Chondrolysis is a degenerative-dystrophic change in the vertebral complex, intervertebral discs and joints. Develops due to metabolic disorders in cartilage and bone tissue of vertebrae and intervertebral discs. Simply put, with osteochondrosis and osteonecrosis, the intervertebral discs and adjacent bony structures wear down over time, compensating for the changes with marginal tissue growth and compression. of them. In case of cartilage degeneration - only the cartilage of the intervertebral disc, and in case of cartilage degeneration - the vertebral bodies adjacent to it. This is a very common disease. According to WHO statistics, up to 80% of the world's population suffers from this disease. Doctors note that it most often occurs due to increased stress on the spine - overweight and a sedentary lifestyle.
Neurologist Igor Matsokin and exercise therapist Oksana Ivanova tell what to do with osteoarthritis and where to go if you suspect the disease.
Classify
According to the ICD-10 classification, spinal spondylosis has code M42. It includes:
- M42. 0 Osteochondrosis of the spine in adolescence Calf disease, Scheuermann disease
Not included: postural hunchback (M40. 0)
- M42. 1 Osteonecrosis of the spine in adults
- M42. 9 Osteoarthritis of the spine, unspecified
Species
Depending on location, there are several types:
cervix
The cervical spine is subjected to high loads and a rather complex range of motion.
Symptom:
Crunching feeling in the neck when turning the head from side to side, stiffness when moving. You may feel a headache (tension headache), aching feeling in the shoulder muscles.
Constant muscle tension can cause numbness and tingling in the hands.
The main focus of treatment is recovery, reducing spasms and inflammation, and restoring range of motion.
Chest
The chest area is less mobile than the rest of the body where osteoarthritis occurs. So it rarely appears.
Symptoms: pain in the chest muscles, often aggravated by static loads.
arm
Shoulder osteoarthritis occurs due to injury, tendon and muscle strains. Most often occurs when there is excessive load on the shoulders in athletes and loaders. But it can also develop into cervical cartilage degeneration complex.
There is a feeling of pain and limitation when moving the joints.
Vertebrates
When osteonecrosis of the spine occurs, the intervertebral discs are destroyed. What happens is that not one part of the spine is affected, but two or more parts. For example, in both the lumbar and cervical regions. This is called multisegmental or widespread spondylosis.
Lumbar
Lumbar osteoarthritis is common. The spine in the lumbosacral region is subjected to the greatest pressure.
Symptom:
- lower back and leg pain
- pain when bending or turning - stiffness when moving the back
Hip
With hip osteoarthritis, the pain is not severe, but it is important to consult a doctor immediately so that surgical intervention is not required.
Knee
Knee joint disease. The cartilage that ensures the joint's ability to slide and move unhindered is destroyed and cannot be restored. Fibrous cartilage forms, causing pain and stiffness in the legs. Pain and limited movement in the knee are the main reasons for seeing a doctor and getting a diagnosis.
youthful
The disease manifests in children, most commonly between the ages of 10 and 18 years old. Degenerative changes occur in the spine, affecting ligaments, joints, discs and bones. Osteochondrosis in adolescents progresses rapidly but in the early stages it is difficult to detect because it does not limit mobility. Only in the morning do people feel uncomfortable after sleeping.
reason
The disease occurs when there is a metabolic disorder. As we age, our cartilage tissue wears away. Lack of water, trace elements and amino acids reduces the elasticity of the intervertebral disc. Salt accumulation is a consequence of osteonecrosis. The cause of pain is usually irritation (or irritation) of the nerve root.
This disease affects athletes who are subjected to high back stress, such as weightlifters. The risk increases after spinal cord injury. Cartilage degeneration often occurs in students who sit for long periods of time, bend over desks, and in drivers. Which factors cause the disease depends on lifestyle.
Degree
For osteonecrosis, there are 4 grades (stages):
- Grade 1 - cartilage. There is already pain
- Level 2 - instability. The affected vertebral disc is displaced relative to the underlying disc, causing acute pain.
- Grade 3 – intervertebral hernia formation. They compress nerve fibers and blood vessels.
- Grade 4—disc fibrosis. Osteoporosis may appear. This is the growth of bones with which the body tries to restore its supporting function.
When is prevention necessary?
Better late than never. If you are overweight and have a sedentary lifestyle, the sooner you start making changes, the more invested you will be in your health.
Symptom
How the disease can manifest itself in different departments:
- back-ache
- coldness and numbness in hands and feet
- headache
- movement restrictions
It is important not to confuse these signs with other diseases. Symptoms may be similar, for example, to thoracic osteoarthritis and diseases of the cardiovascular system. For accurate diagnosis and timely treatment, you need to consult a neurologist or therapist to receive a referral to a specialist.
Pain
Pain is the main problem of osteonecrosis, which is very difficult to get rid of. In addition, not only the disc or joint itself hurts - the pain also spreads throughout the body. And it happens that the pain from thoracic osteoarthritis spreads to the heart, so the feeling is easily confused with heart disease.
How to distinguish between heart attack and osteoarthritis:
- With heart problems, a burning sensation occurs in the chest, which can spread to the arms or neck. The pain appears suddenly and lasts no more than 30 minutes. The temperature rises, dizziness and chills appear. Accompanied by a feeling of lack of air and difficulty breathing.
- Pain during osteonecrosis can be different: pressing, shooting. As a rule, it has a moderate nature. Not accompanied by difficulty breathing and changes in blood pressure and heart rate. It has a shingles nature, which may last for several days or may disappear immediately.
Headache
Whether or not headaches occur depends on the origin of the disease. Headache occurs due to excessive tension of the musculo-ligamentary apparatus of the neck, the action of the muscles on the channels that transmit the painful cutaneous branches of the trigeminal nerve and the action on the trunks of the controlautomatic regulation of vascular tone.
Dizziness and noise in the head
Feelings of dizziness and noise in the head with osteoarthritis occur for the same reason as headaches: due to excessive muscle tension and stimulation of certain areas of the autonomic nervous system leading to vascular reactionsLater. It is important to remember that similar sensations in the ears can be signs of other diseases.
Tumor in the throat
A lump in the throat accompanied by cartilage degeneration of the cervical spine is a common symptom. This is due to the fact that inflamed tissues increase in volume. A person may feel a tickling sensation, a sharp pain in the neck, and even suffocation. Feeling like something is stuck in the throat, especially when swallowing. Such discomfort often forces you to consult a doctor. But this is not always osteonecrosis; It is important to rule out other pathologies, such as thyroid hypertrophy and chronic pharyngitis. If you feel something similar, it's better to start with an ENT doctor. He will determine the cause and refer you to another specialist.
shortness of breath
Difficulty breathing occurs due to compression of vascular bundles. Presents with osteonecrosis of the cervical or thoracic region. Because of the pain, I cannot breathe deeply but have to breathe frequently and shallowly. As a result, respiratory function is impaired, headaches, dizziness occur due to lack of oxygen in the brain. This can lead to serious consequences. If you notice such a symptom, consult your doctor.
Panic attack
A neurosurgeon at an area hospital claims that there is a direct link between panic attacks and osteoarthritis. One of the causes of panic attacks is a sign of violation of blood circulation of the brain. And this often happens with cervical spondylosis due to compression of blood vessels and vertebral arteries. Chest pain and shallow breathing can also cause panic due to this condition.
Temperature
Whether or not temperature can occur with osteonecrosis depends on many reasons. It is important to rule out other factors, such as acute respiratory infection.
Pressure
The disease can affect blood pressure; it is important to avoid such episodes of increased blood pressure.
Clinical guide
Once diagnosed, conservative treatment is recommended, followed by surgery to remove the cause of pain. The following drugs are prescribed in clinical guidelines:
- Nonsteroidal anti-inflammatory drugs in the form of suppositories, injections, ointments, gels.
- For acute pain of high intensity, therapeutic blockades are prescribed, the main drugs being local anesthetics and glucocorticoids.
- Manual therapy, osteopathy, massage.
Acute episode
The sooner treatment is started, the easier it is to avoid future exacerbations. A common cause is lifting heavy objects, especially with one hand. It is important to distribute the weight evenly and not lift it suddenly. It's best not to lift heavy objects. If an exacerbation occurs, medication will come to the rescue.
Treatment
Treatment is very complex, using many methods at the same time. The main goal is to reduce pain and prevent further degeneration of the vertebrae and cartilage.
Exercise therapy (physical therapy)
This is the main method for conservative treatment of diseases of the musculoskeletal system. Quantitative loading for
- nerve root decompression
- Corset muscle correction and strengthening
- maintain correct posture and give the ligament-muscle system the necessary flexibility
- prevent complications
To achieve their goals, patients should regularly exercise using rehabilitation equipment and perform joint exercises. These exercises improve blood circulation, normalize the metabolism and nutrition of the intervertebral discs, help increase the space between the vertebrae, form a corset muscle and reduce the load on the spine.
However, the treatment of diseases of the musculoskeletal system is not limited to exercise therapy. Physiotherapy is based on the use of physical factors:
- low frequency current
- magnetic field
- ultrasound and laser
Physical therapy applications
It allows you to speed up the treatment of many diseases, increase the effectiveness of drug therapy and reduce dosage, as well as avoid typical side effects of drugs.
Massage
Effectively relieves tension and muscle pain, improves blood circulation and has an overall health-boosting effect.
Manual therapy
The doctor's individual action 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.
acupressure
Different techniques and treatments affect the body's reflex zones and acupuncture points. The use of acupressure in combination with other treatments significantly increases their effectiveness.
Drug treatment
Indicated in the stages of exacerbation of the disease and is aimed at relieving pain, eliminating the inflammatory process and enhancing metabolic processes. The drug can be administered intramuscularly or intravenously.
It is important to note that although each of the listed methods is highly effective, the greatest therapeutic effect can be achieved only when they are combined with exercises using rehabilitation equipment. This allows you to create a full muscle corset and ensures long-lasting treatment results. How to treat each type of osteoarthritis depends on its location and cause.
Treatment at home
At home, you can and should continue treatment as recommended by your doctor. First of all, monitor your diet and exercise at home. If you want to add folk remedies or decoctions to your treatment, consult your doctor to see if combining them with medications is safe.
Medicine
Most medications to treat osteoarthritis are aimed at reducing pain:
- nonsteroidal anti-inflammatory drugs (NSAIDs) with diclofenac, ibuprofen, ketoprofen and nimesulide. And not only in tablet form, but also in ointment and gel form. It is important to take medications as a course, not systemically, because they have an effect on the digestive tract.
- Opioid pain relievers (glucocorticoids) are prescribed by your doctor to relieve severe pain if NSAIDs do not provide relief.
- Anticonvulsants or antidepressants are needed for neuropathic pain.
- vasodilators to avoid hypoxia.
- chondroprotectors for the treatment of osteoarthritis - drugs that improve the function of cartilage and joints.
- Muscle relaxants help relieve pain caused by excessive muscle tension.
Applicator
Appliances for osteochondrosis are a popular complementary method of treatment. It affects nerve impulses and improves blood flow, helping to reduce swelling. I mainly use two types of tools:
- Kuznetsov applicator - mat with plastic spikes
- Lyapko applicator - covered with needles and alloys of different metals.
They can be used only after permission from the attending physician.
collar
A collar (or bandage) helps in the treatment of cervical spondylosis to relax the neck muscles and reduce its load. As a result, pain disappears and blood flow to the brain improves. Bandages come in different sizes and hardnesses, so if you have neck pain, you should definitely consult a doctor and find out the cause. If it is osteonecrosis and you have no contraindications, your doctor will tell you which product is best for you.
Darsonval
Darsonval is a medical device that generates electric current in the form of a pulsed discharge. It has a very wide spectrum of effects, from dermatological problems to digestive disorders. Darsonval improves tissue permeability and improves local blood circulation. Thanks to that, the medicine penetrates faster and deeper, the muscles relax and spasms disappear.
dropper
Drops for osteochondrosis provide quick pain relief. They are prescribed in cases where other drugs are contraindicated. This happens, for example, in people who are intolerant to the components of NSAID tablets.
corset
Corsets are used for osteoarthritis to immobilize the spine. This helps reduce stress and prevent displacement of the vertebrae. You can use it after consulting your doctor.
Plaster
Pain in the spine and joints can be alleviated with pain relief patches. They are very convenient to use when it is not possible to apply ointments or creams because they stain clothes.
Injectable drugs
Injections help relieve pain quickly when there is an acute attack. It is effective and acts quickly. It's important to continue to look after your body and even if you improve, follow your doctor's advice and exercise. Injections are also a quick and effective way to deliver nutrients to the discs.
What injections should be given when suffering from osteoarthritis:
- chondroprotector
- NSAIDs
- antispasmodic medication
- vitamin
The choice depends on the course of the disease, the presence of pain and the doctor's recommendations.
Vitamin
- Vitamin D helps absorb calcium, which is necessary for the restoration of spinal bone structure.
- Vitamins A, E, C contribute to the production of collagen and necessary tissues for joints.
- Medical journals talk about B vitamins (thiamine, pyridoxine and cyanocobalamin), which have pain-relieving effects in cervical spondylosis. Thanks to this, you can reduce the amount of painkillers.
Orthopedic pillow
Orthopedic sleeping pillows will not replace treatment, but sleeping with them will be much more comfortable. Pillows come in many different shapes and from different materials. For example:
- a rectangular pillow or one with cushions is perfect for people suffering from any type of osteoarthritis
- crescent shape cures neck and shoulder pain
- A pillow with a center concave or shoulder concave will help people with cervical spondylosis maintain proper blood circulation in any position while sleeping. Optimal for the neck and its natural position.
It is also important to take into account not only the form of osteoarthritis, but also in what position a person prefers to sleep. The neurologist will tell you which pillow to choose correctly after analyzing your sleep preferences and the characteristics of the course of the disease.
Massage
Massage therapy can only be performed for osteoarthritis when the condition is in remission. It will help improve blood circulation, metabolism, flexibility of the spine and muscles. Proper massage will slow or even stop the spread of the disease. But it is not always possible to visit a massage specialist. Special devices will come to the rescue, such as electric massagers for the back and neck. They are especially effective in the early stages of cervical spondylosis. The main thing is to use it correctly and consult a doctor.
Diet
There is no special diet for osteonecrosis. The most important thing is to maintain a healthy weight. If you are overweight, you should discuss weight loss methods with your doctor and find out the reasons for your weight gain.
What a balanced diet means:
- protein
- healthy saturated fats
- complex carbohydrates
- fruits and vegetables
It is important to monitor the amount of salt you consume. It promotes fluid retention in the body.
Exercise
Special types have outstanding healing effects, such as after surgical removal of spinal hernia.
Moreover, these are quite simple exercises even for the unprepared. For example, "first aid" to relieve tension in the neck:
Maintain correct knee and elbow position (do not arch your lower back). Use your hands to slowly push the floor away from you, then "fall" with your back between your shoulder blades. No need to do push-ups. Hands remain in one position. That is the chest area that moves up and down.
Gymnastics to improve thoracic mobility:
Lie on your back, knees bent, arms to the sides, just below the shoulders. Touch one hand to the other. With a look, "follow" the hand. Shoulders can be lifted off the floor. Do this slowly for one minute.
You can reduce discomfort in the neck and shoulder area and improve them by using double massage rollers:
Stand with your back to the wall, place the roller between your shoulder blades and press it against the wall, while placing your feet one step away from the wall. The roller should not press on the spine, but on its edges. Perform a half-squat at a comfortable range, bending your knees but not lifting your heels off the floor. The roller must move along the height of the shoulder blade. You can do it on the neck area in the same way: fix the roller on the neck, relax your arms and slightly lift your chin. While squatting, move the roller to the base of the skull.
Army
Whether a person with osteoarthritis can be accepted into the military depends on the severity of the disease and the exact diagnosis. All documents and certificates must be in order: at least a neurologist's report and a radiograph. On the contrary, after a medical examination, a decision will be made to enlist.
In what cases are they not drafted into the army:
- damage to three or more discs
- Anatomical changes are visible
- pronounced pain syndrome, even after lifting weights
If there are symptoms and certificates, the young man can receive category B - limited service capacity. This means that he will not be drafted into the army but may be conscripted in case of military training.
It is almost impossible to achieve category D - complete exemption from military service. For example, osteochondral kyphosis may occur - the final stage of osteoarthritis.
Questions and answers
Acupuncture for osteoarthritis
Acupuncture or moxibustion is used in combination with other treatments. It is especially effective in times of exacerbation of pain syndrome.
This procedure has several advantages:
- low risk of allergic reactions
- quick results
- Minimal risk of injury
It is important to understand that acupuncture relieves pain but does not cure it.
How to sleep properly when suffering from cervical spondylosis
There are two optimal positions: lying on your back and lying on your side.
Sleeping on your back is the optimal way to relax your body. To properly distribute weight, you should place a small cushion under your knees.
In the side lying position, the neck muscles are relaxed, the load on the spine is reduced, and blood circulation is not disturbed.
It's important to choose the right pillow depending on your preferred position.
Can you take a sauna when you have osteoarthritis?
Normally, bathing is not contraindicated. On the contrary, due to high temperature, blood flow improves and symptoms are relieved.
In case of exacerbation of osteonecrosis, bathing is contraindicated. If blood flow increases at the site of inflammation, it will cause complications.
Can I play sports with osteoarthritis?
Moderate loading is not only permissible, but also necessary for osteoarthritis. But there are still exceptions:
- professional sports
- dangerous sport
- weightlifting sport
Can the neck be warmed when suffering from cervical spondylosis?
You should not warm your neck to relieve pain. In this way, more blood will begin to flow to the inflammation and the condition will become more intense.
Things not to do when suffering from osteoarthritis
- Lift weights, even in the gym
- making sudden movements, such as when playing sports
- sleeping on a mattress that is too soft or a pillow that is too high
- abuse of high-calorie foods, coffee, alcohol
- remaining in a crouched position for very long periods of time, such as when cleaning or gardening
- wear high heels
Yoga cures osteoarthritis
Yoga is a great option for physical activity for osteoarthritis. No sudden movements or heavy objects. Yoga not only eliminates the symptoms but also fights the cause of the disease. In rare cases, yoga is contraindicated, so you should still discuss it with your doctor.
Osteonecrosis is a serious preventable condition. To do this, you need to monitor your diet and physical activity.