Osteochondrosis of the spine — the degenerative changes affecting the intervertebral discs, joints, ligaments, and other tissues, formants vertebral-motor segment (PDS). When the primary disease affects the intervertebral discs, and secondarily to other departments of the spine and musculo-skeletal disorders. It is considered that the prevalence of this disease is frequent among the young and middle-aged people, with a downward trend in people and the senile age.
In the composition of spinal-skeletal segment consists of two near the vertebra, the upper and niinamesai. Between them lies an intervertebral disc, joints, and articular spicy sprouts. Vertebrae adjacent between the articular shoots form a joint connection (bootnote, or facet joints). Pungent and shoots in the vicinity of the vertebrae are ligaments. This design with the cd provides the backbone for mobility and stability.
The causes of occurrence of the degenerative disc disease of the spine up to the present, are not defined. However, the fact that it occurs more often in the occupational categories of the adult, suggests that the main cause of the onset of this disease is a sedentary lifestyle. As a result, the deficit of muscle loads reduce physical of muscular effort and the replacement of their static in parts of the body, which, by their nature, need to be mobile (neck, lower back) relief of the spring and stabilize the functioning of the muscles.
The degenerative changes of the spine occur due to:
- excessive static or dynamic load on the spine (for example, lifting weights);
- heredity;
- confirmed by the wounds of the vertebral column in the past.
During the detection of the similarity of symptoms, consult a doctor. No self-medication is dangerous for your health!
The symptoms of the degenerative disease disk
The main symptom of the disease-degenerative disk — myofascial pain syndrome is a painful muscle spasm, the muscle dysfunction.
Saying on the causes of the syndrome of pain, emit the pain that is caused by a pathology of the structures of the spinal column (or vertebral pain syndromes), or the pain of other origin (nevertebralnah of the pain). What type of pain is detected, depends on the choice of treatment methods.
Types of back pain:
1. Nociceptive — is due to the fact that on the pain receptors have an impact on a variety of precipitating factors (injury or inflammation) when the integrity of all the divisions of the nervous system. For a such a pain characterized by the appearance of zones of constant pain and enhance sensitivity to pain in places of damage to the tissues.
2. Neuropathic — occurs as a pathological outcome of the irritation of neurons in the peripheral or the central nervous system responsible for the reaction to physical damage to the body. Often a hallmark sign of neuropathic pain is the decrease in muscle strength and disorders of the sensitivity, which is manifested, in particular, the fact that the patient is experiencing pain in response to nabolese irritants.
3. Dysfunction (sildenafil) — occurs due to a change in the functional state of the nervous system or altered the perception of the person. Often seen at his buff to the rest after intense activity.
4. Mixed — is manifested by a combination of several varieties of pain described previously.
Usually, the back pain is related to irritation of pain receptors of muscles, joints and ligaments, and it is the pain nociceptive in nature. The patient feels in the place of the event (the local pain) or away from the referred pain). Neuropathic pain in the back is often associated with the fact that in the process involved Karasek nerve or ganglion spinal. This pain is chronic.
Taken into consideration the pain in the back cause of the diseases of the internal organs (in other words, the viceregency of the pain).
Taking into account the cause of the appearance of degenerative disc disease, the clinical manifestations of the disease may be related to a herniated disc or degenerative (pathological) changes in the spine (for example, osteoarthritis, intervertebral joints or formation of osteophytes).
4 major clinical syndrome, which can lead each of the options above:
- local pain local;
- reflected (reflex pain), associated with lesions osteo-muscular (fascial) structures;
- syndrome radicular (neuralgia) caused by the irritation or compression of the blood vessels, lung roots;
- myelopathy – the pain resulting from the compression of the spinal cord, or blood vessels.
The pathogenesis of the disease, degenerative disk
The basis for the development of degenerative disc disease is a number of pathophysiological mechanisms. The disease develops as a result of degenerative processes, which take their source in a fairly young age, as well as inflammation aseptic, dystonia, spasm.
In case of modification of the binding of an intervertebral disc in the beginning is a lesion of the sheath around the nerve fibers (demyelination), and then there is damage to the expansions of the nerve cells (axonopathy), the decrease of blood flow (ischemia) and the following of venous stasis. All of these processes make the situation worse, and if the lack of timely treatment, this led to the emergence of peripheral or central sensitization.
The most often celebrated the defeat gelatinous nucleus and annulus fibrous of the intervertebral disc. The mechanical stresses lead to elastic fibrous ring of the disc loses its elasticity and of its protrusion. Then, through the cracks of the fibrotic ring occurs the loss of parcels jelly-like nucleus of the spinal column, that is to say, the protrusion disc is the successor to a herniated disc.
The herniated disc is called a statement of solid, which sohranyaet link with the body of an intervertebral disc, but sometimes occurs with the loss of its fragments in the vertebral canal (trapping of the disk).
The classification and the stage of development of degenerative disc disease
From the point of view of the location of the release the following varieties of the disease:
- lumbalgia — pain in the lumbar region (lumbosacral) the department back;
- sciatica — pain in the back, trusts in the legs;
- lumbago — lumbar lumbago it is acute intense pain in the lower back;
- torakalgiya — a chest pain;
- cervicalgia, cervicobrachialgia — pain in the neck and upper limbs.
The classification of the stages of evolution of the disease degenerative disk:
Phase 1: decreases the amount of moisture, the intervertebral disc protrudes until it loses its elastic request for the information and the elastic properties request information and charges remain the same. Following disc decreases in height, flattened, occurs the protrusion.
Step 2: if the pathology continues to develop in the fibrous ring noted the appearance of cracks, and because the height of the flattened disk is already reduced, the result is the instability of the state of the vertebral segment.
Step 3: the teaching of the gap in the cartilage tissue of the fibrotic ring. Through it seeps the most liquid of the nucleus and the formation of a herniated disc. These changes can often be found in the regions of the lumbar and cervical.
For the first time the pain in the presence of a herniated disc appears when there is an irritation of pain receptors of the external layers of the fibrotic ring and to the back of the ligament longitudinal.
The complications of the disease, degenerative disk
- The symptom of lumbago. In the early stages, noted the periodic appearance of pain as a reaction to an action, for example, as the result of a sudden movement, weightlifting, the high load (the long hike), a long stay in obezbijede position. This type of pain is familiar to many and who is described as "picked up". Differs from an instance rare, the intensification of the traffic and almost does not manifest itself in a static position. This type of pain is not serious consequences, and it takes place for a week.
- Lumbalgia. This type of pain has the property of being worse when cold, with intense events during the movement. Is not a reaction to the load on the spine, when the judgment doesn't stop, well that fades, leaving a throbbing sensation.
- Sciatica. Pain radiating in the departments. Lumbar low back pain is characterized by irrationalism of the pain in the leg, in the chest in the area of the hand or of the heart; the neck is manifested by migraine headaches.
- Convulsions. They are often exposed to the triceps muscle of the leg. Among other things, highlights the emergence of a very strong pain to the touch in the back or the legs.
- Coccygodynia. Irradiiruet in the area of the tailbone or groin. The pain whining, burning, sterledeva of nature, which may significantly limit the physical activity of the patient
The diagnosis of the disease, degenerative disk
The diagnosis of degenerative disease of the disc consists of several steps:
1. The collection of the history. At this stage, one investigates patient complaints and history of disease. In an interview with the patient, it turns out, where most of them are of unpleasant sensations, their intensity, duration, triggers a reinforcement of the sensation of pain and help to relieve the pain. In addition, in the diagnosis and the important point is to find the history of the illness: the onset of the unpleasant sensations, and stiffness; identify the probable causes of their occurrence; collect information on the carried out previously, the treatment and its effectiveness; the information is collected on the last course of the exacerbation and the nature of his conduct. For the diagnosis it is important to know under what conditions the patient lives and works, what is the image of life, what habits has suffered an illness or an accident, a will and managing hereditary factor.
2. During physiological of the inspection to proceed to the evaluation of the body position of the patient, his gait and movements; of the skin (on the topic of rosacea, redness is peeling), the comparison is made symmetrical areas of the body, the healthy side and painful; is manufactured to the determination of the amount of movement (slopes, using circular movements of the torso, the volume of movements of rotation in the different departments of the spine); during palpation of the plot for the determination of the temperature of the skin, the presence of muscle spasms, swelling and painful joints; palpation of the deep and superficial layers of the muscles allows to assess the state of the muscular system (muscle tone, an increase or a decrease of their volume), and with the help of the tapping special the hammer or the finger is determined by the area of irradiation of the pain with the help of stinging a needle determined painful sensitivity; at the end of a series of attacks special, in order to determine the symptoms, root of the voltage.
3. X-ray. For a better informative is made to the study of the spine separately. In the two projections and oblique in two mutually perpendicular planes (direct and lateral). In some cases, can affect functional x-ray, when the patient is in a position of flexion, extension or side slopes. For indications to get more quality results from the research carried out with the introduction of the contrast agent in the vertebral canal, in the carotid or vertebral artery and a damaged intervertebral disc or in the spinal cord: imaging, discography, myelography, pneumola myelography.
The main x-ray signs of degenerative disease of the disk, think:
- pathological mobility of the vertebrae;
- the shift of their body;
- the calcification of disc (salt deposits);
- uniform narrowing of the intervertebral slit in the lumbar region and cervical services, but in the chest area narrowing wedge shape;
- formation of osteophytes (limit value growths);
- education on the border with hit the disk seal (rgional multiple sclerosis).
5. Magnetic resonance imaging (MRI) is based on the fact that apply to electromagnetic waves, application of information, which create a signal characteristic for each tissue. It is run on a computer, and results in the graphical representation. With this method, we can clearly consider the vessels, the shoots and the intervertebral discs, without the harmful effects of the institute ionizing on the body.
The forecast. Prevention
As practice shows, most of the manifestations of the degenerative disc disease, when it is done correctly, a therapy that is going of the authorisation within a period of 6 weeks.
However, ill-suited to the treatment or self-medication can lead to this syndrome the pain will pass in the chronic form, and will contribute to the worsening of the changes in the vertebral column in the future.
At the onset of pain in the back, or members, first of all, you have to ask a qualified technician for proper diagnosis and adequate treatment.
The most effective treatment for most manifestations of pain in the back is medication and therapy to injection, and acupuncture. Physiotherapy, including laser therapy, massage, manipulation have low and unstable effect, in some cases, can be, and are contra-indicated.
Modern methods of treatment of degenerative disc disease are based on the principle of the continuity of the treatment: that is to say, fast and safe cutting of an episode of acute pain followed by the inclusion of prevention methods. In order to prevent the onset and development of degenerative disease of the disk, you can recommend, first of all, a reduction of the mass of the body obesity) and released in regular physical activity.
Regular sessions with the technique of dynamic muscular stabilization (yoga, pilates in the context of aerobic exercise) is the basis of the rehabilitation and prevention of back pain, helps to improve the strength and endurance of the muscles of the spine.