Excessive back muscle tension causes a lot of discomfort and pain. Osteochondrosis, which causes a violation of the structure of the vertebrae and intervertebral discs, leads to severe constriction of nerve endings. Often, the pathology is accompanied by worsening of blood circulation, which causes disorders in the nutrition of the brain and internal organs.
Osteochondrosis - what is it?
Osteochondrosis is a recurrent type of disease that occurs in a chronic form and is accompanied by destruction of the vertebrae with intervertebral discs. Their tissues are disturbed, which causes a decrease in the degree of their elasticity with a subsequent change in shape. The intervertebral space gradually decreases. This causes a loss of stability of the spine in the areas of pathology development.
Processes of pathological tissue destruction occur in the background of compressed nerve endings that are directed from the area where the spinal cord is located. As a result, the back muscles are in constant tension. In such a situation, patients complain of back pain and other symptoms.
Based on the peculiarities of the localization of the spinal structures, which were covered by degenerative changes, the cervical, thoracic and lumbosacral types of the pathological process are distinguished. The main symptom of the development of osteochondrosis is pain, the intensity and weight of which usually increase during physical exertion.
There is also stiffness in movement. In addition, the clinical picture is characterized by the presence of signs of the vertebral type - headache, changes in blood pressure, deterioration of visual function, hearing, etc.
Development Mechanism
The development of osteochondrosis is associated with the fact that the nucleus pulposus begins to lose its hydrophilic qualities. This semi-fluid structure contains connective tissue fibers and chondroitin, a gelatinous substance. In the process of development of the human body and its growth, the processes of reduction of the vascular bed on the intervertebral discs are actively taking place. Nutrients are delivered diffusely, which is manifested by spontaneous stabilization of concentration. This characteristic becomes the reason for the difficulties in the complete restoration of the cartilage that has suffered damage or excessive pressure on the spine.
Pathological abnormalities become more striking due to violations of the hormonal background and human nutrition. Cartilage tissue begins to feel the lack of nutrients needed for its normal development. Therefore, the disorders appear in the form:
- decrease in strength and elasticity;
- changes consistency parameters and configuration properties.
In the background of the alignment of the intervertebral discs, radial cracks appear in the annular fibrosus. As a result, the intervertebral distance decreases and the facet joints begin to move. Over time, pathological changes cover the types of connective tissue associated with fibrous rings and ligaments.
As the immune system breaks down in tissues, increased amounts of immunoglobulins are produced. This provokes the development of the process of aseptic inflammation, edema is formed in the area where the facet joints are located. They also extend to adjacent soft tissues.
Due to the stretching of the joint capsules, the intervertebral discs lose the ability to fixate the vertebrae. Such instability of the position of the spinal structure increases the risk of constriction of nerve roots or constriction of blood vessels. This characteristic is typical, for example, of cervical osteochondrosis accompanied by intense verbal symptoms.
Causes of the disease
The condition of the intervertebral discs can be worsened by a reduced tone of the skeletal muscles of the spine. Due to the irrational and asymmetrical work of the muscles, the destruction of cartilaginous tissues can occur with long-term preservation of the non-physiological position of the body. This violation is the result of carrying heavy bags on the same shoulder, using soft mattresses and high pillows.
The process of destruction of intervertebral discs is accelerated due to the action of a number of negative factors of external and internal nature. These include:
- endocrine disorders and metabolic disorders;
- pathologies of infectious nature, including chronic form;
- spinal injuries in the form of compression fractures, bruises;
- regular and prolonged hypothermia of the body;
- diseases of systemic and degenerative-dystrophic type - gout, psoriatic, rheumatoid arthritis, osteoporosis, osteoarthritis;
- smoking and alcohol abuse, which disrupts the condition of the circulatory system, disrupts blood circulation and causes a lack of nutrients in cartilage;
- insufficient physical development, problems with posture, flat feet - these shortcomings increase the load on the spine, because the cushioning will not be enough;
- obesity;
- genetic predisposition;
- exposure to regular stress.
Symptoms
The main clinical sign of osteochondrosis of any localization (cervical, thoracic or lumbosacral) is pain syndrome. With relapse, the pain is penetrating, radiating to nearby areas of the body. Even with a slight movement, it intensifies. This forces the patient to place the torso in a forced position to reduce discomfort and pain.
- in cervical osteochondrosis, it will be desirable to turn not one head, but the whole body;
- when the shape of the chest is present, it is difficult for the patient to take a deep breath, and therefore, in order to exclude acute chest pain, he tries to reduce the depth and frequency of breathing;
- In patients with a lumbar type of disease, difficulties arise when they sit down, take an upright position, and move because the nerve is pinched at the spinal location.
Usually patients complain of dull, persistent pain and a feeling of stiffness in movements in the morning after waking up. In this case, a differential diagnosis will be needed to eliminate the risks of developing myositis caused by inflammation of the skeletal muscles of the spine or osteoarthritis.
Pain in pains and pressures occur due to compensatory tension in muscle tissues. This condition is necessary to stabilize the area of movement of the spine. Persistent mild or moderate pain may occur with significant stretching of the intervertebral disc and result in aseptic inflammatory changes.
Osteochondrosis of separate localization is characterized by special symptoms:
- In cervical osteochondrosis, pain is felt in the cervical region, in the upper limbs. Headaches and numbness of the fingers are noticed. If the disease manifests itself in a serious form, then pinching of the vertebral artery can occur. In this case, the patient begins to complain of a significant deterioration in health.
- Localization of the chest is manifested by acute and painful back pain, visceral pain syndrome is present in the heart area, right hypochondrium and abdomen. Patients complain of numbness, skin paresthesia, shortness of breath, crunch of the spine.
- Patients with lumbar osteochondrosis complain of pain in the back and lower limbs of increased intensity during movement. Disorders of the genitourinary system, problems with male potency, and dysfunctional ovarian disorders are often diagnosed. During remission, pain may decrease. However, the influence of the provoking factor leads to its renewal.
- When mixed osteochondrosis manifests, the symptomatology may manifest in several zones simultaneously. This condition is characterized by severe disease.
It should be borne in mind that the movement of the vertebrae and the formation of osteophytes cause compression of the spinal artery. It nourishes the brain, providing its cells with an oxygen component. When squeezing, food is limited, so the patient has problems with coordination, headaches, tinnitus, and arterial hypertension.
Consequences if left untreated
The reason for the complicated course of osteochondrosis is the relatively rapid formation of hernias on the intervertebral discs. Their appearance is associated with the displacement of the vertebral structure in the posterior direction. This causes a rupture of the posterior ligament of the longitudinal type, which results in instability of the position of the disc, protrusion of its individual sections into the area of the spinal canal. Hernia rupture occurs when a disc with core pulp penetrates the canal area.
When pathological abnormalities appear in the vertebral structures, the posterior part of the brain begins to constrict, the patient develops discogenic myelopathy. Symptoms of this condition are associated with numbness and weakness in certain muscle groups of the upper and lower extremities. Paresis, muscle atrophy, and tendon reflexes are evident. In some cases, there are problems with emptying the bladder, with the intestines.
Herniated discs are dangerous by squeezing the arteries that supply the spinal cord. The result of this pathology is the creation of ischemic zones, where nerve cells have suffered damage and death. The manifestation of the neurological effect is expressed in disorders of motor function, a decrease in the degree of tactility and a disorder of trophism.
Diagnosis of the disease
The initial diagnosis is made based on the patient's complaints and symptoms. The specialist studies the condition of the spine in different positions, suggesting that the patient be at rest or in motion. In the next stage, the patient is sent for laboratory diagnostics to help him clarify the diagnosis or refute it.
The research methods used include:
- Radiography- provides a complete examination of the spine with an assessment of the condition of the vertebrae, existing disorders in the form of growths, curvature. The specialist will be able to determine the intervals of the intervertebral type, the condition of the holes. In order to accurately identify osteochondrosis, localized in the chest or cervical area, a two-phase X-ray examination is performed. In the first phase, the patient lies on his side, and in the second directly on his back.
- The method of tomography using MRI or CTprovides highly informative data that help in a detailed examination of the vertebrae without interference in the form of organs that cover them. The picture shows the nerves and the vascular system. MRI helps identify the signs of many spinal diseases and the location of the damage. With CT, hernias are visualized, and possible deviations in the structure of the spine are determined.
- Laboratory examinationto assess the condition of the blood and its main parameters. It allows you to clarify the diagnosis and determine the possibility of developing comorbidities.
In many cases, as a result of examination, doctors diagnose the presence of some background diseases, potentially dangerous for their complications. We are talking, for example, about hernias, protrusion, radiculitis. Proper diagnosis of the problem helps in the effective treatment of osteochondrosis. At the same time, the disease itself in the early stages of development is masked in the symptoms of other diseases.
Therapeutic procedure
Osteochondrosis is treated conservatively or surgically. The choice depends on the severity of the condition, neglect, the level of tissue deterioration, and the causes.
It is important to remember that osteochondrosis cannot be completely cured because there are no medications that help completely restore discs and vertebrae. The therapeutic effect is focused on inhibiting the process of destruction and increasing the duration and stability of remission.
Chondroprotectors based on chondroitin sulfate or glucosamine are used for symptomatic therapy.
The effectiveness of the therapeutic process with the use of chondroprotectors has been clinically confirmed on the basis of long-term tests. If you take these funds for more than 3 months, there is a partial restoration of cartilage and other connecting elements - ligament-tendon apparatus, bursa.
Accumulation of glucosamine and chondroitin in the area of intervertebral discs leads to the manifestation of analgesic, antiedematous and anti-inflammatory effects. Therefore, there is a real opportunity to optimize the dosage of NSAIDs, drugs from the group of glucocorticosteroids, muscle relaxants. You can count on reducing the drug load on the patient.
The effectiveness of chondroprotectors is determined by the correctness of their intake. Otherwise, there will be no results. Inefficiency is also noted in the treatment of osteochondrosis in the 3rd degree, followed by significant destruction of cartilage.
The following groups of medications can be used to relieve pain:
- Nonsteroidal anti-inflammatory drugshelp eliminate inflammatory disorders in soft tissues caused by vertebral displacement. NSAIDs are effective in reducing pain, swelling and stiffness.
- Glucocorticosteroid agents- blockades are usually used in conjunction with an anesthetic. They are able to relieve pain, restore the immune mechanism and provide an anti-exudative effect.
- Muscle relaxants.They are effective in fighting muscle cramps due to nerve entrapment. They help to relax the skeletal muscles and block the reflexes of the polysynaptic spinal type with an antispasmodic effect.
- External medicines with warming effect.Irritation of subcutaneous tissue receptors with activation of blood flow is provided by special gels and ointments. These drugs have analgesic and antiedematous effects.
It is possible to eliminate the symptoms of the vertebrogenic type, which are manifested as a result of the localization of the pathology in the cervical or thoracic zone, with the help of medical devices for activating the bloodstream. Nootropics and drugs to improve microcirculation are also prescribed. In some cases, it may be necessary to take antidepressants, as well as anticonvulsant medications.
Physical therapy is also used during the treatment of osteochondrosis. Procedures for UHF therapy, magnetotherapy, laser therapy, reflexology, massage, exercise, chiropractic, as well as swimming and yoga can be prescribed. If conservative treatment is ineffective, surgery is performed using microdiscectomy, puncture disc valorization, laser reconstruction, or implant replacement.