home Analyzes Disability and degenerative-dystrophic changes in the spine. What are degenerative-dystrophic changes in the lumbosacral region

Disability and degenerative-dystrophic changes in the spine. What are degenerative-dystrophic changes in the lumbosacral region

Today, degenerative-dystrophic changes in the spine are one of the most common chronic diseases. So back pain of varying degrees of intensity is observed in almost every person. And after thirty years, every fifth person develops symptoms of such a disease as discogenic sciatica.

Degenerative-dystrophic diseases of the spine often affect people of working age and lead to disability and even disability. According to statistics, cases of such ailments are becoming more frequent.

Causes of degenerative-dystrophic changes in the spine

The human body is a delicate and precise organism. Nature has made sure that the load on the spine is evenly distributed. A healthy body can withstand weight lifting, jumping, and other impacts. But this rule works only in case of correct posture and a strong muscular corset.

Unfortunately, modern life dictates sedentary image life. This leads to muscle weakness and obesity. Sedentary work and the habit of sitting at a computer for a long time also affect. According to studies, the human spine spends more than eighty percent of the time in a bent position.

Such circumstances lead to degenerative-dystrophic changes in both the vertebral body and intervertebral discs. Thus, the vertebrae lose their shape, and intervertebral discs become less elastic.

As a result of degenerative processes, discs lose moisture. It has cracks and breaks. Subsequently, this may lead to hernia.

The appearance of an intervertebral hernia means displacement of the nucleus pulposus intervertebral disc with ruptured annulus. Among other varieties this disease most frequently encountered.

The vertebrae, under conditions of a changed load level, try to increase their area, thicken, thereby causing entrapment of adjacent nerves.

We can name such reasons that can provoke the appearance of degenerative-dystrophic changes:

The symptoms of degenerative-dystrophic changes in the spine are very wide.

Be sure to consult a doctor if you notice the following symptoms:

Back pain. It can be completely different types of pain - from pulling, aching, to sharp, stabbing pain. The affected areas are also varied. The neck, the area under the shoulder blade, the lower back, etc. can hurt.
, in the intercostal space (usually caused by pinched nerves).
Decreased mobility in various parts of the back - thoracic, lumbar.
Numbness limbs or chest.
Soreness internal organs - stomach, liver, heart.
sexual dysfunction.

Degenerative-dystophic changes do not occur at once, however, a person is able to feel the symptoms of the disease even at the earliest stages. First of all damage to the nerves caused by infringement due to narrowed intervertebral canals make themselves felt. This position causes the nerve endings to swell, reduces their conductivity. The patient feels this as numbness of the limbs, a feeling of fatigue in the shoulders, neck, and back. The vertebrae change the pattern of tissue growth. To reduce the load, the vertebra expands, which subsequently leads to and to even more pinched nerves. People suffering from similar ailments fatigue, changes in gait, persistent back pain.

And if bacteria and / or fungi are added to these lesions, then arthritis and osteochondropathy cannot be avoided. Subsequently, these ailments are transformed into herniated discs. Also, degenerative changes in muscles lead to scoliosis or even displacement of the vertebrae.

In more severe stages of the disease, ischemia, impaired blood supply, paresis, and paralysis of the limbs are observed.

Treatment

There are two methods of treatment of degenerative-dystrophic changes in the spine - conservative And surgical.

The conservative method of treatment includes the following steps:

Limitation of mobility of the spine(carried out with the help of orthopedic bandages or bed rest is prescribed).
Medical treatment . Drugs are used to combat inflammatory and degradation processes, improve vascular patency. Also prescribed sedatives and vitamin complexes of group B.
Novocaine blockades.
Physiotherapy(laser therapy, diadynamic currents, inductothermy, electrophoresis).
Therapeutic methods (traction on the plane, underwater traction). traction considered the most dangerous method treatment of degenerative-dystrophic diseases.
Manual therapy.

One of the conservative methods of treating degenerative-dystrophic changes in the spine is the use of orthopedic bandages. About that, and among the abundance orthopedic products Read more in the articles on our website.

There are rare cases when surgical intervention is necessary.

Separately worth highlighting percutaneous nucleotomy. This method is a boundary method between conservative and surgical treatment. This type of treatment involves a puncture biopsy, the purpose of which is to reduce the volume of the affected intervertebral disc. This kind has big list contraindications.

Surgery is required only in cases of rapidly progressive course of neurological symptoms of the disease, persistent long-term pain syndrome, ineffectiveness of conservative treatment.

In connection with the scale of the spread of degenerative-dystrophic changes in the spine, it is worth taking care to follow preventive recommendations.

These rules will protect against disability in youth and extend the years of activity until old age:

Keep your back dry and warm. Humidity and hypothermia are the primary enemies of the spine.
Excessive, sudden physical exertion should be avoided.
Exercises aimed at developing the muscles of the back will also protect against degenerative-dystrophic changes in the spine.
When working, requiring a static posture, it is necessary to change the position of the body as often as possible.
For office workers, it is recommended to lean back in your chair every half an hour.
Every hour and a half, you need to get up from your chair and make small passes for 5-10 minutes.

You can do the following exercises:

Lying on your stomach, rest your hands on the floor and slowly lift the body. Hold on outstretched arms for a few seconds.
Lying on your back, raise your legs and head up. Hold in this position for a few seconds.

According to statistics, more than 80% of the population suffer from various diseases. caused by degenerative-dystrophic changes in the spine. There is also an increase in this indicator due to the peculiarities of modern life.

Diseases of the spine are very widespread, and most often it is degenerative-dystrophic changes in the lumbar spine that are found among them. It is this important department that accounts for the largest part of the load.

With age, the risk of this syndrome increases, because our body wears out over time. Already after 30 years, the chance of developing this pathology exceeds thirty percent, and closer to old age it is almost inevitable.

This article contains information about the varieties, the causes of the development of degenerative-dystrophic changes in the spine, as well as the main methods of conservative and surgical therapy used for this syndrome.

What are degenerative dystrophic changes in the lumbar spine?

Although there is a slight genetic predisposition to the occurrence of this disease, the true cause of degenerative changes in the spine appears to be multifactorial. Degenerative changes may be due to natural process aging of the body or have a traumatic nature.

However, they are rarely the result of major trauma, such as a car accident. Most often, we will talk about a slow traumatic process, leading to damage to the intervertebral disc, which progresses over time.

The intervertebral disc itself is not provided with a blood supply, so if it is damaged, it cannot recover in the same way that other tissues of the body recover.

Therefore, even minor damage to the disk can lead to the so-called. "degenerative cascade", due to which the intervertebral disc begins to collapse.

Despite the relative severity of this disease, it is very common and, according to modern estimates, at least 30% of people aged 30-50 have some degree of disc space degeneration, although not all experience pain or are diagnosed with it.

In fact, in patients over 60 years of age, some level of intervertebral disc degeneration detected by MRI is the rule rather than the exception.

Varieties of degenerative-dystrophic changes

There are three types of degenerative-dystrophic changes in the vertebrae and intervertebral discs:

spondylosis;
osteochondrosis;
spondylarthrosis.

Depending on the localization, the following types of the disease are distinguished:

degenerative-dystrophic changes cervical spine;
degenerative-dystrophic changes in the thoracic spine;
degenerative-dystrophic changes in the lumbar spine;
degenerative-dystrophic changes sacral department.

With spondylosis bone grows around the edges. Such neoplasms - osteophytes - look like vertical spikes on the x-ray. Osteochondrosis is a pathology in which the elasticity and strength of the intervertebral discs is reduced. It also reduces their height.

Spondylarthrosis often occurs as a complication of osteochondrosis. This is a pathology of the facet joints, with the help of which the vertebrae are attached to each other. With spondyloarthrosis, the cartilaginous tissue of the facets becomes thinner and becomes loose.

Features and signs of dystrophic changes are summarized by several diseases that develop together or separately.

Due to dystrophic changes, thinning of the vertebrae, chronic osteochondrosis occurs;
The destruction of the vertebrae in chondrosis through the occurrence of microcracks appears in people in their youth who experience strong loads on the vertebrae, intervertebral discs;
With degenerative dystrophic changes in the spine, spondylosis occurs. Outgrowths appear from the edges of the vertebrae, over time, the possibilities of the spine's actions are limited due to ossification;
The vertebrae are destroyed due to damage to the joints between them. Such a degenerative dystrophic change is called spondylarthrosis. As with spondylosis, bony outgrowths appear, causing strong field sensations with any kind of movement;
The results of dystrophic changes in the vertebral bodies are manifested in a hernia formed between the vertebrae, the cause of which is a fracture of the fibrous ring of the disc. Squeezing and protrusion of the nerve roots causes pain.

A degenerative change in the spine will indicate the general picture of pathologies accompanied by painful processes.

Causes of pathological changes in the spine

The opinions of experts on this issue are divided, since it is difficult to find a single cause that could provoke the development of the disease in all cases.

In addition, multiple studies have proven the presence of a small genetic predisposition to this pathology. However, with full confidence we can say that the causes of DDIP have a multifactorial orientation. What does it mean?

There are several factors, the combination or presence of which can lead to the manifestation of the syndrome. As an option, we can consider the impact of injuries on the course of the process.

But still, here we will talk about a prolonged pathological effect on the intervertebral disc. By the way, this is a very elastic and at the same time vulnerable part of the spine, which needs special attention.

The intervertebral disc is a body formed by the annulus fibrosus and the nucleus pulposus. Based on the anatomy, it becomes clear that the disk is deprived of its own circulatory system, which means that it cannot regenerate like some other tissues of the body.

Consequently, minimal damage leads to aggravation of the course of the disease, slowly progressing. Also, at the age of over 40 years, some degree of degeneration is observed in many of our compatriots. Moreover, one should not forget about hypodynamia, as the main "bad habit" of our society.

Here are the most "aggressive" causes of degenerative-dystrophic changes in the spine, which often overlap, leading to a aggravation of the process:

inflammatory processes. If the integrity of the fibrous ring is violated, the contents of the disc enter the intervertebral space. Thus, protein structures irritate soft tissues thus causing swelling and inflammation. Typical signs"radicular syndrome" (squeezing of the nerves) will not take long.
Pathological mobility of bone structures in the spinal segment caused by destructive changes in the disc itself. Due to the presence of boundary loads, age-related changes in the gelatinous body and other factors, the disk “dries out”, becomes less elastic and can no longer fill the entire disk space. Gaps appear or the spine “moves out”. This describes the principle of the "degenerative cascade".

The most important cause of pathological changes is an unhealthy lifestyle.

This can include malnutrition, bad habits, lack of physical activity, sedentary lifestyle and many other indicators. Immobility entails degenerative changes in the spine.

But besides this, there are other annoying factors, which include:

Prolonged stay in the wrong position impairs blood circulation in the spine, disrupting metabolic processes in the tissues. As a result of insufficient nutrition with useful substances, cartilage and bone tissue weakens, any movements lead to microscopic injuries. It is at this moment that degenerative changes in the structure of the spine begin to develop.
Large physical loads on the lumbar spine also adversely affect the normal condition of the spinal segments. Most often, people whose work is associated with hard physical labor or professional heavyweight athletes fall into the risk group.
Injuries to the lumbar spine are often the cause of metabolic processes in tissues, which further also leads to degenerative changes.
Job disruption muscle tissue. The back muscles maintain the correct position of the vertebrae. Therefore, after inflammation or during a spasm, the coordinated work of muscle fibers is disrupted, which as a result negatively affects the condition of the spine.
infectious and endocrine diseases quite often affect the segments of the lumbar spine.

The most common cause of back pain, incl. and in the lumbosacral region, today they consider a chronic disease called osteochondrosis.

It is non-inflammatory in nature and can affect both the vertebrae (spondylosis) and intervertebral discs (discosis).

Therefore, osteochondrosis can cause degenerative-dystrophic changes in the lumbosacral region.

Osteochondrosis has its own range of predisposing factors: overweight, age-related changes, spinal overload, posture disorders, a sharp decrease in stress (cessation of sports), genetic predisposition, lifestyle, stress, etc.

Reasons for degenerative changes in lumbar there can be a lot of spine. But the most important thing is to identify them in time and start treatment. Therefore, in order to prevent serious pathologies, it is necessary to undergo a complete examination by a doctor every year.

Signs and symptoms

Dystrophic changes in the disease of the spine proceed slowly, dragging on for many years, so it is not always possible to determine the first symptoms and consult a specialist immediately.

People resorting to folk methods, without examinations, an accurately established diagnosis, aggravate their own situation. When examined using MRI or X-rays, changes in the sacral spine are revealed, which are under the strong influence of the destructive force of pathology.

Dystrophic diseases of the spine are manifested by the following symptoms:

Aching pain in the lumbar region, gaining strength when a person sits, bends over, experiences other loads. It subsides for a period of sleep at night;
Degenerative changes in the intervertebral discs are manifested by pain in the buttocks, lower extremities;
The activity of the departments in the spine decreases;
The working capacity of the organs located in the small pelvis is impaired;
With a degenerative dystrophic disease of the spine, the area of the sacrum of the lower back swells and reddens;
A person gets tired faster;
Numbness and tingling of the buttocks and legs are felt;
From dystrophic changes, gait is disturbed.

If left untreated, degenerative-dystrophic changes in the spine, the processes worsen blood circulation, causing paresis or paralysis.

The clinical picture of changes can be different, depending on which structures of the spine are damaged and how serious these injuries are.

Symptoms of diseases appear as degenerative-dystrophic lesions develop, but on early stages pass without pronounced external signs.

As the pathological process develops, the patient may feel stiffness and heaviness in the lower back. But, the main symptom of all degenerative changes in the spine is pain.

Pain in the lumbar region occurs during a long walk and during physical exertion, prolonged sitting in one position, during bending. The pain syndrome is undulating: it arises, then decreases, disappears.

A progressive degenerative process in the intervertebral discs of the spine can lead to serious and dangerous complications. Degenerative changes develop in stages.

Initial stage. The first symptom, "screaming" about the presence of pathological changes in the lumbar spine, is a pronounced pain syndrome in the lower back. The pain sensations are so palpable that the patient is forced to limit his movements, and this significantly reduces the normal standard of living and working capacity.

Complaints of pain directly depend on the place where the lesion is localized.

The second stage of the disease. Further progression of degenerative changes is characterized by the presence of:

severe mobility restrictions;
"lumbago" that occurs in the lower back;
tingling and "goosebumps" in the limbs and buttocks.

In the second stage of the disease develops radicular syndrome- Nerve roots are compressed.

Third stage. At the third stage, blood circulation is disturbed due to compression of the radicular vessel, which leads to the development of ischemia. In addition to increasing pain, the third stage is marked by partial or temporary numbness in the lower extremity girdle, convulsions.

Fourth stage. Degenerative pathological processes of the spine that have not received proper treatment, at the fourth stage of development are fraught with paralysis, paresis. These complications arise as a result of a complete violation of the blood circulation of the spinal cord.

Diagnostic methods

If the patient complained of pain in the spine, then the following manipulations will be carried out:

examination by a doctor during which painful areas, check the level of mobility;
x-ray;
MRI of the spine.

The latter diagnostic method is the most effective and allows you to make an accurate diagnosis.

Radiological signs of the disease:

shortened disc height;
deformed articular and uncovertebral processes;
subluxations of the vertebral bodies;
the presence of marginal osteophytes.

MRI picture of degenerative-dystrophic changes:

intervertebral discs look darker than healthy ones (due to dehydration);
the cartilaginous end plate of the vertebral body is erased;
there are gaps in the fibrous ring;
there are protrusions;
there may be intervertebral hernia.

If the patient was given the conclusion "MRI picture of degenerative-dystrophic changes in the spine", it is necessary to urgently start treatment.

If the disease is not taken seriously, it will progress, which can even lead to disability.

Fundamentals of Therapy

Usually, in most cases of back pain, a significant reduction in pain can be expected within 2 to 4 weeks after the start of treatment. Also, most patients with back pain return to their usual physical activity during this period, but not always with a complete regression of the pain syndrome.

About two-thirds of patients who have experienced back pain for the first time have a re-exacerbation of the pain syndrome within 1 year.

If during treatment there is a deterioration in the condition and symptoms are found, such as the development of paresis (weakness) in the leg or arm, the syndrome of compression of the cauda equina in the form of paraparesis in the legs with extensive sensory disturbances and urination disorders, or signs of an infectious or oncological disease, then an urgent need is additional examination.

In the case of persistent, severe, treatment-resistant radiculopathy, development of paresis in the leg or arm, or cauda equina syndrome, patients are referred for a consultation with a neurosurgeon and, if indicated, surgical treatment is performed.

If, during the initial visit of the patient, an increasing development of weakness in the arm or leg is detected, or the syndrome of compression of the cauda equina, the patient is urgently referred for a consultation with a neurosurgeon.

For acute severe pain in the neck or back, especially if it occurs for the first or second time, the following measures can be effective and simple treatment measures that are effective in most cases:

Bed rest 1 - 2 days.
Cold on the lesions in the first - second day, heat from 2 - 3 days.
In the most acute period, local short-term cooling of tissues with chlorethyl, cold applications or rubbing with Finalgon ointment or the like can have a pronounced effect. As a rule, these procedures either give a good effect on the first application, or are ineffective.
Appointment of Voltaren 75 - 100 mg / m 1 - 2 times a day.
Ultraviolet irradiation or diadynamic currents, or amplipulse therapy.
With infringement of the meniscoids, manual therapy can have a fairly quick effect.

If these measures do not bring effect or are insufficient for 3-5 days, the following can be added to them:

Massage.
"Paravertebral", epidural blockades or blockades of trigger and pain points with novocaine or lidocaine.
Phonophoresis of hydrocortisone with novocaine or electrophoresis of 4% solution of novocaine.
Acupuncture.
Balneotherapy (low-temperature mud (up to 40 degrees)).
Physiotherapy.

As the pain subsides, the patient gradually returns to active image life, normal activities.

With radicular syndromes, traction (traction therapy) and blockades with local anesthetics mixed with a corticosteroid preparation can be added to the above measures from the very beginning.

If the pain does not decrease within 1 to 3 weeks, or if there is an increase, a re-examination and, if necessary, additional examination of the patient is necessary, in particular, in order to diagnose concomitant anomalies in the development of the spine, diseases of the internal organs that could provoke and support the pain syndrome.

At chronic pain mud therapy, physiotherapy exercises, massage, antidepressants, if available, are added to the treatment anxiety disorders tranquilizers, or carry out complex therapy, as a rule, in stationary conditions, using various combinations of the above methods.

The widespread, routine use of back muscle massage, ultrasound treatment methods, electrotherapy, traction is not recommended, since their appointment, especially for a long time, without monitoring the real effectiveness of the procedures after the first sessions, can contribute to the formation of a “painful” personality, chronic pain course.

Non-surgical treatments

early activation. In most cases of pain syndromes of degenerative-dystrophic origin, the earliest possible, but careful, activation of the patient is necessary. If pain is normally tolerated by the patient, bed rest is not recommended.

In case of severe pain at the beginning of an exacerbation, bed rest is indicated for a period of not more than 1 to 3 days until the most severe pain decreases. After some subsidence of the pain syndrome, the patient is gradually invited to return to the usual daily activities, walks are possible.

In this case, it is necessary to avoid loads that increase pain, long walking and sitting, lifting weights, turning and bending.

Brief immobilization. In the initial period, in case of severe pain, it is possible to wear it for the purpose of temporary external fixation of the spine, cervical orthopedic collar, lumbar corset or weightlifter's belt in the first few days of exacerbation (1 - 3 days) or subsidence of pain when the patient faces long-term static-dynamic loads.

For patients with normally tolerated pain, external fixation is not recommended. Long-term external fixation (especially without concomitant physical therapy) weakens the muscles of the spine and can even contribute to chronic pain due to insufficient activation of the natural active muscle mechanisms of myopically.

Cold, warm. Cold in the acute period, later heat on the sore spot can help relieve pain, but usually for a short time. In addition, it is necessary to have a differentiated approach to the appointment of cold and heat and focus on the effectiveness of these procedures in a particular patient.

Also, in the early acute period, local short-term cooling of the affected tissues of the spine and extremities with chloroethyl can be effective in relieving pain.

Appointment of NSAIDs. In order to obtain analgesic and anti-inflammatory effects, drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed, usually in medium or high therapeutic daily doses, orally or intramuscularly, or intravenously, depending on the severity of the pain syndrome and the patient's response.

It must be remembered that excessive prescription of NSAIDs can cause side effects, primarily gastrointestinal, and pain relief can create an imbalance in complex myopically fixing and other sanogenetic processes and make recovery difficult.

It is necessary to prescribe the lowest possible effective dose of the drug. With moderate severity and normal pain tolerance by the patient, do not prescribe NSAIDs if possible or from the very beginning, or cancel NSAIDs after a short course and achieve pain reduction and switch to non-drug and local methods therapy.

If one of the drugs is ineffective, you can try another. NSAIDs with a pronounced analgesic and anti-inflammatory effect include diclofenac (voltaren), ketoprofen (ketonal), ketorolac (ketones).

Physiotherapy and mud therapy are widely used in the treatment of both exacerbations and chronic forms of osteochondrosis syndromes. For example, ultraviolet irradiation or diadynamic currents, or amplipulse therapy, can be quite effective when prescribed on the first day of exacerbation treatment along with bed rest and an NSAID group drug.

Particular application of individual methods will be discussed below. It must be remembered that unreasonable, long-term use of physiotherapeutic methods, without focusing on effectiveness, can lead to chronicity of the disease.

Acupuncture (acupuncture) is a well-known method used for osteochondrosis. Estimates of the method diverge from mere psychotherapeutic influence to the high effectiveness of the method. Apparently, the method is effective for not very severe manifestations of osteochondrosis as part of complex treatment.

In most cases, it is not necessary to use acupuncture as primary care for exacerbations, but to use it in complex therapy at later stages.

Massage is used in most syndromes of degenerative-dystrophic lesions of the spine. In the acute phase, with severe pain, as a rule, they refrain from massage until some reduction in the pain syndrome.

Classic massage in acute stage in the first days of treatment should be gentle, followed by a more intensive conduction. It should be noted that in many cases of back pain that has arisen for the first time, the widespread appointment of massage does not make sense, since it is quite enough to prescribe bed rest, cold, and a drug from the NSAID group.

Contraindications to massage are: identification of signs that require special alertness, tumors of the spine, acute purulent-inflammatory diseases, acute internal illnesses, in some cases transferred oncological diseases.

Surgery

Indications for surgery, methods of surgical intervention, the effectiveness of surgery - all these parameters are criticized and rethought by specialists, in particular, they depend on such factors as the subjective readiness of the patient for surgery, the capabilities of the instruments available in the operating room, the qualifications of surgeons and the range of operations they perform.

Surgical treatment is used for compression lesions and, thus, the main principle of operations is decompression - release from compression by disc herniation, osteophyte, adhesions of the root or spinal cord.

The main targets for removal are a herniated disc or an altered facet joint that causes root compression.

Decompressive interventions on discs and facet joints can be performed both by percutaneous puncture method and by open intervention through posterior or posterolateral incisions, or, in case of anterior approaches, through incisions in the neck or abdomen.

In the event that the patient has instability, or if there is a potential threat of its development, the so-called surgery is performed as the final stage of the operation. stabilizing interventions by installing special grafts between the vertebral bodies, or fixing one or more segments of the spine with special metal structures- rear fixation systems.

Percutaneous methods are usually performed in the absence of gross pathology in the patient. If, during percutaneous operations, the preoperative group of patients for whom this operation is indicated is selected rather rigorously, then good results are achieved.

At the same time, the advantage of the puncture method is its low trauma and almost outpatient nature of the operation. There is a polar opinion of some surgeons about the lack of sense in conducting puncture interventions.

Low-traumatic microsurgical approaches to disc herniation are widely used.

They, as a rule, are performed by posterolateral approaches from 4–5 cm incisions using a microsurgical instrument under the control of an operating microscope or endoscope and an X-ray image intensifier tube (EOP).

The indications for surgery are:

Acutely developed cauda equina syndrome (usually with prolapse (sequestration) of a herniated disc) with the development, as a rule, of distal paresis in the legs and urinary disorders. In this case, an urgent examination is indicated and an early surgical intervention is possible.
Increasing or acutely developed pronounced paresis or paralysis in the muscles of the limb due to radicular compression. In this case, an urgent examination is indicated and an early surgical intervention is possible.
Severe, disabling, long-term treatment-resistant radicular pain syndrome. The timing of surgery for compression radiculopathy is debatable and varies from 3 to 12 weeks, since it has been established that longer compression can lead to irreversible changes in the root.

An even less traumatic method is microendoscopic discectomy, which is performed from a 4-5 mm incision through a special tube (so-called port) under the control of an endoscope.

Exercise therapy for degenerative-dystrophic changes

Therapeutic exercise is complex method both treatment and prevention and rehabilitation. This method is indicated for almost all manifestations of degenerative-dystrophic diseases of the spine, of course, taking into account the severity of the process, the underlying cause and specific syndromes of the disease.

In the acute phase, physiotherapy exercises, as a rule, are not carried out, until some reduction in pain by other methods, such as rest, local cooling, NSAIDs, blockade. When expressed clinical manifestations osteochondrosis, static or low-amplitude exercises in a slow rhythm are more indicated.

In mild forms with a predominance of vegetative-vascular irritation, complexes of dynamic exercises are preferable. Contraindications to physiotherapy exercises or individual types of exercises are:

Severe somatic diseases, in particular cardiac decompensation.
At cervical osteochondrosis jerky movements of the head are contraindicated in the presence of osteophytes.
With lumbar osteochondrosis, especially with syndromes of a discogenic nature, Negative influence can exert torso forward, especially in frequent and fast mode.

With caution, it is necessary to prescribe exercises for raising a straight leg in a prone and sitting position, sharp turns of the torso, exercises for stretching the muscles and fibrous tissues of a sore leg in the presence of osteofibrosis, for example, with piriformis syndrome, exercises for crossing the legs, a sharp rotation of the thigh inward.

An approximate set of exercises performed outside the period of exacerbation. In the supine position:

Arms along the body, legs together. Hands to the sides - inhale, return to the starting position - exhale.
Arms along the body, legs together. Squeeze and unclench your fingers into a fist with simultaneous flexion and extension of the feet. Breathing is arbitrary.
Arms along the body, legs together. Without taking your feet off the mat, bend your legs at the knee joints, slowly straighten them, sliding them along the mat. Hands to the sides, legs wider than shoulders - inhale. Connect the palms to the right of the body - exhale; do the same on the other side.
Hands along the body, legs together - inhale. Slowly raise alternately the right and then the left straight leg, bend the foot at an angle of 90 °, calmly lower it - exhale.
Arms along the body, legs together. Raise your legs, bent at the knees, hold them, slowly lower them at the expense of 2,3,4. You should raise straight legs low, hold up to 10-15 s. After doing the exercise, you need to relax for 5-10 seconds.
Brushes to the shoulders, elbows to connect in front of the chest. Spread the elbows to the sides - inhale, connect in front of the chest - exhale.
Hands in front, palms inward, feet together. Pull out right hand forward as much as possible. Do the same with your left hand. With this movement, it is recommended to lift the shoulder from the mat. Breathing is arbitrary.
Arms along the body, legs together. Make movements with your legs, as when riding a bicycle. Make sure that the movements are involved alternately ankle, knee, hip joints. Breathing is arbitrary.
Hands to the sides, legs together. Bend and straighten your right leg. Try to bring your knee as close to your stomach as possible (you can use your hands). Do the same with the left foot.
Hands to the sides, feet shoulder-width apart, calm breathing. In this exercise, the main thing is to relax the muscles of the arms, legs and torso as much as possible.
Alternately press the head, shoulder blades, back, lower back, pelvis, hips, shins to the mat. Initially, the tension should last 3-4 s. Breathing is arbitrary.
Lying on your side (first - on one, then on the other). The right hand is under the head, the left is on the mat in front of the chest in emphasis. Bend in hip joint straight left leg, then attach the right leg to it, hold one count, slowly lower. When performing the exercise, the feet should be bent at an angle of 90 °.
The right hand is under the head, the left hand is along the body, the legs are bent, inhale. straightening the legs, left hand lift up, stretch, exhale.
The right hand is under the head, the left hand is along the body, the legs are straightened, inhale. Bend your legs, bringing them as close to your stomach as possible, exhale.

In the prone position:

Hands under the head. Alternate and simultaneous bending of the legs in the knee joints. Breathing is arbitrary.
Hands are stretched up. Imitation of swimming in the breaststroke method, while inhaling, slowly spread your arms through the sides, up, exhale. Flexion in the spine should be minimal.
Hands under your head, put your feet on your toes. Straighten your knees, return to the starting position. Breathing is arbitrary.
Hands up, feet together. Pull up with your right, then your left hand up. Breathing is arbitrary.

In a standing position on all fours:

Slowly sit on your heels, stretch your arm forward, return to the starting position. Perform the exercise slowly, do not bend your back.
As you inhale, take your right hand to the side. Return to starting position, exhale. The same - on the other side.
With the right knee, sliding on the mat, reach the opposite (left) hand, do the same with the other foot.
Sliding on the rug with your right foot back, sit on your left heel. Do the same with the right foot. When performing the exercise, the hands should remain in place, do not raise your head. Lie on your stomach, relax free breathing(within 3 minutes).

In the future, more complex complexes will be required, as well as exercises with objects.

Prevention

Primary prevention. Primary prevention of degenerative-dystrophic diseases of the spine is relevant, starting from childhood and adolescence, in persons with anomalies in the development of the spine, congenital disorders of posture, instability, articular hypermobility, as well as family predisposition (i.e. when one or both parents are sick with osteochondrosis).

For these individuals, all those recommendations that are relevant for secondary prevention are applicable. It is most important to carry out prevention from childhood and until the fibrous end is fixed in the limbus and the development of the spinal motion segment is completed, usually occurring at the end of the second decade of life, less often a little later.

It is necessary to avoid physical overload, powerful jerky loads, uncontrolled weightlifting, lifting weights by bending forward, frequent dynamic bending forward when doing gymnastics.

Harmonious physical development teenagers and young men, the formation of a good muscular corset due to the balanced development of the muscles of the neck, back and abdominals, the development of dexterity and the coordinated action of muscles of various groups.

Of considerable importance is the formation of stereotypes of the correct execution exercise, minimizing monotonous activities and working in fixed positions.

Secondary prevention (prevention of exacerbations). Do not tilt your torso without support on your arm. Torso forward bending in lumbar region more than 15 - 25 degrees are made when the muscles are turned off or insufficiently active, while the main load falls on the ligaments and joints of the spine, which leads to their overstretching and injury.

In this regard, forward bending, especially in the dynamic mode of frequent repetitions or for lifting weights, is contraindicated.

When lifting objects from the floor, do not lean forward, but squat, bending your knees.

Lifting small weights in the remission phase can also be performed in this position, while the initial lifting phase should be provided by extending the legs with a straight back (more precisely, the back in a state of lumbar lordosis), and not by tension of the lumbar muscles and extension in the lower back.

When bending and lifting weights, it is necessary to exclude jerky movements, and having prepared, try to coordinate, unsharply strain the muscles of the legs, back, abdominals, and arms.

It is necessary to change the position of the body often enough, not to stand or sit for too long.

When sitting at a desk for a long time, it is necessary to place the body between the low back of the chair and the table, in a position while maintaining natural lordosis.

When sitting in a kyphotic position, and especially when sitting in an inclined position, the load increases significantly, both on the muscles and on the discs and intervertebral joints. When sitting for a long time in the remission phase, it is necessary to alternate different landing positions (front, back and intermediate position) and avoid fixing in one position.

At the stage of regression of exacerbation and at the beginning of remission, it is advisable to avoid prolonged sitting, and if necessary, sit on a chair as close as possible to the table with the back resting on the back of the chair.

With prolonged sitting in a situation of relaxation of the muscles of the spine and weakening of the muscular corset, there is a danger of discoordination in the spinal motion segment when standing up abruptly.

Particular care is required when sitting with additional loads in the form of shocks, bumps, twisting of the spine, such as while driving a car. In this case, the development of the muscular corset and muscle dexterity is especially important.

It is necessary to be careful about activities that combine dynamic tension and twisting deformation of the lumbar muscles, which is especially traumatic for the structures of the spine even with small loads. Similar loads are possible when throwing a stone, a disc, when hitting a ball with a racket, mowing.

Reducing the risk of injury of this kind of complex movements is possible with gradual training, muscle groups to the state of fatigue and improvement of both their strength, endurance, and coordination of action and dexterity.

It is important to try to avoid local overheating, in particular in hot tub, in which there is a temporary relaxation of the muscles of the spine, which deprives the latter of the muscular corset.

When standing at the kitchen table, washbasin, desktop, it is necessary to support vertical position body and do not lean forward. To do this, one leg, bent at the knee joint, should be placed in front of the other.

Avoid drafts and hypothermia. Among the forms of physical exercises recommended for osteochondrosis, one can single out swimming, in which, under conditions of spinal stretching, the optimal construction of complex movements is achieved due to the involvement maximum number muscles, and not due to their significant tension.

Need to be treated promptly internal diseases and diseases of the musculoskeletal system, contributing to the formation of reflex, in particular, myofascial, osteochondrosis syndromes. It is necessary in each particular case to consider the possibility of implementing such recommendations under the supervision of a specialist in vertebroneurology or a neuropathologist.

Source: spinabezboli.ru; zdorovko.info; lechuspinu.ru; spinheal.ru; pozvonochnik.guru; prohondroz.ru; smed.ru

megan92 () 2 weeks ago

Tell me, who is struggling with pain in the joints? My knees hurt terribly ((I drink painkillers, but I understand that I am struggling with the effect, and not with the cause ...

Daria () 2 weeks ago

I struggled with my sore joints for several years until I read this article by some Chinese doctor. And for a long time I forgot about the "incurable" joints. So it goes

megan92 () 13 days ago

Daria () 12 days ago

megan92, so I wrote in my first comment) I will duplicate it just in case - link to professor's article.

Sonya 10 days ago

Isn't this a divorce? Why sell online?

Yulek26 (Tver) 10 days ago

Sonya, what country do you live in? .. They sell on the Internet, because shops and pharmacies set their margins brutal. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs and furniture.

Editorial response 10 days ago

Sonya, hello. This drug for the treatment of joints is really not sold through the pharmacy network in order to avoid inflated prices. Currently, you can only order Official site. Be healthy!

Sonya 10 days ago

Sorry, I didn't notice at first the information about the cash on delivery. Then everything is in order for sure, if the payment is upon receipt. Thank you!!

Margo (Ulyanovsk) 8 days ago

Has anyone tried folk methods joint treatment? Grandmother does not trust pills, the poor woman suffers from pain ...

Andrew a week ago

What only folk remedies I didn't try, nothing helped...

Ekaterina a week ago

I tried to drink a decoction of bay leaves, to no avail, only ruined my stomach !! I no longer believe in these folk methods ...

Spinal dystrophy is a metabolic disorder in the cells of the spine, which leads to insufficient nutrition of the tissues. Dystrophy, as a rule, leads to degenerative changes, so these two phenomena are inextricably linked.

Degenerative-dystrophic diseases of the spine (DDSD) proceed according to the following scheme:

The content of the intervertebral discs (nucleus pulposus) gradually loses moisture, as a result of which pressure on the disc increases, blood flow and supply to the disc deteriorates. nutrients- this is dystrophy.
As a result of dystrophy, degeneration of the intervertebral discs develops: cracks, ruptures, hernias form. The discs either thin out from the pressure of the vertebrae or take on an abnormal shape.
Changing the shape of the intervertebral disc disrupts the balance between the vertebrae, pinching the spinal roots.
Inflammation develops at the site of degeneration - this is the immune system tries to protect the spine from destruction and signals trouble in the body.

Degenerative-dystrophic changes in the spine lead to serious consequences. It is necessary to diagnose them in time, treat them and take preventive measures.

Degenerative-dystrophic changes in the lumbar: the main symptoms

The waist is the center of gravity of the human body which bears the main burden. Therefore, degenerative-dystrophic processes in it begin earlier than in other parts of the spine.

If there wasn't serious injury, the disease develops gradually, several years and often unnoticed by the patient. At first, stiffness and heaviness in the back area may be felt. But over time there will be pain, because pain is the main syndrome of all degenerative changes in the spine.

This pain has a certain character:

Occurs in the lumbar region and sacrum long walk, sitting / standing in one position, atypical physical exertion, when bending over.
Strengthens and decreases in waves, sometimes disappears altogether.
The pain is aching.
Subsides after lying down.
It spreads to the nearest areas, most often gives to the back of the thigh. The movements of the limbs may be constrained, they feel numbness or "crawling".

About read here.

How do degenerative changes in the lumbar spine develop?

Only when the symptoms become pronounced, and the pain is regular, can the changes be considered large-scale and irreversible. The degenerative process does not have a retroactive effect; over time, the condition worsens or is preserved in a chronic form.

Development stages:

Initial stage. Constant pain in the lower back. Over time, the pain bothers more and more, the efficiency and quality of life decrease.
Second stage. The spinal nerves are compressed (radicular syndrome), mobility is seriously limited. Periodically, “lumbago” occurs in the lower back, tingling and “goosebumps” are felt in the legs and buttocks.
Third stage. Radicular syndrome leads to vasoconstriction and circulatory disorders of the spine, ischemia develops. The pain intensifies, periodically there may be numbness in the legs, convulsions.
Fourth stage. If the patient has not received proper treatment in the previous stages, the circulation of the spinal cord may be completely impaired. As a result, a serious weakening or loss of motor activity (paresis and paralysis).

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Causes of degenerative-dystrophic changes in the spine

Age changes. After 30 years, the nutrition of the cartilage of the spinal column is disturbed in the body. Sooner or later - depends on the individual characteristics of the person.
genetic predisposition. If parents had serious degenerative changes in the spine, then their children are also at risk. The disease can begin at a very early age.
Congenital pathologies. Deviations from the norm in the structure of the skeleton, incl. flat feet, improper muscle development pinch the spine in muscle spasm, which again worsens tissue nutrition and pinches nerve endings.
Large load on the lower back and sacrum. This is already due to the way of life and work of a person: standing for a long time or carrying heavy loads is fraught with microtraumas of the intervertebral discs. Detrimental to the spine and excessive effort in professional sports.
Physical inactivity. As a result of a long stay in one position, cartilage and bone tissue do not receive the right nutrition weaken, and any movement can lead to microtrauma.
Violation of the muscles of the back. They support the correct position of the vertebrae. If the muscles are inflamed, tight, or vice versa without tone, this adversely affects the functionality of the spine.
Spinal injury. Any impacts, falls, can lead to displacement of the vertebrae, microcracks or subluxations of the joints.
Inflammatory diseases of the spine. Infections that enter the body can affect cartilage and bone tissue.
Hormonal diseases. Disorders of the endocrine system reduce the elasticity of the cartilaginous tissues of the spine.
Wrong way of life. This includes malnutrition, bad habits, disturbed daily routine. All this causes a malfunction in the body, metabolic disorders, including spinal dystrophy.
Overweight. All overweight increase the load on the spine, especially in the lumbar region. If ? - read the answer to the question here.

About read here.

Types of diagnostics

For correct diagnosis degenerative-dystrophic disease of the spine, it is necessary to draw up a complete clinical picture: reveal local symptoms, to understand the location of the process, to obtain data from X-ray diagnostics and laboratory studies.

At the initial medical examination, it is highly likely that the diagnosis of ADSD can be made with the following symptoms:

Sharp pains in the neck, spreading to the head, in the back, in the extremities, in the chest. Especially pain occurs during physical exertion, awkward movements, hypothermia.
Acute pain in the lumbar region and lower extremities, badly extended big toe, low sensitivity in the legs and feet.
Pain in the neck, shoulder girdle, arm, weakness in the muscles of the hands, decreased sensitivity.
Bilateral back pain which is aggravated by extension and rotation of the body, and decreases at rest.
Constant It's a dull pain in the back, arms and legs, chest.
Pain in one or both legs while walking above or below the knee or distributed throughout the limb. The pain is relieved by bending forward.
There is no pain in the back or neck, but there is a stable radicular syndrome(pain in the arm or leg, decreased sensitivity of the limbs, muscle weakness and hypotrophy, decreased reflexes). The pain appears either with a vertical load on the spine or with an inclination to the affected side.

Up to 95% of cases, pain in the back and limbs is caused by physical activity against the background of degenerative lesions of the spine. Therefore, when diagnosing, first of all, it is necessary to exclude more serious causes of pain that require rapid intervention (injuries of the spine, tumors of the spine and spinal cord, inflammation, diseases bone marrow and etc).

To clarify the localization of the degenerative process and find out how seriously the intervertebral discs and vertebrae have been affected, instrumental diagnostics are used. The most informative methods - x-ray, computed tomography and magnetic resonance imaging. Electroneuromyography helps to understand where and how the nerve is affected.

It is also necessary to carry out patient's blood test to identify possible infections in the body and endocrine disorders.

About read here.

Pain and crunch in the back over time can lead to dire consequences - local or complete restriction of movement, up to disability.

People, taught by bitter experience, use a natural remedy recommended by orthopedists to cure their back and joints...

Treatment Methods

The initial stages of degenerative changes in the spine can be successfully treated with non-surgical methods. After passing the course of procedures selected by the doctor, pain partially or completely disappears, the affected area of the spine is restored, blood flow improves, processes in the intervertebral disc are artificially normalized.

The work of a surgeon in the treatment of DDSD is required as a last resort, when the disease begins to adversely affect the functioning of the internal organs of a person. But even then it's better to try everything conservative methods treatment before lying down on the operating table, since spinal surgery is very risky even in our time.

The primary goal of treatment is relieve inflammation and pain. For this patient, they are transferred to bed rest and prescribed analgesics, anti-inflammatory drugs, chondroprotectors (with joint damage) or muscle relaxants (with muscle spasms). A positive effect is observed from the use of drugs, but the doctor must clearly measure the benefits for the treatment of the spine with side effects(First of all, they affect the work of the digestive tract).

After the pain will pass or decrease, it is necessary to restore the work of muscles and ligaments. For this, physiotherapy, massage and therapeutic exercises are used. Massage for a sore spine should be trusted only by a qualified specialist, and the exercise therapy complex is selected by the doctor individually.

About read here.

Prevention of diseases of the spinal column

Prevention of degenerative-dystrophic diseases of the spine does not require much effort, but it will allow you to maintain his health and mobility for as long as possible. We cannot completely eliminate the load on the spine and stop the aging of bones and cartilage. But everyone can slow down the process of degeneration of the spine and the entire musculoskeletal system.

This article talks about degenerative-dystrophic changes in the vertebrae. What are the stages of the disease. And also, what are the methods of treatment of this disease.

Degenerative-dystrophic changes in the spine-characteristic

IN modern world the most popular chronic disease can be called degenerative - dystrophic changes in the spine. The disease is characterized by degenerative and dystrophic changes in the tissues of the spine, joints, and intervertebral discs.

With the advanced form of the disease, the following complications are possible:

Lesions from the orthopedic system;
CNS lesions;
Visceral lesions;
loss of working capacity.

There are several options for such changes in the spine:

Hernia of the nucleus pulposus;
Narrow spinal canal;
myofascial syndrome.

These changes are characterized pain syndrome in back.

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Causes of degenerative-dystrophic changes in the spine

There are two main factors, as a result of which degenerative-dystrophic changes in the spine may well occur:

An inflammatory factor occurring in the discs of the intervertebral space;
Wear of the fibrous ring, as a result of excessive motor activity.

It is important to take care of your health. This disease usually affects people over 40 years of age.

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It has the following properties:

Relieves pain syndrome
Promotes cartilage regeneration
Effectively relieves muscle hypertonicity
Fights swelling and eliminates inflammation

Pathogenesis and development of the disease

It is a pity that in the modern world there is no place for movement. Almost every person spends almost 80% of his life in one position.

Ailments such as obesity and weakness in the muscles can occur as a result of this disease.

A person spends most of his life in a half-bent position. This leads to the formation of degenerative-dystrophic changes. As a result of these changes, the intervertebral discs lose moisture, which in turn leads to cracks and ruptures on them. As a result, hernias are formed.

There are several reasons why these changes occur:

abrupt movements;
Constant overload;
Various injuries;
Little physical activity. For example, a sedentary lifestyle;
senile age;
Nutritional errors.

Symptoms of degenerative changes

The clinical picture of this disease is very diverse.

There are several main symptoms:

Pain in the back. Pain can have a different character. The site of pain may extend from the neck to the lower back;
Pain syndrome outgoing from the chest;
Downgrading a function movements in different parts of the back;
The occurrence of numbness in the legs or chest;
Painful sensations coming from the internal organs;
Violations by genitals.

If you have any of the symptoms, you should immediately go to a specialist for help

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Stages of the disease

Degenerative-dystrophic changes can be divided into 4 stages:

Initial stage. During this period, the patient indicates severe pain in the back, while feeling great discomfort. In this regard, it is required to limit some actions. Owing to what the normal way of life becomes far for the patient;
Second stage. This period is determined by a significant limitation, any actions, as well as a feeling of tingling and shooting in the legs;
Third stage. It entails violations of the hematopoietic organs, which leads to a failure in the circulatory system. As a result of this, the occurrence of convulsions and numbness of the lower extremities is noted;
Last stage. This stage is the most difficult. During this period, paresis and paralysis may occur.

In order to prevent the progression of the disease, treatment should be started at the initial stage of the disease.

Degenerative changes in different parts of the spine

Degenerative changes are localized. That is, they can be located in some places.

There are three most important points of degenerative changes:

cervical department;
Thoracic;
Lumbo-sacral region.

Each of these departments has its own individual characteristics. Each section is detailed below.

In the cervical region

Not very often there are degenerative changes in the cervical region. But still there are. In order to carry out effective treatment, it is necessary to identify the cause of the disease.

Among the causes of the development of the disease are the following:

Frequent finding in a bent position, or a sedentary lifestyle;
genetic factor.

The most famous disease in this case is osteochondrosis. This is a very severe form of degenerative changes.

In addition to osteochondrosis, there are other structural changes. For example, intervertebral hernia, narrowing of the spinal canal, instability or slippage of the cervical vertebrae, myofascial syndrome.

The clinical picture for degenerative changes in the cervical spine looks like this:

Vertigo, more often in the morning;
Headache;
Noise in ears;
Nausea;
visual impairment;
Violation of sensitivity;
Violation of motor activity;
myofascial syndrome.

In order to diagnose a disease, it is necessary to cervical radiography. In addition, a CT scan can be done.

Treatment is aimed at relieving symptoms. Since it is impossible to cure degenerative changes in the cervical region.

In the chest

Very rarely, breast calving causes concern. This does not mean that there cannot be degenerative changes. They just appear asymptomatic. Thanks to thoracic region the spine is not particularly active, and degenerative processes develop very slowly there.

However, osteochondrosis likes to be localized in places with little mobility. But it is very difficult to identify the presence of the disease, since it does not make itself felt. The same thing happens with intervertebral hernias.

When the degenerative process gets to the intervertebral joints, pain will appear. It is very difficult to make a diagnosis in this case. Nobody is immune from mistakes. And it's easy to make a mistake here.

In treatment, they mainly resort to medications. Surgery is usually not indicated. Only in the most severe cases.

In the lumbosacral region

In this case, the disease is characterized by back pain.

Degenerative disorders can occur for the following reasons:

genetic predisposition;
Injuries;
Body aging.

The disease most often affects people from 30 to 50 years. Most patients complain of pain, numbness, neurological disorders. To diagnose the disease, it is necessary to examine the patient, collect his anamnesis, and conduct an MRI.

In the treatment, conservative methods are mainly used:

Physiotherapy;
Massage;
Physiotherapy;
Stretching of the spine.

Diagnostics

Before carrying out therapeutic measures, it is necessary to identify the disease. Diagnose it accurately. And after that, you can start treatment.

Diagnostics consists of the following steps:

Patient history. Helps identify genetic predisposition;
Objective examination;
Subjective examination;
X-ray examination;
CT scan.

By conducting these studies, it is possible to determine the type and stage of the disease as accurately as possible.

Treatment

There are only a couple of methods for the treatment of degenerative-dystrophic changes in the spine:

conservative method.

It, in turn, includes the following therapeutic methods:

drug therapy;
Physiotherapy procedures;
Therapeutic methods;
Physiotherapy;
Massage;
Limitation of mobility of the spine;
Novocaine blockade.

surgical method. Surgery is very rarely used. It is used only in cases of too rapid course of the disease.

Medical treatment

Drug treatment is aimed at relieving inflammation and reducing pain.

Therefore, drugs that have an analgesic effect are mainly prescribed, as well as drugs that reduce inflammation.

That is anti-inflammatory drugs. They also prescribe vitamins of group B and sedatives. However, drugs alone cannot cure the disease. Comprehensive treatment with massage, physiotherapy exercises and others is necessary.

Physiotherapy

The following types of such procedures can be distinguished:

Laser therapy;
Diadynamic currents;
inductometry;
Electrophoresis.

All physiotherapy procedures should be carried out only after the appointment of a specialist.

Physiotherapy

To achieve a greater effect in the treatment of degenerative changes, physiotherapy exercises should be resorted to. It must also be prescribed by the attending physician. This is the best remedy for this disease.

Manual therapy

Simply a massage. Very often in the treatment of degenerative changes, massage or yoga is used. Thanks to this, the body relaxes, rests, receives a full treatment. Massage should definitely be used in the treatment of this disease. It not only strengthens, but also relaxes a person.

Possible Complications

Like any other disease, degenerative changes can lead to the following complications:

Nerve damage;
Osteochondrosis;
Excessive fatigue that does not leave;
Change of gait;
Osteochondrosis;
Endless pain in the back;
arthrosis;
Arthritis;
Osteochondropathy;
Herniated discs;
Scoliosis;
Displacement of the vertebrae;
Ischemia;
Paralysis of the limbs;
Disorders of the hematopoietic system.

In view of such complications, treatment should be taken immediately to avoid consequences.

Prevention

To prevent such diseases from occurring on the way, certain preventive measures should be observed:

Should not be allowed hypothermia of the back;
It's best to give up from strong and sharp loads;
Perform various exercises that are aimed at developing the muscles of the back;
During sedentary work you need to take a minute break every 30 minutes: get up or lean back in your chair;
Not recommended for long term time to sit.

Thanks to these preventive measures you may not even meet with degenerative-dystrophic changes in the spine. By taking care of your own health, you can avoid many different diseases. And if one treats health superficially, then this can lead to irreversible consequences.

A healthy lifestyle is the key to health. The main thing is to remember this throughout your life. In addition, stress can also cause all sorts of diseases, so it is necessary to learn stress resistance.

The spine is the main part of every person.

Degenerative-dystrophic changes in the lumbosacral region - a set of pathologies in the intervertebral disc or, alternatively, in the lumbar vertebrae. Mostly, such a disease can be recognized by back pain.

In most cases, able-bodied people suffer from such problems, and gender does not play a role here. Statistics say the following: there are now an extremely large number of people with such a diagnosis, and this number is growing, not intending to slow down the pace of development, which cannot please.

The body of any person is an extremely delicate and well-oiled system. And it is not surprising that changes in the activity of at least one of its components inevitably entail disruptions in the work of all other parts of the body. In recent years, the incidence of diseases of the musculoskeletal system has greatly increased among the population. As a result, people's ability to meet their needs has decreased.

The spine is a component of the human skeleton. This organ plays a certain number of vital functions:

support;
participation in the movement;
giving the body flexibility;
distribution of nerve fibers throughout the body.

Due to the high complexity of the structure of the body, its organs and tissues are not so rare to age earlier than the time allotted by nature. Degenerative dystrophic changes begin to appear in the spine, which necessarily cause osteochondrosis, coupled with extremely powerful pains.

Without such changes in the spine, none of his known diseases is possible. Any osteochondrosis, spondylarthrosis, herniated disc and the like are exactly the results of degenerative dystrophic pathologies of the intervertebral disc that have not been cured in time, which can be detected by making the necessary examination by a specialist. However, an examination is not so necessary, when the most common symptoms of pathology that can be detected during the first examination can indicate the disease.

Despite the fact that a person may not have a very great propensity for this pathology, transmitted to him by inheritance, in reality its root lies in the totality of many genes. Degenerative processes are also possible due to the aging process or due to any injury. And yet, this is not often the result of extensive injuries like the same car accident. In most cases, they occur due to a slow traumatic process, from which the intervertebral disc is damaged. Moreover, this damage gradually becomes more pronounced, which leads to the disease.

The intervertebral disc does not receive blood, and therefore, in case of damage, it will not be able to “patch” them in the same way as other organs and tissues. For this reason, any, even the slightest damage to this tissue can lead to the most serious consequences, starting the so-called "degenerative cascade". That inevitably leads to the destruction of the intervertebral disc. And this severe pathology has a very high "popularity". According to modern statistics, almost a third of the world's population, who has reached the fourth or sixth decade, has such a problem, at least in the very small degree. This means that almost every elderly patient has such a diagnosis or pain, if not both.

Why the disease begins

In more than half of the cases, the occurrence of such a problem has at least one of the following reasons:

inflammatory processes that begin due to the fact that the nerve roots are irritated by a protein located in the disk space during the appearance of a hernia;
microscopic damage that occurs if the fibrous ring wears out, completely losing any ability to bear the load. The consequence is an excess of mobility in the diseased area.

Most often, the combination of these two factors occurs when it begins to develop intervertebral hernia, which is a complication of the pathological process in the intervertebral discs. When it appears, the neurovascular bundle passing through the spinal canal is compressed by mechanical action. Because of this factor, lower back pain becomes much stronger and does not stop anymore.

In general, degenerative-dystrophic pathologies most often cannot occur without an incorrect lifestyle. This is characterized by a lack of moderate physical education, an unbalanced diet, as well as insufficient sleep and, of course, bad habits like addiction to tobacco and alcohol. Other reasons why dystrophy of the lumbar spine may begin:

harmful effect heavy loads on the spine, due to which the lumbar segments become less elastic. Because of this circumstance, great danger people who constantly expose themselves to heavy physical exertion are exposed to this or that disease of the lower back, especially if it is required at work;
a long stay in a sitting position, and with an incorrect posture, which also leads to impaired blood supply. And this affects both the lumbar region and the rest of the body. This entails a metabolic disorder in the bones and muscles. Violation of metabolism spoils the structure of tissues. And because of all this, microtrauma can easily appear in the spine from any movement. On this occasion, pathology may begin to develop;
infectious diseases, as well as diseases associated with endocrine system. Because of them, harmful processes in the lower back can also easily begin;
certain mechanical injuries of the spine. They cause injuries to bones and muscles;
back muscle injury. This, of course, also has a detrimental effect on the spine in general, and on its lumbar region in particular;
often the cause of the pathology can be described with just one simple word: “old age”. Then the disease can hardly be cured. In this case, they do not try to cure a person, but only carry out supporting therapeutic procedures for him to prevent the aggravation of the disease.

What can happen due to this pathology

One has only to start dystrophic changes in the spine, and serious complications are not excluded in the lumbar region:

hernia;
osteochondropathy;
numbness and partial paralysis of the lower extremities;
complete paralysis of the legs;
difficulty going to the toilet;
decrease/loss of libido.

In order to avoid such problems, one should choose in time and correctly what and how to cure the pathology. So you can effectively keep the intervertebral discs intact.

How to recognize the disease

More than half of the patients who have degenerative-dystrophic pathologies in the lower back complain of incessant pain, which, however, can be tolerated. But sometimes they get stronger for a long time. For the most part, each patient has their own symptoms of the disease, but there are several of its common signs:

back pain, with possible pain in the hips and legs;
pain in the lumbar region lasting over one and a half months;
in the lower back pain is dull / aching, and in the hips and legs - burning;
when the patient sits, the pain becomes worse. Standing, walking or lying down, he feels the pain less. Standing too long, bending forward, or lifting something heavy causes the patient to experience more "bright" pain;
if a person has become the owner of a disc herniation, his legs may go numb, their tingling is not excluded. In addition, he may have trouble walking;
if the hernia turned out to be medium in size, it is possible that nerve root, which comes out at the affected level from the spinal cord, will be compressed (foraminal stenosis), and this will already provoke pain in the legs ();

symptoms of neuralgia, like weakened legs, as well as various problems in the functioning of the organs in the pelvic area (difficulties with going to the toilet) can quite eloquently “hint” at the appearance of cauda equina syndrome. Then you need to urgently consult a doctor;
inflammation caused by proteins trapped in the disc causes the nerves to become more responsive to stimuli. It is from this that the legs become numb and tingling is felt. And in most cases, such sensations are localized in the knee or above.

If you want to learn more about how to treat, as well as consider the symptoms, diagnosis and alternative methods treatment, you can read an article about it on our portal.

Lower back pain can easily appear not only due to pathological processes in the discs, but also from the following:

narrowing (stenosis) of the spinal canal, osteoarthritis, any other pathology of the spine that worsens over time, caused by a deterioration in the condition of the discs. However, this does not mean that such diseases cannot be combined;
herniation caused by disc pathology.

Moreover, with the development of the disease, as well as the transition from one stage to another caused by it, its symptoms become more and more severe:

stage№1 . The disease rarely manifests itself in any way. Unless after physical work you can feel a dull pain, but in most cases it is taken for normal fatigue;
stage№2 . It is possible to accurately distinguish symptoms from normal phenomena. From time to time in the back "shoots". It's also hard to bend sometimes. The reason lies in the nerve endings: they are compressed, and therefore the pelvic area "tingles";
stage№3 . Spicy. At this time, the metabolism in the lower back is disturbed, since the blood vessels. There is ischemia, convulsions, numbness of the legs. Pain becomes stronger;
stage№4 . Due to the deformation of the spinal cord, the legs may be paralyzed. This pathology has exacerbations - the time of the greatest severity of symptoms. If the dystrophy becomes chronic, the symptoms subside to a state of tolerable discomfort.

Diagnostics

It is very important that the disease be diagnosed before the first complications appear. For this purpose, diagnosis is made using the most different methods so that they catch many types of stimuli. However, the patient must first be examined by a neurologist. After the examination, the specialist necessarily prescribes additional examinations to make the diagnosis more accurate.

In most cases, the following methods are used: X-ray, computed tomography (CT), and MRI.

X-ray is the most accessible, but at the same time it is the least useful. This technique allows diagnosing pathology when it has already moved to one of the rather late stages. Much better than MRI and CT. With the help of these methods, it is possible to more reliably find out both where the focus of the disease is and how much it has developed.

Moreover, in information about the presence / absence of changes, it is best to rely on MRI.

What can an MRI show for disc dystrophy:

destruction of the disk, if they exceed half of it;
disk dehydration. MRI shows this tissue as darker;
the presence of hernias, as well as protrusions;
erosion of the cartilage plate, which allows the disc to receive nutrients.

Sometimes electroneuromyography is needed, which allows you to recognize where and how the nerve is damaged. Of course, doctors take blood tests. They need this to detect infections and endocrine pathologies.

If you want to know in more detail, as well as consider when magnetic resonance imaging is indicated, you can read an article about this on our portal.

How to treat

First of all, the procedures conservative therapy. Among them are the use of painkillers, warming ointments, therapeutic exercises, massage, physiotherapy. In the absence of benefit from these methods of treatment, an operation is performed.

Medications

First of all, pain should be relieved so that the patient can walk normally. To this end, the doctor prescribes the necessary painkillers (for example, Ketanov and Ketonal), as well as anti-inflammatory drugs (Movalis and Diclofenac).

Further, already to relax the muscles of the lower back, muscle relaxants are used ("Mydocalm" and "Sirdalud"). These drugs are not used constantly, but with periodic breaks, because otherwise they do muscular system less strong.

Chondroprotectors are also used in the treatment. With their help, you can quickly restore cartilage and joints.

But with all the miraculousness of the complex of drugs, it must be remembered that they can easily cause an unpleasant “side effect”, disrupting the functioning of the gastrointestinal tract.

exercise therapy

Of course, therapeutic exercises should be done both during treatment and rehabilitation. Properly selected and planned exercises are very useful for any symptoms of degenerative-dystrophic pathologies in the lower back. When selecting and planning exercises, it is necessary to look at the causes, severity and main signs of the disease.

If the pathology is acute, of course, it is recommended to refrain from exercise therapy. Before it is necessary to use other methods to alleviate pain: NSAIDs, a state of complete rest, local cooling, blockade.

If the symptoms are severe, low-amplitude static exercises will be very useful. But it should be done very carefully, and haste here can only do harm. IN rehabilitation period much better to use dynamic exercises.

As the patient's condition improves, it is possible to complicate, and also begin to use weighting agents in it.

Massage and physiotherapy

Doctors still cannot come to a consensus about the appropriateness and safety of massage for dystrophic changes in the lumbar spine. Even for a spine that is not affected by a disease, it is harmful when it is mechanically affected. If there is absolutely no way without a massage, only a true professional should carry out such a procedure. And only while the pathology is at the first stage of development.

In the acute period, the back is not massaged. This is because, due to such an action, blood rushes to it, and after that, the sore spot begins to become more inflamed and swell.

With remission, that is, the temporary absence of inflammation and acute pain, physiological procedures can be used. Thanks to electrophoresis, acupuncture, and magnetotherapy, the patient can quickly recover from the disease. And with the help of manual therapy, the vertebrae can stand where they are supposed to by nature.

Surgery

Surgical intervention is carried out in case of revealed futility of massage, therapeutic exercises, as well as medication, and further progression diseases. This method is also used in the diagnosis of "intervertebral hernia". During the operation, the doctor installs devices in the patient's body to support the diseased part of the spine. This allows you to reduce pressure on the spine to avoid further development of the disease.

Table. Types of spinal surgery

View	Description
Discectomy	During this operation, the surgeon removes part of the damaged disc to relieve pressure on the nerve endings. It can perform the operation in several ways: open discectomy is performed with a large incision on the back in the lumbar region; Microdiscectomy is performed through a much smaller incision. The surgeon inserts a thin tube with a camera on one end to view and remove the damaged disc. Thanks to this method, pain sensations are significantly reduced, and the functions of the spine and lower extremities are fully restored.
Laminectomy	Laminectomy is an operation in which space is created in the spinal canal by removing the lamina, the back of the vertebra. Also known as decompression surgery, laminectomy enlarges the space to relieve pressure on the spinal cord or nerve endings. This pressure is most often caused by growths in bone or cartilage, which can occur in people with arthritis. Laminectomy is usually used only when conservative treatments such as medications or physical therapy have failed to alleviate symptoms and get rid of the cause of the pain. Laminectomy may also be recommended if symptoms are very severe or worsen rapidly. Surgeons usually perform the operation using general anesthesia, so the patient does not feel any discomfort during the procedure. Doctors monitor his heart rate blood pressure and saturation of oxygen in the blood during the procedure using devices attached to the chest.
Vertebroplasty and kyphoplasty	Vertebroplasty and kyphoplasty are procedures used to treat painful compression fractures vertebrae, which are most often the result of osteoporosis. In vertebroplasty, bone cement is injected into vertebrae that are cracked or broken. The cement hardens, repairs fractures, and supports the spine. Kyphoplasty is similar to vertebroplasty but uses special deflated balloons to create spaces in the vertebrae that are then filled with bone cement. Kyphoplasty can correct spinal deformity and restore lost flexibility. Vertebroplasty and kyphoplasty can increase a patient's functional ability and allow them to return to activity levels without any physical therapy or rehabilitation. These procedures are usually successful in relieving pain caused by a fracture due to vertebral compression; many patients experience significant relief almost immediately or within a few days. After vertebroplasty, about 75 percent of patients regain lost mobility and become more active, which helps fight osteoporosis. After the procedure, patients who are almost unable to move can get out of bed, and this can help reduce the risk of developing other diseases. Generally, vertebroplasty and kyphoplasty are safe and effective procedures. No incision is required - there will be only a small puncture of the skin that does not need to be sewn up.
Spinal fusion (arthrodesis of the vertebrae)	Spinal fusion is an operation to permanently connect two or more vertebrae in the spine, eliminating movement between them. Spinal fusion involves techniques designed to mimic the normal healing process of broken bones. During the operation, the surgeon places bone or additional material in the space between two spinal vertebrae. Metal plates, screws, and rods can be used to hold the vertebrae together so they can fuse into one solid block. Since spinal fusion surgery immobilizes parts of the spine, it changes the way it "works". This puts additional stress and strain on the vertebrae above and below the fusion and can increase the rate at which these areas of the spine begin to deteriorate. Surgery is done to improve stability, correct a deformity, or reduce pain. The doctor may recommend spinal fusion for treatment following issues: vertebral fracture. Not all damaged vertebrae require such an operation. But if a broken vertebra makes the spinal column unstable, surgery is vital; spinal deformities. Spinal arthrodesis can help correct spinal deformities such as scoliosis or kyphosis; spinal instability. The spine can become unstable if there is abnormal or excessive movement between two vertebrae. This is a common symptom of severe arthritis; spondylolisthesis. With this disorder, one vertebra "pops" forward relative to the lower one. If the condition causes severe pain in the back or compression of the nerves, as well as pain in the legs, arthrodesis of the vertebrae is necessary; herniated disc. Such an operation can be used to stabilize the spine after the removal of a damaged disc.
Nucleoplasty	Nucleoplasty is a treatment for people suffering from long-term and severe back pain as a result of a herniated disc that cannot be relieved with traditional treatment methods. Nucleoplasty is a minimally invasive procedure. Performed on an outpatient basis; this procedure uses a "needle" that emits radio waves to get rid of the bulge by dissolving excess tissue. This reduces pressure within the disc and the nerves responsible for causing pain. The procedure usually takes less than one hour. The operation is performed under local anesthesia, and the person can inform the doctor about his condition. The introduction of the "needle" is controlled by fluoroscopy. Discomfort can be experienced for another seven days while the damaged area heals, after which the patient can again live a full life.
Epiduroscopy	It is an excellent procedure for patients with persistent or intermittent back pain after hip surgery. spinal cord or due to compression nerve endings. The source of pain is most often epidural fibrosis in the spinal canal, which irritates the spinal root or causes narrowing of the epidural space. This method is effective in patients for whom conventional therapy does not lead to the desired results. A special needle is inserted into the natural opening of the sacrum under local anesthesia observing the process thanks to x-rays. In the case of a narrow spinal canal, a balloon catheter is inserted to widen the canal and get a clear view of the free space. The duration of the procedure is from 20 to 60 minutes. The patient is under local anesthesia throughout the operation.

The likelihood of complications

By running this pathology, you can prevent the appearance of a hernia. This term hides the displacement of a deformed disc. This rarely can be cured without surgery. Also, with running dystrophic processes, it can become inflamed sciatic nerve and begin disruption of the functioning of the genitourinary system. Moreover, there are usually problems in order to go to the toilet "for small needs."

Prevention

You can prevent such pathologies in the spine by following simple rules. First of all, a lot of physical activity is needed. Morning should start with charging. And it is worth choosing exactly such exercises that would help make the back muscles stronger. Those who have to sit for long periods of time during their work should occasionally take breaks to stretch their muscles.

Also, to maintain the health of the spine, it is useful to be able to choose a mattress: it should be firm, but in moderation. It is best to use orthopedic pillows as well. It is important that the width of such a pillow is suitable for the distance of the shoulders. In case of obesity, you should lose weight: it once again loads the spine.

Outcome

Regular back pain is a reason to see a doctor. Alas, any organism is not eternal, and with aging, the spine suffers first. If a person begins to feel the first signs of the disease, you should immediately be examined by a doctor. Many serious illnesses at first signal themselves with absolutely insignificant discomfort, but if you miss the moment, you can forget about normal life for a long time. It is not always possible to cure degenerative-dystrophic pathologies, but it is quite possible to stop their development and maintain a state of health.

Disability and degenerative-dystrophic changes in the spine. What are degenerative-dystrophic changes in the lumbosacral region

Causes of degenerative-dystrophic changes in the spine

Treatment

What are degenerative dystrophic changes in the lumbar spine?

Varieties of degenerative-dystrophic changes

Causes of pathological changes in the spine

Signs and symptoms

Diagnostic methods

Fundamentals of Therapy

Non-surgical treatments

Surgery

Exercise therapy for degenerative-dystrophic changes

Prevention

Degenerative-dystrophic changes in the lumbar: the main symptoms

How do degenerative changes in the lumbar spine develop?

Causes of degenerative-dystrophic changes in the spine

Types of diagnostics

Treatment Methods

Prevention of diseases of the spinal column

Degenerative-dystrophic changes in the spine-characteristic

Causes of degenerative-dystrophic changes in the spine

Can't deal with joint pain?

Pathogenesis and development of the disease

Symptoms of degenerative changes

Stages of the disease

Degenerative changes in different parts of the spine

In the cervical region

In the chest

In the lumbosacral region

Diagnostics

Treatment

Medical treatment

Physiotherapy

Physiotherapy

Manual therapy

Possible Complications

Prevention

Why the disease begins

What can happen due to this pathology

How to recognize the disease

Diagnostics

How to treat

Medications

exercise therapy

Massage and physiotherapy

Surgery

The likelihood of complications

Prevention

Outcome

Video - What are degenerative-dystrophic changes in the lumbosacral region?