Causes of degenerative-dystrophic changes in the sacral spine and methods for their elimination. Degenerative dystrophic changes in the spine Dystrophy of the lumbar intervertebral discs treatment

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 the supply of nutrients to the disc worsen - 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 trying 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 were no serious injuries, 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, pain will definitely appear, 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 the sacrum with long walking, sitting / standing in one position, atypical physical exertion, with bending.
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".

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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).

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 necessary 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 extra pounds increase the load on the spine, especially in the lumbar region. If a ? – read the answer to the question here.

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Types of diagnostics

For the correct diagnosis of 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 diagnostics and laboratory data.

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, the big toe is poorly extended, low sensitivity in the shins 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 aching 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 of the bone marrow, 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.

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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 is better to try all conservative treatments before going to the operating table, because spinal surgeries are 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 treating the spine with side effects (first of all, they affect the work of the gastrointestinal tract).

After the pain has gone or lessened, 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.

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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.

Minimum preventive measures:

Be active! Without movement, unused muscles atrophy and ligaments lose elasticity. Daily exercise is a necessary condition for a healthy back.
Strengthen your back muscles. In addition to general activity, it is necessary to purposefully develop the muscular corset. Strength exercises in the gym and swimming will help here.
Avoid sudden stress on the spine: do not lift weights, do not jump from a great height without grouping, even from the bed it is recommended to stand on both legs so that there is no sharp blow.
Keep your back always straight, watch your posture.
Choose a good mattress to simultaneously provide the back you need support and let it relax.

Conclusion

If your back starts to hurt on a regular basis, this is cause for concern. Remember that sooner or later our body will begin to age, and the spine often takes the first blow of this natural process. It is not recommended to delay the visit to the doctor because harmless symptoms can develop into serious illnesses.

Degenerative-dystrophic changes are irreversible, but timely medical care can slow down or stop the process and allow you to enjoy flexibility and mobility for many years.

Degenerative changes in the spine are the most common cause of back pain. By and large, this formulation includes all disorders in the intervertebral cartilage and degenerative changes in the vertebral bodies, which lead to a number of pathological conditions depending on the localization.

In the cervical region, dystrophic changes in the spine cause:

pain syndrome, aggravated under load;
radiating pain in the upper shoulder girdle, arms, hands, their numbness, loss of sensitivity;
- dizziness and headache;
difficulty in the act of swallowing;
neurological syndrome - myelopathy of the spinal cord and associated disorders of muscle innervation.

Degenerative-dystrophic lesions of the thoracic segments entail:

localized pain in the thoracic region;
pain syndrome extending to the intercostal space, the area between the shoulder blades;
chest pain, which can be confused with pain of cardiac origin;
violation or difficulty in breathing.

Dystrophic and degenerative changes in the spine provoke the development of pain syndrome

Degenerative changes in the lumbar spine are characterized by the following symptoms:

pain at the site of the pathology;
spread of pain along the nerves to the upper part of the buttock, back of the thigh, lower leg, groin, foot;
numbness of the lower extremities, impaired tactile and pain sensitivity;
impaired mobility: partial (paresis), complete (paralysis);
numbness and loss of control over the paraanal region;
uncontrolled act of urination and defecation;
violation of potency;
cycle disorder in women.

What is behind this

Degenerative-dystrophic changes in the spine can occur both in the intervertebral discs and in the bodies of the vertebrae themselves.

Bone condition

The gradual loss of calcium and other minerals, the predominance of the processes of destruction of bone elements over their formation lead to thinning of the bone beams in the vertebrae. Most older people over the age of 60 are diagnosed with osteoporosis. This means that their vertebral segments become less strong and elastic, less able to bear the load and more prone to deformation.

The aging of the body, affecting all organs and systems, in the bone tissue is manifested by the progressive degeneration of the dense structure of the bone into a spongy one.

To understand the scale of vertebral dystrophy, imagine that at the age of 1 month, a child's vertebra can withstand a load of 135 kg / cm 2, by the age of twenty this figure is 80 kg / cm 2, and in old age only 20 kg / cm 2. An indicator of the strength of bone tissue is the degree of its mineralization. The highest rates are observed in young people in the period from 22 to 35 years (400 kg / m 3), and with age it decreases to 280 kg / m 3. This indicator means that the bodies and processes of the vertebrae can easily crack and break.

Damage to a vertebra will certainly cause a violation of the integrity of the spinal canal, compression of the spinal cord, nerve roots and damage to the organs that they control.

Degenerative-dystrophic changes in the vertebrae associated with natural aging are manifested by characteristic deformities of the ridge. In women, an increase in thoracic kyphosis () is more often observed, and in men, flattening of the lower back is noticeable (smoothing of lordosis). Other signs of calcium loss (osteoporosis):

fatigue, muscle weakness;
frequent cramps in the muscles of the legs;
the appearance of plaque on the teeth;
increased fragility of the nail plates, delamination;
aching pain in the spine;
a noticeable decrease in growth;
curvature of posture;
frequent fractures.

Intervertebral discs

Thanks to the discs that separate the vertebrae, our spine has high mobility and elasticity. Along with natural curves, this structure helps the spinal column to compensate for impacts when walking and perform many complex movements in different planes.

Cartilaginous "pads" also protect the vertebrae from touching each other and form the necessary space for the exit of nerves and blood vessels from the spinal canal. The degeneration of these structures causes significant problems with the back and overall health of the body.

The features of their structure help to perform a shock-absorbing function. Inside is the nucleus pulposus, which is 90% water. Its molecules are able to hold and release liquid. At the moment of increasing load, the core accumulates water, becomes more elastic, in a calm state it gives up some of the liquid and flattens.

This structure is surrounded by a dense annulus fibrosus, which maintains the shape of the disk and is a protection for the internal contents.

In childhood, the core of the disc protrudes above the fibrous membrane, since it is as elastic and saturated as possible with water. With growing up, the blood vessels that directly fed the intervertebral discs close, and from now on, trophism is carried out only by diffusion from the space surrounding the spine. The core loses its elasticity a little, the fibrous ring also thickens. After adolescence, the growth and development of intervertebral discs stops.

With repeated physical exertion, smoking, atherosclerosis of the vertebral vessels, the diffusion of nutrients in the disc is significantly reduced, the entire nucleus is disorganized, and the water content decreases. "Drying out" of the core leads to the loss of gel properties and to a decrease in the hydrostatic resistance of the entire disk. Thus, the pathological circle closes - a decrease in the elasticity of the intervertebral discs provokes an increase in pressure on them and leads to even greater degeneration.

Degenerative diseases of the spine are most often observed in the cervical and lumbosacral regions, where the static-dynamic load on the spine is the greatest.

Intervertebral discs here acquire a fibrous structure, become more rigid, lose their differentiation into the nucleus and fibrous membrane. When squeezed, cracks begin to form in the outer ring, nerve endings and blood vessels grow inside the disc, which are normally absent there. Violation of the integrity of the fibrous ring leads to a gradual extrusion of the nucleus outward with the formation of a hernia.

Degenerative changes in the spine mostly occur gradually, as part of the aging process. But they can also accelerate under certain conditions:

back injury, especially the lumbosacral and cervical;
genetic predisposition;
metabolic disorders, overweight;
infectious diseases;
overload of the spine in sports or during hard physical labor;
exposure to toxic substances;
occupational hazards (vibration), bad habits (tobacco smoking);
flat feet;
posture disorder.

Diagnostics

In the study of patients with diseases of the spine, the method of MRI, CT, X-ray, ultrasound and densitometry is used.

Osteochondrosis is determined by the index of bone mineralization on densitometry.

MRI picture of the cervical spine in normal conditions and with multiple herniated cervical discs

Disc degeneration is usually best seen on an MRI.

The initial stages are associated with regressions of the blood vessels that feed the discs. Constant pressure when sitting or standing, playing sports leads to displacement of the movable part (core) relative to the fibrous ring, stretching the latter. Prolapse occurs - the fibrous ring is squeezed by about 0.02 - 0.03 cm.

At the second stage (protrusions), the protrusion increases to 0.08 mm. As long as the outer shell remains intact, the nucleus can still be drawn back.

At the third stage, the fibrous ring ruptures, and the nucleus pulposus breaks out of it. This is clearly shown by the mr picture, and is also confirmed by the symptoms. The substance of the nucleus irritates the spinal nerve, causing pain in the lumbar spine (lumbago), chronic discogenic pain (radicular syndrome).

On an x-ray, osteochondrosis can be determined by the following signs:

a decrease in the height of the disk;
subchondral sclerosis;
marginal osteophytes on the anterior and posterior surfaces of the vertebral body;
deformation of the vertebral processes;
subluxations of the vertebral bodies;
calcification of the prolapsed nucleus pulposus of the disc.

Treatment

The choice of therapy depends on many factors, in particular, on the cause of the disease, the condition and age of the patient, and the presence of concomitant pathologies. If the damaging factor is known (for example, heavy physical exertion), then treatment begins with its elimination. Also, all patients are advised to sleep on their backs on a hard mattress and a low pillow. This relieves stress on the spine and unblocks the nerve endings and blood vessels. In the acute period, bed rest is prescribed, and to increase the space between the vertebrae, it is recommended to wear a special supporting collar or lumbar corset.

Positive effect of traction traction of the spine

Conservative therapies are used in the early stages. Treatment includes the use of chondroprotectors, anti-inflammatory drugs and analgesics. Remedial gymnastics is also extremely important, which helps to strengthen muscles and create additional support for the spine. To improve tissue trophism, massage, acupuncture, and manual therapy are useful. Also, using the methods of traction therapy (traction), it is possible to achieve retraction of hernias, an increase in the intervertebral space, decompression of nerve endings, and elimination of pain.

Medical treatment

To restore the cartilaginous tissue of the discs, preparations of chondroitin sulfate and glucosamine (Don, Artron complex, Osteoartisi), collagen are used.
In pain syndrome, it is recommended to take analgesics and non-steroidal anti-inflammatory drugs (Diclofenac, Ketorolac, Ibuprofen), preference should be given to selective COX2 inhibitors (Meloxicam, Lornoxicam). They can be taken orally (tablets) or applied pointwise along the spine at the exit of the nerve roots (ointments with Diclofenac, as well as Chondroxide).
Medicines from the group of muscle relaxants are prescribed in the presence of reflex muscle spasm, pinching of the sciatic nerve (Mydocalm, Sirdalud).
Sedatives and tranquilizers at night (Diazepam, Zopiclone) are used to relax the nervous system and relieve the symptoms of ddzp. To maintain the function of nerve fibers, vitamin preparations containing group B (Milgama, Neuromultivit) are prescribed.
Restoration of blood circulation around the nerve roots is achieved using peripheral vasodilators (Tental).
Decompression of vessels and nerves helps to achieve dehydration therapy - the removal of excess fluid from the body to relieve swelling (mannitol).
With very severe pain, a "blockade" of the nerve roots emerging from the spine is performed. Locally administered Dexamethasone, Diprospan (corticosteroids that eliminate inflammation and swelling), Metamizole sodium (analgesic), Phenylbutazone, Meloxicam (NSAIDs), Procaine (local anesthetic).

Operations are most often planned, but can also be performed urgently in case of infringement of the plexus of the cauda equina and myelopathy phenomena

Severe pain and significant dysfunction of the spinal nerves are indications for surgery. During the operation, part of the degeneratively changed vertebrae is removed and the nerve roots are decompressed. Also, if necessary, weakened vertebrae are replaced with artificial ones or fusion of several segments to stabilize the spine.

The spinal column is part of the musculoskeletal system of the human body. It is responsible for several basic functions. Among them, one can single out the support, motor, innervation and flexibility of the body. The complex structure often leads to premature aging of tissues. Degenerative dystrophic changes in the spine appear, leading invariably to the development of osteochondrosis and severe pain syndrome.

It must be understood that it is precisely degenerative-dystrophic changes in the spine that underlie all known pathologies of this structural part of the musculoskeletal system. Osteochondrosis, spondyloarthrosis, spondylolisthesis, protrusion and disc herniation - all these are the consequences of neglected and not treated in a timely manner degenerative dystrophic changes in the intervertebral disc, detected on the MRI picture of the examination. However, even without a special examination, it is possible to reliably diagnose with the help of typical clinical symptoms after the initial examination.

If you have an MR picture of degenerative-dystrophic changes in the cartilaginous tissue of the spine, we recommend that you immediately sign up for a consultation with a vertebrologist. In our clinic of manual therapy, the first appointment with a doctor is free of charge. During the consultation, the patient receives comprehensive information about the prospects and possibilities of the treatment.

What are degenerative-dystrophic changes?

MR picture of degenerative-dystrophic changes in the spine is the result of an examination using magnetic resonance imaging. In the obtained images, the diagnostician sees characteristic structural changes in the tissues of the spinal column. They can affect the vertebral bodies, cartilaginous intervertebral discs, ligaments and muscles. A detailed indication of the localization of degeneration is usually in the description of the picture.

To begin with, let's clarify what degeneration and dystrophy are from a medical point of view. So, tissue degeneration begins with a violation of their nutrition (supply of fluid, oxygen, nutrients, vitamins and minerals). With regard to the intervertebral discs, we can say that they do not have their own circulatory network. Therefore, the supply of fluid and nutrients to them can only be carried out with the help of diffuse exchange between the fibrous ring and the muscle tissue surrounding it.

In order for the diffuse exchange to be constant, a regular load on the muscular frame of the back is necessary. If there is no physical activity, then the muscles lose their ability to transfer fluid and nutrients dissolved in it to the cartilage tissue structures.

Dystrophy is an organic change in structure with dehydration and loss of functional ability. The intervertebral discs are deformed and lose their cushioning ability. The bone structure of the vertebral bodies and their spinous processes becomes porous and may be covered with outgrowths (osteophytes). Muscles lose their volume of myocytes and become unable to fully conduct a nerve impulse, contract or relax.

Degeneration is the replacement of the normal tissue structure with connective fibers (scars) and salt deposits. In this process, there is a complete loss of typical functions characteristic of certain tissues. Thus, the cartilaginous tissue of the intervertebral disc is able to absorb fluid and release it into the surrounding space. Due to this, elasticity and cushioning ability are maintained. With a degenerative change, the fibrous ring of the intervertebral disc becomes hard and loses the ability to absorb fluid. They fill with lime deposits, calcify and become very brittle and brittle.

Causes of degeneration and dystrophy

And now consider the most common causes of degeneration and dystrophy of the tissues of the spinal column. First of all, it is worth noting that recently this condition has ceased to be related to age-related and aging-related conditions. In our time, osteochondrosis is first diagnosed in people under 25 years of age. Residents of megacities and representatives of professions, whose daily work is associated with static long-term stress of individual parts of the body, suffer especially often.

Among the probable causes of the development of degenerative dystrophic changes in the spine, doctors name the following factors of pathogenic influence:

a sedentary lifestyle without regular physical exertion on the muscular frame of the back, torso and abdominals;
excess body weight, leading to endocrine disorders and metabolic pathologies;
incorrect posture (among today's youth, curvature of the spine is detected in 85% of cases);
injuries, bruises, falls, improper distribution of physical activity;
improper organization of the working and sleeping place in violation of the rules of hygiene and ergonomics;
long stay in a static position;
malnutrition and lack of clean drinking water;
smoking, drinking alcohol and many other bad habits.

Despite the cancerophobia common in modern society, tumor processes cause pain in the back, neck and lower back only in 0.5% of cases. And tuberculosis, syphilis and other dangerous infections are even rarer.

A healthy lifestyle, active physical education, the fight against excess weight and compliance with hygiene standards for organizing personal space are the most effective ways to prevent the development of degenerative-dystrophic changes in the spine.

What do initial, moderate and pronounced degenerative-dystrophic changes mean?

You need to be able to correctly understand the conclusion of the doctor, given after the MRI examination. What do these or other terms mean, let's try to figure it out further.

So, most often with intermittent back pain, in conclusion, you can see that there is an MR picture of initial degenerative-dystrophic changes in the spine, in practice, this is the absence of visible structural changes that could significantly impair the function of the musculoskeletal system. The doctor sees that some parts of the cartilaginous, bone or ligamentous tissue do not receive sufficient blood supply and small trophic changes have already occurred.

If effective treatment is not started at this time, then moderate degenerative changes in the spine appear in the future, manifested by quite strong and prolonged pain. This is an advanced stage of osteochondrosis with protrusion of the annulus fibrosus and partial loss of its depreciation ability. Most likely, at this stage, independent physical exercises are already very difficult, and the patient experiences serious stiffness of movements, a decrease in their amplitude and limitation of the flexibility of the spinal column. The help of a specialist in kinesitherapy, therapeutic exercises, massage and osteopathy is needed.

Pronounced degenerative changes in the spine indicate that the disease is already at an advanced stage. It can be manifested not only by severe chronic pain in one or another part of the spinal column. Here, signs of neurological damage to the radicular nerves may appear. This is numbness of certain parts of the body, weakening of muscle effort, muscle cramps and clonic hypertonicity.

Degenerative-dystrophic changes in the cervical spine

Very often, degenerative changes in the cervical spine are detected, associated with constant static tension in the muscles of the collar zone. Office employees who are forced to work in one position at the computer for a long time suffer from a similar pathology.

Degenerative-dystrophic changes in the cervical spine lead to the following clinical manifestations of diseases:

feeling of tension in the neck and collar zone;
pain in the neck and its spread to the upper limbs;
tension headaches, dizziness, decreased mental performance, drowsiness and depressive mood;
increased blood pressure and other symptoms of vegetative dystonia;
numbness of the upper extremities (often begins with the little fingers).

In the absence of treatment, spondyloarthrosis is quickly formed with the loss of habitual mobility, vertebral artery syndrome, leading to impaired cerebral circulation, etc.

Degenerative-dystrophic changes in the thoracic spine

The least common MRI examination reveals degenerative-dystrophic changes in the thoracic spine, this is due to the special anatomical structure. The thoracic vertebrae are responsible for forming the skeleton of the chest. Paired costal arches are attached to them, in front they are balanced by the sternum. Rigid fixation limits mobility and does not create prerequisites for rapid wear of cartilaginous intervertebral discs. Degenerative changes in the thoracic spine usually occur as a result of a traumatic impact, for example, after a fall on the back. They can be associated with deformities, changes in posture, such as scoliosis.

Degenerative-dystrophic changes in the discs of the lumbar spine

Degenerative-dystrophic changes in the lumbar spine, caused by excessive physical exertion, poor posture and other negative factors, are very common in people over the age of 30 years. But cases of manifestation of degenerative changes in the lumbar spine in patients at an earlier age are not uncommon. It is mainly representatives of professions associated with hard physical labor that suffer (loaders, lumberjacks, painters, finishers, builders, etc.).

Degenerative changes in the discs of the lumbar spine cause pain. There may be a stripe distribution of pain syndrome along the inner and outer surfaces of the thigh and lower leg. This is a sign of a pinched sciatic nerve. Very often in the morning hours, immediately after waking up, there is some stiffness of movements. During the day, it completely disappears. In the evening, before going to bed, there is a strong tension in the muscles of the lower extremities, a mild convulsive syndrome or a state of restless legs may develop.

Degenerative-dystrophic changes in the lumbosacral spine

Severe degenerative-dystrophic changes in the sacral spine can only be diagnosed in people under 25 years of age. After reaching this age limit, the intervertebral cartilaginous tissues of the sacrum naturally atrophy and all the vertebrae fuse together. Even if a young person develops degenerative changes in the sacral spine, they will be leveled in the process of fusion.

But degenerative-dystrophic changes in the lumbosacral spine, localized in the joint L5-S1, are of particular danger. Here is the hypothetical center of gravity of the human body. This accounts for the maximum physical, mechanical and static load. Therefore, the disk is destroyed very quickly. The result is severe pain, hernial protrusion and infringement of the sciatic nerve.

Any degenerative changes in the lumbosacral spine require immediate treatment. They often become the cause of a person's disability. This is worth remembering.

Treatment options for degenerative changes in the spine

Modern options for effective treatment of degenerative changes in the spine are extremely limited. Special drugs (chondroprotectors) have been invented that can restore the structure of damaged cartilage. But the difficulty lies in the fact that with impaired diffuse exchange between muscles and cartilage discs (which is the cause of degeneration), it is impossible to deliver these substances to the focus of pathology. There is no point in spending huge amounts of money and injecting chondroprotectors until normal diffuse nutrition is restored.

And manual therapy with its integrated approach can really help this. In our clinic, there are a huge number of practical cases of complete recovery. There is documentary evidence of the complete elimination of diffuse degenerative and dystrophic changes in the tissues of the spinal column after ongoing courses of therapy.

An individual approach is applied. Depending on the existing problem, the patient is recommended reflexology, osteopathy, massage, kinesitherapy, traction traction of the spine and therapeutic exercises. Significant relief of the condition is achieved after 2-3 sessions.

We invite you to book a free consultation with one of our experts. During the appointment, the doctor will conduct an examination, get acquainted with the results of the MRI examination and tell you about all the prospects for treatment.

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

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

The lumbosacral region is the center of gravity of the body, it takes on all the loads that accompany any movement of the human body. Sometimes these loads exceed the permissible limits, temporary changes and deformation of cartilaginous tissues 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. There is a beginning of calcification of a certain area of cartilage tissue. This is degenerative-dystrophic changes in the spine.

In order for degenerative changes to pass into an irreversible phase, a lot of time must pass. And this time the disease wins back in a person, due to the fact that the disease does not manifest itself immediately.

Expressed 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 can be different, depending on which structures of the spine are damaged and how serious these injuries are.

Symptoms of the diseases appear as degenerative-dystrophic lesions develop, but at 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 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:

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.

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.

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

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 noted:

partial or temporary numbness in the lower extremity girdle; convulsions.

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

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

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

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

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

Causes that provoke pathological changes:

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

Unfortunately, degenerative-dystrophic changes in the lumbar spine 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 the most deplorable, up to disability due to impaired motor activity.

Treatment of diseases of the lumbar region is considered complete and promotes recovery if after its implementation there is:

reduction or disappearance of pain syndrome; relieving tension in the muscles of the lumbar, pelvis and lower extremities, strengthening muscles; improvement of blood flow and supply of tissues with nutrients and oxygen, normalization of metabolic processes; removal or reduction of inflammation; normalization of the sensitivity of the lumbar;

Proper treatment is essential to achieve the above results. Specialists prescribe complex therapy using the latest achievements of modern medicine. For the treatment of degenerative changes in the lumbosacral spine, the following is prescribed:

drug therapy; physiotherapy; massage, therapeutic exercises, manual therapy; acupuncture, acupuncture; in extremely severe cases, surgery.

From the foregoing, it follows that there are several ways to overcome diseases of the lumbosacral region. But, it is better not to allow irreversible pathological processes to appear. You should consult a doctor in time, monitor your health, lead a proper lifestyle.

To understand the nature of the development of degenerative-dystrophic changes in the intervertebral discs, it is very important to understand the causes of such processes. The fact is that the human body is a verified mechanism that can withstand enormous loads, but under the influence of various kinds of adverse factors, a weakening of the natural defense mechanism is observed, which leads to a rapid violation of the integrity of the cartilage structures. An important role in the violation of the trophism of the intervertebral discs is played by the modern lifestyle. Thus, the following triggers contribute to the development of degenerative-dystrophic changes in the spine:

sharp loads; inflammatory diseases; passive lifestyle; hypothermia; malnutrition; active sports; hormonal disorders; diseases of the endocrine system; normal aging process; metabolic disorders; chronic 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 eat improperly. The fact is that, normally, the load on the spinal column is distributed evenly, and a developed muscular frame provides significant support to it. In people who lead a sedentary lifestyle and have excess body fat, as a rule, the muscles are poorly developed, so even the slightest strength exercise leads to a 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 cartilaginous 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 makes it possible to take effective preventive measures.

At present, it is well known how degenerative-dystrophic changes in the lumbar spine develop. The spine 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 adverse factors, in the area of the intervertebral discs of this department, malnutrition of cartilage tissues is primarily observed. Directly in the intervertebral discs there are no blood vessels that could feed it directly, therefore, the appearance of malnutrition of the soft tissues surrounding the spinal column is often observed first. In the absence of the proper level of nutrition of the intervertebral discs, the cartilage tissue begins to gradually break down, losing elasticity.

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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 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, protrusions of the discs, may occur. With a critical destruction of the tissues of the fibrous ring, it can rupture, which in the vast majority of cases leads to the release of the gelatinous body 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 a violation of cartilage tissue, activation of the immune system is observed, the cat's cells begin to produce prostaglandins, that is, substances that are inducers of the 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 can become a springboard for the development of a number of dangerous diseases and complications, including osteochondrosis, sciatica, etc.

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

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However, often at this stage of the process there may be severe dull pain in the lower back after increased physical activity. In addition, some people note the presence of a certain stiffness in the lower back.

At the 2nd stage of the development of the disease, severe symptoms can be observed. First of all, people with this stage have a serious limitation of the mobility of the spine, with any flexion, so-called “lumbago”, that is, attacks of sciatica, can appear. Patients may complain of tingling and goosebumps on the buttocks and lower extremities.

At the 3rd stage of the development of degenerative-dystrophic processes, the disease passes into an 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 convulsions.

When degenerative-dystrophic processes of the spine enter stage 4, damage to the spinal cord and its branching roots can be observed, which is fraught with paresis and paralysis of the lower extremities. As a rule, such complications are the result of compression damage to the spinal cord or malnutrition.

In most cases, patients with degenerative-dystrophic processes in the lumbar spine come to the doctor already in the later stages, when the symptoms are quite intense, preventing a person from leading a full daily life. Diagnosis of this pathological condition begins with the collection of 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 prevalence. To confirm the diagnosis, a series of studies using modern medical equipment is required. Such studies include:

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

Despite the fact that radiography is a publicly available diagnostic method, at the same time it is considered the least accurate and informative, since in the early stages of the development of the pathology it does not allow 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 at an early stage. With MR, the picture allows you to notice the existing degenerative-dystrophic changes in the thoracic spine or lumbar, even if they are extremely weakly expressed. Thus, MRI is the most accurate modern diagnostic method.