In the life of modern people, the imbalance between active physical activity and static loads leads to a decrease in the tone of the back muscles, therefore, an increase in the axial load on the intervertebral discs and spinal ligaments creates conditions for their microtraumatization. . The degenerative-dystrophic process called vertebral cartilage tissue, intervertebral discs and ligamentous apparatus develops - doctors call all this collectively polysegmental osteochondrosis.
With age, the natural aging of the intervertebral disc occurs, becoming stronger under the influence of vibration, jerking movements, heavy lifting and falling. The development and worsening of osteochondrosis is facilitated by various back injuries, excessive physical load, poor physical fitness, poor posture and curvature of the spine, flat feet and excess body weight.
Causes of osteochondrosis
- hereditary predisposition;
- metabolic disorders in the body;
- overweight, poor diet (lack of fluids);
- age-related changes;
- spinal cord injury;
- poor posture, scoliosis, flat feet;
- sedentary lifestyle;
- work that involves heavy lifting;
- excessive load on the spine due to walking in high heels and pregnancy in women, etc.
The main symptoms of common osteochondrosis
- constant pain in the back, numbness in the limbs;
- increased pain with sudden movement, physical activity, or heavy lifting;
- reduce range of motion, muscle spasms;
With cervical chondrosis, a person will be disturbed by pain in the arm, shoulder, and headache; It is possible to develop the so-called vertebral artery syndrome, where there are complaints of noise in the head, dizziness, flashing "spots", colored spots in front of the eyes in combination with a throbbing headache.
With osteochondrosis of the thoracic spine: pain in the chest (like a "spike" 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 boring work - designers, programmers, secretaries, dentists, etc. As a rule, the development of cervical osteochondrosis is facilitated by driving and long-term work at the computer. The main signs and symptoms of cervical osteochondrosis include: headache, dizziness, pain in the arms and chest, lumbago, tongue numbness. With cervical osteochondrosis, the head often hurts and feels dizzy, vision darkens, and blood pressure rises. The channel for the so-called vertebral artery passes through the transverse process of the cervical vertebra. It is directed into the cranial cavity and nourishes the brain. Vertebral displacement leads to spasm of the vertebral artery, and in severe cases, to compression. Therefore, the blood supply to certain parts of the brain is disrupted.
When osteochondrosis worsens, radicular symptoms may also be present: the pain radiates to the hands, sometimes to individual fingers, they become numb, and become constantly cold. The reason is a disturbance in the path of impulses along the nerve fibers. With certain finger numbness, the neurologist can assess the displacement of certain vertebrae. The clinical picture of osteochondrosis of the cervical spine is characterized by various symptoms, which are caused by 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 most often. This is explained by the fact that the lower back (lumbar vertebrae), as a rule, bears the main load. Often, lumbar osteochondrosis can be complicated by intervertebral hernia of the lumbar spine. The main symptoms and signs of lumbar osteochondrosis include: lower back pain (lower back pain has bothered a person for many years and is characterized by cycles, getting worse in the autumn-winter period), limited mobility, pain in the legs. Often, with lumbar osteochondrosis, there is acute pain (lumbago) or pain in the leg, affecting a specific part of the leg (for example, on the back or 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 pinching 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 from a nerve root. When a nerve is pinched, the pain spreads along the nerve trunk: to the buttock area, below the knee, sometimes to the calf or heel. A significant disturbance in the nutrition of the nerve trunk is possible, then the legs become numb. Symptoms of sensory impairment are very persistent, sometimes numbness persists for a long time. When the sciatic nerve is pinched, a person begins to limp, leaning towards the healthy side to maximize the vertebrae on the affected side of the body and thus reduce root compression. With osteochondrosis of the lumbosacral spine, the first clinical manifestation is pain in the lower back and legs.
Treatment
Pain syndrome with osteochondrosis usually occurs as a type of exacerbation release. Moreover, if the pain lasts for more than 3 months, doctors talk about chronic pain. It increases the level of anxiety in the patient and tends to a depressed mood. Standard treatment regimens become ineffective when the pathogenesis of pain changes. In such cases, neurologists add treatment drugs 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 of osteochondrosis and modify the lifestyle. And also timely and effective relief of acute pain to prevent its chronicity.
Acute pain develops when tissue is 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 metabolic products of arachidonic acid.
The most popular NSAID is 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.
New drugs containing diclofenac are in great demand. 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.
This drug is used in doses 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 to diclofenac injection form in clinical studies. The results show the advantage of diclofenac potassium in sachet form compared to injection form. It seems that the new drug will significantly expand the possibilities of analgesic therapy for doctors in our country.
The effect on the muscle component of pain involves: post-isometric relaxation, massage and therapeutic exercises, including exercises to strengthen the muscle corset or stretch the spasmed muscles, and the use of muscle relaxation. This method can be combined with reflexology and other physiotherapeutic procedures (DDT, SMT, electrophoresis with local anesthetic, hydrocortisone phonophoresis, etc. ).
Prevention
The main methods to prevent osteochondrosis are: physical activity, a properly equipped workplace that eliminates prolonged postural tension, timely relief of acute pain, and frequent exercise therapy.
The success of the treatment of patients with osteochondrosis depends on the correct management of rehabilitation measures, especially in the early stages of the disease. Physical rehabilitation should be carried out comprehensively.