Osteochondrosis of any part of the spinal column a few years after its debut can be complicated by such a manifestation as radicular syndrome. What changes occur when radicular syndrome occurs can be understood only by understanding why this pathology develops, and what structures are physiologically changing at the same time.
Osteochondrosis with radicular syndrome – what is it
The disease develops osteochondrosis with metabolic disorders in the tissues of the discs located between the vertebrae. Long-term course of pathology and the lack of competent therapy lead to the fact that discs undergoing degenerative changes gradually change their natural structure.
The fibrous ring surrounding the inner core of the disc changes, cracks appear and expand in it, through which a jelly-like substance protrudes. The nucleus, released from its anatomical, normal position, begins to squeeze the spinal nerves, or rather their roots, causing all the symptoms of radicular syndrome.
The irreversibility of the frequent occurrence of radicular syndrome in patients with osteochondrosis is explained by the fact that due to changes in the discs and all adjacent bone and cartilaginous structures, the opening in which the main vessels and nerves pass decreases.
For some people, this process begins to occur after 2-3 years, while others, thanks to treatment and maintaining a healthy lifestyle, can postpone the development of radicular syndrome for decades.
Development reasons
In humans, radicular syndrome with all the pronounced symptoms of the disease in most cases develops precisely because of chronic osteochondrosis.
But there are a number of other diseases that can lead to pinching of the nerves, so a complete diagnosis is always necessary for an accurate diagnosis.
There are several prerequisites that contribute to compression in the roots of some spinal nerves. These include:
- Compression as a result of protrusion , that is, the exit of the center of the disc outside the fibrous restriction ring.
- Pinching of the spinal roots caused by the displacement of adjacent vertebrae.
- Osteochondrosis also occurs with an inflammatory reaction, and this affects tissue edema, including edema of nerve endings.
- Long-term dystrophic changes lead to the fact that the roots of the nerve affected by the pathology lose the myelin sheath, this increases their sensitivity.
- Some signs of radicular syndrome are also explained by ischemic processes occurring in the nerves.
According to statistical data, osteochondrosis is detected in almost half of the population who have crossed the forty-year line of life. At the age of 70, almost all the inhabitants of the planet undergo changes in the vertebrae of varying severity. But this does not always cause radicular syndrome. Pinching of the roots of the nerves is mainly observed if several more provoking factors affect the spine or the entire human body:
- Excessive, constant overload of the spine. A similar effect is observed with obesity, in the last trimester of bearing a baby, while wearing shoes with uncomfortable and high heels.
- Spinal deformity – kyphosis or lordosis. The bending of the spine is also facilitated by the asymmetry of the bones of the legs and pronounced flat feet.
- Infectious processes and severe hypothermia. These conditions enhance the inflammatory response in the spine.
- Lack of dynamic loads, that is, a sedentary lifestyle.
- Injury to the vertebrae and excessive stress on a certain part of the spinal column.
- Incorrect nutritional principles also lead to a rapid pathological change in the tissues of the disc and the vertebrae themselves. This is an excess of salt, a small amount of vitamins in the diet, insufficient fluid intake, overeating.
Clinical characteristics of symptoms
General signs of the development of radicular syndrome depend on the degree of influence of the effect of compression of the roots and on which part of the spinal column undergoes changes.
The main complaint is pain, it always spreads along the passage of the nerves and its intensity is quite pronounced. In addition to pain, the patient complains of numbness, burning, paresthesia in the localization of pain, in the limbs and along the passage of nerve endings.
The clinical features of the ongoing disease depend on the area in which the roots are pinched.
Signs of the disease with cervical osteochondrosis
Violations in the roots of the cervical spine are noted less often compared with the thoracic and lumbar spine.
The pain increases significantly with movements, coughing, so the person tries to provide the cervical spine at the time of the attack. In the cervical spine there are eight pairs of spinal nerve roots, an experienced neurologist, based on patient complaints, can determine between which vertebrae the pathological process is most prominent.
- If the first root of the cervical spine is affected, then the patient complains of pain mainly in the parietal region, and the feeling of numbness in the occipital region and the crown is also worried.
- With the defeat of the second root, the nature of the manifestations of the disease is identical with the defeat of the first root. But besides this, it is possible to reveal laxity of the muscles and skin under the chin, which is explained by hypotrophy and decreased tone.
- With the defeat of the third pair of roots, severe pain appears, numbness of the skin, swelling of the tongue. All these signs appear from the side where the root is squeezed. In addition, the patient has a slight speech impairment during conversation.
- If the 4th root is compressed, then the pain is very disturbing in the area of the scapula, shoulder girdle , clavicle. In some patients, lumbago is fixed in the heart and liver. The patient complains of numbness in the same areas of the body; on examination, muscle weakness is determined.
- With the defeat of the 5th root, pain appears in the neck, along the outer part of the shoulder from the side of the lesion. Pronounced numbness and weakness in arm movements. All changes affect the side where the root is squeezed.
- If the 6th root is affected, then pain and pronounced numbness from the neck pass to the scapula, then to the entire upper limb up to the thumb of the hand.
- Compression of the 7th root causes the spread of pain along the neck, scapula, outer and posterior surfaces of the upper limb. All changes are pronounced and affect the area of the second and third fingers of the hand.
- The defeat of the 8th root leads to the spread of a painful attack and numbness to the little finger on the side of compression. When moving the hand, severe weakness is noted.
All pains during the development of radicular syndrome in the cervical spine begin acutely, significantly increase if you move the neck.
With chest
Pain is expressed in the back or chest area. The manifestations of the disease also depend on which of the 12 roots of the thoracic region is affected.
- With pathological compression of the 1st root of the thoracic region, aching pain occurs and a slight decrease in skin sensitivity in the area of the shoulder blades. Similar signs are determined on the inner side of the upper limb, starting from the axillary region and ending with the elbow joint.
- If the roots are affected, starting from the 2nd and ending with the sixth, then the patient is worried about the pain of a girdle nature. This pain captures the area of the shoulder blades, armpits and the bottom of the chest. There may be marked discomfort in the esophagus and pharynx.
- With the defeat of the 7th and 8th roots, the nature of the pain corresponds to that described above, but the discomfort spreads somewhat lower. There is also some soreness in the stomach and heart.
- When the 9th and 10th vertebrae are compressed, the patient complains of acute pains with a surrounding localization, in front they cover the area from the bottom of the chest to the navel. The back is observed symmetrically.
- With the defeat of the 11-12th vertebrae, pain, numbness and discomfort from the navel reach the groin area.
A pronounced increase in painful attack occurs at the time of coughing or sudden inhalation. By the same signs, radicular syndrome can be distinguished from an attack of angina pectoris that manifests itself with similar symptoms.
Symptoms of the syndrome in the lumbar spine
Since the lumbar spinal column has the largest, constant load, radicular syndrome in this department occurs most often. Its manifestations also depend on which of the roots is damaged.
- When squeezing from 1 to 3 root, pain of an acute or aching nature is observed in the groin and thigh region. These same parts of the body are exposed to pronounced numbness.
- Compression of the 4th root leads to the development of aching, dull pain. It begins in the lumbar region and goes into the lower leg and knee area.
- The defeat of the 5th root causes acute pain in the thigh and lower leg. The pain reaches the foot and affects the big toe.
The pain is significantly reduced at rest, especially if the person is lying on a healthy side.
Diagnostics
Since pain and other manifestations of deterioration in well-being can be caused not only by osteochondrosis and, accordingly, radicular syndrome, it is important to conduct a thorough examination of a person. To clarify the alleged diagnosis of osteochondrosis with radicular syndrome, appoint:
- X-ray of the spinal column in several projections at once. The pictures determine the presence of bone growths of the vertebral bodies, a decrease in the normal distance between the vertebrae.
- MRI allows you to clearly see all the tissues of the disc, roots and changes occurring in them.
Differential diagnosis is sometimes necessary with cardiac pathologies, diseases of the digestive system.
Treatment
Treatment must begin with the elimination of pain. Use:
- Pain medications in injections, in the absence of effect, drug blockade.
- The patient is assigned strict bed rest. It is recommended to lie on a firm, horizontal surface.
- Nonsteroidal anti – inflammatory drugs and muscle relaxants relieve pain and inflammation .
- From medicines, vitamins are also needed , medicines that improve blood circulation. This allows you to normalize metabolic reactions.
After relief of pain, massage sessions, physiotherapy, and physiotherapy exercises are prescribed. A quick recovery also depends on choosing the right food.