DZPP - what is this? Diagnosis, types, treatment
Among the chronic human diseases, spine pathologies are not the last place in medical practice. Pain in the vertebral column, periodically arising, and then disappearing for a period of time, is familiar to many people on the planet. Often people neglect a campaign to a specialist to determine the cause of the origin of pathological conditions. But in vain. Not taken in time, measures lead to the occurrence in the body of irreversible phenomena, significantly reducing the quality of life of the patient. To such pathologies is also DZPP.
Diagnosis of "DDCP" - what is it?
Degenerative and dystrophic spine disease( DDD) - pathology of the peripheral nervous system, which belongs to the group of the most common chronic human diseases, has a recurrent nature and often leads to disability. The most common disease occurs in persons of working age. Unfortunately, today there is no generally accepted point of view on the origin of DWCP.What does it mean? There are no sufficient and effective methods for detecting and treating a disease.
It is believed that the occurrence of pathology occurs for several reasons:
- due to local overloads of vertebral motor segments( PDS);
- due to decompensation in trophic systems.
In view of the fact that DDF is a disease that lasts for years, the changes occurring in the patient's body become irreversible. Therefore, the full recovery of the patient in most cases is impossible. Therapeutic measures are aimed only at restoring the normal function of the spine and eliminating the clinical manifestations of the disease.
The reason for everything - osteochondrosis
The disease leads to a malfunction of the motor segments of the spine, which entails consecutive abnormalities in the work of the entire human body. How does this happen? It is believed that osteochondrosis acts as a trigger mechanism for the occurrence of DDD.What is this pathology? In the medical practice of CIS countries, osteochondrosis is commonly referred to as dystrophic changes in the cartilaginous structures of the spinal column. The cause of osteochondrosis are:
- genetic predisposition,
- disruption of vascular nutrition drives,
- poorly organized work place( uncomfortable stool or table),
- physical work with lifting of gravity,
A gradual change in the structure of the cartilage leads to a decrease in the mobility of the vertebrae, a reduction in the distance between them, a disruption of the nutrition of the tissues adjacent to the spine. If the running process is not stopped, vertebral or extravertebral syndrome develops. There are 4 reasons why this syndrome is formed:
- compression - the disease begins to manifest due to mechanical overload of the motor segments of the spine, leading to compression of the nerve roots;
- dysfiksatsionnaya - pathology occurs due to the weakening of fixation of the motor segments of the spine;
- dyshemic cause - pathology occurs against a background of microcirculation disorders of tissues adjacent to the intervertebral disc at the site of the spine injury;
- aseptic-inflammatory cause - pathology occurs against the backdrop of the inflammatory process in the motor segments of the spine.
The structure of the spine
The vertebral column is a set of vertebrae, each formed by a body and an arc. The vertebrae are located one above the other and form a pillar in the central part of which passes the spinal canal - a kind of tunnel pierced with nerves and vessels.
Vertebrae are separated by cartilages - intervertebral discs consisting of a fibrous ring and a pulpous core. The ring takes over part of the load on the disk. In a young organism, the pulpous nucleus is 90% water, however, the fluid content in it decreases over time. Pulpoid nucleus - shock absorber, which changes its shape under the action of the load, thereby providing mobility of the spine and protecting it from destruction.
The vertebral column is reinforced with ligaments and a muscular corset on all sides. Strong muscles and ligaments reduce the load on the disks and joints. However, over the years, under the influence of various factors, the elasticity of the cartilaginous tissue decreases. The mechanism of the formation of painful conditions is initiated.
How the pathological process of
arises Disorder of posture, overweight, weight lifting, prolonged finding in an incorrect uncomfortable posture and other factors lead to the fact that the disc begins to decrease the fluid content, the elasticity of the cartilaginous structure disappears. Under the influence of the above factors, the load on the fibrous ring increases, its fibers break. In the areas of rupture, an inflammatory process occurs, scar tissue is formed.
When scarring takes on a large scale, the blood vessels that feed the intervertebral discs overlap. Gradually, the height of the disc decreases, as a result of which the distance between adjacent vertebrae contracts, the ligaments stretch and hang, the load on the intervertebral joints increases. As a result, the cartilage is destroyed. The mechanism of formation of DDZP is started. What does it mean? The fiber of the fibrous ring under pressure extends beyond the body of the vertebra, the edges of the vertebra welded to them also change their correct position, osteophytes are formed. The intervertebral disc is clamped, while the mobility of the spine is sharply reduced. Often, this causes a pain syndrome.
Herniation of the intervertebral disc can also lead to the development of pathology. Hernias are called part of the pulpous nucleus, which broke through the fibrous ring, went beyond it and exerts pressure on the nerve roots of the spinal cord.
Concept and classification of dorsopathies
Pathological conditions of the spine that are not associated with internal disease and are accompanied by pain syndrome are combined into a separate group of diseases with the name dorsopathy. In accordance with international standards, all types of dorsopathy are divided into three groups:
- deforming dorsopathies - they include deformations of the spinal column, due to changes in intervertebral disks: this group includes kyphosis, scoliosis, lordosis, spondylolisthesis, osteochondrosis;
- spondylopathy - these include all traumatic and inflammatory spondylopathies;
- Other dorsopathies are manifestations of pain in the neck, body or even limbs that are not the result of disc displacement or impaired spinal cord function.
Depending on the place of origin of the pathology distinguish: DDZP thoracic and lumbosacral spine, as well as DSD of the cervical spine. What is it, we will understand later. A characteristic feature of the pathology is that the symptoms of the disease in each of the localization areas, on the one hand, are very similar, on the other - they have their own distinctive features.
Types of DSDD
Often pathological conditions occur in the lumbar spine. According to the opinion of the majority of doctors, the main reason for this is the uprightness of a person, for which he, in fact, pays. Of course, the disease does not arise from scratch, but is formed under the influence of a number of factors( deterioration of nutrition, disruption of the lymphatic system in the tissues of intervertebral discs, etc.).
- of the cervical spine. What is it? As a rule, this is dorsopathy, which arises in the neck, the anterior thorax, in the hands. Some patients note burning aching pain between the shoulder blades, similar to manifestations of angina pectoris. With cervical dorsopathy, there is increased pain when turning or tilting the head. With the pathology of the thoracic spine, there may be chest pains.
- DDZP of the lumbar spine. May be accompanied by a violation of the sensitivity of the groin and inner thighs. Pain can occur simultaneously in both legs;manifested by a decrease in sensitivity in the lower back and sensitivity of the big toes. Shooting pain, lowering of the sensitivity of the shin, pain in the foot, paralysis of the shin and buttocks, loss of pelvic functions - all these are symptoms of dorsopathy of the lumbar region or DZPP of the lumbosacral spine.
The manifestations of the pathological process in the spine depend on the stage of the development of the disease, as well as on the area and extent of the lesion. The main manifestation of pathology is pain syndrome. As noted above, the cause of pain may be muscle spasms, intervertebral herniated nerve roots of the spinal cord, etc. Often the pain occurs not only in the spine, but also transmitted to other parts of the body. In addition to pain in the affected area, there may be a decrease in sensitivity, as well as muscle weakness.
Therapy for degenerative-dystrophic spine disease can slow the course of the disease and improve the patient's quality of life. The complex of therapeutic measures is aimed at:
- to stop pain,
- to slow down the destruction of cartilage,
- to improve the circulation of surrounding soft tissue spine,
- to reduce the compression of vertebrae against each other,
- to return the motor ability to the patient.
Therapeutic methods include the use of medications, physiotherapy, exercise therapy.
DSD: medication management
The pain can be eliminated by the use of anti-inflammatory non-steroid drugs such as Ibuprofen, Ketoprofen, and Diclofenac. The use of these drugs, however, is often associated with the occurrence of side effects. In this case, you can resort to the reception of selective means - this is "Lornoxicam", "Nimesulid", "Meloksikam."
When there is stagnation in the muscles and the violation of their circulation, resort to the use of a solution of lidocaine in conjunction with steroid hormones. This measure helps to relieve acute pain.
Partly to alleviate the condition and eliminate the pain syndrome is possible with the help of a therapeutic anesthetic plaster( "Dorsaplast", "Nanoplast", etc.).In addition to the fact that the patch stops pain, it also provides an anti-inflammatory effect - it affects the affected area with a magnetic field. Use a patch is recommended both in the period of exacerbation for rapid relief of pain, and in courses. The product does not contain any steroids, it is very comfortable to use: the plaster does not bind the movements, has no smell, does not leave traces on the skin and clothing.
Physiotherapy and orthopedic corsets
Simultaneously with the use of medicines in the treatment of DDS, orthopedic corsets are actively used, which reduce the pain syndrome by fixing the damaged segment of the spine. If the pathological process affects the cervical spine, use the collar of Shantz. The product not only has a warming effect, but also temporarily reduces the mobility of the spine in the affected area, cures muscle spasm, provides favorable conditions for the restoration of damaged structures.
In the pathology of the thoracic spine, semi-rigid correctors are used, which correctly distribute the load throughout the spine, unloading the affected area. If the problem occurs at the bottom of the back, use lumbosacral corsets. Often resorted to the use of orthopedic insoles, removing part of the shock load from the spine.
The physiotherapy procedures also help to stop the pain. These include: electrophoresis, massage, UHF, ultrasound therapy, magnetotherapy.
To stop the destruction of cartilage
As mentioned above, therapy for DDS is not only aimed at eliminating pain. It is very important with this diagnosis to stop the process of destruction of the cartilaginous tissue. For this purpose, there is a whole complex of medicinal preparations - chondroprotectors. These include: "Chondroitin sulfate", "Glucosamine", etc. Often to enhance the effect of drugs taken together. In this situation, you need an accurate dosage of medications. As a rule, the daily dose of "Glucosamine" is 1000-1500 mg, "Chondroitin sulfate" - 1000 mg.
Improve blood circulation in the tissues of the affected area with antiplatelet agents and angioprotectors, which include drugs "Pentoxifylline", "Actovegin."Vitamins of group B( for example, "Neuromultivit") help to balance metabolic processes in the body.
During rehabilitation often resort to the procedure of stretching the spine, which helps to increase the distance between the vertebrae and reduce their influence on each other. It is also important to constantly support the motor activity, strengthen the muscular corset through therapeutic physical training.
To date, the technique of detecting degenerative-dystrophic spine disease can not be called perfect and reliable. Like any other disease, DDZP diagnosis begins with a medical examination. The doctor, when talking to the patient, determines the location of the pain, reveals factors that can increase pain syndrome( for example, changes in the location of the body).The specialist also finds out from the patient the presence of the injured spine and related diseases.
The doctor then examines the paravertebral muscles using the method of palpation. This allows you to identify the presence of muscle tension or prolapse of the vertebra. Laboratory diagnosis involves the examination of the patient's blood and is conducted to determine the presence or absence of infectious processes in the body.
Of course, the most informative diagnostic method for pathology is radiography of the spine, computed tomography( CT) and magnetic resonance imaging( MRI).Electroneuromyography( ENMG) allows you to determine the cause of nerve damage.