Osteochondrosis with radicular syndrome is a very common pathology that develops in humans as a result of long-term treatment of dystrophic disorders in the articular cartilage of the spine. The disease is often accompanied by various complications. Initially, even a profiled specialist will not be able to say what they will be, since they depend on the reason why osteochondrosis developed, as well as on structures that have undergone physiological changes.
Dystrophic processes in the intervertebral joints most often develop in people who have metabolic problems. Cartilage, as well as soft and bone tissue do not receive the proper amount of nutrients, with the result that they begin to change their natural structure. As a consequence, the fibrous ring expands and begins to break, letting the spinal fluid through. Thus, the vertebrae exert pressure on each other, while squeezing the neural column.
The disease is very serious because it is not only accompanied by severe pain, but also limits the physical abilities of the person. It becomes difficult for him to cope even with elementary everyday tasks. And in the absence of proper therapy for a long time, dystrophic changes become irreversible, so it is very important to go to the hospital as soon as possible and begin treatment.
What is radicular syndrome?
Radiculopathy is a often diagnosed neuralgic syndrome, accompanied by pronounced symptoms. It develops as a result of squeezing the roots of the spinal nerves and in fact is a more complex form of degenerative changes in articular cartilage. As a rule, osteochondrosis of the spine with radicular syndrome develops in the second or third year of the pathology, when the patient, for whatever reason, did not seek help from a medical institution or refused therapy. In this case, irreversible complications can develop, and it will be impossible to help the patient.
The main reasons for the development of pathology
As mentioned earlier, most often radicular syndrome is a complication of osteochondrosis. However, this is not the only reason why it can develop. There are a number of factors that significantly increase the risk of radiculopathy.
Among the main prerequisites are the following:
- displacement of the spinal disc,
- inflammatory process,
- destruction or damage to the myelin sheath,
- nerve ischemia.
Statistics show that osteochondrosis with radicular syndrome is diagnosed in about half of the people living in our country who have crossed the mark of 40 years. And at the age of 70 years practically every inhabitant of the planet suffers from this pathology. However, it is important to understand that the damage to the intervertebral discs is not always accompanied by pinching of the neural column.
You should get acquainted with them first. The development of complications is influenced by the following factors:
- excessive physical load on the spine, which is most often associated with harsh working conditions, overweight or wearing uncomfortable shoes with too high heels,
- spinal curvature,
- lower limb asymmetry,
- flat feet,
- severe hypothermia
- various infectious diseases,
- sedentary lifestyle,
- injuries received.
It is worth noting that lumbar osteochondrosis with radicular syndrome can also develop due to malnutrition. At elevated risk are people who consume insufficient amounts of vitamins, minerals and nutrients, or a surplus of salt, which do not maintain the water balance of the body or are prone to overeating.
If you have osteochondrosis with radicular syndrome, the symptoms here depend on the severity of the disease and on how much of the spine has undergone dystrophic changes. Most often, patients complain of severe pain, which is able to manifest itself both locally and throughout the back. In addition, there may be numbness of the lower or upper extremities, most often the first, burning, tingling, and loss of sensitivity.
Thoracic spine affection
This osteochondrosis of the spine, the radicular syndrome, as a rule, is pronounced, and is also accompanied by very severe and acute pain, the localization of which depends on which particular ganglion was affected. In total, there are twelve in the thoracic region of the human spinal column.
When squeezing the first root pain is aching in nature, and they are also accompanied by a decrease in the sensitivity of the epidermis in the area of the shoulder blades and forearm. More complex is the form of the disease that struck the first six ganglions of the thoracic spine. In this case, very often the patient experiences some discomfort of the esophagus, which makes it a little difficult to eat.
If the 7th and 8th ganglia were crushed, then the clinical manifestations are almost completely analogous to those described above, but the discomfort extends to a large area of the body. In addition, the patient often has pain in the abdominal region and near the heart.
If a person has osteochondrosis of the lumbar spine, the radicular syndrome can be of varying degrees of severity, with the defeat of the 9th and 10th ganglia, pain spreads almost along the entire length of the chest and back. At the same time, it becomes difficult for a person to perform not only any physical actions, but also to sit and lie down. In the case when the 11th or 12th root was pinched, then in addition, the symptoms described above are accompanied by numbness and discomfort in the area from the chest to the groin.
Osteochondrosis of the lumbar spine
It is on this area of the spine that the greatest load is created, therefore the manifestations in case of its damage will be the most intense. The symptomatology, as in the previous cases, depends on which ganglia were trapped.
The clinical picture is as follows:
- from 1st to 3rd root - acute aching pain and numbness of the skin in the thigh,
- 4th ganglion - discomfort covers the lower back, lower leg and part of the thigh,
- 5th root - severe pain almost the entire length of the lower extremities.
It is worth noting that the symptoms become more pronounced during the execution of any action and subsides a bit when the person is in a lying position.
As mentioned earlier, only profiled specialist can confirm or deny osteochondrosis with radicular syndrome after a comprehensive examination of the patient.
This pathology has common symptoms with some other diseases, so doctors prescribe the following laboratory tests:
- X-ray of the spine in several planes
- magnetic resonance tomography.
If the results do not give anything, then it may be prescribed to consult with other specialists dealing with problems related to the cardiovascular and digestive systems.
The main methods of therapy
If osteochondrosis with radicular syndrome was confirmed, treatment is aimed at relieving the patient from pain.
To do this, appoint:
- painkillers and injections,
- anti-inflammatory drugs
- muscle relaxants
- drugs that improve blood circulation and normalize metabolic processes,
In addition, patients are contraindicated any physical activity. Moreover, they must adhere to strict bed rest, limiting any mobility.
Radicular syndrome is a dangerous pathology that is diagnosed in a huge number of people around the world. If the first suspicion of this disease occurs, you must go to the hospital to start treatment. Self-treatment in this case can lead to very serious consequences, including disability. Therefore, do not risk your health, but immediately take appropriate measures.
Symptoms of osteochondrosis of the chest section with radicular syndrome are formulated by specialists as follows:
- Pain, which is constantly present or is paroxysmal in nature.
- In those areas where the pinched nerve is located, the sensation of external influence is lost. This clinical manifestation is a characteristic feature of the radicular syndrome. Its presence is easily diagnosed by a specialist at the initial examination. For this, a special needle doctor passes along the spinal column. Where there will be no pain from the injection, and there is a pinched nerve.
- Limited movement This is due to the fact that an atrophic process begins in the muscles due to the pinching of the spinal nerves. The result may be muscle atrophy. In patients with diagnosed osteochondrosis of the thoracic with radicular syndrome, a decrease in muscle mass in the sternum region can be observed visually in comparison with healthy areas.
With radicular syndrome, observed on the background of diagnosed chest osteochondrosis, pain is localized in the sternum or directly in the back. Provocative factors may be:
- stay in an uncomfortable position for a long time
- intense coughing
- sudden movement or prolonged physical activity.
Pain in the radicular osteochondrosis of the thoracic region arises where the heart muscle is located. That is why inexperienced doctors and the patient himself can easily confuse the condition with an attack of angina.
The main difference between these diseases is the duration of the pain attack. If the sensations ceased, as soon as the patient changed physical activity to a state of rest, he took nitroglycerin, which means that it is angina pectoris.
Increased discomfort, especially after a deep breath, is a sign of osteochondrosis of the thoracic spine.
Diagnosing a condition
If a person notes in his pain in the sternum, aggravated when he coughs and / or breathes, he should consult a neurologist. Diagnosis is carried out by several methods:
- Feeling back. This method is used at the initial reception to determine the location of the painful focus.
- Collection of information. All patient complaints and information about other diseases that have been recorded in history are entered into the medical record.
- X-ray examination of the spinal column. Pictures are taken in two projections - straight and side. Comparison of information obtained from images is a reliable way to determine where the nerve and root infringement occurred, and also to find out what the distance between the vertebrae is.
- MRI This method is the most informative, it allows you to get the most reliable results. Pictures taken with the help of the MRI apparatus make it possible with 100% probability to confirm the diagnosis of cervico-thoracic osteochondrosis with radicular syndrome and to determine the nature of the lesion, the degree of its spread.
How to treat pathology
Confirmed after a detailed examination, the diagnosis requires the patient, first of all, strict bed rest for the first three days since the start of treatment. The surface of the bed should be flat and moderately hard. Optimum for a thin mattress to lay the board.
The treatment regimen is always selected individually. The basis is the degree of the disease, the presence of concomitant diagnoses.
Surgery for the treatment of breast osteochondrosis is used in exceptional cases.
Indications for this can be deformities resulting from the development of radicular syndrome.
If the patient's condition does not require surgical intervention, the use of drugs of different spectrum of action is recommended:
- cooling ointment on the area of inflammation,
- analgesics to eliminate pain,
- warming ointments with irritating and analgesic effects,
- B vitamins,
- antidepressants (indicated for patients who suffer from severe pain).
Auxiliary treatment tactics
In order to eliminate the symptoms of the disease as soon as possible and restore the former quality of life, auxiliary medical tactics are being actively used. It consists in the following:
- Massotherapy . Equally useful in the period of exacerbation, and at the stage of remission of thoracic osteochondrosis.
- Electro- and phonophoresis.
- Reception warm baths.
- Compliance with a special diet with the exception of salty, spicy, canned food.
- Using the bandage.
To avoid the development of radicular syndrome, patients with osteochondrosis should monitor their weight, lead an active lifestyle with moderate physical activity.
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Denial of responsibility
The information in the articles is intended solely for general information and should not be used for self-diagnosis of health problems or for medical purposes. This article is not a substitute for medical advice from a doctor (neurologist, therapist). Please consult your doctor first to know exactly the cause of your health problem.
The causes of the disease
There are many factors causing the development of this pathological process. Usually this disease develops gradually (over many years). Osteochondrosis begins to manifest itself at a young age. The arteries supplying the intervertebral disk begin to empty, the disk becomes more rigid and flat, the fibrous membrane surrounding it thickens, and when it ruptures, the intervertebral hernia develops. A directional hernia squeezes the roots of the spinal cord. A hernia entering the muscle tissue causes a series of chemical and immunological reactions leading to autoimmune rejection of inflamed tissues.
At the same time, age-related changes begin to appear: hardening of cartilage, formation of osteophytes, mobility of the vertebrae.
As a result of all these processes, the root syndrome begins to develop in osteochondrosis (compression of the spinal roots during a hernia and displacement of the intervertebral disk). Nerve endings become inflamed and lose the myelin sheath. Symptoms of osteochondrosis of the thoracic or lumbar spine are observed in about half of people over 40 years of age; at the age of 70, the risk of developing this disease multiplies. However, the disease is not always accompanied by damage to the nerve roots.The appearance of osteochondrosis is caused by overweight, wearing shoes with high heels, increased load on the spine during pregnancy, deforming diseases of the spine, a sedentary lifestyle. Osteochondrosis can occur on the background of infectious diseases, hypothermia of the body, excessive loads on the spinal column during sports, injuries, malnutrition, and pathologies of internal organs.
The main symptoms of the disease
The main symptom of cervicothoracic osteochondrosis is paroxysmal pain. She may be permanent. The pain spreads along the squeezed nerve root. Its intensity increases with movement, hypothermia, stress. Along with pain, stinging, numbness, and decreased sensitivity may occur. Subsequently, atrophic changes in the tissues under the control of the damaged nerve begin to develop. Depending on the area affected, the clinical manifestations may vary.
With cervical osteochondrosis, radicular syndrome occurs quite rarely. It is distinguished by severe pain in the neck, extending to the neck, chest, hands and fingers. With advanced stages of the disease, the sublingual, trapezoid, and deltoid muscles atrophy. On examination of the patient, the doctor determines the decrease in sensitivity of the affected area of the body, increased pain when tilting the head, coughing and sneezing. When osteochondrosis of the thoracic region of pain is localized in the back and chest, they appear with sharp movements, coughing and prolonged stay in an uncomfortable position.
Due to the shingles nature of the pain, it can be confused with a sign of angina. Pain in osteochondrosis occurs only after movements, they become more pronounced when you take a deep breath or cough. This is what makes it possible to distinguish osteochondrosis from heart disease. Lumbar osteochondrosis is manifested in the form of sharp pains in the lower part of the spine, while the patient is forced to walk in a certain position, his mobility is sharply limited. When the nerves of the sacral spine are pinched, pain is given to the groin, waist and abdomen. All this allows to confuse the signs of osteochondrosis with renal colic. With the defeat of the nerve endings of this department, the functions of the pelvic organs are disturbed (enuresis, encopresis, impotence develop).
Osteochondrosis with radicular syndrome: diagnostic methods
When examining patients, the doctor first of all specifies the nature of pain and the cause of their occurrence. Examining the patient, he checks the sensitivity of the limbs, muscle reflexes, the degree of limitation of movements.
It is necessary to make a visual assessment of the condition of the skin, posture of the patient, to determine the presence of pathological curves of the spine. In addition, a neurologist may order a survey from other specialists.
The next step is an x-ray examination of the spinal column. With the help of X-rays, you can determine the displacement of the vertebrae, the curvature of the spinal column, the presence of intervertebral hernia, osteochondrosis can be distinguished from a fracture or neoplastic diseases of the spine. More accurate and modern methods of diagnosis of osteochondrosis are MRI and CT.
With their help, produce multi-layered images of the spine, blood vessels, bone marrow and muscles. With MRI, you can determine the location of the hernia and damaged nerve roots. In order to clarify the diagnosis, the doctor may prescribe a complete blood count, myelography or ultrasound.
Treatment of osteochondrosis with radicular syndrome
During the period of exacerbation, the main objectives of treatment are the removal of pain and improvement of mobility. After the pain is resolved, the doctor decides on further conservative or surgical treatment. In the period of exacerbation, the patient is recommended bed rest for 1-3 days. When the pain subsides, the patient should gradually move to physical activity. To alleviate the patient's condition in the first days, warming ointments are applied.
In the treatment of osteochondrosis of the cervico-thoracic region, painkillers are used in the form of tablets or intramuscular injections. For intense pain, the doctor may prescribe narcotic painkillers. Eliminate the inflammatory process help NPVS: Nimesulid, Diclofenac. With prolonged intense pain, the patient is advised to take antidepressants. Chondroprotectors help stop the destruction of intervertebral cartilage.
Concerning the surgical treatment of the disease, the opinions of experts differ. Many of them believe that a lasting positive effect can be achieved with the help of conservative treatment. Others believe that the operation - a quick and reliable way to get rid of pain. However, the operation eliminates the consequences of degenerative changes in the intervertebral cartilage, without reducing the likelihood of re-compression of nerves in another part of the spine.
Traditional methods of treatment of osteochondrosis
Folk remedies are used to relieve pain and prevent disease. Compresses with alcohol, mustard and herbs have the best effect. Manual therapy increases the flexibility of the articular cartilage, suspends the development of a hernia, helps put the displaced vertebra in place.
Such procedures should be carried out by a specialist.
During the period of exacerbation, the patient is recommended to undergo a course of massage that relieves pain and tension in the muscles. After removing the pain, you can do an intensive massage, which is necessary to strengthen the muscular frame and improve blood circulation in the tissues. In the diet of osteochondrosis with radicular syndrome should include foods rich in vitamins. The jelly is especially useful at this disease, and from smoked products, fried and spicy dishes should be refused. When exacerbation of the disease is recommended to reduce fluid intake. The list of recommendations also includes getting rid of excess weight with a low-calorie diet, playing sports with moderate loads, avoiding high-heeled shoes, preventing the body from hypothermia.
What it is? ↑
The radicular syndrome got its name from the localization of the pathological process - in the roots of the spinal nerves.
Spinal nerves exercise the motor and sensory innervation of the skin, skeletal muscles, diaphragm, and internal organs.
Fig .: spinal cord roots
With the defeat of the nerve roots, a set of characteristic symptoms develops, among which the leading ones are sudden intense "shooting through" pains in the back and neck, often spreading in the limbs, buttocks, abdomen, internal organs (kidneys, liver, heart).
Pains are often accompanied by:
- sensitivity disorders
- paresis (partial loss of ability for arbitrary movements),
- trophic changes (hair loss, pallor, cyanosis of the skin, muscle wasting),
- change in tendon reflexes, as determined by neurological examination.
Violations of sensitivity and paresis (in severe cases - paralysis with a complete loss of ability to move) - signs of root-vascular syndrome resulting from ischemia, that is, reducing the blood supply to the root or the whole spinal nerve due to compression of the radicular artery.
Causes of formation ↑
The radicular syndrome, caused by degenerative changes in the spine, is formed due to a number of factors acting both individually and collectively among themselves.
Degenerative-dystrophic processes in the spine develop for a long time, for years and decades:
- already at the age of 20-25 years, physiological desolation of the arteries feeding the intervertebral disk occurs, metabolic processes are disturbed,
- over time, the disk becomes hard, flattens out, bulging the surrounding fibrous ring, diffuse protrusion of the disk occurs (sometimes it is incorrectly called diffuse osteochondrosis),
- in the future, the ring may break, intervertebral hernia is formed. If the hernial protrusion is directed to the side, it leads to compression of the spinal roots,
- in addition, the cartilaginous tissue of the intervertebral hernia, once in the epidural space, triggers a cascade of immunological and biochemical reactions, causing autoimmune inflammation, when the body damages its own tissues and cells,
- at the same time, age-related changes are growing - ossification of intervertebral and articular cartilage, the formation of bone growths, and the pathological mobility of the vertebrae appears.
Fig .: changes in the tissues of the spine
The main prerequisites for the development of radicular syndrome are created:
- mechanical compression of spinal roots during diffuse protrusion of the intervertebral disc, disc herniation, bone growths in the vertebral bodies or pinch between the vertebrae displaced relative to each other,
- inflammation, swelling of the roots,
- demyelination (loss of myelin sheath) roots,
- ischemia of the spinal nerves.
What is dangerous spinal cord injury? Find out here.
Risk factors ↑
Signs of osteochondrosis are found in about 50% of the population who have reached the age of 40 years, and by the age of 70, spinal degeneration is detected in 100%.
However, not all cases of osteochondrosis is accompanied by radicular syndrome.
Its occurrence is provoked by the following factors:
- Excessive uneven load on the spine during obesity, pregnancy, wearing high-heeled shoes,
- The presence of deformities of the spinal column (kyphosis, spermosis, scoliosis, irregular bends with congenital asymmetry of the lower extremities, flat-footedness),
- Constant long-term static loads with the simultaneous absence of dynamic (sedentary lifestyle, "sedentary" work),
- Hypothermia and infectious diseases, aggravating inflammatory processes,
- Microtraumas and sudden heavy loads on the vertebrae during sports, falls, weight lifting,
- Some dietary habits (insufficient amount of fluid in the diet, excess salt, etc.),
- Diseases of the internal organs.
Symptoms and signs
The main complaint presented by patients with the presence of the radicular syndrome is pain, often paroxysmal and very strong, but may be permanent.
The spread of pain occurs along the pinched nerve.
Its intensity increases:
- when moving
- amid stressful conditions
- with supercooling.
Pain can be accompanied by various paresthesias:
- numb feeling
- crawling goosebumps
- overall reduction in pain and tactile sensitivity.
In the long run, trophic disorders appear in the tissue innervated by the affected nerve.
Depending on the level of damage to the spinal nerves, radicular syndrome has clinically significant features.
Radicular syndrome in cervical osteochondrosis does not occur too often and is characterized by persistent cutting pain in the neck.
The pain radiates (gives) along the pinched nerve - in the shoulder, arm, fingers, upper half of the chest, neck, lower jaw, tongue.
With a long course, the hypotrophy of the corresponding muscle (deltoid, trapezoidal, sublingual, etc.) develops.
On examination, the neurologist reveals a decrease in sensitivity on the affected side (by slightly pricking the skin with a needle) and specific symptoms:
- increased pain in the passive bending of the head of the patient in the supine position (Neri symptom),
- increased pain when coughing, sneezing, straining (Degerin symptom).
Osteochondrosis of the thoracic spine
Osteochondrosis of the thoracic spine with radicular syndrome is manifested by chest pains (torocalgia) or back pains (dorsalgia) arising after an awkward movement, an attack of coughing, or a long stay in an uncomfortable position.
Often the pain is shingles or imitates angina attack, arising in the heart, behind the sternum.
The pain of the radicular syndrome is clearly associated with movements, its intensity increases with a deep breath and cough, which makes it possible to distinguish signs of osteochondrosis from a heart attack.
Osteochondrosis of the lumbosacral
Lumbar osteochondrosis with radicular syndrome is the most common cause of back pain.
Lumbar pain (backache, lumbodynia) can be acute and subacute.
Acute lumbodynia is accompanied by sharp pain (it is often compared with an electric shock), characterized by the forced position of the patient, limited mobility, positive symptoms of tension: Lasegue and Wasserman.
The symptom of Lasegha is determined by lifting the patient's leg out of the prone position, and the symptom of Wasserman - from the prone position by bending the leg at the knee joint, the symptoms are considered positive for increased pain.
If the nerves are pinched at the level of the sacral region, irradiation of pain in the groin, external genital organs, lower back, in the abdomen appears (in the last two cases, renal colic can be mistakenly diagnosed).
If the roots of the nerves that make up the cauda equine are affected, the function of the pelvic organs may be disturbed: urination disorders (enuresis, urinary incontinence), defecation (encopresis) occur, in men erectile dysfunctions.
Osteochondrosis of the lumbosacral often causes the formation of the radicular-vascular syndrome with a decrease in sensitivity and the development of paresis in the lower limb, a symptom of which is a kind of "cock" gait in patients.
During pregnancy, due to weight gain, redistribution of the center of gravity physiologically increases the load on the lumbar spine, along with this hormonal changes occur, leading to a decrease in the elasticity of the cartilage tissue.
If there are additional risk factors (sedentary lifestyle, age 30 years and older, previously existing pathology of the spinal column), conditions are created to exacerbate the severity of previously existing osteochondrosis or to manifest it, including radicular syndrome.
Manifestations of radicular syndrome in osteochondrosis in pregnant women do not differ from other cases of osteochondrosis.
However, radicular pain, localized in the lumbar region, radiating down the abdomen is sometimes incorrectly mistaken for false contractions or the threat of interruption.
A neurologist's examination, which is mandatory for all pregnant women, helps to clarify the diagnosis.
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Diagnostic methods ↑
During a detailed examination of patients with complaints of back pain:
- clarifies the diagnosis
- determines the severity of the disease,
- differential diagnosis is carried out with spinal injuries and other diseases (tumors, diseases of the gastrointestinal tract, kidneys, heart, etc.).
Diagnostics, carried out in full, allows you to assign the most appropriate and effective treatment.
Survey and inspection
Presume the presence of osteochondrosis with radicular syndrome in a patient by a neurologist can already at the primary admission. For this, he conducts a survey and examination of the patient.
The survey clarifies complaints and a history of the disease:
- The doctor is interested in the nature of the pain (intensity, duration, irradiation), the reasons for their occurrence (a connection is established with provocative moments), identifies risk factors.
- On examination, a neurologist examines pain sensitivity, severity of tendon reflexes, determines the strength of muscle tone, the possibility of voluntary movements and the degree of their restriction due to pain, the presence of specific symptoms.
- Visually assesses the condition of the skin (signs of trophic disorders are possible), the patient's posture, the configuration of the spinal column (whether or not there are pathological bends), gait features, etc.
If necessary, the neurologist prescribes additional consultations of specialists - a gastroenterologist, cardiologist, oncologist, general practitioner, urologist, gynecologist.
The next step is the X-ray examination of the spine, which allows to identify:
- signs of osteochondrosis,
- spinal deformities
- displacement of the vertebrae
- the presence of calcifications
- indirect symptoms of disc herniation.
Radiographic signs of osteochondrosis are found in most of the study, whose age exceeds 40 years.
At the same time, there is no relationship between the severity of pathological changes and the intensity of the pain syndrome.
However, using X-rays can be used to distinguish the pain of the root syndrome from pain due to injury or tumor.
Computed and magnetic resonance imaging
Computed and magnetic resonance imaging (CT and MRI) are among the modern high-precision methods for diagnosing osteochondrosis of the spine and its complications.
They provide layered images of the spine, spinal cord, blood vessels and surrounding tissues. MRI easily determines the location of the hernia (or protrusion) of the disc, swelling of the roots of the spinal nerves.
An MRI or CT scan is necessary before surgical treatment.
Other research methods
Additionally, in order to clarify the diagnosis can be assigned:
- complete blood count, urine,
- blood chemistry,
- other studies according to indications.
In the acute period of the disease with intense pain, the main task of treatment is its relief and the resumption of the possibility of active movements.
After elimination of the pain syndrome, complex therapy is carried out aimed at preventing the exacerbation, the issue of the need for surgery is resolved.
Working patients with the development of radicular syndrome on the background of osteochondrosis is issued a sick-list.
A sharp limitation of physical activity (up to bed rest) for a period of 1 to 3 days is recommended, and when pain subsides, a careful transition to physical activity is carried out as early as possible.
To relieve pain:
- on the first day they use cooling applications,
- from the second day warming procedures, rubbing with gels or ointments with warming, analgesic, anti-inflammatory effects (“Fastumgel”, “Finalgon”, etc.) are used.
In the treatment of osteochondrosis with radicular syndrome, the following groups of drugs are used:
- Painkillers: are used to relieve pain directly during an attack in the form of tablets (capsules) for oral administration or in injection form for intramuscular, intravenous administration (analgin, ketorol), blockades (novocaine, lidocaine). In rare cases, even high narcotic analgesics can be administered for pains of high intensity.
- Nonsteroidal anti-inflammatory drugs: have two effects at once: analgesic and anti-inflammatory. Appointed course daily, regardless of the presence of pain. The most commonly used diclofenac, nimesulide, meloxicam, indomethacin, ibuprofen, celecoxib.
- Muscle relaxants: reduce muscle tone, thereby relieving pain (clonazepam, diazepam, miolastan).
- Antidepressants: effective for long-existing, chronic pain, exhausting patients (amitriptyline, desipramine).
- Chondroprotectors: drugs that can stop the degenerative processes and promote the restoration of cartilage tissue (chondroitin sulfate, glucosamine).
- Vitamins of group B: in the acute period in the form of injections, then in tablet form (neuromultivitis) - improve the condition of the nerve fibers.
The question of the feasibility of operations with osteochondrosis is still causing controversy among neurologists.
Most physicians are inclined to believe that an adequate amount of comprehensive conservative therapy is sufficient for effective treatment of radicular syndrome caused by degenerative changes in the spine.
On the other hand, the modern level of medicine with the possibility of microsurgical interventions makes it very tempting (especially for patients) to quickly and permanently get rid of back pain.
However, the operation can only one-time eliminate the effects of degenerative processes, without affecting the presence of osteochondrosis and the likelihood of re-infringement at another level.
The main indications for surgery are:
- damage to the ponytail with the presence of pelvic disorders,
- paresis and paralysis of the lower limbs,
- persistent intense pain, not amenable to conservative therapy.
Acupuncture has been proven to effectively relieve pain and while it is a safe procedure, with virtually no side effects and contraindications.
Acupuncture is recommended both in the acute period and outside the exacerbation of the disease.
The main exercises from the complex of medical gymnastics in osteochondrosis with radicular syndrome patients must be trained by an instructor in exercise therapy or by a neurologist.
The nature of the exercises has significant differences depending on the phase of the disease, the localization of the process and the severity of painful attacks.
Outside the exacerbation, gymnastic techniques are recommended, aimed at stretching and increasing the flexibility of the spinal column, strengthening the back muscles.
With some success, traditional medicine methods can be used to relieve a painful attack and beyond as a preventive measure.
The most popular when removing pain are warming compresses and applications of herbs, salt, alcohol, honey, mustard.
So, in the treatment of lumbar radicular syndrome folk remedies are used:
- hot compresses based on infusion of equal parts of thyme, chamomile, St. John's wort, black elderberry,
- tincture of golden mustache on vodka for grinding,
- honey, diluted with vodka or alcohol for grinding and compresses,
- heated coarse salt for applications, etc.
Manual therapy allows:
- relieve pain and muscle spasm,
- increase spinal flexibility and joint mobility
- reduce the degree of hernial protrusion,
- "Set" the displaced vertebra.
Manual manipulations should be trusted only to doctors with an appropriate specialization.
In order to avoid complications, manual therapy is contraindicated for acute signs of radicular syndrome.
Massage and physiotherapy
Massage and physiotherapy with excellent results are applied at any stage of the disease.
In the acute phase are shown:
- relaxing massage to relieve muscle spasm and pain
- diadynamic currents
- electrophoresis with novocaine,
- warm baths.
When exacerbation subsides, massage techniques become more intense, aimed at strengthening the muscles of the back and neck, improving blood circulation and tissue nutrition, and increasing mobility.
Nutrition for osteochondrosis with radicular syndrome should be balanced, enriched with vitamins and chondroitins of natural origin (the latter can be obtained from aspic, fish aspic).
- the use of salt, spicy, pickled products, smoked meats, refined carbohydrates,
- strong tea, coffee, alcohol.
For obesity, you must follow a low-calorie diet.
An advanced drinking regimen is recommended, but only without exacerbation: for pain, the amount of fluid should be reduced to reduce the swelling that squeezes the spinal root.
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Prevention of radicular syndrome in osteochondrosis is primarily aimed at eliminating risk factors.
- take care of weight correction
- lead an active lifestyle with age-related and semi-physical exercise,
- wear comfortable shoes
- avoid hypothermia and other precipitating factors.
Effective treatment of the radicular syndrome can not be achieved only by the appointment of drugs or even surgery.
The patient’s interest in treatment, commitment and readiness to change lifestyles, habits, and dietary habits are needed.
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Characteristic features of the pathology
Radicular osteochondrosis is the final stage of a long destructive-degenerative process occurring in the intervertebral discs. Pain syndrome manifests itself after weight lifting, respiratory or intestinal infection, awkward sudden movement. The fibrous ring of the disk breaks, and it goes beyond its borders. In the vacant space, an intervertebral hernia is formed, compressing the spinal roots. The radicular syndrome develops - a combination of symptoms that significantly complicates a person’s life.
Acute pain occurs not only as a result of trauma to the spinal roots. The situation is aggravated by the formed bone growths and the extended disc, which infringe the nearby soft tissues. This leads to a further increase in pain, and sometimes to aseptic inflammation. Pathogenesis is also complicated by discalgia - pain in the innervation zone of the corresponding roots of the spinal nerves.
Clinically, radicular osteochondrosis is manifested by pain, decreased reflexes, partial sensitivity disorder, and autonomic disorders. The painful sensations that occur immediately after the rupture of the fibrous ring resemble a “backache” or pain that accompanies muscle inflammation. And the formation of the syndrome occurs after the formation of an intervertebral hernia. Tingling and numbness appear first. Trauma to the spine leads to a disorder of innervation - reduced temperature, tactile, pain sensitivity.
Over time, the muscles that are located in the area of the affected spinal root weaken. In severe cases, there is complete atrophy (reduction in size).
Radicular osteochondrosis is classified according to the location of the damaged sensory nerve endings:
But quite often several spinal nerve plexuses are involved in the destructive process. In such cases, patients are diagnosed with a combined lesion, for example, cervicothoracic osteochondrosis with radicular syndrome. For this pathology is characterized by severe symptoms, including signs of damage to the cervical and thoracic vertebrae and discs, as well as the infringement of several nerve endings.
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Types of disease
Depending on the localization of the lesion of the nerve endings of the roots, osteochondrosis of the spine with radicular syndrome can be of three types.
For all of them, their characteristic feature is pain syndromes that appear with different intensity depending on the degree of degenerative changes in the intervertebral discs and the pain threshold of a person.
The most common type is lumbar osteochondrosis. The spine in the lumbar region is the strongest load, and the muscles are usually weak and therefore the loins are most affected.
From which roots suffered, lumbar osteochondrosis with radicular syndrome can have the following symptoms:
- Acute pain in the groin or thigh. At the same time skin numbness can be observed — 1, 2, 3 spine,
- Dull pain in the sacrum or lower back, giving in to the knee, lower leg — 4,
- Intense pains extending to the thigh, shin, foot, numbness of the big toe —5.
With this type of osteochondrosis of the lumbar spine, pain is observed on one side, and usually gradually subsides if the patient lies still. To facilitate the condition, it is recommended to wear a special bandage.
Cervical radicular osteochondrosis
Cervical osteochondrosis with radicular syndrome is quite rare. It is usually diagnosed in people with pinching the arteries of the spinal roots. As a result of insufficient oxygen supply, their oxygen starvation occurs, which becomes the cause of the neck-radicular syndrome. The intensity, nature of pain and symptoms depends on which of the eight cervical roots is affected.
If the patient suffers from the first and second root-neck syndrome, then most often he suffers from severe headaches that are permanent and are accompanied by numbness in the occipital and parietal parts of the head.
At the same time, if the second root is affected, a decrease in the tone of the chin muscles and sagging of the skin may be observed.
In patients with an affected third root, pain in the right or left side of the neck is accompanied by numbness of the skin. Patients with cervical-radicular osteochondrosis experience feelings of swelling of the tongue on the one hand, while it may have difficulty in speaking and swallowing. In case of neck and radicular syndrome of the fourth root, a person experiences unilateral moderate pain in the shoulder, collarbone, scapula. If the fifth person suffers, the pain in the shoulder becomes more intense and affects the neck. The shoulder may become numb, and strong weakness may be felt in the hand.
With osteochondrosis of the roots from the sixth to the eighth, the strongest pain is observed. Which can lead to lower muscle tone and stiffness of the hand. It should be noted that cervico-radicular osteochondrosis will not pass on its own without treatment, and it should be started as soon as possible.
Osteochondrosis of the thoracic spine takes second place after the lumbar spine. A characteristic feature of it is a pronounced flow. Usually painful attacks begin suddenly when coughing, sudden movement, uncomfortable posture.
The pain may be localized in the chest, in the area of the shoulder blades, or it may be shingles. Depending on the site of the lesion, symptoms may be of the following nature:
- In the syndrome of the first, aching pain and numbness of the skin in the scapular region, passing on the inner side of the arm
- In case of a violation from the second to the tenth pain has a shingles character from the chest to the shoulder blades,
- With the eleventh and twelfth root syndrome - numbness and sharp pain from the chest to the groin area.
Because of the nature of the pain and symptoms, chest osteochondrosis with radicular syndrome is often confused with heart attacks. But unlike the latter, the syndrome can not lead to the death of the patient. Usually, pain in the radicular syndrome does not subside after taking heart medications and is aggravated by movement, severe coughing. But it’s still not worth the risk, and with the appearance of painful symptoms, it is better to have a cardiogram.
Radicular osteochondrosis is the sum of the consequences that arise in a person as a result of constriction of the spinal nerves and blood vessels. The more common name used in the development of the inflammatory process in the squeezed areas is radiculitis.
Visit to the doctor
Enumeration of complaints is not enough for a diagnosis, and even more so for the start of the fight against osteochondrosis with radicular syndrome. Experts prescribe patients x-rays in two projections and MRI. The first study allows you to see the gaps between the vertebrae and approximately find the location of the pinched roots.
Magnetic resonance imaging clearly reflects the pinched nerves and blood vessels, but is rarely used due to its high cost.
Symptoms of the disease
For the first time faced with osteochondrosis with a radicular symptom, many patients ask what it is. At infringement of nerve roots several pronounced symptoms are observed simultaneously. Among them stand out sharp "shooting through" manifestations, giving in to the internal organs, buttocks, limbs.
Also often with osteochondrosis with radicular syndrome occur:
- Violations in the tendon reflexes (diagnosed at the reception at the neurologist),
- Deterioration of sensitivity - not only tactile, but also painful,
- Numbness, tingling on the surface of the skin,
- The loss of the ability to free movement, in difficult cases, paralysis,
- Reduced muscle tone, pallor and even cyanosis of the skin, hair loss.
The above symptoms of osteochondrosis with radicular syndrome may be aggravated against the background of stressful situations for the body, hypothermia, with movements or uncomfortable body positions. Many changes in the spine are considered irreversible.
Background of the development of radicular syndrome
Such a disease, as osteochondrosis of the spine with radicular syndrome, does not arise from nowhere. Its development is promoted by various factors that provoke irreversible processes in the spine.
For several years, decades, age changes have occurred. The metabolic processes deteriorate, the intervertebral discs become more rigid and dense, the cartilage stirs and bone growths are formed. Thus, the distance between the vertebrae decreases, which leads to compression of the nerve roots.
By the ages of 40-50, osteochondrosis is diagnosed in 70% of the population. But radicular syndrome in osteochondrosis does not always accompany the disease. There are some factors leading to its appearance:
- A sedentary lifestyle, the absence of dynamic physical exertion — thousands of city dwellers living in the space between home and work and not having time and opportunity to go to the gym, walk in green parks, are prone to this
- Microtraumas, sudden overloads of the spine due to sports, weightlifting - professional athletes and people engaged in heavy physical work every day should pay great attention to recovery after workouts and work shifts,
- Improper nutrition (lack of fluid), as well as addiction to fast food, a surplus of salt, etc.,
- Such spinal deformities, such as kyphosis, scoliosis, etc., are congenital and acquired asymmetry, which requires regular exercises, performance of a physical therapy complex, a visit to the pool,
- Regular uneven load, which leads to excessive body weight, shoes with heels, pregnancy - when the center of gravity shifts, the vertebrae, especially the lumbar region, have an excessive load,
- Inflammatory processes and common diseases, including hypothermia, infection.
Pregnancy and osteochondrosis
This is a special condition of the female body, when several factors that provoke the development of the disease appear at once in a short period.
- A rapid increase in weight and a shift in the center of gravity leads to an increased load on the lumbar region,
- Less movement, lack of physical exertion for several months allows salt to accumulate, cartilage tissue becomes more rigid,
- Hormonal changes adversely affect the elasticity of the ligaments and cartilage.
Localization of pain
Based on what the spine is compressed, the discomfort can be distributed in different areas. Discomfort occurs in the armpits and in the inner parts of the arms, in the area of the shoulder blades and in front between the ribs, behind the sternum, resembling an attack of angina pectoris, in the stomach, and even descend below to the groin area.
After the diagnosis and confirmation of radicular syndrome, the doctor prescribes a comprehensive treatment. Its variants differ for different patients, depending on the characteristics of the disease, anatomical, living and working conditions, etc.
- In the acute stages of the disease can not do without drugs. Painkillers can be in the form of injections, if you need to provide assistance in particularly painful and difficult cases, and tablets. The most common: Diclofenac, Baralgin, Ibuprofen,
- Topical ointments (Finalgon, Kapsikan) help relieve tension and affect a specific area. Apply them should be in accordance with the instructions, observing not only the dosage, but also the conditions of use,
- Muscle relaxants (Sirdalud, Pentoxifylline) - means, eliminating muscle spasm, promoting relaxation - are used for severe symptoms,
- Vitamins of the B-group help to restore the correct physiological functioning of nerve endings. Appointed by the complex and have a noticeable effect after a few weeks. Reception courses may be repeated after a while.
Such procedures as phono- and electrophoresis, magnetic therapy, acupuncture, massage, exercise therapy are also useful and effective in the radicular syndrome.
What is the pathology and the causes of its development
Thoracic osteochondrosis with radicular syndrome is the result of persistent destructive processes in the spine and precedes the appearance of a hernia. Roots are the processes of nerve endings, which in osteochondrosis are clamped by a displacing nucleus of the intervertebral disk. However, there are some additional factors contributing to such damage:
- the displacement of the nucleus of the intervertebral disc beyond the natural limits of the fibrous membrane,
- squeezing the nerve roots with other displaced vertebrae,
- swelling of nerve endings as a result of prolonged inflammatory process in osteochondrosis,
- increased sensitivity of the nerve roots as a result of the loss of their protective myelin layer,
- ischemia of nerve tissue.
The main reason for such deformities is still the lack of treatment for osteochondrosis. On average, the pathology appears 2-3 years after the onset of deformation processes in the spine.
Additional factors provoking the emergence of the radicular syndrome include kyphosis and lordosis, injuries, hypothermia, as well as intense loads with a sedentary lifestyle and the wrong principle of nutrition.
Osteochondrosis of the thoracic spine developing with radicular syndrome is always accompanied by pain. This pain symptom is often quite similar to angina. However, unlike it, the pain factor cannot be eliminated by taking nitroglycerin and stopping physical activity. Any body movement, as well as coughing and even a deep breath, provoke a significant increase in pain.
Common symptoms of radicular osteochondrosis of the thoracic region, in addition to painful lumbago, are paresis, partial or complete lack of sensitivity and a change in the reflexes of the tendon tissues, which is detected during neurological examination. Also, pathology may be accompanied by swelling and cyanosis of tissues, pale skin, and hair loss at the site of damage to the nerve endings.
The spinal spine consists of 12 roots. Symptoms may vary depending on the location of the damaged nerve processes. In this case, the pain usually gives both in the chest area and in the back. The disease is characterized as follows:
- if the 1st root is damaged, there is often discomfort in the pharynx in the form of a cough and a feeling of a lump in the throat. Also, pathology is accompanied by a loss of sensation in the arms from the armpit to the elbow joint,
- damaged from the 2nd to the 6th root provoke intense pain between the shoulder blades, reaching to the armpits and the solar plexus area. There is discomfort and foreign body sensation in the pharynx and esophagus. The condition is often accompanied by cough and insomnia,
- damage to the 7th and 8th roots can bring serious discomfort in the throat and mediastinum. Also, the pain is quite intense in the area of the heart muscle and stomach,
- the pressure on the 9-10th roots provokes a strong surrounding pain in the region from the navel to the chest in front and from the upper lumbar and to the shoulder blades behind,
- damage to the 11th and 12th roots are accompanied by numbness of the area of the corresponding vertebrae. The pain can manifest from the lower chest, to the groin area.
The radicular syndrome of thoracic osteochondrosis is closely associated with physical activity, and the symptoms of damage are significantly exacerbated both by prolonged stay of the body in an uncomfortable posture, and in the case of any movements.
To treat the radicular syndrome is necessary to complex. For this, in the first few days, painkillers and anti-inflammatory drugs are necessarily used. In general, treatment includes taking such medicines:
- nonsteroidal anti-inflammatory drugs. Most often it is Ibuprofen, Diclofenac, Meloxicam, Indomethacin, Celecoxib, Nimesulide,
- painkillers drugs. The most effective drugs have in the form of intramuscular injections, but often used tablets and ointments. The most effective have drugs Ketorol, Ledokain and Novocain, as well as tools with their content. Use of Analgin is strictly limited to cases of severe pain,
- muscle relaxants, providing removal of increased muscle tone, which can significantly reduce pain. These include Diazepam, Miolastan and Clonazepam,
- chondroprotectors. These drugs provide a stop to the destructive processes of the cartilage and bone tissues of the spine. At the same time, they contribute to the accumulation in the body of a sufficient amount of substances to regenerate the damaged parts of the spine. The most commonly used drugs are Chondroitin, Don, Hondroxide,
- B vitamins that improve the condition of nerve fibers.
Often used in the treatment of radicular osteochondrosis and drugs of the antidepressant group. They are necessary due to long-term problems with sleep and general well-being arising from intense pain.
Treatment of the radicular symptom of osteochondrosis of the thoracic spine requires a lot of time. However, for effective results, drugs and therapies should be prescribed exclusively by the attending physician. This is the only way to avoid serious pathologies and restore your body as quickly as possible.