Osteochondrosis of the spine is a disease in which a chronic degenerative process of intervertebral discs develops with their hernial protrusion towards the spinal canal. Reactive changes occur in the adjacent tissue, and arthrosis develops in the facet joints. To diagnose the disease, doctors at the Yusupov Hospital conduct a comprehensive examination of patients. The neurology clinic is equipped with the latest equipment from leading companies in Europe, the USA and Japan.
Pain syndrome during an exacerbation of clinical manifestations of spinal osteochondrosis can manifest itself at any level: in the cervical, thoracic, lumbar and coccygeal spine. How to quickly relieve pain due to osteochondrosis? Doctors at the Yusupov Hospital take an individual approach to treating each patient. They prescribe those painkillers that are most effective and safe. Non-drug treatment methods (physiotherapeutic procedures, manual therapy, physical therapy) are also used to relieve pain.
Causes and mechanism of development of pain syndrome in osteochondrosis
Over the years, people lose the elastic properties of intervertebral discs, which provide significant softening of shocks during shocks and jolts that occur when running, walking, and jumping. This occurs due to age-related changes in blood vessels and impaired blood supply to the disc. As a result of insufficient supply of oxygen and nutrients to the intervertebral disc, it becomes dehydrated, and the core becomes thicker and less elastic.
The load on the fibrous ring increases. It stretches and protrudes beyond the vertebral bodies. These processes begin at the age of twenty, and over time the pathological changes worsen. Cracks, detachments, and radial tears occur in the fibrous ring. The tissue of the intervertebral disc, which has undergone degenerative changes, protrudes towards the spinal canal and irritates the posterior longitudinal ligament, which is rich in pain receptors. Local pain and reflex tension of the paravertebral muscles occur periodically.
Due to thinning and perforation of the posterior longitudinal ligament, a hernial protrusion is formed. It irritates the nearest spinal root. An autoimmune process develops at the site of inflammation, which is manifested by periodically worsening radicular pain syndrome.
During the next exacerbation, compression of the radicular artery occurs. This leads to ischemia and acute dysfunction of the corresponding spinal nerve. When the radicular-spinal arteries are involved in the pathological process, chronic or acute insufficiency of blood supply to the spinal cord develops. In the presence of cervical osteochondrosis, the blood supply to the brain in the vertebrobasilar region may be disrupted.
Probable causes
Among the likely causes of the development of pathological processes in the knee, it is worth highlighting:
- age characteristics
– mechanical wear and natural aging of tissues causes the destruction of cartilage in patients over 60 years of age;
- increased body weight
– the more weight, the faster the joints wear out. The risks of pathology with excess body weight are several times higher;
- hereditary factor
– causes the development of pathological processes mainly for young people;
- increased physical stresslanguages
– the main reason for the development of pathology in people whose work involves increased stress on the lower extremities.
It is also worth noting the existence of increased risks of musculoskeletal diseases after operations and injuries.
Clinical signs of osteochondrosis
Clinical manifestations of osteochondrosis develop with additional load on the spinal segment. Pain syndrome can develop after flexion and subsequent sharp extension of the lumbar spine, especially combined with lifting weights, or due to a sudden movement of the head. In the initial stages of the disease, pain occurs due to protrusion of the intervertebral disc towards the spinal canal and irritation of the posterior longitudinal ligament, rich in pain receptors. Its peculiarity depends on the location of the pathological process.
If pain occurs at the lumbar level, it is referred to as lumbago or lumbodynia. Pain syndrome at the cervical level is called cervicago or cervicalgia, and at the thoracic level - thoracalgia. Due to a reflex muscle reaction, pronounced tension in the paravertebral muscles occurs. This causes increased pain and flattening, smoothing of cervical or lumbar physiological lordosis, as well as limited mobility of the spine.
Cervicago is characterized by acute pain in the neck, provoked by head movements and tension in the neck muscles. Cervicalgia is manifested by severe pain and paresthesia (a feeling of tingling or crawling) in the cervical spine due to irritation of the receptors of the meningeal branches of the spinal nerves. When examining the patient, the neurologist determines pronounced tension in the neck muscles, fixation of the head, pain in the spinous processes of the cervical vertebrae and paravertebral points.
Lumbago or lumbodynia differ from each other in the degree of severity and duration of pathological manifestations. Due to pain, patients develop flattening of the lumbar lordosis and severe limitation of movements in the lumbar spine. Over time, the pain syndrome due to osteochondrosis of the lumbar spine fades away and remission occurs. An exacerbation of the disease occurs due to additional displacement of the intervertebral disc. During the next episode, the posterior longitudinal ligament is perforated, which leads to the development of the second stage of neurological complications.
In the second stage of osteochondrosis, as a result of perforation of the posterior longitudinal ligament, the prolapsed tissue of the intervertebral disc penetrates into the epidural space located above the dura mater. It irritates the spinal roots and spinal nerve, causing radicular syndrome. The cartilage tissue found in the epidural space performs the functions of an antigen. A focus of aseptic autoimmune inflammation occurs in the epidural space. Nerve roots are also involved in the pathological process. Patients often experience pain for a long time.
In the third, vascular-radicular stage of neurological disorders in spinal osteochondrosis, motor disorders and sensory disturbances develop due to ischemia of the roots or spinal nerve and compression of the corresponding radicular artery. While walking, the patient raises his leg high, throws it forward and at the same time slams his toe on the floor.
The fourth stage of neurological manifestations is characterized by dysfunction of the radicular spinal arteries. If this occurs at the cervical level, the patient develops signs of cervical discirculatory myelopathy, reminiscent of the manifestations of the cervical-upper-thoracic form of amyotrophic lateral sclerosis.
Functional insufficiency of the arteries of the lower thoracic and lumbar region can cause the development of chronic cerebrovascular insufficiency of the spinal cord, which manifests itself as intermittent claudication. Patients complain of weakness and numbness in the legs that occurs while walking. They disappear after a short rest. The most severe manifestation of the fourth stage of neurological disorders in spinal osteochondrosis is an acute disorder of spinal circulation such as spinal ischemic stroke.
Symptoms of the disease
Among the general clinical symptoms of osteochondrosis of the knee joint, it is worth highlighting:
- painful sensations
– a classic sign, the intensity of manifestation of which is determined by the degree of development of pathological processes;
- local manifestations
– slight swelling;
- limited mobility
– initially there is a limitation of active movements (walking and running), and then passive ones (bending/extending a limb with outside help);
- characteristic crunching sound when performing movements
– mainly in the first hours after waking up, disappearing as daytime activity increases;
- transient lameness
, turning into a permanent one.
Diagnosis of osteochondrosis
Diagnosis of osteochondrosis at the Yusupov Hospital is carried out by a neurologist-vertebrologist. After the initial examination, he prescribes the following additional studies:
- radiography of the spine in two projections;
- magnetic resonance imaging of the spine;
- myelography.
A targeted examination of the affected intervertebral disc is possible using discography. Electrophysiological studies (electroneurography, evoked potentials, electromyography) are used to determine the extent and location of damage to nerve pathways.
After analyzing the examination results, the doctor draws up an individual treatment plan. The most severe cases of the disease are discussed at an expert council with the participation of candidates and doctors of medical sciences, as well as related specialists.
Treatment of pain syndrome
Neurologists at the Yusupov Hospital use innovative treatment methods to quickly relieve pain due to osteochondrosis and prevent its transition to the chronic stage. In the first days after the attack, the patient is provided with strict bed rest. To fix the body in the desired position, special orthopedic collars or corsets are used.
For acute and severe attacks of pain, centrally acting analgesics (tramadol) are used, as well as drugs that affect the central mechanisms of pain (benzodiazepines). They promote muscle relaxation, have an anxiolytic effect (reduce anxiety and fear), and improve the patient’s mental state. Additionally, muscle relaxants are prescribed (baclofen, mydocalm or tizanidine). In some cases, pain in osteochondrosis is relieved with anticonvulsants, which have an analgesic effect associated with the influence on the central mechanisms of pain formation. Carbamazepine is most often prescribed for this purpose.
Neurologists at the Yusupov Hospital relieve pain by performing paravertebral blockades with local anesthetics. The main treatment for pain in osteochondrosis today are non-steroidal anti-inflammatory drugs. They have an inhibitory effect on the synthesis of the enzyme responsible for the development of the inflammatory response. Suppression of its production leads to a persistent reduction in inflammation, a decrease in tissue swelling and attenuation of pain. The most commonly used non-steroidal anti-inflammatory drugs are:
- cake makers;
- nimesulide;
- celecoxib;
- diclofenac;
- ibuprofen.
In the acute stages of the disease, drugs are administered intramuscularly, and later they switch to oral tablets.
Drug therapy for pain due to osteochondrosis at the Yusupov Hospital is complemented by non-drug methods, which include physiotherapeutic procedures, manual therapy and massage, physical therapy and psychotherapy. Neurosurgeons at partner clinics perform surgical interventions in cases of spinal cord compression. The operation consists of removing a herniated intervertebral disc and decompressing the spinal canal. It is possible to perform puncture valorization of the disc, microdiscectomy, laser reconstruction of the disc, stabilization of the spinal segment, and replacement of the affected disc with an implant.
If you have pain, call the Yusupov Hospital. The clinic's neurologists quickly relieve pain and prescribe comprehensive treatment for osteochondrosis.
Treatment of osteochondrosis of the hip joint
Therapy takes months and even years. Treatment for osteochondrosis of the hip joint is selected according to the stage of the disease. Here we need an integrated approach that solves several problems at once: strengthening and improving blood flow to the affected area, regulating the quantity and quality of lubricating fluid, relieving pain, ensuring good tissue nutrition, normalizing metabolism and restoring cartilage. All this can be achieved through a combination of drugs, exercise therapy and other rehabilitation methods.
How to treat osteochondrosis in the hip joint?
- Medication.
- Physiotherapy.
- Therapeutic exercise.
- Massage.
Attention! In particularly severe cases, surgery may be required. It is the most risky and is not suitable for everyone.
Gymnastics for osteochondrosis of the hip joints
The exercises are aimed at relieving muscle stiffness, strengthening smooth muscles, and improving blood circulation. These are activities that will take no more than 20-30 minutes a day.
Features of exercise therapy:
- You cannot make sudden jerks.
- If pain occurs, you need to reduce the range of motion or stop the exercise.
- Repeat the movements no more than 10-15 times, start with a small number of repetitions.
Effective exercises for osteochondrosis of the hip joint:
- Lie on the bed and alternately rotate your legs. Raise your leg and rotate from side to side like a pendulum. Alternately stretch your feet towards the ceiling.
- Lying on the bed, bend your knees and leave your heels on the bed. Lower your left knee to your right foot, touch the bed, and then vice versa (right to left).
- Sit on a chair, legs together. Next, bend over and touch your toes to your feet, return to the starting position and repeat.
You can do gymnastics at home in the morning, before bed, or at any free minute.
Nutrition for osteochondrosis of the hip joint
Therapy necessarily includes changes in diet. It is very important to enrich the menu with protein, sulfur for collagen production, fatty acids, vitamins and other microelements. For example, salmon, sardines or mackerel can be a source of Omega 3, and eggs, legumes, cabbage, radishes and other vegetables can be sources of sulfur.
How do you recommend eating?
- Eat in small portions, but 5-6 times a day.
- Add cereals and legumes, as well as fermented milk products to your diet. For example, cottage cheese or kefir.
- Include vegetable salads in the menu.
- Minimize the amount of salt.
- Prepare dishes from lean meat. For example, you can use chicken breast or beef.
- Exclude fried, fatty, salty, canned food, sausages, semi-finished products, baked goods, alcoholic and carbonated drinks.
Doctors recommend adhering to the basic principles of proper nutrition, since the body needs a supply of high-quality nutrients to restore the joint capsule and, in particular, cartilage.
Physiotherapy for osteochondrosis of the hip joint
Physiotherapy in itself does not cure the disease; it is only an auxiliary method that speeds up the treatment of osteochondrosis of the hip joint and generally alleviates the condition. Electrophoresis improves cell regeneration and increases the conductivity of nerve impulses, magnetic therapy is used to relieve tension and start metabolic processes, and laser therapy is used to reduce inflammation.