Osteochondrosis of the spine (intervertebral osteochondrosis) – neuro-orthopedic degenerative disease of the spinal motion segment, primarily affecting the intervertebral disc and adjacent vertebrae, which further leads to the secondary development of compensatory and dekompensatornyh changes in spinal ligaments.
The term “osteochondrosis” and his theory of justification – the achievement of the Soviet and post-Soviet medicine. The term is not quite correct and unreasonably overpriced post-Soviet neurologists and orthopedists.
Osteochondrosis in the English language used to refer to a degenerative process in the centers of ossification in children (Osteochondrosis – A disease of the growth or ossification centers in children, which begins as a degeneration or necrosis, followed by regeneration or recalcification). In the literature of post-Soviet countries for these diseases used the term “osteochondropathy.”
In English literature instead of osteochondrosis use such terminology:
• «herniated disc» – en: Spinal disc herniation; herniated disk,
• degenerative disease of the intervertebral disc – en: degenerative disk disease, en: Degenerative disc disease (DDD),
• Back Pain – en: Back pain, lower back pain – en: low back pain (LBP), pain in the neck – en: neck pain,
• spondylosis – en: spondylosis
• damage to the drive – en: annular tear, internal en: disc disruption syndrome, discogenic pain en: discogenic pain,
• radiculopathy – en: radiculopathy,
• neck – shoulder syndrome – en: cervicobrachial syndrome, lumbago with sciatica – en: lumbago with, en: sciatica.
The term “osteochondrosis” in English and in the post-Soviet literature – is a completely different disease. Which is reflected also in the International Classification of Diseases ICD-10.
The analysis of the pathogenesis of osteoarthritis and pain on his background:
As a result of chronic microtrauma at sub-optimal dynamic and static physical activity, locking spinal motion segment with the change of microcirculation, trophic and other biochemical processes – the annulus becomes less elastic with the formation of micro-cracks, loosened, then it implemented the nucleus pulposus, which subsequently breaks through the fibrous ring with subsequent traumatization of the posterior longitudinal ligament, compression and irritation of the venous plexus of the dura mater. Thus is formed a herniated disc. At the onset of pain are important mediators of pain and other biologically active agents (interleukins Prostoglandin, substance P, tumor necrosis factor, histamine, etc.). These substances are released at the time of formation of disc herniation or ligament injury. Also during stimulation of the nerve sinuvertebralnogo Lyushka formed reflex muscle pain component with limited mobility in spinal motion segment. When completed biochemical cascade and which edema, despite the presence of a herniated disc pain is still gone.
Most often overstretched Lower cervical and lower-lumbar vertebral-motor segment, at least – thoracic spine.
Syndromes of the intervertebral osteochondrosis: 1 – compression, 2 – reflex syndromes (musculo-tonic, neuro-degenerative, vegetative-vascular reactions).
The view that low back pain is the leading cause of back pain and pain radiating to the extremities – in practice is confirmed as the primary cause in the third case. Pain in osteochondrosis may occur in advanced stages or in the event of a large protrusion or herniation of intervertebral disc formation. Pain disturbed only during the formation of structural changes after the passage of a period of acute herniated disc causes no pain, but the presence of the hernia vertebral-motor segment is not quite a full-fledged structure that at low loads can easily be overloaded and cause a relapse. After the recovery period, the injured structures of the spine, degenerative changes may not cause pain.
Various authors have previously discussed, whether the “spondylarthrosis” in the term “low back pain”, at the present time are the two disease entities. Osteoarthritis of the facet joints can themselves cause both local and referred pain is a herniated disc. Just facet capsule injury or harm to the folds of the capsule may give local acute pain (what an MRI or X-ray can not be seen).
In 1/3 of the cases between the vertebral dorsopathies (osteochondrosis) is not a cause of pain in the neck or back. Not rarely the paradox, when revealed a herniated disc on MRI, or degenerative changes on radiographs, but this area is painless, and radiating or referred pain is not invested in the topography of Neurology localization of hernia, and the causes of pain are rooted not in osteochondrosis. There is plenty of reflex myofascial pain and carpal tunnel syndrome, which in no way associated with osteochondrosis. It may be the result of purely myofascial, viscero-autonomic reflex-muscular syndromes with the formation of secondary tunnel syndrome, or reflected visceral pain. A number of these syndromes may be in the early stages of compensatory and adaptive (but later become not adequate to the situation), and the root cause may be the place blocking tissue (fixation of the joint, organ or fascia), and she did not send pulses of pain (be dumb problem).
Also in the third case there is a mixed clinical situation where the degenerative pathology of intervertebral disc and facet joints act as an aggravating factor, not the underlying cause.
Engaged in the treatment of degenerative disc disease of the intervertebral neurologists and orthopedists, as well osteopaths and therapists, and advanced stages – neurosurgeons.
In view of the different views on these issues (English-language medicine, post-Soviet medicine and alternative medicine) – should be given to the role in the formation of osteoarthritis pain in the neck and back, do not overestimate the additional methods of inspection data (in this case, and not to neglect them) rely primarily the clinical picture of the individual patient, wider and deeper approach to the problem of pain syndromes, low back pain is not treated, and the reasons that actually cause pain and can also cause low back pain himself. To avoid confusion in terminology, medical traditions of different countries – to use the terminology of medicine constructive to English-speaking countries under the international classification.
Osteochondrosis and osteopathy
The effectiveness of osteopathic treatment of pain in patients with the inter vertebral discopathy (protrusion or herniated disc) is that with the help of soft techniques there is an influence on the internal organs and spine units craniosacral system, causing the patient’s body, using its own hidden reserves and self-recover .
The osteopath will diagnose and correct the cause of the disease, improve the biomechanics that facilitates the launch of the system of self-regulation body and mechanical load redistribution.
In addition, thanks to osteopathic treatment, balanced, not only the musculoskeletal system, and hormonal, vascular, neural and other functional aspects of life. With the help of osteopathic techniques can reduce the secondary vein swelling in the affected vertebral-motor segment, improve regional drainage of tissue fluid and blood, which will accelerate the elimination of inflammatory mediators; overstrained balance the deep paravertebral muscles, which also facilitate the patient’s condition and reduce the degree of pain.
Thus, osteopathy combines the high efficiency of the causal treatment of degenerative disc disease with safety and softness therapy.