Inflammation of the spine can be infectious and aseptic. In the first case, the potential cause is the penetration of pathogenic microflora (most often during surgery or when the integrity of the skin is violated, as well as through the hematogenous and lymphogenous route). Infectious or purulent inflammation can only be treated with etiotropic pharmacological therapy. Antibiotics, sulfonamides, antimicrobial and antiviral drugs are used. In this article we will consider cases of aseptic (non-infectious) inflammation of the tissues of the spinal column. We will tell you about the symptoms and treatment of spinal inflammation without the use of medications.
Inflammation of the spine is the body’s reaction to a certain pathogenetic effect. Inflammation can affect different tissues of the spinal column. To understand this process, it is worth familiarizing yourself with the anatomy and physiology of the spine.
Let's start with the structure of this part of the musculoskeletal system of the human body:
- the spine consists of individual vertebral bodies, to which the arcuate and spinous processes are attached;
- intervertebral cartilaginous discs are located between the vertebral bodies;
- they consist of a dense membrane (annulus fibrosus) and a corpus pulposus located inside (nucleus pulposus);
- the vertebrae together with the arcuate processes form the spinal canal;
- the spinal cord is located in it and the radicular nerves, responsible for the innervation of the entire human body, depart from it through the foraminal openings in the lateral surfaces of the vertebrae;
- intervertebral discs provide protection from compression to the radicular nerves and lateral surfaces of the vertebral bodies;
- intervertebral discs do not have their own vascular network; they receive nutrition only through diffuse exchange with nearby muscles.
The vertebrae are connected to each other using joints. They are uncovertebral, facet, and facet. The stability of the position of the vertebral bodies is ensured by the long longitudinal and short transverse ligaments. The adjacent paravertebral muscles participate in the diffuse nutrition of the cartilaginous tissues of the intervertebral discs and allow a person to perform a variety of movements: bending, twisting, turning the body.
Inflammation is the body's response to a negative impact. During the development of the inflammatory reaction, special substances are drawn into the focus, which provoke expansion of the capillary network, tissue swelling, increased local temperature, etc.
Various tissues of the spinal column can become inflamed: cartilage discs, bone tissue, radicular nerves, ligaments, tendons, muscles, endplates, intervertebral joints.
Comprehensive treatment based on differential diagnosis is necessary. Therefore, you should not do this yourself - it is better to consult an experienced doctor.
In Moscow, you can make a free appointment with a chiropractor, vertebrologist, neurologist or orthopedist in our clinic. Experienced doctors conduct consultations here. During the initial consultation, they examine the patient, make a diagnosis, and recommend additional examinations as necessary. After an accurate diagnosis is made, an individual course of treatment is developed. The patient receives recommendations for making changes in his daily life. The initial appointment for any patient in our manual therapy clinic is always free.
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Causes of inflammation of the spine
There are various causes of inflammation of the spine in addition to infectious tissue damage. Potential risk factors for the occurrence of an aseptic inflammatory reaction include:
- excess body weight - creating excess pressure on the surface of the vertebral bodies, endplates and intervertebral cartilaginous discs, it provokes ischemia and pain;
- poor posture and curvature of the spinal column - when cartilage tissue is deformed, intervertebral joints are destroyed and connective tissues are transformed;
- the development of degenerative dystrophic changes in the cartilaginous tissues of the intervertebral discs - when their height decreases, a compressive load begins to be exerted on the radicular nerves;
- hernial protrusion of the nucleus pulposus through a crack formed in the fibrous ring - proteins of the corpus pulposus irritate other tissues of the spinal column;
- traumatic effects (falls, bruises, sprains and ruptures of ligaments, tendons and muscles, compression fractures of vertebral bodies or cracks of the spinous processes);
- tumor processes in the spine that exert pressure due to their growth;
- diseases of internal organs;
- impaired blood supply (for example, with diabetic angiopathy or atherosclerosis);
- ankylosing spondylosis (Bechterew's disease);
- systemic lupus erythematosus;
- rheumatoid polyarthritis of intervertebral joints;
- instability of the position of the vertebral bodies, antelisthesis, retrolisthesis, etc.
Elimination of the potential cause of spinal inflammation is a prerequisite for effective therapy without the risk of relapse of the pathology. Therefore, at the first appointment, the doctor collects a complete medical history and strives to eliminate all possible factors of negative impact on the human body.
It is important to exclude the possibility of extreme physical stress on the spine, heavy physical labor, leading a sedentary lifestyle, poor nutrition, and violation of the rules of ergonomics of the sleeping and working place.
1.General information
The word “ostitis” (not to be confused with otitis) in a broad sense means inflammation of the bone, or, more correctly, inflammation of bone tissue.
In fact, this is a group of heterogeneous diseases, pathological conditions and processes in relation to which much remains to be explored, clarified and clarified. In the current Tenth Revision of the International Classification of Diseases (ICD-10), such inflammatory processes are classified under the heading “Other bone diseases,” and the unifying characteristic is precisely the presence of inflammation.
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Symptoms of spinal inflammation
Clinical symptoms of spinal inflammation develop quickly. Pain occurs at the site of tissue damage. It is accompanied by severe pain and limited mobility in the affected part of the spinal column.
Aseptic inflammation of the spine, which occurs for the first time, can safely go away on its own. But this does not always mean recovery. Most often, when severe symptoms subside, the disease enters the phase of chronic relapsing course. This is a much more dangerous condition than an acute inflammatory reaction.
The most pronounced symptoms are caused by inflammation of the spinal roots:
- sharp, shooting pain at the site of compression of the nerve fiber;
- spread of pain along the affected radicular nerve (radiates to the arm, leg, groin area, chest, anterior abdominal wall, etc.);
- decreased muscle strength at the site of innervation of the affected nerve;
- paresthesia, decreased skin sensitivity, convulsions and other manifestations;
- increase or decrease in the intensity of tendon reflexes.
If such clinical symptoms appear, it is necessary to visit a neurologist as soon as possible. The doctor will conduct an examination and examination, prescribe an effective and safe course of therapy.
2. Reasons
The main trigger (trigger factor) in the etiopathogenesis of osteitis is secondary infection during fractures and other injuries, which include surgical interventions on bone structures. The infection can be either nonspecific (streptococci, staphylococci and other widespread pathogenic microorganisms) or specific (mycobacterium tuberculosis, gonococcus, treponema pallidum).
Osteitis also includes Paget's osteitis deformans - a chronic, progressive disease of unknown etiology, in which the regeneration of bone tissue (normally, its renewal occurs constantly) is carried out due to the formation of tissues with an irregular, altered structure. Paget's disease usually affects the pelvic, femur, humerus bones, as well as the spinal column and skull bones.
Unfortunately, in isolated cases, the cause of the development of osteitis is non-compliance with the BCG vaccination procedure.
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Inflammation of different parts of the spine
Inflammation of the cervical spine most often develops in people engaged in sedentary mental work. With prolonged static tension of the muscles of the neck and collar zone, ischemic zones are formed. They negatively affect the performance of intervertebral cartilaginous discs. Therefore, an inflammatory reaction occurs, designed to compensate for the insufficient height of the intervertebral disc and protect the radicular nerves from compressive effects.
Inflammation of the cervical spine manifests itself in the form of pain, tension, and limited mobility. Headaches, dizziness, decreased mental performance, etc. may occur.
Inflammation of the thoracic spine is relatively rare. The costovertebral joints and intercostal muscles are most often affected. The vertebrae and intervertebral discs themselves are rarely affected, since they do not have pronounced mobility and are rigidly fixed by the costal arches.
Very often, people leading an active lifestyle develop inflammation of the lumbosacral spine, with the L5-S1 intervertebral disc suffering mainly. It bears the maximum shock-absorbing load when lifting heavy objects, walking, running, jumping, etc.
Inflammation of the lumbar spine can be caused by heavy physical labor, a sedentary lifestyle, improper foot placement, etc. Inflammation of the sacral spine is a serious pathology, since the articular tissues of the iliosacral joint of the bones are most often affected. In this case, the patient experiences severe pain in the sacrum area. The functions of the pelvic organs and abdominal cavity may be impaired.
4.Treatment
The therapeutic regimen is determined by the results of the diagnostic examination. Depending on the scale, localization and etiology of inflammation, antibacterial drugs, anti-inflammatory drugs, immunomodulators and immunostimulants are prescribed. Absolute indications for surgical intervention are often identified - in particular, to remove necrotic (dead) areas. Therapy with special proteolytic enzymes, as well as physiotherapeutic methods, are effective. Sanitation of all foci of chronic infection, relief of exacerbations of diseases concomitant and/or primary in relation to osteitis (for example, rheumatoid arthritis, syphilis, tuberculosis) are mandatory.
An important task is to prevent the inflammatory process from becoming chronic. In this regard, the time factor is crucial: at the first symptoms of trouble in any bone tissues or structures, contacting a doctor should be immediate. The earlier a reliable diagnosis is made and treatment is started, the more favorable the prognosis, i.e. higher chances of complete healing of osteitis.
Inflammation of the nerve roots of the spine
Inflammation of the nerve of the spine is radiculitis. A serious pathology that provokes severe pain, impaired mobility, stiffness and decreased muscle strength in the area for which the damaged nerve is responsible for innervation.
Most often, inflammation of the spinal roots occurs against the background of other degenerative dystrophic processes. These are osteochondrosis, spondyloarthrosis, instability of the position of vertebral bodies, cicatricial deformities of ligaments and tendons, and ankylosing spondylitis.
Inflammation of the nerve roots of the spine can occur for several reasons. Most often this is compressive pressure on the nerve fiber. Pressure can be caused by a tumor, edematous tissue, inflamed muscle, cicatricial deformation of the ligament, or prolapsed intervertebral hernia. Without eliminating the factor that has a compression effect, there is no need to talk about treatment.
Also, inflammation of the radicular nerves can be ischemic in nature. Most often, impaired trophism is a consequence of diabetic angiopathy, atherosclerosis or cardiac vascular failure.
Treatment of aseptic spondylitis
Treatment of non-infectious spondylitis is a rather complex, lengthy and not always successful process.
Non-steroidal anti-inflammatory drugs are used as symptomatic treatment drugs to relieve pain, reduce inflammation and relieve stiffness in the spine, and, if they are ineffective, glucocorticosteroids. Additionally, to normalize increased intraosseous pressure and reduce receptor irritation, intraosseous blockades are prescribed.
The fundamental method of conservative treatment of aseptic spondylitis is therapeutic exercises, which help correct posture, maintain flexibility and prevent the development of further complications. Physiotherapeutic thermal procedures have also proven themselves to be effective in eliminating stiffness and relieving pain.
In an advanced stage of the pathological process, the only optimal treatment method is surgery.
At the Yellow Emperor Traditional Chinese Medicine Clinic, patients suffering from aseptic spondylitis can be prescribed reflexology treatment (vacuum therapy, acupressure, acupuncture), as well as taking herbal medicines that help improve the passage of nerve impulses and increase the effectiveness of treatment procedures. At the same time, an individual course of therapeutic muscle-joint exercises can be carried out, aimed at eliminating excessive back tension, as well as at physical and emotional recovery.
How to treat spinal inflammation
Inflammation of the spine can be relieved only by eliminating the cause that provoked it. For example, if this is an injury and a hematoma develops in the area of inflammation, then all measures must be taken to stop internal bleeding. The smaller the size of the post-traumatic hematoma, the less the strength of the inflammatory reaction. Therefore, after a bruise or fall, it is necessary to apply cold to the injured area for about 2-3 hours.
Before treating inflammation of the spine, you need to conduct a thorough differential diagnosis and make an accurate diagnosis. Treatment of inflammation of the spinal roots with the help of pharmacological drugs is justified only in one case: if it is provoked by an infection. In all other situations, it is most effective and safe to carry out treatment using manual therapy methods.
In our clinic, treatment of spinal inflammation is carried out using the following methods of influence:
- osteopathy stimulates microcirculation of blood and lymphatic fluid, improves tissue trophism and relieves edema;
- massage improves the elasticity of soft tissues and their permeability, relieves excess muscle tension and restores blood flow;
- physiotherapy accelerates the metabolic process at the cellular level;
- reflexology starts the process of regeneration of all damaged tissues by using the hidden reserves of the human body;
- therapeutic exercises and kinesiotherapy restore muscle tone and ligamentous apparatus, improve diffuse nutrition of the cartilage tissue of the intervertebral discs;
- laser exposure and electrical myostimulation are used according to indications.
If you require effective and safe treatment for spinal inflammation without the use of medications, you can make an initial free appointment with a spine specialist at our manual therapy clinic. The doctor will conduct an examination, make a diagnosis and talk about the prospects and possibilities of such treatment in your individual case.
Mechanism of disease development
The leading role in the development of this disease is played by a complex of inflammatory changes leading to necrosis (necrosis) of the bone tissue of the vertebral body. This condition entails disruption of the joints and ligaments. As a result, mobility is significantly reduced and deformation of the spinal column develops.
As the pathological process develops, the affected vertebrae begin to acquire a wedge-shaped shape. Ultimately, this leads to compression (displacement and deformation) of the spinal cord substance and the development of compression fractures.