The stages of the disease are determined by the degree of damage to the facet joints and the structures surrounding them.
Spondylarthrosis of the 1st degree is characterized by aching morning pain, quickly passing after a warm-up and easy self-massage. The range of motion in the spinal segment is almost normal. Initial spondylarthrosis on radiographs appears minimally.
Spondylarthrosis of the 2nd degree is characterized by increased pain, persistent restriction of movement in the affected vertebral section. At the stage of moderate spondylarthrosis, bone growths of the vertebral bodies and moderate narrowing of the joint spaces are revealed on the radiograph. Grade 2 polysegmental spondylarthrosis is characterized by similar manifestations at several levels and by common spondylosis in the images.
Constant expressed pain is a manifestation of spondylarthrosis of the 3rd degree. On the x-ray, the inter-articular fissures are sharply narrowed, up to full overgrowth, which explains the lack of movement in the affected spine.
- Which doctor treats spondylarthrosis?
- Methods of treatment
- Treatment by folk methods
- What is spondylarthrosis of the spine and how to treat it?
- Causes of pathology
- Author: Petr Vladimirovich Nikolaev
- Spondylarthrosis of the cervical, thoracic, lumbar spine – what is it
- The mechanism of development and causes of pathology
- The degree of development of spondylarthrosis
- Methods of treatment of spondylarthrosis
- Drug treatment
- Non-drug treatment
- Surgical intervention
- Spondylarthrosis of the lumbar spine
- Symptoms of spondylarthrosis
- Cervicarthrosis (cervical spine)
- Dorsarthrosis (thoracic)
- Lumbararthrosis (lumbar)
- Treatment of spondylarthrosis
- Physiotherapeutic treatment
- Operative therapy
- What is spondylarthrosis?
- Causes of pathology
- Stage of the disease
- Species of spondylarthrosis of the spine
- What are the symptoms?
- How to treat a problem?
- Physiotherapy and massage
- Treatment with folk remedies
- When is the operation necessary?
- Consequences and their prevention
Which doctor treats spondylarthrosis?
Which doctor should I contact for spondylarthrosis? If pain appears in any part of the spine, you need to contact a local therapist. After interviewing the patient, clarifying the circumstances of the disease, directions will be given for laboratory and instrumental examinations.
Who further treats spondylarthrosis? After receiving the results and making a preliminary diagnosis, the doctor will determine which doctor to refer the patient to. These may be the following specialists: orthopedist, traumatologist, vertebral neurologist.
The diagnosis of spondylarthrosis is made only on the basis of a comprehensive examination of the patient, including the following procedures:
Spondylarthrosis of the arches of the cervical spine can lead to the need for duplex scanning of the arteries of the neck and head.
Methods of treatment
How to treat spondylarthrosis of the spine? Therapeutic tactics include conservative and surgical methods, the choice of which depends on the neglect of the disease.
Conservative treatment of spondylarthrosis in the acute stage includes the use of the following drugs:
- non-steroidal anti-inflammatory drugs – Diclofenac, Movalis;
- muscle relaxants – Midokalm.
Physiotherapeutic treatment of spondylarthrosis of the spine is carried out by the following methods:
- electro- and phonophoresis with solutions of anesthetics, hormones;
- diadynamic currents;
- UHF therapy.
With spondylarthrosis of the back, paravertebral blockades with the introduction of anesthetics and hormonal drugs into the lesion are effective. They are especially indicated if local temperature is elevated during spondylarthrosis.
How to treat spondylarthrosis in remission? Of the medicines used are chondroprotectors (chondrolone), vitamins (milgamma). The range of physiotherapeutic procedures is expanding. Effectively mud therapy, electrical stimulation, magnetotherapy, massage. An important role is played by physical therapy with an individual selection of exercises that are performed in a gentle manner.
Surgical treatment is carried out only in advanced cases, with persistent pain and ineffective conservative approach.
Currently, implants are implanted between the vertebrae. The purpose of the intervention is to expand the intervertebral foramen to reduce compression of the nerve roots.
Treatment by folk methods
Treatment with folk remedies is used only against the background of the main therapy and in the stage of stable remission. Any medicine prescriptions should be agreed with your doctor.
Fir oil has a good effect. It can be used externally as a warming ointment and inside, diluting 15 g of the product in 100 ml of warm milk or water.
As a grinding, a warming tincture of calendula is also used. To prepare it for 50 g of plant material, you need a glass of vodka or cologne. The tool is prepared in two weeks.
Instead of a special corset on the lower back, you can wear a warm belt made of camel hair.
The prognosis of spondylarthrosis depends on the timeliness of treatment, the patient’s age and state of health. The most common complications of pathology:
- the formation of osteophytes (bone growths);
- compression of nerve roots;
- ankylosis, leading to loss of mobility of the intervertebral joints;
- spinal deformity.
Prevention of the disease is not specific and consists in strengthening the muscular corset and maintaining the flexibility of the spine. For this, yoga, swimming are suitable.
Weightlifting and strength sports can have a negative effect on the spine. So, falls, jerking movements when trying to lift weights can provoke back injuries. These sports can only be practiced after consulting a doctor and under the supervision of a trainer.
An adequate treatment for diseases of the spine prevents the occurrence of pathology. In addition, it is important to eat right, to exclude hypothermia and less nervous.
Spondylarthrosis of the vertebrae is a chronic pathology requiring prolonged persistent therapy. The success of treatment depends on a timely visit to a specialist: since the disease can be easily corrected in the early stages.
What is spondylarthrosis of the spine and how to treat it?
With spondylarthrosis of the spine, the intervertebral joints are affected. Spondylarthrosis of the spine is one of the forms of osteoarthrosis, in which the inflammatory process leads to a restriction of the mobility of the spinal column. In the joints, degenerative changes occur as a result of a violation of the blood supply to the cartilage. Pathology often develops in older people, mainly women.
Causes of pathology
The causes of the development of spondylarthrosis are associated with an inflammatory process in which all components of the joint are involved: cartilage, ligaments, subchondral bone, periarticular muscles and the capsule. Intervertebral spondylarthrosis develops gradually. First, the cartilaginous tissue of the joint atrophies, as a result, the elasticity of the cartilage is lost, the articular surfaces of the bones begin to be exposed. This process begins in the central part of the cartilage with the transition to the periphery. Then the joint capsule becomes inflamed, and bone tissue grows along the edges of the articular surface.
Vertebrae, trying to protect the discs from pressure, as if fused with each other by bone processes – osteophytes.
Spondylarthrosis occurs due to the development of degenerative-dystrophic changes. They are due to the influence of both pathological factors and physiological. The latter include natural aging processes. Pathological factors include:
- Genetic predisposition;
- Autoimmune diseases;
- Defects in the formation of the musculoskeletal system.
The risk of developing spondylarthrosis increases with increased load on the spine, injuries, overweight, impaired posture, flat feet, instability of the vertebrae, osteochondrosis, spinal surgery.
With flat feet, gait is impaired, and body weight is distributed unevenly, which leads to an incorrect load on the spine. Sedentary work and prolonged stay of the body in one position can also cause disturbances in the spine. Often, the pathology develops as a result of kyphosis or scoliosis, which is associated with excessive bending of the spinal column to the side or forward.
Injuries that increase the risk of developing spondylarthrosis include compression fractures of the spine. They lead to a change in the anatomically embedded ratio of the size and distance between the vertebrae. Playing sports, some of its types, for example, weightlifting, with insufficiently developed and weak muscle corset can provoke the development of spondylarthrosis.
The clinical symptoms of spondylarthrosis in the spine are characterized by manifestations such as pain and morning stiffness. Pain occurs when the body posture changes and when moving, pass at rest.
Stiffness after morning awakening occurs with the progression of the disease, lasts for 30-60 minutes.
In its development, spondylarthrosis goes through 4 stages:
- Spondylarthrosis is asymptomatic, only occasionally there may be unpleasant sensations in the back.
- Pain sensations become more noticeable and manifest more often after a night’s sleep or a change in body position. The patient feels stiff in the place of the spine where the disturbance is localized.
- Spondylarthrosis is characterized by complications. There is an overgrowth of bone tissue in the intervertebral joints and pinching of the nerve roots. As a result of pathological processes, a narrowing of the spinal canal occurs.
- Ankylosing of the affected joint of the spine occurs, i.e., it is immobilized as a result of fusion. The patient feels severe pain, the functioning of the limbs and internal organs located close to the spine is disrupted.
The main danger of spondylarthrosis of the spine is the development of ischemic stroke as a result of damage to the cervical spine and impaired blood supply to the brain.
Diagnosis of spondylarthrosis is carried out using palpation, x-rays, computed tomography or magnetic resonance imaging. An experienced doctor will be able to determine the pathology in question during examination and according to the patient’s complaints. On x-rays, which should be made in 2 projections, you can find articular changes characteristic of this disease. In particular, this can be a narrowing of the joint space or its absence, compaction in bone and cartilage, as well as subchondral sclerosis.
Tomography, both computer and magnetic resonance imaging, allows you to identify abnormalities in the bone and cartilage of the spine at an early stage of development of pathology. A radioisotope scan of the spine is also used, which allows you to determine the presence of an inflammatory process in the joints of the spine.
The main treatment for spondylarthrosis of the spine is carried out in 3 directions: drug therapy, physiotherapy and exercise therapy. Surgical treatment methods are rarely used, only in severe cases, in the absence of the effectiveness of conservative treatment. Since the disease is progressive in nature, it will not work out quickly and easily. Therefore, the main therapeutic goal is to slow down and gradually stop the development of the disease.
You can relieve pain with the following types of drugs:
- Nonsteroidal anti-inflammatory drugs;
- Analgesics and other painkillers;
- Corticosteroid hormones.
Since the disease is associated with the destruction of the cartilage tissue of the joint, treatment can not do without the use of chondroprotectors. It is necessary to take them quite a long time, the effect of them appears within 2 months.
Physiotherapeutic methods are prescribed only in remission and include:
- Ultraphonophoresis, which helps to reduce symptoms and restore the functionality of the joints through ultrasonic administration of drugs;
- Massage, which will help to remove the arising restriction in the movement of the vertebrae;
- Electrophoresis, with which you can achieve the removal of inflammation;
- Electrical stimulation that improves metabolic processes in tissues through exposure to electrical impulses;
- Diadynamic therapy, which helps to relieve swelling and stimulates the processes of cellular nutrition.
With the help of physiotherapy exercises, the deep back muscles that support the spine are strengthened and stretched. Preference should be given to exercises that are performed in a sitting or lying position and aimed at strengthening the muscles of the back. In some cases, the doctor may recommend wearing special orthopedic corsets, they will help significantly reduce pain due to fixation of the spine.
It is advisable for patients suffering from the pathology under consideration to reduce body weight if it significantly exceeds the norm. It must be remembered that all medical methods associated with the treatment of spondylarthrosis should be carried out strictly under the supervision of the attending physician.
Author: Petr Vladimirovich Nikolaev
The doctor is a manual therapist, orthopedic traumatologist, ozone therapist. Methods of exposure: osteopathy, post-isometric relaxation, intraarticular injections, soft manual technique, deep tissue massage, analgesic technique, craniotherapy, acupuncture, intraarticular administration of drugs.
Spondylodiscitis of the spine – what is it and how is it treated
What is uncovertral arthrosis of the cervical spine?
Spondylarthrosis of the cervical, thoracic, lumbar spine – what is it
Spondylarthrosis is a disease of the spine, most commonly found in older people. According to statistics from the International Health Organization, 90% of people over 65 suffer from this disease. Spondylarthrosis occurs as a complication against other diseases of the spine, and only in rare cases as an independent disease. Therefore, the best prevention of this pathology will be the timely treatment of all inflammatory and degenerative processes of the spinal column.
The mechanism of development and causes of pathology
Spondylarthrosis (or facet syndrome) is an inflammatory disease of the spine, degenerative-dystrophic in nature, which affects the cartilage tissue, and ligaments and the bone itself.
As the degenerative and inflammatory processes in the vertebrae and intervertebral discs progress, the cartilage tissue becomes thinner, and pressure on the arched joints increases. If treatment and preventive measures are not taken at this stage, then synovitis occurs – inflammation of the synovial membrane. Between the facets of the joint, fluid collects, the process of destruction of the cartilage begins. The joint capsule is deformed, and sclerotic changes begin outside the joint. On the edges there are bone growths – osteophytes, which completely block the mobility of the joint. Growing, osteophytes irritate the nerve roots, thereby causing pain.
This process can be divided into several stages:
- degenerative processes in the cartilage;
- violation of the blood supply to the cartilage, loss of elasticity;
- cartilage tissue is destroyed, leaving the surface of the bone defenseless;
- sclerotic changes begin on the surface of the joint;
- synovitis develops – inflammation of the synovial membrane of the joint;
- osteophytes occur at the edges of the joint.
The causes of spondylarthrosis can be divided into internal and external. External causes include excessive stress, spinal injury, overweight.
Internal causes of the development of spondylarthrosis:
- hereditary factor;
- anomalies in the formation of the skeleton;
- diabetes mellitus, gout;
- autoimmune pathology;
- elderly age;
- instability of the vertebrae;
- scoliosis, kyphosis;
- neoplasms in the spinal column.
Spondylarthrosis is classified according to several criteria.
Depending on the progression of the disease and the degree of damage to the arched joints:
- degenerative – the dystrophic process of the cartilaginous surface of the facet joints is irreversible. The bone structure is also destroyed;
- deforming – the joint is deformed due to significant bone growths along the edges;
- dysplastic – with this type of spondylarthrosis, there is a restructuring of the bone structure;
- ankylosing – the affected joints are fused and the area of the spine;
- polysegmented – vertebrae can be affected simultaneously in several places of the spinal column. The most complex type of pathology, requires long-term treatment.
Depending on the location of the inflammatory process:
- lumbararthrosis – spondylarthrosis of the lumbar spine, the most common form. It is characterized by sharp, sharp pain in the lower back, buttocks and hips. With any, even minor physical activity;
- cervicoarthrosis – affects the cervical spine. Osteophytes affect the nerve processes in the neck, provoking the appearance of radicular syndrome. Perhaps the development of intervertebral artery syndrome due to the risk of ingrowth of bone growths in the vertebral artery. With cervicoarthrosis, pain occurs in the occipital region, and gives to the shoulders and shoulder blades;
- dorsartrosis – a pathology affects the thoracic spine. Due to physiological characteristics, neurological syndromes practically do not appear. After all, this part of the spine is the least mobile, and is not subject to significant loads, so injury to the vessels is practically excluded.
The degree of development of spondylarthrosis
In the course of disease progression, 4 degrees of development are distinguished. Each stage is characterized by its symptoms and physiological changes in the vertebrae.
- Grade 1 – the disease is asymptomatic, so it is difficult to diagnose, and irreversible changes progress. In rare cases, you may feel discomfort in the back after physical exertion. Initial changes occur in the intervertebral discs, the synovial membrane, the elasticity of the ligaments decreases;
- 2 degree – when the pathology goes to the next degree of development, the spine loses its flexibility, sharp pains appear after sleep or a long stay in one position. In the area of the affected vertebrae, puffiness appears. At this stage, damage to the fibrous ring occurs. Particularly difficult is spondyloarthrosis of a polysegmental grade 2, when swelling and pain occur in several affected areas of the spine at once;
- Grade 3 – tissue damage reaches the bones, the first osteophytes appear, the functioning of the ligamentous apparatus is disrupted. Deformation of the vertebrae occurs, the inter-articular gap narrowed almost completely. Osteophytes injure nerve processes in the intervertebral canals, which can lead to spondylolisthesis – muscle pain syndrome;
- Grade 4 – bone growths on the edges of the joint have a significant area. Blood circulation and transmission of nerve impulses in the affected area is disturbed, the vertebrae are completely fused and their movement is limited. The danger of developing spondylosis is the blocking of the holes of the nerve processes.
If you experience stiffness in the back, pulling pains after physical exertion, you should consult a family doctor. The doctor will make an anamnesis based on complaints and examination of the patient. By palpation, he will study the condition of the back muscles, evaluate the mobility of the spine and the correct posture. With a preliminary diagnosis, the patient will be referred to a specialist – a neuropathologist, surgeon, orthopedist. The choice of a narrow-profile doctor depends on the severity and characteristics of the progression of spondylarthrosis.
Methods for the diagnosis of spondylarthrosis:
- radiography – allows you to diagnose pathology at 2 degrees of development, when the first osteophytes appeared;
- magnetic resonance imaging – it is possible to detect spondylarthrosis, starting with the first changes, since changes in cartilage tissue can be recorded on MRI.
Methods of treatment of spondylarthrosis
The treatment of this pathology is aimed at eliminating the pain syndrome, restoring motor activity in the affected joint and reducing the progress of the disease. All treatment methods can be divided into surgical and conservative. A conservative, in turn, is not medicament non-medicament.
To reduce the pain syndrome, analgesics in the form of injections and tablets are used – Analgin, Baralgin, Paracetamol. The use of non-steroidal anti-inflammatory drugs is possible only under the supervision of the attending physician, since they have a number of side effects. Used in the form of ointments and tablets, relieve pain well, and reduce inflammation in the affected joint. These are drugs Diclofenac, Deep Relig. With limited movement in the affected area of the spinal column, a course of corticosteroids is prescribed – biologically active hormones.
In addition to drugs that reduce pain and the inflammatory process, chondroprotectors are prescribed as an obligatory course. These are drugs that help restore cartilage, nourish cartilage and slow down its destruction. This is teraflex, chondromed, structure.
- Spinal traction. This is a medical procedure aimed at restoring the physiological position of the vertebrae, increasing the distance between them.
- Physiotherapy. With spondylarthrosis, UHF and phototherapy are used. Procedures allow you to pointly affect the affected areas, contribute to improved blood circulation and restoration of joint nutrition.
- Massage. Soft massage techniques are used. The method helps to relieve muscle tension, restores blood flow in affected tissues.
- Exercise therapy – therapeutic exercises is the most effective treatment for spondylarthrosis. Special exercises gradually restore mobility in a sore joint, train back muscles, forming a strong muscle corset, improve blood circulation and nutrition of joints.
Surgery for spondylarthrosis is rarely performed, only in cases where conservative therapy has not brought proper results, and the progression of the pathology continues rapidly. For surgical intervention, serious indications are needed – an extreme degree of vertebral instability, impaired motor function in the limbs, and others.
Decompressive surgery is usually performed at the level of microsurgery – this is the removal of a bone growth of the vertebra. And with severe neurological symptoms – radiofrequency innervation. This is a coagulation of nerve processes using an electrode.
Spondylarthrosis is an irreversible disease that can lead to disability. At the initial stage, it is asymptomatic, and with progression there is an unpleasant pain syndrome and limitation of mobility in the affected area of the spinal column. The best prevention of all diseases of the spine is regular physical activity, good nutrition and weight control.
Spondylarthrosis of the lumbar spine
Spondylarthrosis of the lumbar spine is a disease in which there is a deformation of the vertebral bodies and the formation of bone growths of various sizes along their edges, most often at levels T9-10 and L3. Such bone growths (osteophytes) are located mainly on the anterior, lateral, and less often on the posterior edges of the vertebral bodies; over time, they can cause compression of one or more nerve roots.
Performing most household and working manipulations is accompanied by a high range of movements in this part of the spine. The early deforming type of the disease (under the age of 30 years) is often associated with intense and prolonged physical exertion, chronic congestion, deterioration of the vertebral motor segment, trauma to the cartilage of the vertebrae of this spine. With some pathologies of the spine (scoliosis, kyphosis) or the habit of maintaining an incorrect body position, this medical condition can also develop in children.
The development of the disease is gradual. Manifesting usually in adulthood, spondylarthrosis of the lumbar spine is the result of metabolic disorders. Often the process becomes widespread, covering other parts of the spine.
Among the factors that increase the likelihood of developing a disease, we can distinguish:
- injuries (previous fractures, dislocations, damage to the ligaments and structures surrounding the joints);
- professional overload;
- spinal surgery;
- overweight, low physical activity;
- severe osteoarthritis;
- osteoporosis (causes small bone cracks).
Together and simultaneously with the disease, spondylosis also develops, in which the cartilage of the intervertebral disc is destroyed. Deforming spondylosis is characterized by the growth of bone protrusions and hooks around a degeneratively altered intervertebral disc. Over time, such changes can lead to spinal stenosis; when the channel becomes narrow, compression of the spinal cord occurs, causing a variety of neurological disorders (paresthesia, paralysis of the legs).
With this disease, the following symptoms are observed:
- pain in the back, lower back, rarely with a return to the thigh;
- pain, the intensity of which decreases after the cessation of exercise or after rest;
- muscle rigidity – muscles in this area can be tense and painful;
- limitation of spinal mobility;
At the initial stage, the disease is most often asymptomatic. Up to 30% of patients with radiological signs of this disease do not experience pain symptoms. Pain due to damage to the facet joints of the spine, as a rule, increases during walking and standing, with the progression of the process, difficulties with walking can occur. Patients may complain of back pain, heaviness, and stiffness in the morning, which disappear after a warm-up.
Such pains are mild, but some patients may develop lumbalgia due to their condition – a chronic, prolonged pain in the lumbar region caused by irritation of nerves and nerve roots.
Lumbar spondylarthrosis is rarely an independent disease that leads to severe pain in the back when a person is unable to move. With the addition of serious neurological disorders, it must be considered comprehensively with other pathologies. Pain in the lower back, buttocks, back of the thigh, impaired sensation in the legs indicate osteochondrosis. If a nerve is squeezed (deformed vertebrae compress the nerves passing through them), numbness, tingling, burning in the extremities are observed.
Severe neurological disorders, persistent pain, prolonged temporary disability, disability can be the result of the development of complications caused by this pathology and concomitant diseases in case of untimely seeking medical help.
The diagnosis is simple. Characteristic complaints of the patient about the severity of pain and stiffness, the results of a physical examination of the mobility of the spine, palpation of the lumbosacral region suggest that this is developing an ailment. Of great importance in the diagnosis are such examination methods:
- X-ray examination;
- for the determination of inflamed joints – a radioisotope scan of the spine;
- CT scan;
- magnetic resonance imaging (MRI).
The most diagnostic value is MRI, which allows you to visualize the intervertebral joints, vertebrae, intervertebral discs, nerves, ligaments, diagnose nerve impairment, if any, establish the stage of hernia formation. The same methods are used to identify complications. With the development of muscle weakness and sensitivity disorders, electromyography and a test for the speed of nerve conduction are used.
Standard treatment lasts from 1 to 3 weeks and consists of the following options:
- drug therapy (analgesics, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), steroid hormones);
- therapeutic blockade – injection of drugs (corticosteroids and local anesthetics) into the joints of the spine to relieve pain and relieve swelling;
- physiotherapy (e.g. short-wave diathermy for muscle relaxation and pain relief);
- spinal traction (the most effective form of treatment when back pain is caused by a pinched nerve);
- medical gymnastics, swimming (appointed after drug therapy);
- surgical intervention.
It is advisable to conduct several courses of treatment, even if the patient has no exacerbation of the condition. This reduces the risk of relapse of acute pain and the need for treatment for many years.
The basis for eliminating pain symptoms is the use of NSAIDs, which have an analgesic, anti-inflammatory, antipyretic effect (aspirin, ketorolac, naproxen, nabumeton, ibuprofen). Manual therapy, which may be appropriate for some patients, especially in the first months of pain, in this case has contraindications (bone growths on the surfaces of vertebral bodies, instability of several segments, inflammatory, rheumatoid arthritis).
A surgical operation during which osteophytes are removed is indicated only as the last treatment option, in case of complications, in the absence of positive dynamics from conservative treatment methods.
The most common recommendation for patients is gymnastics, which will help increase the strength and elasticity of the muscles supporting the spine, reduce stiffness in the back and relieve pain. It has been established that this is the most effective and soothing procedure. Recommended class duration is 15 minutes daily. It is useful to perform physical exercises for stretching the muscles of the back and spine, for elasticity of the spine, strengthening abdominal muscles, extensors of the back.
Static reduction exercises for a specific muscle or muscle group also help maintain muscle strength.
Patients whose development of lumbar spondylarthrosis is associated with metabolic disorders are prescribed a diet with the exception of red meat, white potatoes, coffee, spicy, salty, hot, fatty foods, as they increase the acid load on the body. It is recommended to include fruits and vegetables rich in vitamins A and C, foods containing high amounts of calcium (milk, almonds, soy), omega-3 and vitamin E (oilseeds, fish, nuts).
The course of the disease is dynamic and progressive. But in most cases, even a few weeks of therapy can reduce the symptoms, stop or slow its development.
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The information is provided solely for popular educational purposes, does not claim to reference and medical accuracy, is not a guide to action. Do not indulge in self-medication. Consult a specialist.
Spondylarthrosis is spinal osteoarthritis, a disease that affects all components of the facet joint (capsule, ligaments, articular surfaces of the vertebrae, cartilage). In 85-90% of cases affect older men and women, after 60-65 years. However, this pathology can be found in 25-30 years. Most often, the cervical vertebrae are affected, less often the lumbar and thoracic ones. About 10-12% of all back pain occurs in spondylarthrosis. With timely diagnosis, the disease is easily treatable and does not affect the patient’s lifestyle.
Vertebrologists identify several main causes of the development of spondylarthrosis:
- Spinal injuries (most often spondylarthrosis is formed due to subluxation in the joints of the spine);
- Anomalies in the development of the spine (the presence of an additional 6th lumbar vertebra, fusion into a fixed block of the 5th lumbar vertebra with the sacrum, asymmetric processes of the spine, incompletely formed vertebral arches, etc.);
- Vertebral instability;
- Constant increased loads on the spine (sedentary work, professional sports, flat feet, work with weights).
There are also a number of predisposing factors that increase the risk of developing this pathology:
- Age after 65 years;
- Women after menopause;
- Hereditary predisposition to diseases of the spinal column;
- Autoimmune diseases;
- The presence of diabetes mellitus, gout;
- Violation of the regime and nutritional balance.
Spondylarthrosis develops gradually and begins with atrophic changes in the cartilage of the joints. With the course of the disease, cartilage cells die, degenerative processes occur in the cartilage, and their elasticity is lost (from the center to the periphery). Next, there is a decrease in the size of the cartilage and, as a result, exposure of the articular surfaces on the bone components of the joints. Connective bone tissue is replaced (sclerosing) and small inflammatory processes occur in the joints. This is due to the fact that the collapsing cartilage crumbles into small fragments and these fragments fall into the synovial fluid. The marginal parts of the bone surfaces of the joints begin to grow and form osteophytes.
Spondylarthrosis is divided into three large groups, depending on the location of the process:
- Cervicoarthrosis – spondylarthrosis of the cervical spine;
- Dorsarthrosis – spondylarthrosis of the thoracic spine;
- Lumbararthrosis – spondylarthrosis of the lumbar spine.
There are also 4 stages of the development of the disease:
- Stage 1 – an asymptomatic course with initial processes in the joints (loss of elasticity of the disc, disorders in the ligaments and articular membranes), is diagnosed by chance, with prof. inspections;
- Stage 2 – the first pain symptoms, back fatigue, impaired mobility of the spine, disturbances already at the level of fibrous rings;
- Stage 3 – inflammatory processes join, the bone surface of the joint is affected, small osteophytes appear, the function of the ligamentous apparatus is impaired;
- Stage 4 – there are no movements in the affected spine, there is ankylosis and spondylosis, osteophytes of large sizes, impaired vascular and nerve patency. This stage is not reversible ..
Depending on the course of the pathological process, spondylarthrosis is divided into several types:
- Deforming type – deformation of the shape of the vertebrae by osteophytes occurs;
- Degenerative type – there is a destruction of the articular surfaces at the junction of the spine with ribs and in the region of the arches of the vertebrae, as well as the destruction of the structure of the intervertebral disc;
- Ankylosing type – is called ankylosing spondylitis, affects many joints of a person, significantly deforming them;
- Arched type – processes occur in the joints between the spine and ribs and in the arched joints;
- Uncovertebral type – located between the spinous processes on the posterior surface between 1 and 2 cervical vertebrae;
- Dysplastic type – manifests itself as a complete violation of the structure of the joints, their deformation;
- Polysegmented type – affects at the same time 2 or more parts of the spine.
Symptoms of spondylarthrosis
Symptoms of damage to the joints of the spine are slightly different in different departments.
Cervicarthrosis (cervical spine)
- Pain in the neck, radiating to the back of the head, shoulder blades, shoulders and arms, from periodically occurring after exercise or an uncomfortable position, to constant, aching, shooting;
- Noise in ears;
- Discomfort when turning and tilting the head, progressing to complete immobilization of the neck;
- Crunch in the joints of the neck;
- Aching pains to change the weather (especially for high humidity).
- Pain in the thoracic spine – initially periodic, after exercise, and then constant;
- Discomfort or aching pain in wet weather;
- Limited mobility in the affected spine;
- Morning stiffness in the spine;
- Atrophy of the back muscles in the projection of the affected area of the spine;
- Cracking with sudden movements.
- Pain in the lumbar region, thighs, buttocks, aching, occur in the early stages of spondylarthrosis, aggravated by movement of the spine in the affected section;
- Morning stiffness;
- Impaired mobility in the affected joints;
- Violation of posture and gait.
First of all, the patient’s complaints, the course of his illness (when it first appeared, with what manifestations began and how it progressed) and examination (muscle atrophy, impaired posture and mobility) are primarily used as diagnostic methods. After these methods, instrumental studies are prescribed:
- X-ray (in lateral and direct projection) – allows you to determine the structure of bone tissue, the presence of fusion of the vertebrae, osteophytes, etc .;
- CT (computed tomography) – a more accurate diagnosis, compared with x-rays, which determines small deviations from the norm, both bone tissue and cartilage;
- MRI (magnetic resonance imaging) – allows you to detect the smallest pathology of cartilage, ligaments, bones and blood vessels;
- Radioisotope scanning – allows you to identify inflammatory processes in the joints;
- Angiography (contrast x-ray examination of the vertebral artery) – allows you to determine its patency and the presence of pathological changes in the blood stream;
- Diagnostic block (is the last step in the diagnosis of spondylarthrosis) – Lidocaine (or another anesthetic) and glucocorticosteroid (Prednisolone, etc.) are injected into the cavity of the alleged affected joint. Discontinuation of pain indicates damage to the joint of the spine.
Treatment of spondylarthrosis
The treatment of spondylarthrosis can be divided into 2 main groups:
- Conservative (medication, physiotherapy);
This type of therapy is aimed both at eliminating the symptoms of the disease, and at the mechanism of the development of pathology. Several groups of drugs are used:
- NSAIDs – reduce pain and inflammation. Both tablet forms (1-3 tablets per day for pain) and injection (1-2 injections per day for severe pain) are used. These are Diclofenac, Dicloberl, Analgin, Piroxicam, Baralgin, etc.
- Chondroprotectors – reduce the destruction of cartilage, partially restore cartilage cells. They are used more often in tablet form, but intra-articular administration is also possible. These are Glucosamine, Chondroflex, Mucosat, Arthrin, Elbon, and others;
- Muscle relaxants are prescribed as adjunctive therapy when reflex tension of the muscular back frame occurs. These are Tolperizon, Sirdalud, Midokalm, etc.
- Vitamins of group B – the most effective way is to use the injection of vitamins B1, B2, B6.
Physiotherapy can enhance the effects of taking medications, speed up the healing process, and prevent the progression of the disease. The most used and effective methods:
Corsets for the back are also quite effective, which contribute to the unloading of the spine and, thereby, reduce the progression of the disease and accelerate recovery processes.
It is performed quite rarely and with certain indications:
- Violation of the function of the pelvic organs with compression of the spinal cord;
- Stenosis (narrowing) of the spinal canal;
- Paresis or paralysis due to spinal cord injury;
- Spinal instability;
- The progression of the disease and the lack of effect of conservative treatment.
Most often with spondylarthrosis, a facetectomy is applied – the removal of the affected joint and the creation of a fixed block. Thus, it is possible to completely eliminate the pain syndrome, however, the area of the spine will be motionless. Also, osteophytes are removed and the joint is replaced with an artificial implant. In the case of narrowing of the spinal canal and the development of neurological symptoms, restoration of conduction along the nerve endings and spinal cord is carried out.
3 and 4 stages of spondylarthrosis often give complications:
As a prevention of the primary development of spondylarthrosis, its exacerbations and progression, it is recommended to follow a number of simple rules:
- Weight loss and the fight against obesity;
- Regular exercise or light exercise (fitness, fitness equipment, etc.);
- Rational and balanced nutrition (adequate distribution of proteins, fats and carbohydrates, intake of vitamins and minerals);
- Injury prevention;
- Walking in the fresh air (at least 5 km daily);
- Correct distribution of load on the spine;
- Properly selected mattress and pillow;
- Wearing orthopedic shoes.
The more recommendation points are regularly performed, the lower the risk of developing spondylarthrosis.
What is spondylarthrosis?
A disease in which intervertebral structures undergo degenerative-destructive disorders is called spondylarthrosis of the spine. The causes of the development of the disease may be different, but the initial manifestations often occur in old age. The consequences of the pathology are dangerous, and if spondylarthrosis is not treated in a timely manner, a person gets disability. Treatment of the disorder is often medication, but if it was not possible to stop the destruction of the joints of the spine, the doctor performs a surgical operation.
According to the ICD 10 pathology, the code M 45 – M 49 “Spondylopathy” is assigned.
Causes of pathology
Spondylarthrosis or osteoarthrosis of the intervertebral joint is a degenerative inflammatory disease that is localized in the region of the arched facet joints. The causes of the disease are often associated with age-related changes, so if the pathology was diagnosed in old age, it is often accompanied by osteochondrosis, osteoporosis can also occur.
In men and women of young age, signs of spondylarthrosis occur under the influence of such factors:
- Congenital pathologies of the development of the ridge structure, in which the number of lumbar vertebrae is increased or, conversely, reduced. As a result of this pathology, degeneration of the intervertebral joints is observed, the spine loses its functionality due to the uneven distribution of the load.
- Instability of the vertebrae of the lumbar or thoracic spine.
- Back injuries when subluxation of the joints of the vertebra occurs.
- Spondylarthrosis, in which there is a displacement of the vertebral bodies.
The causes of exacerbation of spondylosis and spondylarthrosis are as follows:
- traumatic and difficult sport, which a person is engaged in constantly,
- hormonal and endocrine changes, for example, when pregnancy or menopause occurs,
- autoimmune and systemic pathologies,
- genetic predisposition.
Stage of the disease
Depending on the degree of progression, a person will be disturbed by distinguishable symptoms. There are 4 stages of pathology:
- At the first degree, the initial spondylarthrosis is often asymptomatic. Degenerative phenomena affect the synovial membrane, ligamentous apparatus.
- At stage II, the symptoms become more pronounced. After physical exertion, a moderate pain syndrome is disturbing in the back, joints lose their usual mobility, a person quickly gets tired. The intervertebral disc is thinned, the structures of the fibrous ring are damaged.
- At stage III, the cartilage tissue is greatly thinned, bone structures are involved in the degenerative-dystrophic process. Inflammation spreads, osteophytes grow in the inter-articular cavity. The joint loses functionality, the work of the ligaments is also disrupted.
- In stage IV, bilateral spondylarthrosis is often diagnosed. With a running disease, the joints become completely immobilized. Osteophytes become large and fill the entire inter-articular space. Disrupted blood supply and nutrition of these sites. It will be possible to cure the problem only surgically.
Species of spondylarthrosis of the spine
Given the location of inflammatory-dystrophic disorders, the following types of spondylarthrosis are distinguished:
- Lumbar arthrosis of the lumbar. The problem is often accompanied by a herniation of the L5 S1 disk, provoking acute pain symptoms that spread from the upper point of the lower back to the buttocks and thighs. This type of pathology is the most common, if diagnosed at the initial stage, it will be possible to overcome it with the help of medical exercises.
- Cervicoarthrosis or uncovertebral arthrosis of the cervical spine. It is characterized by the spread of pain and discomfort in the shoulder-shoulder area. As the pathology progresses, radicular syndrome develops.
- Thoracic dorsarthrosis. It is diagnosed less often than others, since it does not manifest itself with any pronounced symptoms. Neurological and functional disorders with the defeat of this site do not occur.
Given the nature of pathological changes in the arched joints, spondylarthrosis is distinguished:
- Degenerative. Joint structures are completely destroyed and disorders began to develop in the bone tissue.
- Deforming. Regional pathological growths are observed.
- Dysplastic. It is characterized by changes in bone structures.
- Ankylosing. Ankyloses develop, due to which the joint becomes immobilized.
What are the symptoms?
If degenerative processes occur in the area of faceted joints, the patient is concerned about:
- impaired mobility of the spine in the morning after waking up,
- pain during physical exertion and sudden movements,
- joint crunching
- worse weather changes.
With damage to the costal vertebral joints, a person feels:
- pain at the site of inflammation,
- limited functioning of the joint,
- atrophy of the muscle corset,
Spondylarthrosis of the uncovertebral joints manifests itself in such signs:
- discomfort along the location of the nerve fibers,
- noise in ears,
- visual impairment.
If a person has such signs, this means that the pathology is progressing. To find out the diagnosis, you should immediately consult a doctor. Based on the results of the study, a specialist will select effective drugs for the treatment of spondylarthrosis.
To effectively treat and fight the problem, it is important to establish an accurate diagnosis, so a visit to the doctor is required. After the initial examination, palpation and history taking, the patient is sent to instrumental research methods. With the help of an X-ray examination, the doctor will be able to assess the volume of damage to large joints of the spine, the progression of narrowing of the joint spaces, the size of osteophytes. CT or MRI for spondylarthrosis is prescribed to diagnose lesions of soft tissues – discs, cartilage, ligaments.
How to treat a problem?
If spondylarthrosis is diagnosed in the initial stages, and after the development of a moderate pain syndrome, a little time has passed, you can get rid of the problem with conservative methods. Drug therapy involves the use of such groups of drugs:
Chondroprotective drugs are used as an external application. Chondroxide ointment for spondylarthrosis has proven itself, which helps to accelerate the restoration of cartilage tissue, due to which motor activity improves. For the period of drug treatment, a sick leave is issued to the patient. The duration of its duration will depend on the effectiveness of the prescribed treatment.
Physiotherapy and massage
Manual therapy for spondylarthrosis helps to establish blood circulation in the affected areas, thereby eliminating cramping, pain, and muscle atrophy is prevented. With an exacerbation, massage should be easy, because intense manipulations can provoke negative consequences. Physiotherapeutic procedures also facilitate the course of pathology, to restore prescribed:
- magnetic therapy
- laser heating.
Massage and physiotherapy are contraindicated in acute cases, when the symptoms are pronounced.
It is recommended to perform static training, in which the muscles of the shoulder, hip and knee joints are tensed. If spondylarthrosis is diagnosed at the level of th12-s1 segments, but there are no right-handed or left-handed protrusions, you can engage in light sports, yoga, swimming, walking fast.
Treatment with folk remedies
As a prophylaxis of exacerbations, it is recommended to use such recipes:
- Honey compress. Mix 2 tbsp. l honey with a spoonful of radish juice. Warm up to a comfortable temperature. Apply to the affected area, wrap on top with polyethylene and a woolen scarf.
- Vodka grind. Warm up the vodka and moisten it with a natural cloth. Attach to a sore spot for the night. Treatment with folk remedies will be safe if all recipes are agreed with the doctor.
When is the operation necessary?
If conservative methods are ineffective, surgical treatment is performed. An implant is installed between the affected vertebrae, which will help relieve the arched joints. Thanks to surgery, it will be possible to expand the intervertebral gap and free the spinal canal.
Consequences and their prevention
In advanced stages observed:
- squeezing and damage to large vessels,
- spinal instability,
- violation of sensitivity.
To prevent these complications, it is important to monitor your health, eat right, exercise, refuse a sedentary lifestyle in favor of an active one. For severe symptoms, consult a doctor, because self-medication can lead to exacerbation, worsening of the situation and disability.
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