The degenerative-dystrophic diseases of the spine, or more simply osteonecrosis, affect not only an increasing number of the adult population of our planet, but also becoming much younger. Today, more than 80% of the working-age population on our planet is regularly plagued by pain in the spine.
Bone tumor- a disease of the spine, which leads to degenerative-dystrophic lesions of the intervertebral discs and underlying bone tissue, accompanied by thickening of vertebral processes and loss of elasticity of the ligaments along the spine. This leads to aging, dehydration and instability of cartilage tissues.
Osteoma is not only a manifestation of pain in the spine or decreased sensitivity in the limbs but it is a disease of the whole organ. And as many studies have demonstrated, osteonecrosis has a direct effect on almost all internal organs. For example, disorders of the cervical spine affect the functioning of the organs of vision, hearing, mental functioning, and mind. In the thoracic region, they disrupt the work of the cardiovascular system, gastrointestinal tract. And degenerative-dystrophic changes in the lumbar spine lead to small pelvic organ problems, includingin the urogenital region and lower extremities. For example, in the same lower extremity, it is accompanied by different pains, muscle cramps, "crawling ants", numbness of the extremities, and then atrophy. Therefore, early detection and qualified treatment of this pathology is very important. Many people who are faced with a diagnosis of a herniated disc for the first time are faced with choosing their treatment options. The suggestion of surgical treatment left many people in shock, forcing them to seek alternative therapies. Some immediately turned to healers, others took various medications, others did nothing, adhering to the view that the disease should be treated when it is very worrisome. . In this regard, there is a winged expression of neurosurgeons - "walking with a hernia is like walking with a grenade, no one knows when it will explode! ". But, unfortunately, surgical treatment, be it neurosurgery or orthopedic, is not a panacea. In many patients, even after surgery, pain in the spine persists, is associated with the development of skin adhesions, and recurrence often occurs (a new exacerbation ("return") of the disease. after obvious recovery) - repeated hernias.
With osteonecrosis, the discs are most commonly affected. These unique cartilage rings don't just connect our 33 vertebrae to the spine. Its good working condition, mobility, elasticity, resilience, load capacity directly depends on the state of the intervertebral discs. They act as spring shock absorbers to cushion the load.
Osteoma manifests itself in the first decades of life and is observed more often in boys than in girls.
If not treated to prevent and treat cervical spondylosis, the disease will progress gradually, affecting the entire spine, eventually leading to disc herniation, compression of nerves and organs. part of the spinal cord. In severe cases, the consequences of osteonecrosis can be eliminated only by surgical intervention with a long recovery and recovery period.
Types of osteonecrosis
Depending on the part of the spine affected by the disease, the following types of osteonecrosis are distinguished:
- Cervical bone necrosisor osteonecrosis of the cervical spine.
- Bone necrosis in the chestor osteonecrosis of the thoracic spine.
- Lumbar osteonecrosisor osteonecrosis of the dorsal spine.
- Common osteonecrosis,this is when the disease spreads to two or three parts of the spine at once.
- Firstly:The main symptom of osteonecrosis at this stage is instability, manifested in the initial disorders of the vertebral disc. Feeling unwell and uncomfortable.
- Monday:The main symptom of the second stage of osteonecrosis is disc protrusion. The destruction of lumbar fibrous begins, the space between the vertebrae decreases, compression of nerve endings with pain syndromes can occur.
- The third day:at this stage of osteonecrosis, the destruction of the ring occurs with the appearance of disc herniation. The third stage is characterized by significant deformation of the spine.
- Wednesday:the final and most severe stage of osteonecrosis. It becomes difficult to move around. Any movement leads to acute pain. Periodically, the condition improves and the pain subsides, but this clearly indicates the formation of bone growth. They connect the vertebrae, restricting mobility and leading to disability.
Four stages of development of osteonecrosis
Characteristic symptoms of osteonecrosis
Patients with osteonecrosis complain of constant back pain, often accompanied by numbness in the limbs. If not adequately treated, weight loss and limb atrophy will occur. The main symptoms are:
- constant back pain, numbness in the limbs;
- pain that increases with sudden movements, exertion, lifting weights, coughing and sneezing;
- reduced range of motion, muscle spasms;
- cervical spine osteonecrosis: arm, shoulder pain, headache; Possible development of the so-called vertebral artery syndrome, which includes the following complaints: noises in the head, dizziness, flashing "flies", color spots in front of the eyes combined with a painful headachethrobbing. The cause of vertebral artery syndrome may be its spasm in response to both direct stimulation of the sympathetic plexus due to bone growth, disc herniation, disc degeneration. and a reflex response due to stimulation of any of the spinal receptors. The presence of vertebral artery syndrome may aggravate the coronary or myocardial process, if present;
- with osteonecrosis of the thoracic spine: pain in the chest (like "piles" in the chest), in the heart and other internal organs;
- with osteonecrosis of the dorsal spine: back pain, radiating to the sacrum, lower extremities, sometimes to the pelvic organs;
- nerve root damage (herniated disc, bone growth, spondylosis, spondylolisthesis): pain and decreased sensitivity, decreased tone, hypotension, weakness of internal muscles, decreased reflexesradiation.
Diagnosis of osteonecrosis
The establishment of a preliminary diagnosis is made during the initial examination of the patient. The examination usually performed by a neurologist involves patient complaints of local changes, which may manifest as pain, deformity, or limitation of mobility. Examine the spine when the patient is standing, sitting, and lying down, both at rest and during movement. The extent of spinal cord injury is determined by counting the number of vertebrae from certain anatomical landmarks or according to a special scheme.
When examining the back, it is necessary to pay attention to the posture, structural features of the body, mark the line of the spinous processes (medial groove of the back), the lower corners of the scapula, the iliac crest, and the lateral line. contours of the waist and neck, position of the shoulders, deviation of the intercostal groove from the vertical, exposure of convexity and convexity of spinous processes with attention to the release of muscles adjacent to the spine.
Sensation of the spine allows you to add test data (with or without deformity), to determine the location, extent and nature of the pain. On palpation, tension in the muscles adjacent to the spine is also noted. Most spinal injuries and diseases are accompanied by increased muscle tone.
Spinal curvature is used to determine range of motion in different parts of the spine.
The main role in spine research is assigned to radiography, computed tomography, and magnetic resonance imaging, with the help of which extent the lesion is determined, the diagnosis is clarified and concretized, andhidden pathologies are revealed. Diagnostic data allows the attending physician to determine treatment tactics and select the most effective treatment.
Spinal osteosarcoma, treatment with movement
Complex conservative treatment includes physiotherapeutic exercises, physiotherapy, massage, manual therapy, spinal traction (pulling), acupressure, drug therapy.
Physical therapy exercises (exercise therapy) - the main method of conservative treatment of diseases of the musculoskeletal system, is to create dosages aimed at decompressing nerve roots, adjusting andstrengthens the muscle corset, increases mass and the development of a certain pattern of movement and correct posture, gives the musculoskeletal apparatus the necessary flexibility, as well as prevents complications. This is achieved through regular exercises with rehabilitation equipment and joint fitness. As a result of the exercise, blood circulation is improved, the metabolism and nutrition of the discs are normalized, the disc space is increased, the muscle corset is formed and the load on the spine is reduced.
Physiotherapy is a treatment method that uses physical factors: low-frequency current, magnetic field, ultrasound, laser, etc. It is used to relieve pain, reduce inflammation, and restore function. after trauma and surgery. When using physical therapy, the treatment time of many diseases is shortened, the effectiveness of drugs is increased and the dosage is reduced, without the inherent side effects of drug treatment.
Massage is a set of methods of mechanical impact in the form of friction, pressure, vibration, performed directly on the surface of the human body by hand. Effectively relieve muscle tension, muscle pain, improve blood circulation, have a blood-tonic effect.
Manual therapy is a individually tailored manual effect on the musculoskeletal system to relieve acute and chronic pain in the spine and joints, as well as increase range of motion and correct posture. One of the directions of manual treatment is organ manual therapy, which restores the normal mobility of organs, improves blood supply, lymphatic circulation, normalizes metabolism, restore immunity and prevent exacerbations of chronic diseases.
Traction (traction) of the spine is an effective method for the treatment of pain syndromes in the spine and joints using a load selected individually using special equipment. This procedure aims to increase disc space, relieve pain, and restore anatomically correct shape of the spine.
Reflexology - various therapeutic techniques and methods aimed at affecting the reflex-producing areas of the human body and acupressure points. The use of acupressure in combination with other therapeutic methods will significantly increase the effectiveness. Most often, acupressure is used for osteonecrosis, which is accompanied by pain, diseases of the nervous system, sleep disorders, mental imbalance, as well as overweight and smoking. By working on certain points, you can bring your body into harmony and treat many ailments.
Drug therapy is indicated in the exacerbation of the disease, aimed at reducing pain, reducing inflammatory processes and increasing metabolism by taking orally or using drugs by intramuscular or intravenous injection.
Although each of the above methods is highly effective, a long-term therapeutic effect can only be achieved when combined with exercises on the rehabilitation equipment, i. e. when creating a full-body corset. .
Recommendations for prevention and prevention of osteonecrosis
To prevent osteonecrosis or relieve pain, people with this condition should stay in the position for as long as possible so that the load on the disc is as little as possible, and at the same time, it is necessary to stretch the back muscles as often as possible for support. metabolism around the spine. General recommendations depend on compliance with the rules of a healthy lifestyle, in addition, in each case, the attending physician determines individual recommendations.
For prevention, it is necessary to observe the following rules:
- Do not overload the spine, do not create favorable conditions for increased pressure in the disc:
- limit vertical loads;
- do not make sudden movements, especially turning when bending;
- avoid falls and jumps from great heights, spinal cord injuries and bruises;
- change your body position more often;
- keep your back straight;
- Try to maintain the natural physiological curves of the spine: in the supine position, the load on the spine is minimal, but a semi-firm bed is recommended (preferably on a firm orthopedic mattress and an adjustable pillow). Figure); In a sitting position, keep your back straight due to the muscles or lean against the back of the chair (the seat must be hard enough, the back should be curved in the lumbar region), keep the head straight; in a standing position, change the leg on which you lean more often; Getting out of bed or out of a chair, as well as lying down and sitting down, must be done by hand without straining or arching the back;
- before physical activity, drink water and massage your back, this will help disperse the blood, accelerate metabolism and allow the intervertebral discs to absorb a sufficient amount of moisture;
- Do not lift or hold heavy objects on your outstretched arms, to lift an object, squat down, then stand up with the object, while keeping the object as close to the body as possible;
- When carrying weights, try to distribute the load evenly, i. e. do not carry the bag with one hand, etc. v. , if you must carry an object in front of you, keep the object as close to you as possible, and when passing. it, does not stretch the arms forward, and is also used to carry heavy loads, strollers, bags or suitcases on wheels, backpacks;
- when performing heavy work involving lifting, moving or carrying weights must use wide belts or special bras;
- do not lift the load more than 10 kg;
- when doing any work, try to bend as little as possible and stay bent and periodically unload the spine (hanging on the bar, straightening with raised arms, lying down);
- Wear comfortable shoes, women should avoid wearing high heels.
- Exercise regularly to strengthen and maintain your corset. Swimming is very helpful.
- Contrast bath, soothing the body.
- Do not over-cool.
- Avoid conflicts and stressful situations.
- Eat right.
- No smoking.