Osteochondrosis 1 degree
Intervertebral disks function as cartilaginous pads between adjacent vertebrae. Thanks to this, it is possible to straighten, lift and carry weights, perform complex movements in the various parts of the spine - from the neck to the waist and the sacrum. In order for disks to function all the time, regeneration processes( upgrades) must continuously take place in them. Due to various reasons( weak immunity, overweight, malnutrition, metabolic disorders), regeneration processes in the intervertebral discs are suspended - osteochondrosis of the 1st degree of the spine develops.
Degrees and stages of
What is the 1st degree of osteochondrosis? Like any pathology, osteochondrosis proceeds in several stages. In the absence of treatment, the disease progresses, and each subsequent stage is heavier than the previous one. However, in the case of terminology, mistakes are often made in this case - the stages are often confused with degrees. The degree implies the features of the clinical course of osteochondrosis, and under the stage - structural and morphological changes of the spine. For example, stage 1 is characterized by minimal changes in intervertebral discs, subjectively it can not be manifested at all, it is called preclinical.
But osteochondrosis of the first degree is already felt by the patient. This degree is the most initial, morphologically it corresponds to the compaction of the cartilaginous tissue of the vertebra. The spine is still stable, but the hook-shaped processes of the vertebral bodies are already increasing. Although the dislocation of the disc is minimal, but at this stage it is possible to break its external fibrous capsule. Clinical signs in this case are pain, sometimes sharp, like a lumbago, which occurs after sudden movements, physical exertion, prolonged stay in an uncomfortable position.
The clinical picture of degree 1 of osteochondrosis varies depending on its location. In this regard, osteochondrosis of the neck and lower back is noteworthy. It is these anatomical areas that are most significant in functional terms, and therefore, osteochondrosis here is much more common than in the thoracic department.
The first sign that shows the osteochondrosis of the cervical department of the 1st degree is the pain in the projection of the affected segment, cervicalgia. It can be observed after sharp turns of the head, hypothermia, a long fixed posture( "lying on the neck").In these cases the pain arises sharply, according to the type of lumbago or cervicago. The pain syndrome is accompanied by local reflex tension of the neck muscles. In the initial stage of cervical osteochondrosis, the vertebral artery syndrome has not yet developed to the fullest. However, in a number of cases, general cerebral symptoms are noted - patients complain of headache, dizziness, general weakness, sleep disturbance.
The clinical picture of osteochondrosis of 1 degree of lumbar division has similar features. Initially, pain( lumbalgia, lumbago) is noted in the projection of the affected segment. The most vulnerable in this regard is the disc located between 4-5 lumbar vertebrae. The main provoking factor of the pain syndrome is a physical load, in which the disk is displaced posteriorly and sideways, as a result of which the radicular syndrome develops. Pain can give in the side, in the groin or in the lower extremity. Because of this lumbar osteochondrosis is sometimes mistaken for kidney disease, abdominal organs, inflammation of the knee joint.
TreatmentMore article: How to do massage with lumbar osteochondrosis?
Treatment of the first degree of osteochondrosis is aimed at the removal of pain and inflammation, normalization of metabolic processes in the cartilaginous tissue, strengthening of the muscular framework. The purpose of these measures is to prevent the transition of osteochondrosis to the next, 2nd degree. In the surgical intervention at this stage, there is no need. Conservative therapy involves the use of:
- Physiotherapy procedures
- Wellness gymnastics.
The main group of medicines is non-steroidal anti-inflammatory drugs( NSAIDs).The medications of this group interrupt the course of inflammatory reactions, and thus eliminate pain. To achieve the desired results it is desirable to use combined NSAIDs by injection, ingestion and topical use. For this purpose Diclac gel, Orthofen, Indomethacin, Ibuprofen, Ketanov is shown. Very good pain is eliminated in lumbar osteochondrosis paravertebral blockades. However, anesthesia in this case does not affect the essence of the pathological process.
Normalization of the metabolism in the cartilage of intervertebral disks helps the intake of tablets chondroitin complex in combination with the treatment of problem zones with ointment chondroxide. Beneficial effects on cartilage tissue preparations containing Tocopherol acetate( Vit E).And relax relaxed muscles will help muscle relaxants - Orfenadrin, Chloroskoson.
Complex treatment necessarily includes physiotherapeutic( muscle electrical stimulation, phonophoresis, UHF) and massage procedures. With their help, the muscular corset is strengthened, the spine stabilizes. And they complement the effect of exercise physical therapy, during which there are moderate stresses on the muscles of the back, waist and neck. In conclusion, it should be noted that, in spite of the assurances of some "healers", even the first stage of osteochondrosis is irreversible. However, to prevent the development of subsequent degrees and stages with persistent complications is quite feasible provided timely and regular therapy.
Osteochondrosis of cervical department of 1st degree
People very often complain of pains in the neck and shoulders. A common cause of this is osteochondrosis of the cervical department of the 1st degree. At the same time, people characterize their health as "tolerant".But even in this case, an examination of the doctor is required, which will decide which treatment to appoint in each particular case. And it is better not to take independent measures.
itself is to blame Cervical osteochondrosis of the first degree makes itself felt by acute pain( lumbago), which is usually called a lumbago. Most often, problems begin to bother the neck( also the lower back).The explanation is simple: intervertebral discs are damaged primarily in a place where the mobile part of the spine( neck) is connected to a department that is less mobile( thoracic).If you do not take measures, it will reach up to 4 degrees of osteochondrosis, and therefore to a significant aggravation of health, even disability. To get rid of the main cause of the disease, you need to move more.
The person sits a lot, and the muscles adjacent to the spine do not train at all. As a result, the blood circulation of the vertebral cartilages and bone tissues is disturbed. But blood flow carries nutrients through the body. Not getting them in the right amount, cervical vertebrae begin to age. In natural conditions, this occurs to 50 years and without painful disorders. If there is an osteochondrosis of the cervical department of the 1st degree, bad changes in the spine( they are called degenerative in medicine) can begin in 20 years. Therefore, having felt the first signs of the disease, you should consult a doctor to get effective recommendations.
The cervical spine has 7 vertebrae. The first two - the atlas and the epistrophe - support the skull directly. Thanks to this, we can turn our heads in different directions, tilt it, look under our feet, or lift, looking up at the sky. Between each other the vertebrae are joined by the mobile ligaments and joints. Between them are laid discs - elastic pads of cartilaginous tissue.
The whole whole column of the spine can also be adjacent to a muscle - the so-called muscle corset. If each of these parts is in order, then the healthy spine will have three qualities: flexibility, strength and elasticity. It is necessary to lose at least one of them, and the ailment will begin to develop.
Where it hurts and why
The first degree of cervical osteochondrosis has symptoms, according to which it can be said with certainty that the disease began its destructive activity:
- Shoulder periarthritis syndrome means pain in the shoulder joints, shoulders and neck. They can become sedentary. Pinching the nerve roots leads to spasm of blood vessels and arteries. This leads to an inferior blood supply to the shoulder joint, its ligaments, tendons and muscles. So there is a source of inflammation( periarthritis).
- Radicular syndrome occurs due to squeezing the roots of the spinal nerves. This painful condition is called radiculitis. Turning the head causes burning pain. In an effort to avoid it, the patient is unnaturally holding his head.
- Cardiac syndrome is when a person becomes frightened that they have a heart attack. Surveys do not confirm this. And painful sensations cause irritations of the nerve roots.
- The syndrome of the vertebral artery causes headaches and dizziness, nausea, vomiting, burning pain in the back of the neck and neck. Vision may worsen, and sometimes it's as if the "fly" flies before their eyes, or they suddenly become covered with a "veil".The condition is aggravated by general weakness.
Even if one of these symptoms makes itself felt, it is an occasion to consult a specialist and begin treatment.
Prevention is cheaper
To cervical osteochondrosis 1 degree did not arise at a young age and delayed its manifestations in the elderly, you need to engage in prevention. Because even minor problems with the spine will necessarily affect negatively on other organs and systems. And first of all you need to take care that the spine is working. Namely: twisted, bent, bent, unbent.
Lumbar osteochondrosis: preventive measures and treatment
- Preventive measures and measures
Osteochondrosis of the lumbar region is diagnosed in patients more often than other types of this disease, since it is this part of the body that accounts for the main load. Dystrophic changes in the area of intervertebral discs in the lumbar region begin to develop due to weight lifting or from excessive physical exertion.
First of all, such signs of lumbar osteochondrosis as stiffness and motor limitations begin to appear. With the timely treatment of the disease, especially at the beginning of its development, complications can be prevented and the disease eradicated painlessly and quickly.
Manifestation of the first degree of lumbar osteochondrosis
There is osteochondrosis of 1 degree of lumbar part in the form of a small compaction of the area of intervertebral discs of the lumbar region. Symptoms of the initial stage of the disease are exclusively orthopedic and are expressed by the following manifestations:
- Faint pain at the moment of tilting or turning;
- Acute short-term attacks in the performance of sudden movements;
- The appearance of stiffness, which is accompanied by a distinct crunch;
- The appearance of discomfort at the bottom of the back with prolonged sitting.
Pain in osteochondrosis of the lumbar part of the initial stage is not expressed clearly and is eliminated when performing therapeutic physical exercises and massage. In the case of a more severe pain syndrome, it is recommended to use external agents or non-prescription analgesics of light exposure.
Second degree of lumbar zone osteochondrosis
If after starting the symptoms of the initial stage of lumbar osteochondrosis does not start treatment, then it is possible to go to the second and more serious stage of the pathology. Treatment of osteochondrosis of the 2nd degree of the lumbar region is possible only with the help of medication.
This degree of severity arises due to instability of the spine, the consequence of which is a decrease in the height of intervertebral discs. It is because of this and there are strong and sharp pains, which are accompanied by numbness of the groin and limbs.
In order to cure this stage of the disease, you should eliminate the causes of osteochondrosis of the lumbar region, and then take a course of physical therapy and massage, and it is recommended to take the following drugs:
- Anesthetics - reduce inflammation and prevent the appearance of pathological reflexes;
- Vasoactive and non-steroidal preparations - reduce inflammation in affected areas;
- Pyrazolone and antihistamines - prevent further progression of osteochondrosis;
- Calcium preparations - compact the bone tissue.
Osteochondrosis of the lumbar part of the symptoms, which are expressed by moderate severity, is treated with alternative therapy, which implies exposure to the affected part of the body with magnetic or electric current, and also with acupuncture. The choice of a specific technique is influenced by the individual characteristics of each patient.
Third degree of lumbar osteochondrosis
An osteochondrosis of 3 degree of lumbar spine is characterized by a condition that is the threshold of a hernia. Therapeutic exercise and massage in this case is unlikely to be effective. Symptoms of osteochondrosis of the lumbar region of this stage consist in constant pain in the lumbar region, which are accompanied by limited movements. With the passage of time, this pathology contributes to the development of diseases of internal organs.
Intervertebral osteochondrosis of the lumbar region is followed by the following manifestations:
- Frequent and pronounced urge to urinate;
- disorders of the functioning of the gastrointestinal tract;
- Severe relief of symptoms by local means.
To begin with, patients with this stage of osteochondrosis are recommended to undergo a course of prednisolone medications, and in the absence of positive dynamics, surgical intervention is indicated.
The choice of therapeutic methods for different stages of osteochondrosis depends on the characteristics of the organism of each person. The most important moment for effective treatment is the timeliness of its onset, since this disease develops very quickly.
Degrees of osteochondrosis.
With such a disease as osteochondrosis, at least every second inhabitant of our country meets. And this disease every year only gets younger. Therefore, the issue of detailed information of the population about all its features is most acute. Let's consider what are the degrees of osteochondrosis, in time to recognize this insidious disease. And also we learn what methods of treatment are used based on the degree of severity of this ailment.
The first degree of osteochondrosis. Features of treatment.
At the first degree of severity of osteochondrosis, the intervertebral disc is slightly compacted. There is also an increase in hook-shaped processes with the presence of small exostoses. In this case, the lumbar lordosis itself is straightened.
How can you treat osteochondrosis at the first degree of severity? First of all, anesthetics are used to avoid pathological reflexes. Then spend anti-edematous therapy. In this case, the spine itself is stretched along the axis, which removes the load from the discs. Further, the patient takes non-steroidal, antihistamines and vasoactive drugs.
Second degree of osteochondrosis. Features of treatment.
This degree of osteochondrosis entails instability of the spine itself. In this case, there is a narrowing of the vertebral canal and the holes between the vertebrae. All this leads to a decrease in the height of the discs themselves.
How can you treat osteochondrosis with a second degree of severity? In such cases manual therapy is used. The patient takes antihistamine, pyrazolone preparations and calcium. Also passes sclerosing physiotherapy, stretching with fixation of the vertebrae and massage. The third degree of osteochondrosis. Features of treatment.
This degree of severity of this disease is considered the most difficult. All because there are already much more serious changes, such as a strong narrowing of the vertebral canal and intervertebral foramen. And all this leads to the formation of such a dangerous defect as a hernia. At this degree, surgical intervention is most often used.
How can you treat osteochondrosis with a third degree of severity? Depending on the state of compression, the root can apply the same treatment methods as in the second degree of expression. But, if the pain does not pass more than 15 days, as well as there is a development of symptoms of prolapse, then resort to surgical intervention.
Fourth degree of osteochondrosis. Features of treatment.
This degree, as such, can not be isolated separately, since it is already a consequence of third-degree treatment. It is called regenerative. At the fourth degree, only spondylolisthesis remains, which, as a compensatory reaction, rapidly increases. As a result, the osteophytes of the vertebrae coalesce. With the fourth degree of severity of osteochondrosis, conservative treatment is used.
We told you about the features of each of the 4 degrees of severity of osteochondrosis. They told about the methods of treatment. But, remember that on your own you will not be able to determine this or that degree of osteochondrosis, since it is determined exclusively by X-ray examination. Therefore, with the first discomfort in the spine, immediately contact a medical institution.
Degrees and stages of osteochondrosis and its development
In the figure you can see the degrees of osteochondrosis passing into the mesodermal hernia
Osteochondrosis is one of the most common and frequently occurring diseases of the spine. It is unlikely that someone who does not face this disease will be able to meet, but few know that osteochondrosis is not just an ailment, it is rather a complex of diseases that occurs when the spine is not subjected to various loads.
The first place in terms of the prevalence of diseases of the spine is undoubtedly due to osteochondrosis. It is hardly possible to find a person who is not aware of this terrible disease, but very few people know that osteochondrosis is not a disease, but, most likely, a condition that includes a voluminous complex of diseases that arise as a result of attempts made by the spine to adapt tounfavorable conditions.
Osteochondrosis is a degenerative-dystrophic lesion of the intervertebral discs that occurs as a result of a decrease in the amount of fluid in the intervertebral discs.
In the vertebral, thoracic and cervical spine, intervertebral disks are arranged between the bodies of adjacent vertebrae, consisting of a special cartilage and water representing a gelatinous nucleus, as well as a fibrous ring, which is essentially a denser cartilage. The main purpose of the intervertebral disc is to perform depreciation.
With a decrease in the amount of liquid in the core, the depreciation becomes difficult or impossible, as a result of which the actual osteochondrosis itself appears. Describing the stages of development of osteochondrosis, as a rule, use the classification proposed in 1971 by the neurosurgeon A.I.Autumn.
When the amount of moisture decreases, the intervertebral disc loses its elastic and elastic properties, while the load on it remains at the same level. As a result of this influence, the disc height decreases due to its flattening, protrusions begin to appear.
If the pathology continues to develop in the fibrous ring, cracks appear, and since the height of the flattened disc is already reduced, this leads to instability of the entire segment.
A gap is formed in the cartilaginous tissues of the fibrous ring, through which a part of the more liquid nucleus seeps - a hernia of the intervertebral disc is formed. Such changes are most often found in the lumbar and cervical spine.
To a lesser extent the appearance of the intervertebral hernia is susceptible to the thoracic area due to the fact that as a result of the pathology of the discs, a certain portion of the load is taken up by the ribs and sternum.
As a result of the protrusion( hernia) of the intervertebral disc, the roots of the spinal nerves are affected, manifested as pain, inflammation, conduction disorders of nerve fibers, as well as inflammation.
As a result of the fact that the damaged intervertebral discs do not provide adequate resistance, the bodies of adjacent vertebrae converge. There is a spondyloarthrosis - violations of the intervertebral joints, as a result, the vertebrae can be twisted or moved relative to each other( spondylolisthesis).
At this phase the compensatory forces of the body come into play - to remove the load from the deforming disc, the vertebra is flattened, its area enlarged due to the growth in width. Also, there is often a partial replacement of the destroyed tissue of the fibrous bone ring. Sometimes at this stage, the pain decreases, but this is not for long, since the sprouting vertebrae lead to an even greater narrowing of the spinal holes and nerve transmission.
The classification used in medicine is based not on the stages, but on the degrees of development of osteochondrosis. The disease is most fully described only with the appearance of pain, when it is possible to accurately diagnose the disease.
Comes with a rupture of the intervertebral disc, which occurs as a result of critical loads or sudden movements. There is a sudden pain on the background of the muscular reflex tension, and in the spine there is a feeling similar to the passage of an electric charge.
The second degree is caused by symptoms of instability of the spine and intervertebral protrusion. There is a constant pain, which increases with increasing loads and sudden movements.
In the cervical region, pain is observed in the case of a long stay in one position, pain in the hands, shoulders, sometimes numb fingers, a headache appears. For the disease of the sacral department of this degree, permanent pain in the lower back, gluteal region, regular fatigue of the hands, periodic pain of the sacrum are inherent.
It manifests itself in the form of hernia symptoms of herniated disc intervertebral space( marked by pain syndrome in the direction of the affected nerve, numbness of legs and hands, headaches, changes in gait and posture) or distant symptoms of intervertebral hernia( cervical region - buzzing in the ears,dizziness, decreased muscle strength of the hands, hearing and vision, thoracic region - difficulty breathing, cardiac arrhythmia, lumbar - changes in the genital area, diseases of the gastrointestinal tract, kidneys, weakness in butah, or numbness).
The beginning of the fourth degree of osteochondrosis is the condition when the hernia disappears, the symptoms of the disease decrease, but there is instability of the spine in the form of twisting and slipping of the vertebrae, as well as the residual phenomena of fixing the vertebrae relative to each other.
This adds the effects of spina bifida, as a result of which the spinal nerves can be transmitted, leading to atrophy or overlapping of the spinal canal( secondary channel spinoza) and compression of the spinal cord( spinal cord ischemia).
Also, the fourth degree of osteochondrosis includes the consequences resulting from the operation, in the case when the hernia was removed - paresis, inflammation, disturbance of innervation.
Spinal column diseases are not diagnosed at an early stage of development. Why is this happening? Potential patients of the orthopedic department believe that minor ailments in the back are not a reason for visiting the hospital. And even if the diagnosis of "osteochondrosis 1 degree" is already set, they, as a rule, are slow to follow the doctor's recommendations. And this is not the correct point of view, because this disease is serious enough and can quickly progress.
Why do we care about osteochondrosis?
Osteochondrosis of the neck, and then of the lumbar region, is diagnosed most often when treated. This is due to the fact that these parts of the spine are the most mobile, therefore, the most susceptible to deformation. Chondrosis can also be detected in the thoracic department, but it is very rare. The vertebral column in this place is quite strongly protected by the muscular tissue, in addition it is immobile.
The first stage of the disease is characterized by the onset of changes in the outer walls of the intervertebral disc. It is manifested by their gradual destruction, the inner core of the cartilage is compacted, but the intervertebral hernia is not yet formed. In addition, the compensatory processes of the organism itself are included: the pathological growth of the hook-shaped processes of the cervical vertebrae and the tension of nearby muscle tissues are noted. All this can lead to a narrowing of the cervical artery and the addition of symptoms of oxygen starvation of the brain.
Symptomatology of pathological process
Osteochondrosis of cervical department
Osteochondrosis of the cervical department of the 1st degree may manifest with the following symptoms:
- Significant soreness of the entire shoulder girdle and neck. Strain of muscle tissue and constriction of blood vessels can lead to a lack of nutrition, as muscles, and bone, as well as cartilage tissues. A consequence of this may be the occurrence of an inflammatory process, which is called periarthritis.
- Manifestation of a complex of symptoms of sciatica. They are caused by pressure on the nerve roots. The patient complains of the pain that appears when the head turns. During the visual inspection, the doctor records that the patient is in a permanent forced position.
- Pathological effects on the nerve endings of can trigger a false pain symptom in the chest similar to a heart attack, which is not determined on the cardiogram.
- As already mentioned above, compresses the vertebral artery of , and as a result, symptoms of oxygen starvation of the brain appear: dizziness, loss of consciousness, headaches. In severe process it is possible that the circulation of the brain is impaired.
The main directions of therapy in the initial stages of osteochondrosis
LFK with osteochondrosis
The sooner you go to the doctor and start treatment, the better the prognosis of the course of the disease. At the first stage of osteochondrosis disorders of any localization, a set of therapeutic measures has been developed, which has the following directions: medication and non-pharmacological assistance.
In the acute period, medical care begins with the treatment of medications. Most often this occurs on the basis of a stationary department, since the administration of certain medications( eg, muscle relaxants) requires constant medical control. Therapy is aimed at removing pain symptoms and stopping the inflammatory process. To eliminate pain, any analgesics are used. In the event that it can not be stopped, it is recommended to conduct a Novocain blockade. As anti-inflammatory agents are prescribed non-steroid drugs. The expediency of their application is based on good anti-inflammatory and analgesic effects. In the event that the clinical picture is supplemented with muscle spasms, it is permissible to prescribe several injections of muscle relaxants. Locally, anti-inflammatory and anesthetic ointments and gels are prescribed.
After acute pain and inflammation is removed, go to non-drug therapy. Osteochondrosis of the 1st degree of the cervical department assumes the appointment of a course of therapeutic physical training, which is carried out in the department of exercise therapy or on the basis of a polyclinic. The complex of exercises is developed by a doctor who specializes in this area of medical care and is conducted under his supervision. The course of massage, both classical and manual, has also proved its worth. In this case, self-treatment is also unacceptable. Procedures should be carried out by a specialist with a medical background. You can also prescribe a course physiotherapy treatment. Most often it is combined with local action drugs.
The onset of the disease is directly related to a decrease in muscle tone and a violation of the correct posture, which causes an increase in the load on the spine.
Features of osteochondrosis 1 degree
The initial degree of the disease is characterized by the tightening of the cartilaginous tissue of the intervertebral discs, there are small changes in their structure. At this stage, the vertebral body slightly changes, the hook-shaped processes increase. In the pathological process, the nerve fibers surrounding the vertebra are also involved.
As a result of considerable physical exertion, hypothermia, prolonged stay in the forced position, with sudden movements, the patient is able to experience painful sensations. They can be either pulling, or sharp, sudden;they are accompanied by a reflex tension in the muscles of the neck or waist - the localization and character of the pain depends on the type of osteochondrosis.
Features of osteochondrosis in the initial degree
Pain in the beginning of cervical osteochondrosis is given to the neck, shoulder, shoulder blade, can cause numbness of the fingers, unpleasant tingling sensations associated with a violation of the normal conductivity of nerve fibers. Pain in the neck can be accompanied by dizziness, agonizing headaches, muscle weakness and insomnia.
For osteochondrosis of the lumbar region of the first degree, a pain syndrome that occurs after a significant physical load is characteristic. In this case, the intervertebral disc squeezes the nerve endings, which causes pain. It can localize in the leg, cause the appearance of seizures. Often the first manifestations of osteochondrosis are mistaken for diseases of internal organs, or knee joints.
The cause of osteochondrosis of the thoracic spine is often a scoliosis( curvature of the spine).The disease is accompanied by aching pain in the region of the heart, between the scapula;possibly tingling sensation, crawling crawling on the back. A sharp pain that occurs with unsuccessful movements or after physical exertion, also often turns out to be an osteochondrosis.
Osteochondrosis of the first degree: treatment of
If you start to treat the disease at this stage, you can normalize metabolic processes in the cartilaginous and bone tissues. It is necessary to try to strengthen the muscles of the back and avoid further progression of the disease. The therapy must necessarily be comprehensive, including:
- pharmacological preparations that can remove inflammation and pain, improve the restoration of cartilaginous tissue and normalize the function of the affected nerve fibers. For this purpose, NSAID preparations, complexes of B vitamins and preparations that remove vascular and muscle spasms and improve the blood supply of affected tissues and organs are prescribed.
- therapeutic massage and health improving gymnastics. The goal of the exercises is to strengthen the muscular corset to relieve the load from the spine. To do this, you should regularly do special exercises to provide a moderate load to the muscles of the back and neck. Excellent results give swimming, running.
- physiotherapy procedures. Good results are obtained by UHF, electrostimulation of muscle groups, phonophoresis;
- non-traditional methods of recovery, including manual, reflexotherapy, folk methods.
The earlier the treatment of osteochondrosis is started, the more impressive results will be achieved, restore health and avoid unnecessary complications. Given that the symptoms of osteochondrosis are similar to manifestations of many diseases, it is necessary to conduct a thorough examination. Self-medication can damage a patient, because taking pain medications can lubricate the picture of the disease. In such cases, it is impossible to exclude the possibility that the doctor will not be able to deliver the correct diagnosis and the necessary time will be missed.
Osteochondrosis of the lumbosacral spine: treatment and symptoms
Symptoms of lumbar osteochondrosis
Osteochondrosis of the lumbar spine is characterized by a wide variety of clinical manifestations. The symptomatology of the disease depends on the stage of the pathological process and the degree of degenerative changes in the affected vertebral column. The disease develops gradually, beginning with minor changes in the cartilaginous tissue of the intervertebral discs, and at the initial stages is not manifested.
As the degenerative processes progress, the pathological changes in the discs become more pronounced, and over time, the patient begins to appear some signs of osteochondrosis. Depending on the severity of the lesion of the cartilaginous tissue of the spine, three degrees of the process can be distinguished.
Osteochondrosis 1 degree
In the initial stages of lumbar osteochondrosis, small seals of the intervertebral discs are observed, which does not disturb the patient in any way or is manifested only by orthopedic symptoms: a feeling of stiffness in the lower back, unpleasant sensations in the form of weak pulling pains with tilts and bends of the trunk. Acute pain in the loin associated with osteochondrosis in this stage does not happen. A typical sign of the initial manifestations of lumbar osteochondrosis is the appearance of rapid fatigue with a static load, it becomes difficult to sit for a long time in one position. After a prolonged sitting, there may be a crunch in the lower back while moving in the lumbar spine.
Osteochondrosis 2 degrees
Further progression of the pathological process leads to more pronounced changes in the disc, which causes its protrusion beyond the vertebral bodies - protrusion occurs. At first it arises only with the vertical position of the body, but with time it assumes a constant character. At this stage, osteochondrosis is manifested by vertebral syndromes.
Lumbago is often the first manifestation of lumbar osteochondrosis. The pain arises suddenly, usually with an awkward movement: a deep tilt forward, an attempt to abruptly rise from a sitting position, lifting the gravity in front of him. Pain in lumbago is usually compared with a shock of current. When a patient is shot, the patient freezes in a pose in which there is no sharp pain and is afraid to move. In this case, a constant, pronounced muscle tension is observed. They protrude, in the form of ridges, located on both sides of the spinous processes. Muscular hypertonus is a protective reflex that facilitates the physiological immobilization of the lumbar spine.
Another manifestation of vertebral syndrome may be lumbolgia - chronic pain in the lower back. Unlike lumbago, there is no clear connection with the movements and the appearance of pain. Painful sensations of aching slightly increase with quiet movements. Patients can perform not hard work, but it is usually difficult for them to bend and even more difficult to unbend. The pain is aggravated after prolonged sitting or standing, because of this, patients try to change the position of the body more often. Adopting a horizontal position leads to a reduction in pain, since the load on the intervertebral discs is significantly reduced. Pain can last for months, periodically receding and intensifying when there is another exacerbation of the disease.
Osteochondrosis of 3 degree
With far-reaching destructive changes, the formation of herniated intervertebral discs occurs. As a result, a pronounced compression of the spinal structures develops and a number of other manifestations of the disease are added to the vertebral syndrome in the clinical picture.
Radicular syndrome, most often, develops against a background of long-lasting vertebral manifestations. In most cases, there is a sudden sudden pain localized in the lumbar region on the one hand with irradiation to the buttock, the hip joint, gradually spreading to the entire leg. Aggravation is usually associated with awkward movement, prolonged forced position or lifting of weights. Painful sensations in the root syndrome increase with movement, increased intra-abdominal pressure( coughing, sneezing, straining).After a while there are disorders of sensitivity in the lower limb, such as hyperesthesia, hypesthesia, paresthesia, in severe cases - anesthesia. The muscle tone decreases, weakness develops, there is a hypotrophy of the leg muscular tissue.
Compression myelopathy( compression of the spinal cord) at the level of the lumbar region is manifested by motor disorders in the lower extremities, there is a significant decrease in the volume of the thigh, shin, decrease and even no reflexes. There may be a malfunction of the pelvic organs: incontinence or retention of urine, feces, a violation of sensitivity in the perineum. This symptomatology is extremely unfavorable in terms of prognosis and requires immediate treatment. The spinal cord disturbance syndrome is manifested by intermittent claudication, a feeling of weakness in the legs, pain, painful paresthesias during walking, extending to the lower parts of the trunk and into the perineum. The patient can be persecuted by constant urge to urinate, later there are violations of the function of the pelvic organs. There is a tendency to develop bedsores.
Neurotic disorders develop in the long course of the disease, when severe pain and various motor and sensory disorders are severe. In patients, irritability increases, there may be manifestations of aggression towards the surrounding people, the mood changes rapidly, sleep is often disturbed, and disability declines. As a rule, very hypochondriacal people with a labile psyche are susceptible to neurologization.
How to treat lumbosacral osteochondrosis?
In the case of 1 and 2 degrees of osteochondrosis, treatment is usually carried out at home using conservative methods. In most patients, properly prescribed therapy allows you to stop the symptoms of the disease for several weeks, after which a remission occurs, the duration of which depends on the patient's lifestyle, the severity of osteochondrosis, and the use of therapeutic and prophylactic measures. Constantly conducted prophylaxis allows to achieve remission for many years.
Surgical treatment of osteochondrosis of the lumbar spine is used when an intervertebral hernia occurs. It is indicated by 15-20% of patients and is used in the development of serious neurological complications or inefficiency of conservative methods for several months.
When the disease worsens, the emphasis is on medication, the main purpose of which is to fight with pain. For this, the following medicines are used:
- Drugs that have an anti-inflammatory effect, are prescribed by mouth or intramuscular injections. In most cases, drugs are used that belong to the group of non-steroidal anti-inflammatory drugs: diclofenac, indomethacin, ketarol, ibuprofen, nemisil, moovales, etc. In parallel with the general application of NSAIDs, these drugs are also prescribed for topical use, in the form of medicinal forms such as ointment orgel. In the absence of the effect of nonsteroidal agents, local anesthetics are used in combination with hormones in the form of epidural and paravertebral blockades.
- Muscle relaxants give a good effect in combination with diuretics and vasoactive substances. The use of these drugs allows you to remove muscle spasm and reduce tissue swelling, improve blood circulation in the area of compression.
- Sedatives, daytime tranquilizers, antidepressants are used to treat and prevent the development of neuroticism.
- Group B( B1 and B12) vitamins improve nerve tissue nutrition, promote its rapid recovery after compression effects.
After the acute period of the disease treatment should not stop. To fix the positive effect of drug therapy, during the period of remission the following medical measures are applied:
- Massage massage is considered one of the most effective therapeutic and prophylactic measures in combination with other therapeutic methods. It allows you to significantly reduce the rigidity of the lumbar muscles, improve blood circulation, lymph circulation directly in the tissues adjacent to the lumbar spine. In the case of hypotrophy associated with radicular syndrome, lower limb massage contributes to the improvement of trophism and the innervation of hypotrophic muscles.
- Physiotherapy is prescribed in conjunction with a massage after relief, in the absence of pain syndrome. Classes are held daily, therapeutic gymnastics begins with minimal, gradually increasing loads, since otherwise one can provoke another exacerbation. The complex of exercises must be started, avoiding sudden movements and refraining from doing high-amplitude exercises. Exercises for the waist are shown to patients who used the corset for a long time. Systematic exercises of exercise therapy will significantly strengthen the muscles of the waist, thereby reducing the undesirable load on the intervertebral discs.
- Strict compliance with the sparing regimen is an integral part of the successful treatment of osteochondrosis, as well as the prevention of its exacerbations. For the back, especially the lumbar region, it is extremely important to fulfill the following conditions: to sleep on a bed equipped with an orthopedic mattress and a special cushion of medium stiffness of small sizes;under the neck you need to put a special roller.
- Avoid prolonged stay in uncomfortable position. After a long sitting, you need to get up slowly, without sharp jerks. After that, the elementary charge and a small self-massage should be performed, which will allow to eliminate stagnant phenomena in the lower back.