Osteochondrosis is a disorder that self-limits bone development. More precisely, osteochondrosis is an aseptic ischemic necrosis. Psychosomatics of osteochondrosis (Louise Hay described in detail all the influencing factors) further.
Starting events in the pathogenesis of osteochondrosis have not been found so far, but the data indicate ischemic necrosis of the ossification center. It may be caused by a primary vascular event due to a traumatic event or multiple traumas. And there may be psychosomatic causes of osteochondrosis.
It can contain one epiphysis or many, and even sashamoids are not spared from this (as in Sinding Larsen's syndrome, and when taking the first metasarsal sesamoids). The underlying processes appear to be the same for isolated and multiple diseases.
Incomplete healing or complete failure of treatment can lead to chronic pain and even disability later in life. In detailsmore about the symptoms and treatment of osteochondrosis of the cervical spine.
Symptoms
For all types of osteochondrosis, the following symptoms are characteristic:
- Undetermined etiology.
- Clinical progression.
There are also such models of the disease:
- Normal pineal gland subjected to trauma (e.g. pitcher's elbow with osteochondritis of capitelilla dissecans).
- Mildly dyschondrotic pineal gland caused by external stimuli (eg, Perthes disease).
- Severely affected dyschondrotic pineal gland subjected to normal stress (e.g. femoral epiphysis in Gaucher disease).
There are pathogenic factors that require further investigation for: altered collagen-proteoglycan ratio, biochemical abnormalities (eg, altered expression of matrix metalloproteinases [MMPs] such as MMP-1, MMP-3, and MMP-13), and overexpression of glycosaminoglycans and aggrecan as a consequence of altered mechanics that exacerbate cartilage damage.
Psychosomatics of osteochondrosis diseases
May appear not only for physiological reasons, but also for psychosomatic reasons.
The human body is highly susceptible to psychological pressure. More than half of the diseases that appear in people are most often not real diseases, but stressful loads, experiences, and nervousness. Psychosomatic conditions and osteochondrosis are closely related.
Osteochondrosis of the neck
The cervical region connects the thinking part with the acting part. The reasons for the psychosomatics of cervical osteochondrosis is that a confident person always holds his head high. While an insecure person, on the contrary, presses it into himself, which destroys the tissues of the cartilaginous parts. Psychosomatics of cervical osteochondrosis is treated only by changing the worldview and thoughts.
Osteochondrosis of the breast
Psychosomatics of osteochondrosis of the thoracic region is that a person is in a bad mood. This includes sadness and loss of spirit. Because of them, a person begins to hunch over.
Osteochondrosis of the lower back
Psychosomatics of lumbar osteochondrosis appears in those women who have a load of family worries. Also, a strong self-doubt affects the appearance of the disease. All this together leads to painful sensations.
Classification
Early classifications of osteochondrosis divide them into pressure, traction and atavistic types (Burroughs classification) or compression, tension and atavistic types (Goff classification). These systems were inadequate. Siffer proposed a classification that divides osteochondrosis into articular, non-articular and fiseal types. This scheme is largely accepted nowadays.
Articular osteochondrosis has the following characteristics:
- Primary involvement of articular and epiphyseal cartilage and lower endochondral centerossification - Freiberg's disease.
- Secondary involvement of the articular and epiphyseal cartilage due to ischemic necrosis of the podzolic bone - Perthes' disease, Koehler's disease, osteochondritis dissecana.
Osteochondrosis occurs in the following places:
- Trend - Osgood-Schlatter syndrome, Monde-Felix disease.
- Ligamentous ligaments - spinal ring.
Ficial osteochondrosis includes the following:
- Long bones - Tibia vara (Blount's disease).
- Scheuermann's disease.
Related violations
Scientists have found that the main disorders of the genitourinary system are associated with Perthes disease. The risk of getting an inguinal hernia is increased by 8 times in patients with this disease. Femoral slippage can occur in patients with Scheuermann's disease.
Considerable attention has been paid to the occurrence of growth retardation with osteochondrosis. Supporting evidence for this association includes reduced urinary deoxypyridinoline and glycosaminoglycan excretion, as well as low plasma levels of insulin-like growth factor (IGF)-1. These changes cause disruption of collagen metabolism. In the future, this change may be associated with the pathogenesis of osteochondrosis in syndromic terms.
Probable causes
In addition to the psychosomatics of osteochondrosis, there are other reasons. The oldest, most controversial, and therefore leastcommon ones are social deprivation, malnutrition, and passive exposure to smoke (an unknown industrial factor). The studies that suggested these factors as causes were geographically specific, and their results may have been considered etiological error.
Main reasons
Factors that are considered the most likely causes of osteochondrosis - alone or in various combinations (with a multifactorial disease) - are:
- Genetic predisposition.
- Environmental factors.
- Acute or repeated injury.
- Embolism.
- Copper (micronutrient) deficiency.
- Infectious disease.
- Mechanical factors.
In terms of genetic predisposition, Blount's disease is known to be inherited in an autosomal dominant pattern. However, inheritance patterns of other potentially inherited disorders (such as Scheuermann's disease) still occur.
An area deserving further study is the genetic predisposition that causes a hypercoagulable state due to a deficiency in tissue factor pathway inhibitor (TFPI). Others include defects in fibrinolysis involving protein S, protein C deficiency, and resistance to activated protein C. Similarly, there is no consensus regarding inherited disorders of thrombophilia due to mutations in the genes for prothrombin (mutation G20210A), factor V Leiden (mutation G1691A), methylenetetrahydrofolate reductase (mutation C677T) or anticardiolipin antibodies.
With regard to both genetic predisposition and environmental factors, exposure to second-hand smoke may be associated with the development of Perthes disease as a result of the G-455-A polymorphism of the beta-fibrinogen gene.
Micronutrient deficiencies (eg copper and zinc) have been suggested as likely causes based on animal studies.
Infection, once apparently unanimously discredited as the cause of osteochondrosis, has now been shown to cause or exacerbate the disease process. Its effect may be direct or related to autoimmune mechanisms.
Individual mechanical factors may be associated with the development of specific diseases such as Osgood-Schlatter disease and Sindin-Larsen-Johansson disease. Examples of such factors are the long patella (Grelsamer type II) and the extensor device and external torsion of the tibia. Various authors have suggested that Osgood-Schlatter syndrome is traumatic in nature and that it is not associated with ischemic necrosis.
Associated factors
Factors associated with osteochondrosis have also been identified. These include hormonal imbalances (hypothyroidism), sickle cell anemia, Gaucher disease and mucopolysaccharidoses, tetany due to magnesium deficiency, and cystic fibrosis. However, all of these conditions are now well-established diseases in their own right and, according toauthors, should not be associated with osteochondrosis.
Treatment
After we have de alt with the symptoms of osteochondrosis of the cervical spine, treatment and epidemiology will be discussed further.
Because osteochondrosis is a self-limiting disease, treatment outcomes are usually good. Most often, in fact, the syndrome goes unnoticed. However, when osteochondrosis is not limited to conservative treatment or surgery, the patient's prognosis is usually disappointing. In these cases, patients may need urgent interventions or joint replacements later in life to manage secondary changes. Patients must be properly informed and educated before such interventions are undertaken.
Epidemiology
The frequency with which osteochondrosis affects different areas is different. Because they are self-limiting disorders, they often go undiagnosed; hence accurate documentation is difficult. Perthes disease is considered the most common disabling osteochondrosis, but not the most common of all types. Some types are so rare that the doctor may never encounter them in his entire practice.
A large number of osteochondrosis occurs after the appearance of the bone core in the patient, because at this moment the pineal gland, most often cartilaginous, grows very quickly, so it is incredibly susceptible to injuries of various types and strengths. Exceptions to this general statement include pain in osteochondrosis dissecans,Scheuermann's disease, Osgood-Schlatter's, which mainly occur during a period of very rapid growth of adolescents.
Freiberg's disease is more common among women and adolescents This is the pain of osteochondrosis of the elbow joint (head). All other possible and studied types of osteochondrosis are most often found in men. A delay in the appearance and maturation of the growth center in boys may explain this difference. Also, a high level of activity additionally injures the fragile bones of a child or teenager.
Some of the very common and well-studied osteochondrosis have certain racial and ethnic differences in frequency and prevalence in the world. For example, Perthes' disease, mentioned earlier in this article, is rare in people of African or Chinese descent. While Blount's disease is very common on the African continent, the same disease is quite rare in Western Europe as well as in North America.
