Pain in the back takes 2nd place in the frequency of visits to doctors, after ARI 1 .
The prevalence of back pain reaches 80% of the population, in 20% of patients of working age this pain becomes chronic 2 .
We are not talking about a healthy spine. Quite often, back pain is caused by pathology of the joints of the spine connecting the individual vertebrae 2 . 40% of all back pains are associated with arthrosis of the intervertebral joints 4 .
Osteochondrosis of the intervertebral , in which there is a pathological process of destruction of the cartilage tissue 3 , leads to spondylosis of the vertebral bodies,wich causes compression and irritation or pinching of the spinal nerves in the place of their contact with the capsules of the facet (motor) joints of the spine.
Osteochondrosis of the spine also called spondylosis
- Pain in the neck (persistent or shooting). Strengthen after sleep or with sharp turns of the neck, may be accompanied by a crunch and forced head position
- Neck pain may extend down to the chest or up to the back of the head
- The pain can be aching with the transition to the arm with difficulty in abduction above 90º
- Pain in the shoulder and hand with swelling and stiffness of the joints of the hand may join
- Osteochondrosis of the cervical spine can be manifested by a headache starting from the back of the head and passing to the parietal and temporal regions. May be accompanied by nausea, tinnitus, visual impairment.
- Pain in the shoulder girdle and between the shoulder blades, which go to the area of the heart, aggravated by a change in the position of the arm, head, cough, may disturb.
- Dull, less often burning pain between the shoulder blades, a feeling of compression of the chest, aggravated by load or body turns
- Pain may become shingles along the intercostal nerves
- Sensitivity disorders may join
- Possible pain in the heart, liver, gastrointestinal dysfunction
- Pain in the spine (dull or aching) in the lumbosacral region. It can be spread on the leg or only in the leg with amplification during sudden movements. It changes with the body position and Fades in the supine position.
- Pain when raising the leg above 60º or when extending the hip joint, or when bending the knee.
- Possible lumbosacral pain when bending the neck
- Bladder, sphincter dysfunctions, decreased pelvic sensitivity may develop
- Concomitant restrictions on spinal mobility with the transfer of gravity to a healthy leg and leaning forward
WHAT HAPPENS AT ARTHROSIS
- the cartilage tissue of the joint is thinned and damaged
- cartilage functions are impaired: depreciation, protection, support
- inflammation and swelling occur in the joint capsule, its volume increases
- cartilage nutrition is reduced, the joint cavity is mechanically damaged by cartilage fragments
- production decreases and the composition of the synovial fluid of the joint changes
- the bone adjacent to the joint remains unprotected, is subject to friction and excessive loads
FACTORS FAVORING THE DEVELOPMENT OF INTERDERVASAL ARTHROSIS:
- back injuries
- excessive load on the back
- inadequate physical activity in everyday life
- lack of physical education, reduced physical activity
- overweight or obesity
- unhealthy posture
HOW TO TREAT THE JOINT
Early access to a doctor helps early treatment of back pain caused by intervertebral arthrosis.
Drugs for treatment (including chondroprotectors based on chondroitine sulphate) of the joints of the spine will help
- reduce back pain
- maintain the structure and function of articular cartilage
- slow down the development of the disease
- restore activity and prevent disability
Treatment of the spine should be comprehensive and include measures to eliminate the causes of its pathology ( adequate physical activity, control body weight, healthy posture..)
Chondroprotectors are well tolerated, and recommended by many of international and Russian associations:
- [ American College of Rheumatology (ACR)/Arthritis Foundation (AF) 2020.
- European Anti-Rheumatic League (EULAR).
- International Society for the Study of Osteoarthritis (OARSI).
- Association of Russian Rheumatologists (ARR).
In addition,injections increase the ability of chondroitine sulphate to be absorbed (increase the availability of the active substance in the bloodstream) which can lead to a faster and more effective results.
- I. Khamtsova, A.A. Ivashkina, M.V. Azarenko Features of the course of dorsalgia depending on the social status of patients. Bulletin of the Smolensk State Medical Academy, 2011, p. 49-50.
- Neurology: national leadership / ed. E.I. Gusev, A.N. Konovalova, V.I. Skvortsova, A.B. Hecht. – M: GEOTAR – Media, 2010, p.431
- Neurology. H. Mumethaler, H. Mattle; Per. with him; Ed. O.S. Levina – 2nd ed. – M. Medpress-inform, 2009. p. 792
- EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis. Ann Rheum Dis 2003; 62: 1145–1155