Startled osteochondrosis cartilage disksgradually degenerates and becomes a kind of bone. The cured disc shrinks, loses properties absorber between the vertebrae and begins to put pressure on the nerve endings, which leads to the appearance of symptoms.
The initial stage of osteoarthritis more often than notIt manifests itself any unpleasant sensations in the spine and can be diagnosed as the disease of the internal organs, and the true diagnosis is revealed only after numerous surveys.
Localization distinguish osteochondrosis to, cervical, thoracic, lumbar, sacral and common low back pain. Most often diagnosed lumbar osteochondrosis (over 50% of cases), cervical (25%) and common (about 12%).
The intervertebral disc is afibro-cartilaginous plate. In the middle of the disc is the core, surrounded by a fibrous ring (fabric, reminiscent of a tendon). The intervertebral disc has its vascular system and, therefore, eats at the expense of other tissues. An important source of nutrients for the drive are the muscles of the back, it is their degeneration often leads to the development of osteoarthritis. When lifting weights, jumping and other physical activities, disks act as shock absorbers and maintain the required distance between the vertebrae. Since the greatest burden falls on the lumbar spine, it is in it, often formed protrusion and intervertebral hernia is a complication of osteoarthritis.
Protrusion of the intervertebral disc - Protrusion (prolapse) of the disc without breaking the fibrous ring.
Slipped disk - Protrusion (prolapse) of the disc with a breakfibrous ring and "streaming" nucleus pulposus. Very often, a hernia is formed by spinal injury or during simultaneous tilt and rotate the torso to the side, especially if there is heavy in the hands of subject. In this position, intervertebral discs have a very heavy workload, the pressure inside of the intervertebral disc is increased, the vertebrae press on one side of the disk and the kernel forcibly displaced in the opposite side and put pressure on the annulus. At some point, the fibrous ring can not withstand such a load, and bulging disc occurs (fibrous ring is stretched, but remains whole) or formed hernia (fibrous ring breaks and break through "implies" part of the contents of the nucleus). With increasing load on the spine and creating conditions for increasing the pressure in the damaged herniated intervertebral disk grows in size.
Very important is the direction of the protrusion andthe size of the hernia, if the hernia goes forward or to the side, it can lead to pain and malfunction of certain organs, and with protrusions at the side of the spinal cord and damage, the consequences can be much more serious. If the intervertebral hernia affected nerve roots or shoots of a certain segment of the spine, it causes a malfunction of the body, and is responsible for which the damaged spinal segment.
There is another option: due to disc protrusion in one direction, in the opposite side of the distance between the vertebrae decreases and this leads to a pinched nerve processes already vertebrae themselves. Intervertebral herniation in the lumbar spine most often causes pain in the legs, a hernia in the thoracic region contributes to the emergence of dizziness, pain in the heart, disorders of respiratory function, etc., herniation in the cervical spine can cause headaches, dizziness, numbness in the hands .
The most dangerous intervertebral hernia larger than 10 mm, dramatically narrowsspinal canal, clamping blood vessels and traumatic nerve endings, prolonged exposure to which not only leads to severe pain but also to circulatory problems, loss of sensation in the limbs, followed by complications.
But the most dangerous are sequestratedherniation of intervertebral discs, that is, hernia ready for destruction or detachment of the fragment, followed by lowering it into the spinal canal, which can lead to serious consequences: disorders of pelvic organs and paralysis of the lower limbs.
Causes of disease
The causes of changes in the intervertebraldiscs is not fully understood. People begin to feel the symptoms of degenerative disc disease most often after 35 years. The development and exacerbation of osteochondrosis by a variety of back injury, static and dynamic overload and vibration. The older the person, the greater the manifestations of osteochondrosis. But in recent years more and more people aged 18 to 30 years were treated with complaints of back pain. The reasons for the early manifestations of the disease are many: poor physical fitness, posture and violation of curvature of the spine, flat feet and overweight. And so, we distinguish the main causes that contribute to osteoarthritis:
- hereditary (genetic) predisposition;
- metabolic disorder in an organism, infection, intoxication;
- overweight, unhealthy diet (micronutrient deficiencies and liquids);
- age-related changes;
- spinal injuries (bruises, fractures);
- violation of posture, curvature of the spine, hypermobility (instability) of the spinal column segments, flat feet;
- adverse environmental conditions;
- sedentary lifestyle;
- work associated with heavy lifting, frequent changes in body position (rotation, flexion and extension, jerky movements);
- prolonged exposure to awkward postures in the positionstanding, sitting, lying, lifting and carrying heavy loads, performing other work in which increased pressure in the drive and the load on the spine as a whole;
- excessive exercise, uneven development of musculoskeletal system;
- overload the spine associated with diseases of the foot, and as a result of wearing uncomfortable shoes, high heels and pregnant women;
- abrupt discontinuation of regular training professional athletes;
- nervous stress, stress, smoking;
- hypothermia, adverse weather conditions (high humidity at low temperatures).
Symptoms typical of osteochondrosis
Patients suffering from osteochondrosis, complainconstant aching pain in the back, which is often joined by numbness and a sense of aching limbs. In the absence of adequate treatment, there is a weight loss and atrophy of the limbs. The main symptoms of osteoarthritis are:
- constant aching back pain, numbness and aching limbs;
- increased pain at sharp movements, physical activity, weight lifting, coughing or sneezing;
- decrease in range of motion, muscle cramps;
- osteochondrosis of the cervical spine: pain in the arms, shoulders, headaches, possible development of the so-called syndrome of the vertebral artery, which is composed of the following complaints: noise in the head, dizziness, flashing "flies", colored spots before his eyes in combination with burning throbbing headache. The cause of the syndrome of the vertebral artery spasm it can be in response to both its direct stimulation of the sympathetic plexus due to bony growths, disc herniation, osteoarthritis of the intervertebral joints and reflex reaction due to irritation of any receptors spine. The presence of vertebral artery syndrome can worsen during coronary or heart muscle disease, if any;
- the thoracic spine osteochondrosis: chest pain (such as "count" in the chest), in the heart and other internal organs;
- osteochondrosis of the lumbosacral spine: pain, radiating to the sacrum, the lower limbs, sometimes pelvic organs;
- loss of nerve roots (with herniasintervertebral discs, bony growths, spondylolisthesis, spondyloarthrosis): shooting pain and sensitivity disorder, malnutrition, hypotension, weakness in muscles innervated, decreased reflexes.
Diagnosis of osteochondrosis
Establishing a preliminary diagnosisIt carried out the initial evaluation of the patient. Inspection usually spends neurologist in connection with the complaints of the patient on the local changes that may occur pain, deformity or limited mobility. The spine is examined in the patient standing, sitting and lying down, both at rest and in motion. spinal injury level is determined by counting the number of vertebrae from certain anatomical landmarks or special scheme.
When viewed from the back pay attention to posture,especially the body structure, mark the line of the spinous processes (the median furrow back), the bottom corners of the blades, the iliac crest, the side contours of the waist and neck, the position of shoulder girdle, the deviation mezhyagodichnoy furrow from the vertical, reveal the protrusion of the spinous processes, paying attention to muscle relief near with the spine.
The feeling of the spine allows you to addinspection data (the presence or absence of deformation), to determine the localization, the extent and nature of pain. When the feeling is also noted muscle strain near the spine, because the majority of injuries and diseases of the spine accompanied by increased muscle tone.
Flexion of the spine is used to determine the range of motion in various parts of the spine.
The main role in the study of the spine is withdrawnradiography, computed tomography and magnetic resonance imaging, by which determines the level of destruction, to be confirmed and concretized the diagnosis, identify hidden pathologies. These diagnostics allow the physician to determine treatment strategy and to choose the most effective treatments.
Methods of treatment of degenerative disc disease and its complications
The treatment of degenerative disc disease and its complications is carried outusing conservative methods aimed at eliminating pain, disorders of spinal roots function and prevention of the progression of degenerative changes in the spine structures. With the ineffectiveness of conservative treatment and for special indications carried operative (surgical) treatment, the amount of which depends on the level of injury and clinical manifestations of the disease.
The duration of treatment of degenerative disc disease and itscomplications mainly depends on the severity of the disease, age-related changes, applied treatments, as well as the diligent performance of assignments and recommendations of the attending physician. As practice shows, the active phase of treatment in most cases lasts for 1-3 months when using conservative methods, and the recovery period after surgery - about 1 year.
At the beginning of the treatment, some patients mayincreased pain associated with muscle reaction system and other formations on the unusual effects for the organism. Pain cropped in a short time using physiotherapy, medical preparations, and special exercise. The result of treatment depends largely on the behavior of the patients themselves, who are required patience, perseverance, persistence, a certain strength of will, and a desire to get well. The most effective conservative therapy and rehabilitation after surgery can be achieved in a specialized medical centers and sanatoriums, equipped with modern diagnostic and medical facilities, as well as highly qualified practitioners in applying the complex treatment of diseases of the musculoskeletal system.
Complex conservative treatment includes exercise therapy, physiotherapy, massage, manual therapy, traction (traction) of the spine, reflexology, medical therapy.
Physiotherapy (physical therapy) - The main method of conservative treatmentdiseases of the musculoskeletal system is to provide a metered loads, designed to decompress the nerve roots, correction and strengthening of the muscular system, the increase in production and a certain stereotype movements and correct posture, giving the ligament-muscular system the necessary flexibility, as well as the prevention of complications. This is achieved by regular classes on rehabilitation equipment and joint exercises. As a result, exercise improves blood circulation, normalizes metabolism and nutrition of intervertebral discs, intervertebral space increases, forming a muscular corset and the load on the spine is reduced.
Physiotherapy - Treatment method which usesphysical factors. currents of low frequency magnetic fields, ultrasound, laser, etc. It is used to relieve pain, inflammation, rehabilitation after injuries and operations. When using physiotherapy techniques reduced terms of treatment of many diseases, increases the effectiveness of medications and reduce their dosage, there are no side effects associated with drug therapy.
Massage - A set of mechanical methodsdosed in the form of friction, pressure, vibration conducted directly on the body surface by hand. Effectively relieves muscle tension, muscle aches, improves blood circulation, has a tonic effect.
manual therapy - Individually picked up a manualeffects on the musculoskeletal system to relieve acute and chronic pain in the spine and joints, and increase range of motion and posture correction. One of the areas of manual therapy is Visceral manual therapy, which helps to restore normal mobility organs, improves blood circulation, lymphocirculation, normalizes metabolism, restores the immune system, prevent exacerbation of chronic diseases.
Traction (traction) of the spine - An effective method of treatment of pain syndromesspine and joints using individually selected load with the use of special equipment. The procedure aims to increase the intervertebral space, pain relief and restoration of an anatomically correct shape of the spine.
Reflexology - Various therapeutic techniques and methods of influenceon the reflex zones of the human body and acupuncture points. Application reflexotherapy in combination with other therapeutic methods greatly increases their efficiency. The most commonly used reflexology in osteochondrosis, accompanied by pain syndrome, nervous system disorders, sleep disorders, mental imbalance, as well as obesity and smoking. Influencing certain points in the body can result in harmony and treat many diseases.
Drug therapy is indicated during theexacerbation of disease, aimed at pain relief, removal of inflammation and increased metabolism by receiving or administering drugs via intramuscular or intravenous injection. Although each of the above methods is a highly effective, yet stable therapeutic effect can be achieved only by combining them with classes on rehabilitation equipment, ie to create a full-fledged muscle corset.
Recommendations for prevention and prevention of degenerative disc disease
For the prevention or reduction of osteochondrosispain for people suffering from this disease, it is recommended that the largest possible amount of time to be in a position in which the load on the intervertebral discs will be minimal, and at the same time, you need as often as possible to knead the muscles of the back for the fact that to maintain metabolic processes around the spine . General recommendations are to comply with the rules of a healthy lifestyle, in addition, in each case, the attending physician determines the particular recommendations.
The following rules must be observed for the prevention of osteoarthritis:
Do not overload the spine, do not create an environment conducive to increase the pressure in the intervertebral discs:
- Limit vertical load;
- do not make sudden movements, especially the corners of the body is tilted;
- Avoid falls and jumps from a great height, trauma and spinal injuries;
- often change the position of the body;
- keep your back straight;
- Try to keep the natural physiologicalbends the spine: in the supine position, the load on the spine is minimal, but the bed should be semi-rigid (it is desirable to sleep on a solid orthopedic mattress and an orthopedic cushion) in the sitting position back to keep exactly due to muscle or pressing it to the back of a chair or a seat (the seat should be tough enough, but to have a rest in the curve of the waist area), keep your head straight; standing more often change the pace, relied on; get out of bed or from the chair and go to bed and sit down, be by hand without straining and without bending the back;
- before exercise, drink water and massage your back, it will disperse the blood, accelerate metabolism and allow the intervertebral disc to absorb sufficient moisture;
- do not pick up or hold heavy objects onoutstretched arms, to raise the subject sit down on his haunches, and then get up with him, and the items should be located as close as possible to the body;
- when carrying heavy weights, try to evenlyto distribute the load, ie do not wear a bag in one hand, and so, if you have to carry the object in front of you, keep it as close as possible to the body, and passing it, do not pull the hand forward, as well as use for carrying heavy truck, bag or suitcase on wheels, backpacks;
- when the hard work associated with the rise, movement or transport of loads, use a special belt or corset;
- for people suffering from osteochondrosis, do not lift a load greater than 10 kg;
- in the performance of any work, try asYou can bend down and be less flexed and periodically unload the spine (hanging on the bar, sipping a lift arms, rest lying down);
- wear comfortable shoes, women should be limited to walking in high heel shoes;
Exercise regularly to strengthen and maintain a muscular corset. Useful lessons in swimming.
Take a contrast shower, body quenched.
Do not supercool.
Avoid scandals stressful situations.
Do not smoke.
The complex of physical exercises for self-study
The system is designed for the prevention ofvertebral osteochondrosis. Daily Exercising will help to strengthen muscles, maintain the spine flexible and mobile. The complex serves as a complement to the regular practice of strength training aimed at enhancing and maintaining the muscular system.
Exercises for cervical spine:
- Push down on the forehead and hand tighten the neck muscles. Exercise, do 3 times in 7 seconds. Then the palm push nape and 3 x 7 seconds.
- Straining the neck muscles, push left temple on the left hand (3 x 7 seconds), and then push the right temple on the right hand (3 x 7 seconds).
- Head slightly zaprokinte ago. Overcoming the resistance of the neck muscles tense, push the chin to the jugular fossa. Do exercise at least 5 times.
- Head and shoulders keep straight. Slowly turn your head to the right as possible (5 times). The same time, follow the movement of the left.
- Chin to lower the neck. Turn first head 5 to the right once, and then 5 times to the left.
- Head zaprokinte ago. Try to touch the right ear of the right shoulder (5 times). Do this same movement, trying to touch the left ear of the left shoulder (5 times).
Physical exercises for the thoracic spine:
- Ip - Making a breath, stand up straight, hands down, feet together. Stretch your arms up - exhale. Decayed back and take a deep breath. Then lower your arms, lean forward slightly rounded back, lower your shoulders and head - exhale. Repeat 8 - 10 times.
- Ip - Sitting on a chair. Get your hands behind your head - inhale, arch your back maximum 3 - 5 times, drawing the shoulder blades against the back of the chair - exhale.
- Ip - Get on all fours. Maximum arch your back and pause for 2 - 3 seconds in this position. Keep head straight. Breathing is arbitrary. Repeat the exercise 5 - 7 times.
- Ip - Lie on your stomach and place your hands on the floor. Force maximum arch your back, trying to tear the body off the floor. Breathing is arbitrary. Repeat 5 - 8 times.
- Ip - Lying on his stomach, arms along the body. Rotten in the thoracic spine, trying as much as possible to raise up his head and feet. Breathing is arbitrary. Repeat 5 - 8 times.
Physical exercise for the lumbar spine:
- Vis or poluvis for 70 seconds. on the bar, which can be nailed over the door.
- Ip - Standing, hands on hips. Lean forward, backward, right, left. Repeat 10 times in each direction.
- Ip - Standing, hands on hips. The movement of the pelvis forward, backward. Repeat 10 times in each direction.
- Ip - On his knees, straight arms in emphasis floor. Built like a penknife, then return to starting position. Repeat 15 - 20 times.
- Ip - Lying on his stomach, the emphasis bent arms to the floor. Straighten your arms, push off the floor, keeping the legs. Repeat 10 - 15 times.
- Ip - On his knees, straight arms in emphasis floor. Maximum arch your back up, go back to the initial position Repeat 10 - 15 times.
- Ip - Lying on his back. Push the bent knees to his chest. Repeat 10 - 15 times.
Recommendations for patients who underwent surgery to remove a herniated disc
The rehabilitation process takes 3 months to 1year after surgery, depending on its complexity. After 6 months, patients are advised to continue training on rehabilitation equipment under the supervision of a physician or physical therapy instructor for the purpose of preventing recurrence of herniation of intervertebral disk, which individually selected set of exercises to build muscular system and improve blood circulation in problem areas.
The recovery period is held under the supervision of a physician neurologist, who appoints a course of drug therapy, recommends consultation with other specialists for more effective treatment.
The recovery period is held under the supervision of a physician neurologist, who appoints a course of drug therapy, recommends consultation with other specialists for more effective treatment.
Early rehabilitation period (from 1 st to 3 months).
- Not to sit for 3-6 weeks after the surgery (depending upon the severity of the operation).
- Do not make any sudden movements, and deep in the spine, bending forward, sideways, twisting motion in the lumbar spine for 1-2 months after surgery.
- Do not get behind the wheel and go in transport in the sitting position for 2-3 months after surgery (you can ride as a passenger reclining seat spread out).
- Do not lift more than 3-5 kilos in 3 months.
- Within 3 months after the operation do not follow cycling, watching and playing sports (football, volleyball, basketball, tennis, etc.).
- Periodically unload the spine (rest in the supine position for 20-30 minutes during the day).
- Wearing a corset postoperative no more than 3 hours a day.
- It is advisable not to smoke and not to drink alcohol during the rehabilitation period. Intimate life is not contraindicated.
Once the patient is allowed to walk, it shouldconsult with your doctor regarding the appointment of gymnastics terms and complex physical therapy, which depend on the volume and nature of the surgery and post-operative complications. One month after an uncomplicated operation are shown training in the gym (not in the fitness!) Under the supervision of exercise therapy doctor, becomes without loads. Useful swimming on his stomach.
One month after surgery in uncomplicated cases, you can get to work (on the dates and specific work carried out in each case is solved individually with a physician).
Late rehabilitation period (3-6 months).
Do not lift more than 5-8 kg, especially without a warm-up and warm-up muscles of the back, jumping from a height, long journeys by car.
When going outside in bad weather: wind, rain, low temperature, it is advisable to put on the lumbar region to insulate the belt.
Wearing a corset, especially long-term, it is not recommended to prevent atrophy of the long back muscles.
This period can be carefully controlled by medical exercise therapy to begin formation of muscular system, doing exercises to strengthen the back muscles.
After 6 months, and at least 2 times per year it is recommended to undergo a course of massage, physiotherapy and gentle manipulation of the spine to all departments.
A healthy lifestyle, not smoking, regular exercise at the gym, swimming, sauna, weight lifting restriction significantly reduces the risk of hernias of intervertebral discs.
For the prevention of back pain should be avoided: stress, hypothermia, prolonged monotonous work in a forced posture, weight lifting, sudden movements in the cold, not warm up the muscles, the appearance of excess body weight.
Furthermore, at any stage of rehabilitation can be included in the complex rehabilitation and physical therapy acupuncture.