosis

In the structure of all types of osteochondrosis, these departments are confident leaders, accounting for more than half of all cases of diagnosis. The reason is that the greatest load falls on this side of the body, both when standing and sitting. Body weight, load In case of incorrect weight lifting, in a long bent position - the nucleus of the intervertebral discs is in a state of compression, through the cartilaginous plates in the vertebral bodies - an umbilical hernia is formed. . Excessive tension and muscle spasm disrupt the location of the small joints of the spine relative to each other - the articular cartilage collapses, mobility decreases.

Several vicious circles develop simultaneously: Muscle spasm causes pain - pain reflexively increases muscle fiber contraction, acute pain forces a person to restrict movement, saves the injured area - decreases muscle frame strength and spine support, this increases his instability, lumbar osteochondrosis.

At the cellular transition pointLumbar spineIn a single monolithic motionless sac, there is a danger of the fifth lumbar vertebra slipping from the surface of the sac. It catches the nerve bundle, developing radicular syndrome.

Symptoms of lumbar osteochondrosis

  • Low back pain, especially sitting and standing. After resting, the horizontal position improves. With prolonged course, the pain is usual, painful, attractive
  • A sharp sudden lumbago when changing body position, lifting weights, heavy loads. The patient is trapped in the position in which the attack was caught, it is difficult to straighten, to start the movement. Lumbago is usually associated with spinal nerve root compression that has developed acutely.
  • Pain in the gluteal region, legs. The largest nerve in the body, the sciatic nerve, is a direct extension of the spinal cord, so patients with lumbar osteochondrosis often suffer from sciatica.
  • Because nerve fibers control muscle and blood vessel tone, regulate tissue nutrition, changes are observed in the part of the stem responsible for the diseased nerve. The limb is colder than healthy. With prolonged course of the disease, muscle atrophy, skin dryness and swelling are noticeable. Local immunity is lowered - any scratches, cuts, abrasions can easily become a gateway for infection
  • Defeat of sensory fibers leads to impaired sensitivity - superficial and deep. The patient may have burned or froze because he did not feel a dangerous change in temperature.
  • Very dangerous symptoms - numbness of the skin of the perineum, loss of control over the pelvic organs. The patient does not feel a full bladder, does not feel the need to empty the bowels. Over time, urine and feces begin to excrete on their own, making it impossible to store them. In this case, the treatment of osteochondrosis of the spine and its complications is carried out surgically, as a matter of urgency.

Diagnosis of osteochondrosis

It is performed by a neurologist or orthopedist after the therapist has ruled out pathology of the internal organs.

  • The specialist determines the main complaints, during their appearance, development, action of drugs on the intensity of pain, rest, changes in the rhythm of life.
  • Mandatory external examination is carried out when the patient takes off his underwear - it is necessary to compare the condition of the skin and color on symmetrical parts of the body, tissue tone, reaction to various stimuli: pain, touch, cold. Or heat. Symptoms of tension are established, which indicate muscle tension and irritation of their tendons and internal membranes - fascia.
  • The neurological hammer will reveal the uniformity and symmetry of the reflexes
  • The neurologist records the volume of active (independent) and passive (performed by the doctor) movements in the joints, the ability to rotate the head, the upper part of the body without interfering with the lower parts of the spinal column.

If necessary, send additional inquiry

  • Thermographic diagnostics
  • ENMG (Electroneuromyography): Radiography. To get the necessary information, it is carried out in at least two projections - direct and lateral. The picture tells about the condition of the bone tissue, the severity of osteoporosis, the size and safety of the vertebral bodies, and reveals osteophytes. Damaged discs are determined by the width and uniformity of the intervertebral discs. Inequality of the lower or upper borders of the body will lead to the suspicion of a shingles hernia. Computed tomography is recommended to determine the nature of changes in the structure of the spinal bone. Multislice examination allows three-dimensional modeling of the spine. If necessary, MRI is prescribed to check the condition of soft tissues - muscles, ligaments, intervertebral discs.

It should be borne in mind that the results of the study should be compared with the complaints and changes found during the investigation. Detection of signs of spinal osteochondrosis and even disc herniation without complaints does not require any serious measures.

Treatment of osteochondrosis of the spine

Removal of acute manifestations of the disease

  • Strong pain and sharp tension of the muscles strengthen each other, do not allow the aggravation to subside. Therefore, the first is pain relief.
  • Prescribe nonsteroidal anti-inflammatory drugs in injections, muscle relaxants - muscle relaxants
  • If these measures are not sufficient, blockade is performed with analgesics and hormonal drugs.

Radiofrequency denervation

Bed rest is recommended for a few days

After the symptoms disappear it is necessary to start the movement, gradually increasing the range of motion and load. At this time it is undesirable to actively stir, massage due to possible complications.

Osteochondrosis: Treatment without exacerbation

When the patient's condition stabilizes, the usual sluggishness remainsOsteochondrosisThe treatment consists of several components:

  • Medication. All the same anti-inflammatory painkillers in tablets, capsules and ointments. The specific drug is chosen by the doctor according to the patient's condition, lifestyle, concomitant diseases, the preferences of this or that component of osteochondrosis. A course of B vitamins will improve the conduction of impulses along the nerve, normalizing tissue nutrition. The use of muscle relaxants will continue while maintaining increased muscle tone. There is no magic pill, injection that can restore vertebrae and cartilage to their original state. Medications relieve symptoms, improve mobility and performance. But they can not completely stop the progression of the disease.
  • Physiotherapy. It is used for direct delivery of drugs to the painful site (electrophoresis), for warming (paraffin, infrared radiation). The impact of the therapeutic flow relaxes the muscles, improves the work of nerve fibers. After a few sessions the pain decreases, mobility is restored. Not prescribed for active inflammation
  • Manual manipulation, massage, acupuncture, acupressure. Relieve spasms by stretching and relaxing muscles. If only the upper layer of the muscles is injured during the massage, then the manual therapy reaches deeper, so the requirements for specialists are higher. Be sure to do an MRI first to find out the anatomy of a particular patient
  • Spine traction. The vertebrae are separated from each other, the normal distance between them is restored, the stretching of the nerves is reduced. The procedure has contraindications, so only a doctor can prescribe it
  • Physiotherapy. The most effective method of treatment. The only warning is that it must be used for life. Benefits - provides activity, improves mood, increases tissue tone. The best methods are a set of exercises recommended by your doctor, from basic yoga asanas, Pilates, swimming. They are held smoothly, without sudden and traumatic movements, stretching the tissue, gradually increasing the amplitude.
  • Proper nutrition and abandonment of bad habits
  • Adequate supply of nutrients to tissues, good condition of blood vessels and adequate blood supply to vertebrates and structures around them are measures to prevent the progression of osteochondrosis. Proper nutrition normalizes weight, reduces stress on the spine

Surgical treatment of spinal osteochondrosis.Modern clinics have a large arsenal of minimally invasive interventions:

  • Treatment and diagnostic blockade
  • Radiofrequency ablation
  • Cold plasma and laser nucleoplasty
  • Endoscopic removal of a disc herniation
  • Microdiscectomy

Radiofrequency thermal ablation of phase joints

Special needles are placed exactly on the side of the intervertebral discs, where the median branch of the lumbar nerve passes. The needles are fitted with electrodes whose tip is heated to 80 degrees for 90 seconds. This causes the nerve to coagulate. The pain goes away.

Cold plasma nucleoplasty

A special cold plasma electrode is applied to the disc tissue through a needle inserted into the disc. Intradiscal pressure decreases, hernia (protrusion) rises inside.

Microdiscectomy

During a hernia, compression of the surrounding nerve roots and blood vessels occurs, resulting in extremely painful sensations and various disorders of innervation of the limbs. If the effect of conservative treatment is no longer there, then surgical intervention to remove the hernia is the only possible solution for many patients. The operation is performed under anesthesia with a 2-3 cm long incision using microsurgical equipment and instruments. The duration of the operation is 45-60 minutes. Pain syndrome is significantly reduced or completely disappears in 95% of patients after surgery. The next day the patient is allowed to walk and will soon be discharged from the clinic.

Endoscopic removal of a herniated disc:

The hernia or free-lying sequestrant is removed through the lateral intervertebral foramen. A 5 mm incision is made in the skin to insert the tube. The muscles, fascia and ligaments are not damaged, they are dismantled using a system of tube retractors with a gradual increase in diameter. The operation is almost bloodless and lasts only 40-50 minutes. Patients can return to normal after three weeks. The risk of complications is minimal.

Decompression and stabilization surgeries are performed when complications arise, such as a large disc herniation, strong compression of the spinal nerve root, and spinal cord. If signs of sudden loss of sensation, movement, or pelvic dysfunction are detected, the patient should be referred immediately to a neurosurgeon. The sooner it is possible to eliminate the contraction, the more complete the recovery will be, the person will quickly return to a normal life. In this case, surgical treatment aims to decompress the compressed nerve structures and stabilize the affected segment. This is a heme or laminectomy. Fixation is performed by a transpedicular system, with an intercostal cage providing a 360-degree fusion. Interspinous stabilization of vertebrates is widely used. There are several interspinous implants today. Microdiscectomy in combination with interspin stabilization, especially in the elderly, can significantly increase the effectiveness of long-term outcomes and reduce the likelihood of recurrent disc herniation.