A therapist with 50 years of experience once remarked, "When I started working, there was not a single young patient with osteonecrosis at this site. And today, almost every second of these patients. 30 year olds all have this problem. "
Osteochondrosis - a disease caused by the deposition of salts in the spine
Wrong. The intervertebral disc consists of the medullary nucleus, the fibrous nucleus, and the hyaline cartilage that covers it from top to bottom.
With the destruction of these elements, the balance between the load on the spine and its ability to carry it is disturbed. As a result, the vertebrae begin to compress neighboring nerve and muscle tissues, growing along the edges, forming the so-called. bone-forming substance, producing a characteristic crunching sound during movement (misinterpreted by the patient as "salt deposition").
If the back and neck are painful, then this is just osteonecrosis.
Osteochondrosis is not the only cause of back pain. This diagnosis is usually made by the patient himself. However, in addition to this pathology, which belongs to the group of spinal degeneration-dystrophy, there are also osteoarthritis and osteoporosis, which can only be distinguished by general examination.
- Degenerative-dystrophic changes occur in 30-50% of cases in people 30-40 years old, in 75-100% of people over 40 years old.
- These pathological processes account for 20. 4% of the total disability due to diseases of the musculoskeletal system.
- Long walking is bad for the spine
Opposite. Motor activity has a beneficial effect on the functioning of the spine: maintaining muscle tone, preserving disc mobility, stimulating blood circulation and metabolism. In the course of the disease, hypoxia and prolonged lying in a position, especially uncomfortable, are "sin".
Another thing is that if an overweight person walks a lot, carrying heavy objects, the spine has to bear an increased load.
Flat feet contribute to the development of osteonecrosis
Right. The arches of the feet, as well as the physiological curves of the spine, are designed to absorb the impact loads of walking, running, and jumping. If the foot is not adequately protected when interacting with the support, then the spine receives an additional load, which significantly impairs the nutrition and functioning of its structures, and accelerates the growth of the spine. development of the disease.
Back pain is the only symptom of the disease.
Not sure that way. As a rule, patients complain of constant pain in the back, often accompanied by numbness in the limbs. Over time, if not treated, the muscles of the limbs gradually atrophy, the joints become less mobile, and muscle spasms appear.
Such an acute condition occurs due to spasm of the arteries as a response to the effects of bone growth, as well as from herniated discs, intervertebral fibrosis, as a reflex response to stimuli. of spinal cord receptors.
- If a person has coronary or cardiovascular disease, vertebral artery syndrome will be worse.
- With osteonecrosis of the thoracic region, a feeling of tightness in the chest (as if a stake is stuck there) - in the area of \u200b\u200b the heart and other internal organs; with systemic lesions - in the lower back (irradiation to the sacrum, lower extremities, sometimes to the pelvic organs).
- If complications of osteonecrosis develop (herniated disc, bone growth, spondylolisthesis, spondylolisthesis), then nerve root damage is noted - pain becomes radiating, intensityThe sensitivity is aggravated, there is weakness in the internal muscles, and the degree of reflexes is reduced.
- Osteochondrosis can cause dysfunction of various organs and tissues.
With osteonecrosis, the risk of circulatory disturbances in the cerebellar, trunk, and occipital regions of the brain is increased.
Headaches that are persistent - first at the back of the head, then radiating to the temples and temples, aggravated by neck movements (more often in the morning).
Elderly people who turn their heads sharply may lose consciousness. This is preceded by dizziness, ringing in the ears, blurred vision and hearing, nausea, and vomiting.
Sometimes there is pain in the heart area - persistent, throbbing, bored. With degenerative bone disease of the cervical spine, especially in the elderly and elderly, the soft tissues often change - they become more dense.
Degenerative processes in the spine can cause gastrointestinal obstruction, disruption of the bronchopulmonary system, which is subject to inflammation and other diseases.
Vascular dystonia, intercostal neuralgia - consequences of osteonecrosis disease
Not sure that way. Osteochondrosis may be one of the reasons (so far not the only) for the development of these diseases.
As the intervertebral discs are "erased" and osteocytes grow, the intervertebral discs and tubes of the vertebral artery narrow and deform, and this leads to encroachment of various structures.
In particular, when the nerve root is compressed, there will be signs of intercostal neuralgia, and when the vertebral artery is compressed, the same symptoms will appear as for dystonia -plant circuit.
Osteonecrosis cannot be cured
Indeed, the structures of the spine that have undergone degenerative changes cannot be completely restored. However, adequate complex treatment can eliminate the symptoms of the disease, stop the development of pathology and avoid complications.
In case of problems with the discs, it is useful to warm the sore spots
Wrong. Temperature fluctuations, especially extreme heat (for example, a person just starting to take a bath), can cause severe exacerbations. Moderate heat procedures are used in complex treatment but must be prescribed by a doctor.
If you perform head rotation movements with cervical osteonecrosis, your health will deteriorate.
Right. These exercises are best done for prevention - they help maintain range of motion of the disc joints. With severe osteonecrosis, careless circular movements can aggravate vertebral artery syndrome, myopathy, etc. v.
Non-steroidal anti-inflammatory drugs are essential for treatment
Not really. In the period of remission or when the pain is not strong, conservative treatment is performed (physical, reflex and manual therapy); physical therapy, traction techniques are used. Drug therapy is indicated during exacerbations and is intended to relieve pain, reduce inflammation and accelerate metabolism (intramuscularly or intravenously).
Among the most effective agents are nonsteroidal anti-inflammatory drugs (NSAIDs), which are prescribed to reduce inflammation and pain; with severe pain, novocaine blocking drugs are used; steroid drugs (epidural, intramuscular); NSAIDs in the form of ointments, gels and creams that relieve pain and irritation; muscle relaxants - to relieve muscle spasms; Vitamin B - to improve metabolism in the spine (B1, B6, B12).
Bone tumors can lead to serious consequences
Right. Due to compression of the spinal cord or nerve roots, osteonecrosis can cause paralysis and, if the vertebral artery is compromised, loss of consciousness.
Exercises to "stretching" the spine help improve the condition
Traction, or traction, allows you to increase disc space, relieve pain, and restore the anatomically correct shape of your spine. However, the individual load must be calculated correctly. "Abdominal" can lead to reflex muscle contraction of the vertebrae and aggravate the condition.
Only a traumatologist-orthopedist is authorized to treat osteonecrosis
Wrong. Most patients are examined by a neurologist, with a significant degree of pathology - a neurosurgeon or a vertebral surgeon.
Local therapists may also prescribe drug treatment to relieve exacerbations.
Spinal osteonecrosis: causes and treatment
Up to 76% of people suffer from back pain every year. This statistic affects people of all ages and professions. The causes of pain can be different, one of which is osteonecrosis of the spine.
Due to a sedentary lifestyle, osteoporosis in the spine is increasingly common and you can't always beat it on your own. Let's talk about why it happens and how to deal with it.
What is spinal cord tumor?
There are some differing views on the definition. Some experts think it's better to use the generic name - back pain, or nonspecific back pain.
The difficulty in definition is also related to the fact that many specialists work with the disease - neurologists, orthopedists, neurosurgeons and general practitioners.
Sometimes a person diagnosed with osteonecrosis of the spine has to go to a cardiologist, because the symptoms of the disease are very similar to a heart attack.
The term "osteonecrosis of the spine" was proposed by Hildebrandt in 1933 as a multifactorial degenerative disease of the spinal motor segment (as defined by Popelyansky). What is the motion segment of the spine? These are two vertebrae located on top of one vertebra and between them is a disc.
Thanks to this articulation, the human spine can bend and not bend, bend and twist. But due to many different reasons, the discs gradually lose their properties, undergo a degenerative process, and then gradually change affecting the vertebrae themselves.
That is, the essence of the process of bone destruction in the spine is the gradual destruction of the discs.
Osteoma can develop in any part of the spine.
Due to the heavy load, lumbar spondylosis is the most common. The symptoms are:
- lower back pain, which may be sharp or dull, constant, which may increase with movement;
- there may be pain in the legs, pelvic organs, to the sacrum;
- in severe cases, there may be a violation of sensitivity or mobility, muscle atrophy of the lower extremities.
The second most common is cervical osteonecrosis, which is often associated with prolonged uncomfortable head posture, for example, when working with a computer or with documents. Cervical spondylolisthesis is manifested by the following symptoms:
- headache and dizziness, migraine;
- visual or hearing disturbances, flashing "flies" in front of the eyes;
- pain may radiate to the back of the head, shoulders, collarbone;
- may violate the sensitivity in the hand.
Less often, osteonecrosis affects the thoracic spine, as the vertebrae are inactivatedly connected. A lesion in this area can masquerade as heart or lung disease. Symptoms of osteonecrosis of the thoracic spine:
- Pain in the back at the level of the shoulder blades, at the chest, which may increase when bending, turning, when inhaling or exhaling;
- skin sensitivity disorders.
Regardless of the extent of the injury, the pain of spondylolisthesis can be increased by the pressure on the vertebrae involved in the process.
With the failure of several departments, we can immediately talk about widespread osteonecrosis of the spine.
Risk factors and causes of the disease
The spine is highly resilient, and the development of the disease requires the action of several provoking factors at once. It is important to understand that most, if not all, of these factors can be influenced by the patient and thus reduce the likelihood of developing the disease.
- lack of movement - this reduces the blood supply, and therefore the nutrition of all elements of the spine;
- Excessive physical activity is also harmful and can damage the discs;
- lying for a long time in the wrong position, not psychologically correct - the height of the table or chair is not suitable, resulting in the patient having to constantly tilt his head and stoop;
- stress - excessive muscle tension can lead to compression of the vessels that feed the spine;
- overweight;
- smoking impairs microcirculation in all tissues of the body;
- Insufficient water and protein intake will affect the condition of the disc.
The causes of osteonecrosis of the spine are not always clear, but the following options can be distinguished:
- genetic predisposition - genetically programmed features of cartilage and bone tissue, in which the wear and tear occurs faster;
- spinal cord injury - a variety of complications can develop at the site of injury, including osteonecrosis;
- occupational hazards, such as vibration;
- exposure to infections or chemicals;
- natural aging of the body.
People from many different professions are at risk of developing osteonecrosis of the spine. These are builders and athletes, surgeons and office workers.
Stages of osteonecrosis and possible complications
The description of the four stages of osteonecrosis of the spine was proposed by Osna in 1971. They are not used to make a diagnosis, but allow you to understand how the disease progresses.
- The discs become less elastic. The disc may be slightly deformed, with displacement of the nucleus pulposus within the disc. This stage does not manifest itself in any way, or there are minor pains.
- In the second stage, cracks may appear in the disc, and the surrounding ligaments may weaken. The connection of the vertebrae becomes unstable. There are acute debilitating pain.
- The third stage is characterized by complete damage of the disc. When the nucleus pulposus leaves the disc, a herniated disc occurs. Spinal deformities or nerve root adhesions may occur.
- In the fourth stage, surrounding tissues are affected - vertebrae, ligaments, spinal membranes. As a result, the vertebrae may completely lose mobility.
As a result of bone marrow destruction, in some cases, many different complications can occur. Problems with discs, herniations, and bulging eyes can lead to narrowing of the spinal canal, compression of the spinal cord, and disability.
Depending on the extent of the damage, different problems with nerve root involvement can occur. This is intercostal neuralgia, a violation of the sensitivity and motor function of the upper and lower extremities, disorders of the functioning of internal organs. Inflammation of the sciatic nerve, also known as sciatica, can not only cause severe pain, but can also lead to pelvic pain and infertility.
In addition to nerve roots, osteonecrosis can compress the vertebral vessels. If blood flow is disturbed in the vertebral arteries that pass through the cervical region and feed the brain, brain disorders, problems with vision or hearing, breathing, or heart function can develop.
Approaches to diagnosis and treatment of osteonecrosis: conventional and alternative approaches
Within the framework of formal medicine, the diagnosis of osteonecrosis includes an examination by a neurologist to determine the extent of damage to the nerve roots, testing of reflexes and sensitivity.
Among the instrumental methods, the following can be used:
- Vascular ultrasound allows you to determine the degree of circulatory disorders, for example, in the vertebral arteries;
- X-ray of the spine;
- CT also uses radiographic methods, but allows you to build a three-dimensional image of the area being studied, to identify even small displacements of the vertebrae;
- MRI specializes in the study of soft tissues, allows you to assess the condition of the spinal cord, visualize the internal structure of the discs.
For differential diagnosis, laboratory tests, general urine and blood tests, and indicators of calcium metabolism are used.
Treatment of osteonecrosis is complex.
- The first and very important tool in the treatment of osteonecrosis is lifestyle. Normalization of working conditions, moderate and regular exercise, as well as healthy sleep significantly improve the patient's condition.
- For drug treatment of osteonecrosis of the spine, a neurologist or general practitioner may prescribe medication. Usually, non-steroidal anti-inflammatory drugs are prescribed - this is the standard treatment for osteonecrosis of the spine. They relieve pain and reduce inflammation. Muscle relaxants help reduce muscle spasms. Vitamins and antioxidants are prescribed to protect nerve tissue from damage. However, any medicine has side effects, for example NSAIDs can adversely affect the stomach.
- In addition to drugs, physical therapy is used, such as massage to cure osteochondrosis of the spine, as well as manual therapy. In severe complications of osteonecrosis, surgery may be required, but is prescribed only if there is no effect from long-term conservative treatment.
Treatment of osteonecrosis in classical medicine is in most cases a lengthy process and can have a negative impact on human health.
Therefore, some drugs, especially analgesics and muscle relaxants (especially those with sedative effects), can be addictive, and some drugs adversely affect the functioning of the gastrointestinal tract.
Also, you can look at the methods used, such as in traditional Chinese medicine.
Traditional Chinese medicine is very popular all over the world, in many countries there are special training centers and courses. The approach and therapy in the Celestial Empire differed from the conventional European view of disease diagnosis and treatment.
All diseases are considered to violate the balance and movement of Qi energy in the body, and therapeutic measures aim to restore this balance. In China, various medicinal herbs, animal ingredients, minerals, as well as various external methods such as acupuncture and acupressure are used.
These techniques have the most indications and the fewest side effects.
Acupuncture
The synonyms of this method are acupuncture, acupressure. The principle of treatment through acupuncture is to insert needles into biologically active acupuncture points. Each point is associated with the organ where the impact is made.
Acupressure allows you to relieve tension and muscle spasms, has an anesthetic effect, helps relieve pain. This method is safe because most doctors use disposable sterile needles.
And where gold or silver coated needles are used, they must be disinfected without damage. The feeling during the procedure depends on the sensitive body of each person, the patient may experience tingling or numbness.
It is important that the procedure is performed by a highly qualified, experienced specialist. Improper needle placement will be useless or even harmful. In some cases, acupuncture is associated with exposure to low doses of electrical current.
Exhausted Moxibs
This is a specific way to hit the active points with the help of special mugwort cigars. The principle of action is similar to that of acupuncture and is often used in combination. A smoldering cigar is mounted on the body in a special wooden house, and at the same time the active points are heated. Wormwood has antiseptic, soothing and relaxing effects.
This method is safe because the glowing part of the cigar does not come into contact with the skin, although in some parts of China direct exposure is used.
Massage
Massage therapy in China is practiced by a number of different schools. They use rotation techniques, one-finger press, manual therapy methods. Traditional massage techniques allow you to exercise muscles and joints as well as indirectly affect other organs and tissues, and help increase the body's defenses.
Qigong
Traditional Chinese gymnastics, such as massage, have several schools. Qigong movements, flexibility, stretching and twisting, are excellent exercises for the spine with osteonecrosis.
The qigong technique requires no special equipment and can be done at home.
However, before that, it is best to choose the right exercises for your doctor, as well as perform the correct technique under the guidance of a qualified specialist.
The level of science and medicine in China is very high, the combination of tradition and innovation gives amazing results. An example of the achievement of Chinese science is DNA therapies and DNA vaccines - these are the methods that are currently being used to develop cancer treatments and fight HIV.
Osteoarthritis of the spine in the elderly. Features of rehabilitation
People are of different ages: some keep their minds clear, are optimistic about life situations and cheerful. Others, past retirement age, lose interest in life.
- The rate of aging of the body depends on many factors, which are:
- 1) the genetic program for the growth and decay of the organism;
- 2) impact on a person of various life events, adverse.
- Adverse effects on a person due to poor housing conditions, toxic working conditions, living in unfavorable climatic conditions, inability to receive adequate medical and social assistance in a timely manner, lifestyleunhealthy (malnutrition, bad habits and prolonged emotional stress).
- When organizing treatment and rehabilitation measures for the elderly, it is necessary to take into account the changes in function and age during this period of life.
- With aging, muscle mass decreases, muscle contractility weakens, changes occur in all parts of the spine.
Cervical fibroids. The main stage of the disease does not require special treatment. Standard precautions can cope with the pathology at this stage.
The greatest danger is a violation of the blood circulation of the brain, which leads to a general disorder of functions and the formation of multiple foci of necrosis of brain tissues.
Prevent
Regardless of the treatment option chosen, the prevention of osteonecrosis plays an equally important role. What can be done for the health of the spine:
- drink enough water;
- control weight, do not overeat;
- choose the right shoes, if necessary - orthopedic insoles;
- choose a good mattress for sleeping, not too soft and enough support for the spine;
- eat collagen-rich foods (fish, turkey, aspic, various jellies);
- Exercise regularly;
- Adjust the height of the desktop and chair, taking into account the growth.
As far as alternative prevention methods are concerned, massage, qigong, and acupuncture all work well, for the reasons that are fairly understandable and described above.
It's important to remember that back pain can and should be treated. To make lifestyle changes, it is not necessary to wait for the first signs of illness.
You can now get up from your computer, stretch your neck, include a walk or a massage on your to-do list.
And if spondylolisthesis has become a problem that prevents you from living in peace, the joint efforts of science and traditional medicine will help restore health and the joy of movement.