Osteochondrosis
It is a degenerative change in the intervertebral disc. Age-related loss of fluids leads to a decrease in the height and strength of its fibrous tissues, as a result of which pseudospondylolisthesis of the mobile segment occurs . Sliding and rubbing movements accelerate the degenerative process.
Etiology of osteochondrosis
The disease develops mainly under the influence of improper static load (scoliosis, kyphosis), as well as due to congenital tissue dysplasia.
Osteochondrosis Clinic
Pain in the lower back and in the back of the girdle and radiating nature with myogelosis ; mobility in the affected segment of the spinal column is limited.
Osteochondrosis Treatment
Physiotherapy, manual and underwater massage, therapeutic exercises, the use of a Pearl extractor or Glisson loop , rubbing until hyperemia, as well as local heating in the form of radiation. In the absence of improvements, complete rest is shown with the use of appropriate bandages.
Deforming spondylosis
We are talking about bone tumors on the vertebral bodies.
Etiology of deforming spondylosis
Changes develop due to loosening of the movable segment with insufficiency of muscular support function as a result of osteochondrosis.
Clinic of deforming spondylosis
It generally corresponds to osteochondrosis. The lumbar region of the spine is mainly affected, since it is it that is subjected to particularly strong loads. X-ray data do not correlate with patient complaints.
Treatment of deforming spondylosis
Treatment is mainly carried out conservatively, as in osteochondrosis. In the advanced stages of the disease, traction is necessary to prevent loosening of the segment, since bone neoplasms can lead to restrictions on the mobility of segments of the spine. In such cases, immobilization of the lumbar region using cruciate bandages or corsets is recommended.
Herniated disc
Prolapse of tissues of a degenerated intervertebral disc as a result of its rupture to the dorsal or dorsolateral sides leads to narrowing and compression in these areas. With dorsal prolapse, a narrowing of the spinal canal occurs, which can lead to damage to the myelin sheath or even the bone marrow itself. With dorsolateral prolapse, the roots of the spinal nerves that exit through the intervertebral holes can be damaged.
Etiology of herniated disc
Damage to the intervertebral disc is the result of loosening of the movable segment, especially with one-sided loading (working position) and overload in a bent position, as well as when carrying and lifting weights, when the body rotates when the pelvis is stationary.
Clinic of herniated disc
Depends on the localization of the affected segment. Often prolapse occurs in the lower lumbar spine, as it experiences the greatest stress. Pain from the affected area radiates to the leg, and with certain body movements (coughing, sneezing) or tremors intensify. The phenomena of weakness of certain muscles (extensors of the toes, calf muscles) or even complete paralysis may develop. By the loss of functions of certain muscles, as well as by the degree of weakening of the reflexes of the Achilles tendon and patella, it is possible to judge the localization of the lesion. Similar conclusions can be made on the basis of increased or, conversely, reduced sensitivity of the skin of the leg.
To relieve the load on the damaged root of the nerve, the patient reflexively takes a gentle posture (the so-called pain, or sciatica , scoliosis).
Treatment of herniated disc
First, it is carried out conservatively: the appointment of bed rest, local heating, injections of painkillers, traction using the Perl apparatus , mechanotherapy, as well as local application of various anesthetics. With a weakening of muscle functions, indicating a beginning paralysis, prompt elimination of pressure on the nerve is required.
Shoulder Syndrome – Arm
There are pains radiating from the shoulder girdle to the arm, disorders of sensitivity and movements in the arm and hand.
Etiology of shoulder – arm syndrome
Pain arises as a result of degenerative changes in the lower cervical spine, direct mechanical irritations of the roots of the spinal nerves and increased autonomic sensitivity to subthreshold irritations of the cervical spine of the sympathetic trunk.
Shoulder Syndrome Clinic – Arm
In contrast to the suddenly occurring symptoms of prolapse of the intervertebral disc in the lumbar or cervical spine with shoulder-arm syndrome, external manifestations develop slowly. Often vegetative symptoms come to the fore: hypersensitivity to pain, myogelosis , deep pain in the shoulder and arm (except the hand), soreness and limitation of movement in the cervical spine and shoulder, sparing posture. Due to mechanical irritation of the nerve, segmental disorders of skin sensitivity, perversity of reflexes and loss of motor functions can occur. Degenerative changes in the cervical spine are recognized radiographically.
Shoulder Syndrome Treatment
To relieve the load on the cervical spine, Shants cotton-gauze dressings, orthopedic collars, as well as the Glisson loop are used . In addition, massage, mechanotherapy, warming and medicines that calm the autonomic nervous system are used.
Fractures of the processes and arches of the vertebrae
Isolated fractures of the back of the vertebrae, arches and processes are less common; damage mechanism is often direct. More often the transverse processes of the lumbar vertebrae are damaged (one or more). The damage mechanism is a blow to the lumbar region or sharp muscle tension (tear-off effect of m. Psoas , etc. quadratus lumborum ). Clinical symptoms of fractures of the transverse processes manifest IB localized pain in the apices of the processes, sharp muscle tension, limitation of spinal mobility; often in a number of patients radiculitis is observed. Fractures of the spinous processes are less common; clinically localized pain, sometimes crepitus. Treatment of patients with fractures of the spinous processes is reduced to bed rest (patients lie on their stomach for 2-3 weeks), early therapeutic exercises and massage. Disability of patients is usually restored after 2 months.