Among chronic human diseases, pathologies of the spine are not the last in medical practice. Pain in the region of the spinal column, which periodically occurs and then disappears for a certain period of time, is familiar to many inhabitants of the planet. Often people neglect going to a specialist to find out the cause of the origin of pathological conditions. But in vain. Measures not taken in time lead to the occurrence of irreversible phenomena in the body, significantly reducing the quality of life of the patient. DDZP also belongs to such pathologies.
Diagnosis "DDZP" - what is it?
Degenerative-dystrophic disease of the spine (DDSD) is a pathology of the peripheral parts of the nervous system, which belongs to the group of the most common chronic human diseases, has a relapsing character and often leads to disability.
The most common disease occurs in people of working age. Unfortunately, today there is no generally accepted point of view on the origin of DDSD. What does it mean? There are no sufficient and effectivemethods for detecting and treating the disease.
It is believed that the occurrence of pathology occurs for several reasons:
- due to local overloads of the vertebral motor segments (VMS);
- due to decompensation in trophic systems.
Due to the fact that DDSD is a disease that lasts for years, the changes occurring in the patient's body become irreversible. Therefore, complete recovery of the patient in most cases is impossible. Therapeutic measures are aimed only at restoring the normal function of the spine and eliminating the clinical manifestations of the disease.
The reason for everything is osteochondrosis
The disease leads to a failure of the function of the motor segments of the spine, which entails consistent disruptions in the work of the entire human body. How does this happen? It is believed that osteochondrosis acts as a trigger for the occurrence of ADHD. What is this pathology? In the medical practice of the CIS countries, osteochondrosis is usually called dystrophic changes in the cartilaginous structures of the spinal column. The cause of osteochondrosis are:
- genetic predisposition,
- Disorders of vascular nutrition of discs,
- hypodynamia,
- poorly organized workplace (uncomfortable chair or table),
- physical work with weight lifting,
- overweight.
Gradual change in the structure of the cartilage leads to a decrease in the mobility of the vertebrae, a reduction in the distance between them, a violationnutrition of tissues adjacent to the spine. If the running process is not stopped, a vertebral or extravertebral syndrome develops. There are 4 reasons due to which this syndrome is formed:
- compression - the disease begins to manifest itself due to mechanical overload of the motor segments of the spine, leading to compression of the nerve roots;
- disfixation - pathology occurs due to weakening of the fixation of the motor segments of the spine;
- dysgemic cause - pathology occurs against the background of impaired microcirculation of tissues adjacent to the intervertebral disc at the site of spinal injury;
- aseptic-inflammatory cause - pathology occurs against the background of an inflammatory process in the motor segments of the spine.
Structure of the spine
The spine is a collection of vertebrae, each of which is formed by a body and an arch. The vertebrae are located one above the other and form a column, in the central part of which the spinal canal passes - a kind of tunnel penetrated by nerves and blood vessels.
Vertebrae are separated by cartilage - intervertebral discs, consisting of the annulus fibrosus and nucleus pulposus. The ring takes on part of the load on the disk. In a young organism, the nucleus pulposus is 90% water, however, over time, the fluid content in it decreases. The nucleus pulposus is a shock absorber that changes its shape under the action of a load, thereby providing mobility.spine and protecting it from destruction.
The spinal column is reinforced on all sides with ligaments and a muscular corset. Strong muscles and ligaments reduce stress on discs and joints. However, over the years, under the influence of various factors, there is a decrease in the elasticity of cartilage tissue. The mechanism of formation of painful conditions is launched.
How does a pathological process occur
Violation of posture, excess weight, heavy lifting, prolonged exposure to the wrong uncomfortable position and other factors lead to the fact that the fluid content in the disc begins to decrease, the elasticity of the cartilage structure disappears. Under the influence of the above factors, the load on the fibrous ring increases, its fibers are torn. In places of rupture, an inflammatory process occurs, scar tissue forms.
When scarring becomes large, there is an overlap of blood vessels that feed the intervertebral discs. Gradually, the height of the disc decreases, as a result of which the distance between adjacent vertebrae decreases, the ligaments stretch and sag, and the load on the intervertebral joints increases. The result is cartilage destruction. The mechanism for the formation of DDZP is launched. What does it mean? The fibers of the fibrous ring under pressure go beyond the vertebral body, the edges of the vertebra soldered to them also change their correct position, bone outgrowths are formed - osteophytes. The intervertebral disc is clamped, while the mobility of the spine is sharply reduced. Often this causes pain.
Herniated disc can also cause the development of pathology. A hernia is a part of the nucleus pulposus that has broken through the fibrous ring, gone beyond it and puts pressure on the nerve roots of the spinal cord.
The concept and classification of dorsopathies
Pathological conditions of the spine, which are not associated with a disease of the internal organs and are accompanied by pain, are combined into a separate group of diseases called dorsopathy. In accordance with international standards, all types of dorsopathy are divided into three groups:
- deforming dorsopathy - these include deformities of the spinal column due to changes in the intervertebral discs: this group includes kyphosis, scoliosis, lordosis, spondylolisthesis, osteochondrosis;
- spondylopathies – these include all traumatic and inflammatory spondylopathies;
- other dorsopathies are manifestations of pain in the neck, body or even limbs, which are not the result of disc displacement or dysfunction of the spinal cord.
Depending on the location of the pathology, there are: DSD of the thoracic and lumbosacral spine, as well as DSD of the cervical spine. What is it, we will understand a little later. A characteristic feature of the pathology is that the symptoms of the disease in each of the areas of localization, on the one hand, are very similar, on the other hand, they have their own distinctive features.
Types of DDPD
Often, pathological conditions occur in the lumbar spine. According to most doctors, the mainthe reason for this is the upright posture of a person, for which he, in fact, pays. Of course, the disease does not arise from scratch, but is formed under the influence of a number of factors (poor nutrition, disruption of the lymphatic system in the tissues of the intervertebral discs, etc.).
- DDZP of the cervical spine. What it is? As a rule, this is dorsopathy that occurs in the neck, anterior chest, in the hands. Some patients note a burning aching pain between the shoulder blades, similar to the manifestations of angina pectoris. With cervical dorsopathy, there is an increase in pain when turning or tilting the head. In the pathology of the thoracic spine, retrosternal pain may occur.
- DDZP of the lumbar spine. May be accompanied by a violation of the sensitivity of the groin and inner thighs. Pain can occur simultaneously in both legs; manifested by decreased sensation in the lower back and sensitivity of the big toes. Shooting pain, decreased sensation in the lower leg, pain in the foot, paralysis of the lower leg and buttocks, loss of pelvic functions - all these are symptoms of dorsopathy of the lumbar or ADHD of the lumbosacral spine.
Therapeutic measures
The manifestations of the pathological process in the spine depend on the stage of development of the disease, as well as on the area and extent of the lesion. Pain is the main manifestation of the pathology. As noted above, the cause of pain can be muscle spasms, nerve roots of the spinal cord squeezed by an intervertebral hernia, etc. Often pain occurs not onlyin the spinal region, but is also transmitted to other parts of the body. In addition to pain in the affected area, there may be a decrease in sensitivity, as well as muscle weakness.
Therapy for degenerative-dystrophic disease of the spine can slow down the course of the disease and improve the patient's quality of life. The complex of therapeutic measures is aimed at:
- stop the pain,
- slow down cartilage breakdown,
- improve blood circulation in the surrounding soft tissues of the spine,
- reduce compression of the vertebrae against each other,
- restore the patient's motor ability.
Therapeutic methods include the use of medications, physical therapy, exercise therapy.
DDSD: medication treatment
You can eliminate the manifestation of pain by taking anti-inflammatory non-steroidal drugs, such as Ibuprofen, Ketoprofen, Diclofenac. The use of these drugs, however, is often associated with side effects. In this case, you can resort to taking selective agents - these are Lornoxicam, Nimesulide, Meloxicam.
When congestion occurs in the muscles and their blood circulation is disturbed, they resort to the use of a solution of lidocaine in combination with steroid hormones. This measure helps relieve acute pain.
Partially alleviate the condition and eliminate the pain syndrome with the help of a medical anesthetic patch("Dorsaplast", "Nanoplast", etc.). In addition to the fact that the patch relieves pain, it also provides an anti-inflammatory effect - it acts on the affected area with a magnetic field. It is recommended to use the patch both during the period of exacerbation for quick relief of pain, and courses. The product does not contain steroids, it is very comfortable to use: the patch does not hinder movement, has no smell, does not leave marks on the skin and clothes.
Physiotherapy and orthopedic corsets
Simultaneously with the use of medications in the treatment of DDSD, orthopedic corsets are actively used, which reduce pain by fixing the damaged segment of the spine. If the pathological process affects the cervical spine, use the Shants collar. The product not only has a warming effect, but also temporarily reduces the mobility of the spine in the affected area, relieves muscle spasm, and provides favorable conditions for the restoration of damaged structures.
In case of pathology of the thoracic spine, semi-rigid correctors are used, which correctly distribute the load throughout the spine, unloading the affected area. If the problem occurs in the lower back, lumbosacral corsets are used. Often they resort to the use of orthopedic insoles, which remove part of the shock load from the spine.
Physiotherapy also helps to relieve pain. These include: electrophoresis, massage, UHF, ultrasound therapy,magnetotherapy.
Stop cartilage breakdown
As mentioned above, therapy for DDSD is not only aimed at eliminating pain. It is very important with such a diagnosis to stop the process of destruction of cartilage tissue. For this, there is a whole range of medications - chondroprotectors. These include: "Chondroitin sulfate", "Glucosamine", etc. Often, to enhance the effect, drugs are taken together. In such a situation, an accurate dosage of medicines is necessary. As a rule, the daily dose of "Glucosamine" is 1000-1500 mg, "Chondroitin sulfate" - 1000 mg.
It is possible to improve blood circulation in the tissues of the affected area with the help of antiplatelet agents and angioprotectors, which include the drugs "Pentoxifylline", "Actovegin". B vitamins (for example, "Neuromultivit") help to balance the metabolic processes in the body.
During the rehabilitation period, spinal traction is often used, which helps to increase the distance between the vertebrae and reduce their influence on each other. It is also important to constantly maintain physical activity, strengthen the muscular corset through physiotherapy exercises.
Diagnosis
To date, the method for detecting degenerative-dystrophic disease of the spine cannot be called perfect and reliable. Like any other disease, the diagnosis of DDSD begins with a medical examination. The doctor, when talking with the patient, determines the location of the pain, identifies factors that can increase the pain syndrome(for example, changing the location of the body). The specialist also finds out in the patient the presence of past spinal injuries and concomitant diseases.
Next, the doctor examines the paravertebral muscles by palpation. This allows you to identify the presence of muscle tension or prolapse of the vertebra. Laboratory diagnostics involves the study of the patient's blood and is carried out in order to establish the presence or absence of infectious processes in the body.
Of course, the most informative method for diagnosing pathology is spinal radiography, computed tomography (CT) and magnetic resonance imaging (MRI). Electroneuromyography (ENMG) allows you to determine the cause of nerve damage.
