What are degenerative dystrophic changes in the lumbosacral region? Degenerative-dystrophic changes in the lumbar spine

Degenerative-dystrophic changes in the spine are observed in 80% of the adult population of the planet. They worsen the quality of life and lead to the development of serious complications. How to avoid pathologies?

Take any person: everyone has suffered from lower back pain at least once in their life. Medical statistics say: 20% complain of lumbar pain permanently, and 1-3% require surgical treatment.

The lumbosacral region is the center of gravity of the body; it takes on all the loads accompanying any movement. human body. Sometimes these loads exceed permissible limits, temporary changes and deformation of cartilage tissue occur in the spine. Under the influence of pressure on the damaged area of ​​the spine, salts present in the bloodstream and plasma begin to actively penetrate into its structure. Calcification of a certain area of ​​cartilage tissue begins. These are degenerative-dystrophic changes in the spine.

For degenerative changes to move into an irreversible phase, a lot of time must pass. And this time the disease plays out in a person, due to the fact that the disease does not manifest itself immediately.

Pronounced symptoms show themselves when time is lost, and the degenerative changes themselves have become large-scale and irreversible.

The medical term “degenerative-dystrophic changes in the spine” summarizes several diseases:

The clinical picture of changes may vary, depending on which spinal structures are damaged and how serious the damage is.

Symptoms of the disease appear as degenerative-dystrophic lesions develop, but in the initial stages they 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 spine - pain. Pain in the lumbar region occurs during long walking and physical activity, prolonged sitting in one position, and bending. The pain syndrome is wave-like: it arises, then decreases, and disappears.

The progressive degenerative process in the intervertebral discs of the spine can lead to serious and dangerous complications.

Degenerative changes develop in stages:

The first symptom that “screams” about the presence of pathological changes in the lumbar spine is a pronounced pain syndrome in the lower back. The pain is so noticeable that the patient is forced to limit his movements, and this significantly reduces normal level life and performance.

Complaints of pain directly depend on the location of the lesion.

Further progression of degenerative changes is characterized by the presence of:

severe mobility limitations; “lumbago” that occurs in the lower back; tingling and goosebumps in the limbs and buttocks.

At the second stage of the disease, radicular syndrome develops - compression of the nerve roots occurs.

At the third stage, blood circulation is disrupted due to compression of the radicular vessel, which leads to the development of ischemia. In addition to increasing pain, the third stage is noted:

partial or temporary numbness in the lower extremities; convulsions.

Degenerative pathological processes of the spine that have not received proper treatment at the fourth stage of development are fraught with paralysis and paresis. These complications arise due to complete disruption of blood circulation spinal cord.

The human body is a delicate and calibrated mechanism. It is determined by nature itself that the load on the human spine should be distributed evenly. A healthy spinal column can withstand both jumping and heavy lifting. But all this works only when a person watches his posture and has a strong muscle corset. The modern lifestyle is sedentary. And this leads to weakening of the muscle corset and weight gain.

Sedentary work contributes to the appearance of degenerative changes in the spine.

According to research, the human spine is in a bent position 75-80% of the time: the intervertebral discs become less elastic, and the vertebrae become deformed.

Due to degenerative changes, intervertebral discs lose moisture, cracks and all kinds of ruptures form in them. This contributes to the appearance of intervertebral hernias. When the load changes, the vertebrae try to increase their area, grow, and become increasingly thick, pinching the adjacent nerves.

Reasons that provoke pathological changes:

constant or sudden loads; active sports with heavy loads; injuries; natural aging; inflammatory diseases of the spine; poor nutrition.

Degenerative-dystrophic changes lumbar region spine, unfortunately, are observed in a large number of people, and therefore the question of how to treat these pathologies is very relevant.

After all, if degenerative changes are not treated, they will progress, and the consequences can be very dire, including disability due to impaired motor activity.

Treatment of diseases of the lumbar region is considered complete and promotes recovery if after treatment the following is observed:

reduction or disappearance of pain; relieving tension in the muscles of the lumbar region, pelvis and lower limbs, muscle strengthening; improving blood flow and supply of tissues with nutrients and oxygen, normalizing metabolic processes; removal or reduction of inflammation; normalization of lumbar sensitivity;

To achieve the above results it is necessary correct treatment. Specialists prescribe complex therapy using the latest achievements of modern medicine. For the treatment of degenerative changes in the lumbar sacral region spine is prescribed:

drug therapy; physiotherapy; massage, therapeutic exercises, manual therapy; acupuncture, acupuncture; in extremely severe cases - surgical intervention.

From all of the above, it follows that diseases of the lumbosacral region can be overcome in several ways. But it is better not to allow irreversible pathological processes to occur. You should consult a doctor on time, monitor your health, and lead a correct lifestyle.

To understand the nature of the development of degenerative-dystrophic changes in intervertebral discs, it is very important to understand the reasons for the appearance of such processes. The fact is that the human body is a proven mechanism that can withstand colossal loads, but under the influence of various kinds of unfavorable factors, a weakening of the natural defense mechanisms is observed, which leads to a rapid breakdown of the integrity of cartilaginous structures. Modern lifestyle plays an important role in disrupting the trophism of intervertebral discs. Thus, the following triggers contribute to the development of degenerative-dystrophic changes in the spine:

sudden loads; inflammatory diseases; passive lifestyle; hypothermia; poor nutrition; active sports; hormonal disorders; diseases endocrine system; normal aging process; metabolic disorders; old and recent spinal injuries.

Most often, degenerative-dystrophic changes in the spine are observed in people who lead an extremely sedentary lifestyle and at the same time have an unhealthy diet. The fact is that normally the load on the spinal column is distributed evenly, and a developed muscular frame provides significant support to it. People who lead a sedentary lifestyle and have excess fat deposits, as a rule, have poorly developed muscles, so even the slightest strength exercises lead to serious overload of the intervertebral discs. In this case, the muscular frame can no longer take on part of the load during movement, which contributes to the rapid appearance of degenerative-dystrophic changes.

The influence of other unfavorable factors and their combinations also affects the condition of the spinal column, so in most cases it is extremely difficult to determine what exactly was the impetus for the appearance of such disorders in the cartilage tissue of the intervertebral discs. At the same time, understanding the cause of the appearance of such a pathological condition as degenerative-dystrophic changes in the spine allows us to take effective preventive measures.

It is now well known how degenerative-dystrophic changes in the lumbar spine develop. The spinal column in the sacrum and lower back bears the greatest load during any movement and even while sitting. Due to the influence of overloads, as well as other unfavorable factors, in the area of ​​the intervertebral discs of this department, a disruption of the nutrition of cartilaginous tissue is primarily observed. There are no blood vessels directly in the intervertebral discs that could feed it directly, so often the first appearance of nutritional disturbances in the soft tissues surrounding the spinal column is observed. In the absence of the proper level of nutrition of the intervertebral discs, cartilage tissue begins to gradually deteriorate, losing elasticity.

IMPORTANT TO KNOW! Dikul: “Remember! If the joints of your legs and arms begin to hurt, under no circumstances should you..."

The second stage in the development of degenerative-dystrophic changes is the thinning and weakening of cartilage tissue. At this time, there is a gradual drying out of the cartilage, which leads to a slow decrease in the height of the intervertebral discs. Due to the destruction of the fibrous membrane, various protrusions, that is, disc protrusions, can occur. With critical destruction of the tissue of the fibrous ring, its rupture may occur, which in the vast majority of cases leads to the exit of the corpus pulposus beyond the intervertebral disc and the appearance of a hernial formation. Such protrusions inevitably entail changes in the proportions of the vertebrae and pinching of the nerve roots extending from the spinal cord.

In response to disruption of cartilage tissue, activation is observed immune system, cat cells begin to produce prostaglandins, that is, substances that are inducers inflammatory process. Due to the production of these substances, there is an increase in blood supply and swelling of the soft tissues surrounding the spinal column, which is often accompanied by the appearance of even greater stiffness of the lumbar spine and pain in the affected area. Degenerative-dystrophic changes in the lumbosacral spine, as a rule, are characterized by slow progression and chronic course. In the future, dystrophic changes in the lumbar spine may become a springboard for the development of a number of dangerous diseases and complications, including osteochondrosis, radiculitis, etc.

In the vast majority of cases, patients cannot independently determine the onset of development of degenerative-dystrophic changes, since initial stages As a rule, there are no pronounced symptoms of this pathological process. In fact, there are 4 main stages of development of degenerative-dystrophic changes, each of which has its own characteristic features. At the initial stage of obvious symptoms that may indicate a person without medical education existing spinal problems may not be observed.

How I cured OSTEOCHONDROSIS without doctors...

To prevent a blood vessel from bursting in your head, drink 15 drops of regular...

However, often at this stage of the process severe dull pain in the lower back may occur after increased physical activity. In addition, some people report some stiffness in the lower back.

At the 2nd stage of the disease, severe symptoms may be observed. First of all, in people with this stage there is a serious restriction in the mobility of the spine; with any flexion, so-called “lumbago” may appear, that is, attacks of radiculitis. Patients may complain of tingling and pins and needles sensations in the buttocks and lower extremities.

At the 3rd stage of development of degenerative-dystrophic processes, the disease enters the acute stage, since at this time there is compression of the radicular blood vessel and malnutrition of the soft tissues surrounding the spinal column, which leads to their ischemia. The physical manifestations of this stage include increasing pain, frequent cases of numbness of the lower extremities and cramps.

When degenerative-dystrophic processes of the spine enter stage 4, damage to the spinal cord and its branching roots may occur, which can lead to paresis and paralysis of the lower extremities. As a rule, such complications are a consequence of compression damage to the spinal cord or disruption of its nutrition.

In most cases, patients with degenerative-dystrophic processes in the lumbar spine go to the doctor in the later stages, when the symptoms manifest themselves quite intensely, preventing the person from leading a full-fledged life. daily life. Diagnosis of this pathological condition begins with a detailed analysis, examination of the lumbosacral spine and palpation.

As a rule, an external examination is not enough to assess the presence of pathological changes in the intervertebral discs and their extent. To confirm the diagnosis, a number of studies using modern medical equipment are required. Such studies include:

general analysis blood; radiography; computed tomography: magnetic resonance imaging.

Despite the fact that radiography is a publicly available diagnostic method, it is at the same time considered the least accurate and informative, since early stages the development of pathology does not allow us to identify existing degenerative changes in the lumbosacral spine. CT and MRI are more reliable and modern imaging tools, so they can detect existing abnormalities even in the early stages. With MR, the picture allows us to notice existing degenerative-dystrophic changes thoracic spine or lumbar, even if they are extremely weakly expressed. Thus, MRI is the most accurate modern method diagnostics

Degenerative-dystrophic changes affecting intervertebral discs can affect not only this entire anatomical formation (annulus fibrosus and nucleus pulposus), but also be limited only to the outer part of the disc ring. In cases where a patient develops localized damage to the outer part of the fibrous ring and the tissues of the anterior longitudinal ligament of the spinal column while maintaining the normal structure of the rest of the disc located between the vertebral bodies in the lumbar and sacral region, the doctor, after a comprehensive examination, can diagnose lumbar spondylosis. sacral spine.

Despite the smaller area of ​​tissue damage on one disc, the total surface of degenerative changes is often larger than with the development of diffuse osteochondrosis, hernia and disc protrusion - the outcome of the disease, the onset of which is likely in the absence of treatment, is the development of fusion of the vertebral bodies into one single whole. Such an outcome of the disease can lead to a significant limitation in the patient’s ability to work or the onset of disability - which is why timely diagnosis and earlier initiation of the entire necessary set of treatment measures become so important.

Why does spondylosis develop?

Spondylosis of the lumbosacral spine is a disease that develops at the initial stage as a compensatory reaction of the body - in response to excessive load on the vertebral bodies, compensatory growth occurs in the place of greatest overload bone tissue, helping to reduce adverse impacts. At the same time, a spasm of the muscle fibers surrounding the affected area of ​​the spinal column develops, which can only slightly limit its mobility.

With continued exposure, the compensatory-adaptive reaction becomes pathological - the area of ​​contact gradually increases. Bone growths gradually turn into the so-called “skirt” - osteophyte growths that can reach enormous sizes, and at this stage of the development of the disease, the anterior longitudinal ligament of the spine can also be involved in the degenerative-dystrophic process. Bone growths can injure the roots of the nerves extending from the lumbosacral segment of the spinal cord (lumbar and sciatic nerves), as well as affect the membranes and substance of the spinal cord.

At the same time, dehydration processes occur in the tissue of the intervertebral disc itself - the structures of the disc gradually lose water, which inevitably causes a further decrease in the height of the disc, and these processes only increase the severity of the symptoms of the disease in the patient. It is according to this principle that an intervertebral hernia develops with spondylosis of the lumbosacral spine. At this stage of the disease, the disc is practically flattened between the bodies of two adjacent vertebrae, and the area of ​​the disc (cartilage tissue) protrudes beyond the surface of the vertebral body. Spondylosis deformans develops with advanced, untreated osteochondrosis of the lumbosacral spine.

The causes of spondylosis can be:

• traumatic damage (both direct and indirect) to the ligaments and muscles of the spine in the lumbar and sacral region;
• static loads on the spine - prolonged stay of the body in a physiologically unfavorable position;
• dynamic loads – short-term physical tension of the muscles surrounding the spine, against the background of severe physical inactivity;
• constitutional and hereditary predisposition;
• age-related changes in the tissues of the spinal column;
• infectious diseases or tumors.

What are the manifestations of this disease?

The most common symptom, which can be detected in patients suffering from spondylosis of the lumbosacral spine, becomes pain - it can occur at the moment of movement or intensify during the day, with a sharp change in body position. In some patients, pain may worsen when weather conditions change (increased meteosensitivity). At the initial stages of the pathological process, back pain may be unstable, and periodic spontaneous intensification and easing of discomfort in the affected area of ​​the spine is possible.

As the changes progress, a limitation in the range of motion in the vertebrae of the lumbar spine may appear - the degree of limitation will directly depend on the severity of spondylosis. When palpating and tapping the spinous processes of the vertebrae, pain occurs, the distribution zone of which corresponds to the location of the vertebrae and discs involved in the process.

In some cases, the first manifestation of the disease may be the development of radicular syndrome and the appearance of signs of damage to the fibers of the lumbar and sacral nerves, as well as symptoms of plexitis (inflammation) of the lumbosacral plexus. The patient experiences a false “intermittent” claudication (pain in the legs), which does not disappear in a state of physical rest - in this it differs from the “claudication” that occurs as a result of the development of obliterating endarteritis of the vessels of the lower extremities.

The patient may complain of pain radiating to the buttocks and lower extremities, weakness in the legs, which may decrease when moving up the stairs or bending forward, because during these processes a physiological increase in the area of ​​the intervertebral disc occurs.

It is worth remembering that with osteochondrosis, unlike spondylosis of the lumbosacral spine, pain almost never occurs when pressing on the spinous processes of the affected vertebrae.

When the lumbosacral spine is affected, spondylosis is most often localized in L3-L5, in contrast to osteochondrosis, which affects the L5-S1 vertebrae.

How is the diagnosis done?

To confirm the diagnosis, it is necessary to carry out:

• comprehensive neurological examination of the patient;
• X-ray examination of the spine - images should be taken in standard and lateral projections. This research method is used to assess the condition of the vertebrae, identify osteophytes, pathological mobility of individual elements of the spine at extreme degrees of flexion and extension, and detect displacement;
• computed tomography and magnetic resonance imaging – used to determine the height of the intervertebral discs, the width of the spinal canal and its condition.

Comprehensive treatment of spondylosis

As with any other disease of the spinal column, when diagnosing this disease, the doctor must prescribe comprehensive treatment to his patient, the purpose of which is to prevent the progression of degenerative changes in cartilage and bone tissue. It is important to remember that self-medication for this disease can worsen the condition of the tissues of the spinal column and limit the patient’s capabilities.

The prescribed treatment must be comprehensive and take into account all the characteristics of the patient’s body - it should be aimed at:

1. Improving the condition of intervertebral disc cartilage.
2. Restoration of blood supply and innervation to the tissues of the spine and intervertebral disc.
3. Relief of severe pain.
4. Reducing friction and pressure of the vertebrae.
5. Strengthening the muscular-ligamentous apparatus of the spine.

Can be used for treatment medications, mainly in the acute stage (to relieve pain), treatment methods such as:

• Acupuncture (immediate relief)
• Electrophoresis (but only with the Ionoson apparatus)
• Khivamat (pain goes away in 2 sessions)
• Ozokerite application

Degenerative-dystrophic changes in the spine

Every adult has experienced lower back pain at least once during their life. In 80% they are associated with degenerative-dystrophic diseases of the spine. It is believed that such destructive processes occur in old age, since tissue degeneration is a sign of old age. But in modern society these diseases have become younger. This is due to various reasons, but primarily to a sedentary lifestyle.

Degenerative-dystrophic changes in the lumbar spine are now often found in middle-aged people. This leads to loss of performance, and often to disability. It is very important to detect signs of the disease in time to stop tissue degeneration.

How do degenerative-dystrophic changes develop?

The human body is created in such a way as to evenly distribute the load on the spine. With normal posture and a strong muscle corset, he can withstand heavy loads without harm to health. But the trouble is that most modern people lead a sedentary lifestyle. This leads to weakening of muscles and ligaments. According to statistics, the spine of many people spends 80% of the time during the day in an unnatural state.

Most cases of dystrophic changes are associated with the destruction of intervertebral discs. Due to prolonged stay in one position or during heavy physical activity, they become thinner, lose moisture, and cracks and micro-tears appear on them. There is no blood supply inside the discs, so they recover very slowly. Because of this, even minor trauma leads to degeneration.

In such conditions, the vertebrae experience heavy loads, so they also undergo changes. Salts from the bloodstream penetrate into the damaged area of ​​the spine. Calcification begins. Moreover, most often such degenerative processes occur in the lumbar region. After all, the greatest load while standing and sitting falls on the lower back. According to statistics, more than 30% of people over 30 years of age have some kind of degenerative diseases of the lumbar spine.

Reasons for this condition

Such pathological processes in the lumbar spine can be caused by various reasons. Therefore, they develop regardless of a person’s age and lifestyle. Most often these changes provoke the following phenomena:

• active sports with heavy loads on the lower back;
• sudden loads, such as lifting weights;
• injuries to the spine, muscles and ligaments, even microtrauma due to constant overload;
• inflammatory diseases, infections, hormonal imbalances;
• poor nutrition leading to nutritional deficiencies;
• excess weight;
• bad habits;
• a sedentary lifestyle, which weakens muscles and ligaments;
• aging of the body, leading to disruption of tissue nutrition;
• genetic predisposition.

Symptoms of such diseases

In order to stop the destructive processes in time, you need to consult a doctor at the first signs of tissue degeneration. But the problem is that such processes proceed very slowly, often over years. Many people try to cope with recurring back pain with home remedies. It happens that during a routine examination, for example, an X-ray or MRI, degenerative-dystrophic changes in the lumbosacral region are detected. But often the destruction is already very strong.

Therefore, it is very important to know the first signs by which you can determine that such processes have begun:

• aching pain in the lower back, increasing during sitting, bending and other loads, and subsiding during night rest;
• pain may spread to the legs and buttocks;
• decreased mobility of the spine;
• dysfunction of the pelvic organs;
• swelling and redness in the affected area of ​​the lumbosacral region;
• increased fatigue;
• tingling sensation, numbness in the lower extremities and buttocks;
• gait disturbance.

Without proper treatment, degenerative processes lead to impaired blood circulation and innervation in the spine. This causes paresis or paralysis.

Types of diseases

The term “degenerative-dystrophic changes” refers to the general picture of pathological processes in the spine. But she generalizes several diseases that have not only general signs, but also its own characteristics. They can develop separately or together with each other.

• Osteochondrosis is characterized by gradual thinning of the discs. The disease occurs in a chronic form.
• Chondrosis occurs most often in young people who subject the spine to heavy loads. In this case, microcracks appear in the vertebrae, which is why they gradually collapse.
• Spondylosis is the formation of bone growths along the edges of the vertebrae. The gradual ossification of the spine greatly limits the range of movement.
• Spondyloarthrosis is a lesion of the intervertebral joints, their gradual destruction. At the same time, the discs become thinner, and bone growths form on the vertebrae. This leads to severe pain with any movement.
• Intervertebral herniation occurs due to the destruction of the fibrous ring of the disc. The nucleus pulposus protrudes and compresses the nerve roots.

Diagnosis of diseases

The sooner the patient sees a doctor for examination and correct diagnosis, the more successful the treatment will be. Usually, to make a decision about the presence of degenerative-dystrophic processes, the doctor needs the following information:

• general picture of the patient’s health status;
• X-ray examination data;
• MRI scan.

Features of the treatment of such pathologies

Based on the examination results and diagnosis, the doctor selects the most effective methods therapy. Treatment should be aimed at removing pain, slowing down degenerative processes, strengthening muscles, restoring cartilage and bone tissue, as well as improving spinal mobility. Various treatment methods are used for this.

In the acute period, spinal traction is used, as well as limiting its mobility with the help of special orthopedic bandages. Drug therapy is indicated. In addition to NSAID tablets, novocaine blockades or hormonal injections are used. During the period of remission, massage, exercise therapy, and physiotherapy are indicated. And if there is no result after conservative treatment and continued severe pain, surgical intervention is used.

Treatment of such processes in the lumbar region should be comprehensive. Be sure to follow a special diet rich in vitamins, calcium and jelly products. All doctor's recommendations must be followed. But this treatment still continues for several months. And if it was started on time, the patient was patient and did everything correctly, the spine can be completely restored within a year.

Drug therapy

It is definitely prescribed to relieve pain. These may be analgesics or non-steroidal anti-inflammatory drugs. Muscle relaxants are also used to relieve muscle spasms.

A mandatory step in the treatment of such diseases is the restoration of cartilage tissue. This is done with the help of chondroprotectors. All such drugs are taken orally or used in the form of ointments and gels for external use. Such complex treatment more effectively stops the development of degenerative processes.

In addition, drugs that improve blood circulation, sedatives, and B vitamins are prescribed.

Physiotherapeutic treatment

During the period of remission in the absence of acute pain and inflammation, various methods of physiotherapy are used:

• massage improves blood circulation and metabolic processes;
• manual therapy restores the correct position of the vertebrae;
• electrophoresis, magnetic therapy, UHF, acupuncture and other procedures relieve pain and inflammation and speed up recovery.

Exercise therapy for degenerative-dystrophic processes

A specially selected set of exercises helps the patient maintain spinal mobility. Exercise therapy performs the following functions:

• slows down degenerative processes;
• improves blood circulation and metabolism;
• returns correct posture;
• strengthens the muscle corset;
• preserves the elasticity of the spinal segments and increases its mobility.

Prevention of spinal tissue destruction

Such diseases associated with degenerative changes in the lumbar spine are now very common. Therefore, every person should know what to do to prevent such processes and maintain activity until old age. This is possible subject to the following rules:

• protect your back from hypothermia and humidity;
• avoid sudden stress on the lower back;
• regularly perform exercises to strengthen your back muscles;
• not be there long time in one position, during sedentary work, periodically get up and do a warm-up;
• Make sure your diet is rich in vitamins and minerals.

It is necessary to consult a doctor promptly if you experience discomfort in the lower back. Only careful attention to the condition of your spine will help keep it healthy and prevent destruction.

Degenerative-dystrophic changes occurring in the lumbosacral region are the result of the gradual destruction of the cartilage and bone tissue of the spine. Over time, the elasticity of the intervertebral discs weakens and the vertebrae lose their shape, causing deformation of the cartilage tissue. As the vertebra thickens, it pinches nearby nerves, causing the person to feel pain. Unlike other organs, intervertebral discs are not provided with a circulatory system, so they are not capable of recovery.

Dystrophic changes in the lumbar spine occur rather slowly, for this reason, in the first stages of the disease, patients may not pay attention to minor pain.

Having understood what dystrophic changes in the lumbar region are, we will consider the types of pathologies, causes, symptoms and methods of treating the disease.

Degenerative-dystrophic changes and pathologies (DDZD) of the lumbosacral spine mean a generalization of several diseases. They have both common features and their own characteristics. It is not uncommon to have several diseases at the same time. The following types of changes are distinguished:

• chondrosis – violation of the integrity of the discs;
• osteochondrosis – thinning and deformation of discs, a complication of chondrosis;
• spondylosis – the formation of pathological growths on the vertebrae that limit movement;
• spondyloarthrosis is the destruction of the intervertebral joints, causing severe pain with the slightest movement.

While chondrosis is most often observed in the cervical spine, due to its strong mobility, with osteochondrosis the lumbar spine most often suffers. Osteochondrosis of the thoracic spine is diagnosed less frequently.

Degenerative-dystrophic changes in the spine (DDI) are a set of pathologies of cartilage and bone tissue that causes painful sensations. Degenerative-dystrophic processes are presented as a group of symptoms; they cannot be used as a term naming a separate disease.

Types of diseases

The term “degenerative-dystrophic changes” refers to the general picture of pathological processes in the spine. But she summarizes several diseases that have not only common symptoms, but also their own characteristics. They can develop separately or together with each other.

We advise you to read:Gymnastics for protrusion of the lumbar spine

• Osteochondrosis is characterized by gradual thinning of the discs. The disease occurs in a chronic form.
• Chondrosis occurs most often in young people who subject the spine to heavy loads. In this case, microcracks appear in the vertebrae, which is why they gradually collapse.
• Spondylosis is the formation of bone growths along the edges of the vertebrae. The gradual ossification of the spine greatly limits the range of movement.
• Spondyloarthrosis is a lesion of the intervertebral joints, their gradual destruction. At the same time, the discs become thinner, and bone growths form on the vertebrae. This leads to severe pain with any movement.
• Intervertebral herniation occurs due to the destruction of the fibrous ring of the disc. The nucleus pulposus protrudes and compresses the nerve roots.

The diagnosis is made based on examination of the patient and computer scan data

Modern medicine identifies three main types of degenerative-dystrophic changes occurring in segments of the spinal column:

• Osteochondrosis;
• Spondyloarthrosis;
• Spondylosis.

Spondylosis provokes the formation of vertical spines on the spine (osteophytes). Osteophytes, in turn, begin to compress the roots of the nerve endings of the spinal cord. This process causes pain in the patient.

With osteochondrosis, intervertebral discs lose their normal elasticity and strength. The height of the discs is also reduced. Deformations occurring in the intervertebral discs lead to rupture of the fibrous ring and penetration of the contents of the disc core outward. This process causes the appearance of an intervertebral hernia, which, as it develops, begins to compress the spinal nerve endings. This leads to pain in the patient.

Spondyloarthrosis is a complication of osteochondrosis. Spondyloarthrosis is a pathology of the facet joints (with their help, the vertebrae are attached to each other). As pathology develops, the cartilage tissue of these joints begins to thin out and collapse. It can act as an independent disease, as well as in combination with other pathologies of the human body.

The following degenerative diseases of the joints and other parts of the spinal column are most often diagnosed:

• Osteochondrosis is characterized by a decrease in the elasticity and strength of intervertebral discs. In addition, their height decreases.
• In chronic osteochondrosis, against the background of deformation of the IVD, the fibrous ring ruptures, and its contents (nucleus pulposus) bulge out. This is how an intervertebral hernia occurs. The nucleus pulposus compresses the nerve endings of the spinal cord, causing severe pain.
• Arthrosis of the joints of the spinal column. Due to pathological changes in bone tissue, the height of the IVD decreases, and the pressure on the facet (intervertebral) joints increases. Then the surface of the joints wears out and deforms faster.

Osteochondrosis of the lumbar region is a common disease

Reference. Arthrosis most often damages the knee and hip joints, and the spine - less often. In the first case, the disease occurs as a result of injury or infection and is accompanied by damage to the menisci (cartilaginous formations in the knee joint).

• With spondyloarthrosis, the facet joints become thinner and destroyed. Arthrosis is early joined by dystrophic processes in the bone adjacent to the joint, which threatens to limit or completely immobilize the joint.
• Spondylosis is a chronic disease in which spine-like growths appear along the edges of the vertebral bodies.
• With spondylolisthesis, one of the vertebrae is displaced anteriorly, posteriorly, to the right or to the left.
• Spinal stenosis is a chronic pathology that manifests itself as a narrowing of the central spinal canal, as well as compression of the spinal cord and roots.

These degenerative diseases of the spine require timely and competent treatment.

There is such a disease as ankylosing spondylitis (Bechterew's syndrome). This rare pathology is more common in middle-aged men and provokes dangerous complications. The inflammatory process affects the intervertebral joints, which threatens the fusion of the joints. If left untreated, the likelihood of damage to the hip, shoulder, knee, ankles, and sacrum increases.

Reference. DDI of the lumbosacral spine is diagnosed more often, since this area is subject to greater load than the cervical or thoracic spine. Therefore, doctors often diagnose L5-S1 osteochondrosis (a lesion between the fifth lumbar and first sacral disc). This disease increases the likelihood of intervertebral disc herniation, as well as leg paralysis.

Spinal pathologies of a degenerative-dystrophic nature include several diseases. They have common symptoms and distinctive features. Often a person develops several types of such pathologies simultaneously:

• chondrosis (the integrity of the intervertebral discs is compromised);
• osteochondrosis (discs become deformed and become thinner);
• spondylosis (growths form on the spine);
• protrusion (disc protrusion);
• spondyloarthrosis (intervertebral joints are destroyed).

This area is considered the most vulnerable. Therefore, degenerative-dystrophic changes in the cervical spine are most often diagnosed. The condition is due to the fact that the muscles of the collar zone are constantly in good shape. Most often, people in sedentary professions are susceptible to pathology.

Signs of degenerative-dystrophic changes in the cervical spine:

• irradiation of pain from the neck to the shoulders and arms;
• migraine;
• dizziness;
• fast fatiguability;
• decreased mental and physical activity;
• sleep disturbance;
• manifestation of symptoms of vegetative-vascular dystonia;
• numbness of fingers.

If, with degenerative-dystrophic changes in the cervical spine, the patient is not provided with timely assistance, restriction of movements and further loss of functionality are observed.

Degenerative-dystrophic changes in the thoracic spine are most often provoked by injuries. People who are forced to lift too heavy a load and engage in extreme sports often suffer from pathology. When this area is affected, osteochondrosis, spondylosis, and spondyloarthrosis are most often diagnosed.

Regardless of age, discs become deformed. At the same time, they become thinner, causing subsidence of the vertebrae. If spondylosis develops, in most cases osteophytes form on the outer part of the discs. Over time, growths also form along the edges of the vertebrae. All this causes clinical manifestations:

• girdle pain;
• discomfort or lumbago in the area of ​​the heart, kidneys, liver;
• stiffness of movements.

Often, due to degenerative changes in the thoracic vertebrae, a person feels as if other internal organs are hurting.

Degenerative-dystrophic changes in the lumbosacral spine in an advanced form pose a great danger to human health, up to and including complete loss of working capacity.

It is noteworthy that pathologies in the sacral area appear only at a young age (up to 25 years). Then all the vertebrae in this area naturally fuse together. In this connection, all defects that arose earlier are eliminated on their own.

But degenerative-dystrophic changes in the lumbar spine require timely response. This zone is hypothetically called the center of gravity, so it is constantly subject to statistical and mechanical loads.

The risk of developing diseases is high for all people whose activities involve heavy physical labor. Strength sports also cause rapid wear and tear on the tissues of the support column in this area. As a result, hernias, bulging discs, and pinched nerves form. Pathologies provoke severe pain, numbness in the lower extremities and dysfunction in the pelvic organs.

Which doctor treats degenerative changes in the spine?

If you notice any alarming symptoms, you should immediately consult a neurologist. Only timely initiation of therapy will stop the progression of the disease.

Depending on the causes and provoking factors, other specialized specialists (osteopath, chiropractor, endocrinologist, nutritionist, infectious disease specialist, pulmonologist) may be involved when drawing up a treatment plan.

To correctly diagnose a degenerative-dystrophic disease of the spine, it is necessary to draw up a complete clinical picture: identify local symptoms, understand the location of the process, obtain X-ray diagnostic data and laboratory research.

During the initial medical examination, it is highly likely that a diagnosis of DDSD can be made if: the following symptoms:

• Acute pain in the neck spreading to the head, back, limbs, and chest. Pain especially occurs during physical activity, awkward movements, and hypothermia.
• Acute pain in the lumbar region and lower extremities, does not straighten well thumb feet, low sensitivity in the legs and feet.
• Pain in the neck, shoulder girdle, arm, weakness in the muscles of the arms, decreased sensitivity.
• Bilateral spine pain which worsens with extension and rotation of the body, and decreases at rest.
• Constant aching pain in the back, arms and legs, chest.
• Pain in one or both legs when walking above or below the knee or spread throughout the entire limb. The pain decreases when 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, weakness and wasting of muscles, decreased reflexes). Pain appears either with a vertical load on the spine or when tilting to the painful side.

Treatment methods

All methods of treating degenerative and dystrophic pathologies of the spine are conventionally divided into two groups. Conservative methods involve the use of medications, physiotherapy, and orthopedic bandages. An integrated approach to solving the problem is considered very effective.

Medicines

Therapy consists of prescribing medications to relieve pain, inflammation, improve blood circulation and the condition of cartilage tissue:

• Anti-inflammatory drugs (Nimesil, Diclofenac, Ibuprofen).
• Medicines that improve vascular patency (Actovegin, Trintal, Piracetam).
• Painkillers (Analgin, Oxadol, Tramal).
• Antispasmodics (Lidocaine, Novocaine, Bipivucaine).
• Chondoprotectors help restore the structure of cartilage and bone tissue (Rumalon, Chondrolon, Chondrolitin).

Physiotherapy

Methods of physiotherapeutic treatment are actively used in the fight against the progression of degenerative processes in the spine:

• The laser has a complex effect. During the procedure, an anti-inflammatory, analgesic and regenerating effect is achieved.
• The vibration method involves the use of vibrating belt massagers.
• Magnetotherapy - a special device affects the treated area at the cellular level.
• Electrotherapy - the procedure involves local effects on tissue. During its implementation, blood circulation improves, resulting in relief.
• Shock wave therapy– an innovative technique based on the influence of an acoustic wave on the affected area. After the procedure, microcirculation in tissues and metabolic processes improve, pain and swelling decrease.

Manual therapy and massage are often combined with other physical treatments.

Physical training

There are several sets of exercises to improve the condition. Therapeutic exercises for people suffering from degenerative changes in the lumbar, thoracic or cervical spine improve metabolic processes and blood circulation:

1. You should start with a warm-up. Circular rotations are performed with the head, then with the arms (holding your shoulders with your fingers) and with the torso around the axis, while keeping your hands on your belt. In this case, sudden movements should be avoided.
2. Stand up straight, clasp your fingers above your head. Move your neck from side to side (10 times). Do not change the direction of the head.
3. Lie on the floor with your arms and legs straight and perpendicular to the floor surface. Then, with a relaxed torso, they perform movements that imitate the crawling of a snake.

Regular exercise forms correct posture and strengthens the muscle corset. As a result, degenerative processes slow down their development.

Surgical treatment

In modern medicine, various surgical methods are successfully used to combat the progression of degenerative processes in the spinal column:

• Laminectomy.
• Laser vaporization.
• Decompression (anterior, posterolateral).
• Foraminotomy.
• Facetectomy.

In case of significant damage, stabilizing operations are performed using titanium implants.

If a patient notices symptoms of DDSD (degenerative-dystrophic diseases of the spine), then he needs the help of a specialist. This means that the patient should consult a therapist, vertebrologist, neurologist or orthopedist.

Attention. Treatment of degenerative-dystrophic disorders should be comprehensive: medication, exercise therapy, physiotherapy, surgery.

The following medications are used to combat the disease:

• Nonsteroidal anti-inflammatory drugs are intended to relieve pain.
• Muscle relaxants are prescribed to relax smooth muscles, eliminate spasms, swelling, and normalize blood circulation.
• Novocaine blockades (supplying a low-concentration solution of novocaine into cellular spaces) are used to eliminate unbearable pain.
• Steroid medications are taken if NSAIDs and other painkillers are ineffective.
• Vitamin- mineral complexes used as part of complex treatment to normalize metabolic processes, saturate tissues, as well as muscles with nutrients.

Exercise therapy is used as part of complex therapy for degenerative-dystrophic changes in the spinal column

It is recommended to treat degenerative-dystrophic disorders of the spinal column with the help of physical therapy. Exercise therapy improves blood circulation in the affected area, relaxes muscles, and helps saturate depleted tissues with nutrients. Special exercises normalize metabolism, accelerate blood flow to the lower back, and help get rid of excess weight.

The preparation of the exercise complex is carried out exclusively by a specialist for each patient separately. You can do gymnastics only after the pain has subsided a little.

During the treatment of spinal pathologies, acupuncture is sometimes used

Physiotherapy is carried out when there is no pain and inflammation:

• Massage accelerates metabolism in affected tissues and eliminates spasms.
• Using manual therapy, the doctor returns the vertebrae to their normal position.
• Acupuncture is the insertion of thin, sharp needles into specific points to relieve pain.
• Magnetotherapy is a treatment using a magnetic field to relieve pain, inflammation, and accelerate tissue regeneration.
• Iontophoresis is an introduction medicine through intact skin using galvanic current, which has an anti-inflammatory, analgesic, and immunostimulating effect.
• Ultrahigh-frequency therapy eliminates swelling, stimulates blood circulation, relieves pain and spasms.

The question of whether to prescribe surgery is decided when conservative methods have proven ineffective. During the intervention, devices are installed in the patient's body that support the spine. This is necessary to relieve pressure from it and stop the deformation of the intervertebral discs.

Surgery carried out for severe lumbar hernia, when the disc extends beyond the boundaries of the spinal column. Then the nucleus pulposus is pulled out in the same way as fat deposits during liposuction, or burned out with a laser.

To avoid problems with the musculoskeletal system until old age, you need to protect your back from humidity and hypothermia, avoid making sudden movements, avoid excessive stress, exercise and eat right. When the first symptoms of DDSD appear, you should urgently seek help. medical care and carry out comprehensive treatment.

Based on the results of the examination and the diagnosis, the doctor selects the most effective methods of therapy. Treatment should be aimed at relieving pain, slowing down degenerative processes, strengthening muscles, restoring cartilage and bone tissue, as well as improving spinal mobility. Various treatment methods are used for this.

In the acute period, spinal traction is used, as well as limiting its mobility with the help of special orthopedic bandages. Drug therapy is indicated. In addition to NSAID tablets, novocaine blockades or hormonal injections are used. During the period of remission, massage, exercise therapy, and physiotherapy are indicated. And if there is no result after conservative treatment and severe pain continues, surgical intervention is used.

Treatment of such processes in the lumbar region should be comprehensive. Be sure to follow a special diet rich in vitamins, calcium and jelly-like products. All doctor's recommendations must be followed. But this treatment still continues for several months. And if it was started on time, the patient was patient and did everything correctly, the spine can be completely restored within a year.

Treatment is prescribed depending on the characteristics of the disease

It is definitely prescribed to relieve pain. These may be analgesics or non-steroidal anti-inflammatory drugs. Muscle relaxants are also used to relieve muscle spasms.

In addition, drugs that improve blood circulation, sedatives, and B vitamins are prescribed.

During the period of remission in the absence of acute pain and inflammation, various methods of physiotherapy are used:

• massage improves blood circulation and metabolic processes;
• manual therapy restores the correct position of the vertebrae;
• electrophoresis, magnetic therapy, UHF, acupuncture and other procedures relieve pain and inflammation and speed up recovery.

Massage and physical therapy will help restore spinal mobility

A specially selected set of exercises helps the patient maintain spinal mobility. Exercise therapy performs the following functions:

• slows down degenerative processes;
• improves blood circulation and metabolism;
• returns correct posture;
• strengthens the muscle corset;
• preserves the elasticity of the spinal segments and increases its mobility.

In most cases, treatment does not involve surgery. The impact on vertebral tissue occurs chemically (with the help of medications), mechanical and electromagnetic.

Medicines in this case perform 2 important tasks - they relieve pain, and also promote tissue restoration by improving their nutrition. For these purposes the following are used:

• muscle relaxants (relaxes the back muscles);
• chondroprotectors (restore cartilage tissue);
• sedatives and painkillers (to relieve pain and as sedatives for general relaxation of the patient);
• B vitamins and mineral complexes are introduced so that the tissues receive additional nutrition and recover faster.

Medicines are administered both intravenously (injections, droppers) and externally (ointments, gels).

Complications

In the absence of competent treatment for dystrophic disorders of the spine, the likelihood of such complications increases:

• Scoliosis (curvature of the spinal column).
• Disc protrusion (damage to the fibers of the annulus fibrosus).
• Paresis (decreased muscle strength, limited movement).
• Arthrosis (slow destruction of cartilage inside the joint).
• Intervertebral disc herniation.
• Chondropathy (destruction of spongy bone tissue, which threatens microfractures).

In the absence of proper treatment of degenerative-dystrophic lesions of the spine, the likelihood of scoliosis increases

DDI of the thoracic region in the initial stages does not manifest itself with severe symptoms. Painful sensations occur when the intervertebral canal narrows or nerve endings are pinched.

Complications of DDI of the thoracic spine:

• Arthritis (inflammation of the joints).
• Arthrosis.
• Chondropathy.
• Thoracic radiculitis (compression or irritation of the intercostal nerves).
• Scoliosis due to weakening of the muscles of the back, chest, and abs.
• Restricted muscle movement or paralysis.

Degenerative changes in the lumbar region threaten the following consequences:

• Formation of hernias.
• Chondropathy.
• Limitation of mobility and sensitivity of the lower extremities.
• Leg paralysis.
• Disorders of stool, urination.
• Sexual dysfunction.

To avoid such complications, it is necessary to identify the first signs of DSD, conduct a thorough diagnosis and adequate treatment.

megan92 2 weeks ago

Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!