Osteochondrosis - Causes, Symptoms and Treatment .MF .
osteochondrosis - a chronic relapsing-remitting degenerative intervertebral disc disease, vertebral body, intervertebral joints, ligaments, roots, veins, arteries, the sympathetic nervous system, the fascia and the muscular system.
base of the spine pathology - all vertebral motor segment (PDS) - the two vertebral bodies, disk surrounding neuromuscular structures.The main character of pain - muscle structure.
To develop PDS Pathology matter
- pathology of vertebral bone structures - arthrosis, arthritis, osteoporosis;
- vascular pathology,
- muscle imbalance,
- pathology ligament apparatus (atrophy of ligaments followed by calcification contribute to pinched nerves and blood vessels),
- pathology drives: pathology of hyaline plates, pathology of the fibrous ring - front hernia (not clinically significant), side(with compression roots and blood vessels - and radikuloishemii radiculopathy), rear (compression shells, vessels, spinal cord), the pathology of the nucleus pulposus.
chondrosis core - is fluid loss, low back pain - altered nucleus formed around the degenerative-dystrophic changes.
osteochondrosis develops under the influence of basic factors that change the person is unable - to walk upright, sitting, inadequate blood supply to the spine, leading to early hypoxia and fiziolgicheskomu aging, autoimmune reactions, the gipotalyamo-pituitary-adrenal structures.It is deforming spondylosis - a protective reaction of the organism."Thorns, hooks» on radiographs is the protection of spondylolisthesis.
Risk factors for osteoarthritis
disease cause risk factors:
- muscular dysfunction
- microtrauma, forced postures
- infection and intoxication
- pathology of the internal organs (according odnosklerotomnoy localization of diseased internal organs can cause pain in the spine, the patient spine canaggravate existing pathology of the internal organs, but did not cause it)
- «bad" leg, leading to dysfunction of the spine - flat feet, varus and valgus deformity ... violate gait, causing muscle imbalances (with walking engage the muscles that do not have to go), hypertonicity and pain syndrome
- psychogenic factor (vyvzyvaet degenerated muscle hypertonicity and pain).
pain - it is always a lack of endorphins.Their number is governed by the limbic-reticular formation and the cerebral cortex.In times of stress and impaired regulation of endorphins enough.As a consequence, any acute pathology., Including muscle.Psychogenic pain - muscle.
symptoms of degenerative disc disease in the cervical level.
cervical spine characterized by low muscle mass, a large number of vital organs - the vertebral artery supplies the cervical spine and the limbic-reticular complex, posterior cervical sympathetic plexus trunkus simpatikus, thyroid, ENT - organs.This determines the clinical picture of disease.
Cervicalgia - pain in the cervical spine.This undifferentiated muscle response to any pathology in the cervical region.Have the values of angina, acute respiratory infections, retropharyngeal abscess, lung pathology tops, mediastinum, teeth, coronary spasm, and even myocardial infarction.Pain may be sharp and blunt, worse when bending the head, cough, may radiate to the head (tservikokranialgiya).When viewed from the positive symptom Neri, Dejerine, dvideniya limited extent painful.
cervicobrachialgia - neck pain, radiating pain in the arm, may impair sensation in the hand, numbness, paresthesia.
syndrome anterior scalene muscle - neck pain, numbness, paresthesia, tingling, rash, then pleksalgiya becomes complex.At the heart of anterior scalene muscle spasm in only 25 - 28% of the "guilty" osteochondrosis, remaining% - this injury, the pathology of the lungs, mediastinum, calculous cholecystitis.
of shoulder and periarthritis periarthrosis - pain in the shoulder joint, collarbone, shoulder blade, restricting movements of the hand upward and backward institution.
Epikondilez - pain in the elbow joint, local, or in nyruzhnom internal condyle, limitation of movement.More common for injuries in athletes, while working on an assembly line, the garden ...
syndrome shoulder-brush - pain in the neck, then shoulder, then to the brush, the brush is attached swelling, rash, after the pain disappears and developatrophy, necrosis.
cardialgia .True vertebral cardialgia not."Bad," the spine may be a risk factor for compromised cardiac muscles.
syndrome vertebral artery -
- functional - s / m zadnesheynyh sympathetic syndrome (S / M Bar-Leu, cervical migraine) - half headache and pain in the neck, "as withdrawn helmet", nausea, vomiting, vestibulopathy- staggering, dizziness, photopsias, noise in the ear,
- organic - vertebro basilar insufficiency - develops in the presence of atherosclerotic manifestations in the blood vessels.
radicular syndrome - are rare (18%) - or compression-triggered iritatsiey root or container (radikuloishemii):
C2C3 - neck pain, feeling of swelling of the tongue, glossodiniya;
c3c4 - pain in the shoulder and upper arm, the heart, the diaphragm elevated tone;
S4S5 - pain in the neck, shoulder, forearm, hypotension in the area C5, the weakness of the deltoid muscle;
S5S6 - pain from the shoulder girdle on the outer surface of the shoulder to the thumb and index finger, reduced sensitivity in the root zone, fell reflex biceps muscle, reduced strength in the fingers 1 and 2;
S6S7 - pain for posterolateral surface of the forearm with irradiation in the middle finger, reduced sensitivity in the root zone, fell reflex triceps, triceps weakness;
S7S8 - pain in the shoulder girdle, the inner surface of the shoulder and arm, 4 - 5 fingers hypoalgesia in root zone, muscle weakness.
symptoms of degenerative disc disease at the thoracic level.
thoracic section is characterized by a small number of muscles, the presence of bone (edge-sternal) framework for the internal organs of the thoracic spine low mobility.Degenerative - dystrophic pathology develops faster and earlier in the thoracic region.
Thoracic department often prone kifo-scoliosis.
Torakalgiya - chest pain - muscle-vegetative complex, undifferentiated muscle response to any pathology.Pain associated with immobility - prolonged standing, sitting, night pain, worse when bending, deep breath, coughing.Most torakalgiya called diseases of internal organs - lungs, heart, stomach, gall bladder, herpes infection.Acute respiratory infections, bronchitis, pneumonia, pleurisy, pneumothorax, pulmonary tumor, pulmonary tuberculosis, angina, heart attack, myocarditis, peptic ulcer, cholecystitis, pancreatitis, esophagitis - all will torakalgiyu.More often intercostal neuralgia or myalgia.
syndrome anterior scalene muscle .
anterior chest wall syndrome - pain at the front of the chest, parasternal, depend on the situation.
posterior chest wall syndrome - pain in the shoulder blades, interscapular region, the presence of foci mioosteofibroza (as a result of chronic hypoxia and muscular degeneration).
Trunkalgichesky syndrome - pain in the side of the chest.
radicular syndrome at the thoracic level - a rare phenomenon.
symptoms of degenerative disc disease in the lumbar level.
at the lumbar spine accounts for the largest load, the biggest muscles, a lot of joints.Sacral plexus "floats" in the pelvis, and any pelvic pathology cause spasm of the piriformis muscle and compression of the sacral plexus.The sciatic nerve runs deep in the gluteal muscle.Prolonged sitting, injections may cause pain along the nerve.Pathology of the knee affects the bifurcation of the nerve in the popliteal area.On the lower extremities commonly affected vessels - arteries and veins, which contributes to pain syndrome.
lumbalgia - back pain (lower back) - undifferentiated muscle reaction in response to any pathology in the region.It is possible for diseases of the kidneys and urinary tract, genitals, gastrointestinal disease - intestinal tract.When vertebral lumbalgia pain sharp, shooting, aggravated by movement, slopes, cough, bent his head, picked up the legs.The patient was difficult to lie down, sit down, stand up.When viewed from the positive symptoms natchzheniya - Lassega, Neri, Dejerine's, Wassermann.
sciatica - back pain and leg, tyanushie, aching, are twisting, shooting, associated with movement, coughing, accompanied by numbness of the legs, paresthesias, decreased tendon reflexes, neuromuscular, neurodystrophic, neurovascular syndrome - muscle spasms, cramps, Tunnelsyndromes, miofibroza centers, joint pain, psevdoarteriitami
L4 - pain in the anterior thigh, the inner surface of the knee and lower leg, hypoesthesia, weakness of the lower leg flexor, knee-jerk dropped, ankle living;
L5 - pain along the sciatic nerve to 1 toe, hypoesthesia in the root zone, the weakness of the rear flexor foot;
S1 - pain along the sciatic nerve to the 3 - 5 fingers foot hypoesthesia, weakness of the foot, the knee jerk saved, Achilles fell.
Vascular syndromes - radikuloishemii - developed in vascular compression - no pain, there is muscle weakness.cone syndrome - weakness of both feet, dysfunction of the pelvic organs, hypoalgesia sacral area.
Diagnosis of osteochondrosis
described syndromes tebuyut once a thorough examination by a doctor - a neurologist, and not for hiking "reposition" dropped disks and knock out salts spine."Hide" under the mask of osteochondrosis can a serious disease and is unacceptable to do manual therapy in myocardial infarction and fizioteploprotsedury with metastatic tumors in the spine, and so on.
necessary examinations - blood and urine tests (first overall, and then individually depending on the clinical picture), ECG (if tservikotorakalgii) and consultation of the cardiologist, chest X-ray of lungs or chest X-ray with the advice of a therapist, spine radiographs, computed tomography, magnetic resonancetomography.Due to the variety of options and combinations you may need advice and additional inspections at the urologist, gastroenterologist, gynecologist, traumatology, orthopedics, neurosurgery, vascular surgeon, TB doctor, oncologist, otolaryngologist.
Treatment of osteochondrosis
Treatment is prescribed individually according to the established diagnosis, stage (acute, subacute, remission), severity of pain (marked, moderate, remission) and concomitant somatic pathology.
treatment in acute pain: rest, non-steroidal anti-inflammatory drugs (dikloberl, Voltaren ... coxibs - Arcoxia ...), antispasmodic mixture intravenously blockade medicinal agents, muscle relaxants, tranquilizers, vitamins, gabapentin (gabantin, Tebantin, gatonin), korsetirovanie, locally - rubbing (Fastum gel, Deep Relief, Apizartron, Larkspur ...).
In severe cases do not respond to pain and the presence of compression spine disc herniation operative treatment.
used in treatment chondroprotectors - Don (injections, then powders courses), calcium supplements (calcium D3), medications to improve blood circulation and venotoniki, with muscle weakness anticholinesterase drugs (Neostigmine, neuromidin), lipoic acid, Nucleo CMF.
Rehabilitation actions: physiotherapy (diadynamic currents, magnetic therapy, darsonvalization, ultrasound, electrophoresis, incentive Miauton), massage, manual therapy, traction, postisometric relaxation, acupuncture, spa baths, physiotherapy, health - resort treatment (balneotherapy, radon,ozokerite, mud, underwater traction ...).
Prevention - is the impact on the risk factors - the fight against sedentary lifestyle, obesity, therapeutic exercise, swimming, exercises on simulators, fitness, massages ... - improvement of the muscular system.When spondylolisthesis in the lumbar corset used during exercise.For a good night's rest to use mattresses and pillows.Ensure correct posture when walking and sitting.Avoid hypothermia.The more muscle and better mobility in the spine - the less will disturb pains.
neurologist Kobzev SV