Spondyloarthritis

Intervertebral spondyloarthrosis (deforming arthrosis) is a chronic pathology that often develops in elderly patients, less often in young ones.

The main manifestations of the disease are back pain and limited movement.

Spondyloarthrosis of the spine

This pathology is explained by degenerative and dystrophic damage to the vertebral-costal and facet joints. Isolated variants of spondyloarthrosis are rare. They usually occur in combination with osteochondrosis or spondylosis.

What is the danger of spondyloarthrosis? If the disease is not treated in time, significant limitation of movement in the damaged section of the spinal column may occur, as the marginal osteophytes gradually grow and even grow together. The pain will only increase over time, interfering with a full life and physical activity. Moreover, the sharp angles of the osteophytes can not only exert pathological pressure, but also damage the spinal artery, which can even provoke a fatal outcome in the patient.

The consequences of spondyloarthrosis are unfavorable, since other possible complications of the disease may be the formation of a hernia or spondylolisthesis (pathological displacement of the vertebra backwards or forwards from the next lower vertebra). In this situation, surgery is no longer possible: the vertebrae will be fixed with metal pins. However, even after surgery, restrictions on physical activity are inevitable.

Assessing the above, we can say with confidence that the treatment of the disease must be carried out necessarily and in a timely manner. You should not wait for the occurrence of complications and adverse effects, and contact a doctor in time.

Causes of spondyloarthrosis

Old age is the most common period of disease manifestation. Changes in cartilaginous tissues that occur with age favor the development of spondyloarthrosis. Over the years, the spine finds it increasingly difficult to cope with physical exertion.

However, spondyloarthrosis often appears in young people. The following factors can contribute to this:

• weakness of the muscles and ligaments of the back, pathology of posture, curvature of the spinal column;
• foot deformations, flattening;
• an overly active lifestyle, engaging in sports that involve excessive strain on the spine;
• frequent and prolonged sitting or standing in an incorrect and uncomfortable position;
• osteochondrosis;
• metabolic disorders;
• professional, sports or domestic back injury.

In childhood, the causes of the disease can be birth injuries, congenital defects of the spine (fusion of vertebrae, curvature of the spinal column, non-fusion of the vertebral arches).

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Symptoms of spondyloarthrosis

Manifestations of the deforming form of spinal arthrosis, especially in the early stages of the disease, can rarely be distinct not only in terms of symptoms, but even on an X-ray.

At later stages, the process may manifest itself as pain in certain areas of the back, and a violation of the amplitude of movements of the body. In general, the symptoms may largely depend on the localization of the lesion, so several types of pathology are usually distinguished:

Cervical spondyloarthrosis

With cervicarthrosis (the second name of the pathology), patients usually complain of pain in the neck area, with irradiation to the shoulder joints, between the shoulder blades, to the back of the head, to one of the upper limbs. Bone and cartilaginous growths in the cervical spine can contribute to deformation and reduction of the lumen of the spinal canal, as well as the development of radicular phenomena. In addition, osteophytes can be pressed into the wall of the spinal artery, which provokes disorders of blood flow to the brain. This can be accompanied by dizziness, headaches, cochlear disorders.

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Thoracic spondyloarthrosis (dorsarthrosis)

It is not detected as often as cervical or lumbar spondyloarthrosis. This is explained by some difficulties in diagnostics, since in this area the facet joints are hidden behind the ribs. In addition, the pathology itself is much less common here, since the thoracic region is initially less mobile than other parts of the spine.

Lumbar spondyloarthrosis (lumboarthrosis)

A common variant of the disease. It is characterized by constant nagging pain in the affected area, radiating to the femoral region and buttocks. The pain becomes more pronounced when turning and bending the body backwards. Most often, the pain appears as a result of prolonged sitting or lying down and is relieved after some physical activity (warm-up, physical exercise).

Spondyloarthrosis of the lumbosacral region

The main symptom is pain in the lumbosacral spine. The pain is aching, possibly radiating to the femoral and gluteal region, but only to the knee area. Initially, pain may appear only during physical activity. Over time, the process increases, pain begins to manifest itself both during movement and at rest. The most common localization of pathology in the lumbosacral spine is spondyloarthrosis L5-S1. The disease, detected in a timely manner, can be treated conservatively without surgical intervention.

Degrees of spondyloarthrosis

As we have already said above, initial spondyloarthrosis usually proceeds asymptomatically. As a rule, manifestations of spondylosis or osteochondrosis come to the fore - degeneration of the fibrous rings of the anterior longitudinal ligament. In this case, the lesion of the small joints of the spine does not yet have sufficiently pronounced symptoms, it is characterized only by marginal bone growth in the thoracic and lumbar areas.

Initial signs of spondyloarthrosis appear only when the bone marginal growths become large, the articular processes lengthen, the contour of the joints changes, and the articular surfaces increase. As a result, the joint spaces narrow, and the ratio of the articular axes often changes, which cannot but affect the functions of the affected section or the entire spine as a whole.

Spondyloarthrosis goes through several stages in its course:

• 1st degree – loss of elasticity of the intervertebral disc, joint membranes, ligaments, reduction in the range of motion of the spinal column;
• 2 degrees – increased load on the discs, loss of the ability of the fibrous rings to fully perform their functions;
• 3 degrees – X-ray confirmation of bone growths, degenerative changes in the ligaments;
• 4 degrees – the presence of bone growths of impressive size, limited mobility of the spine, compression of nerve endings and vascular walls.

The mechanism of pathology formation can be called the processes of dystrophy in cartilage tissues, the spread of changes to the structure of the fibrous ring, degeneration of the ligaments that hold the vertebrae, and the growth of osteophytes.

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Types of spondyloarthrosis

Depending on the course and stage of the process, spondyloarthrosis is divided into several variants. We will consider general information about each of them.

Deforming spondyloarthrosis

The term "deforming" can be applied to almost any type of spondyloarthrosis, because this disease occurs against the background of deformation (change in size, configuration and shape) of the vertebrae and the posterior part of the spinal canal due to the formation of bone growths and displacement of the intervertebral discs. The deformation is irreversible and is detected radiologically.

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Degenerative spondyloarthrosis

It is also a complex concept, since spondyloarthrosis is a degenerative-dystrophic disease in itself. With this pathology, the facet joints and vertebral-costal joints, as well as the fibrous rings of the intervertebral discs, are subject to degeneration. The rings lose elasticity, flatten, and shift. This gives the corresponding clinical picture of the disease.

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Uncovertebral spondyloarthrosis

This term refers to arthrosis of the facet joints, which develops in the space between the spinous processes on the posterolateral surface of 1-2 cervical vertebrae. Its main symptoms are neuritis (brachial, cervical), hypertension, imbalance of body balance and weakness of neurological reflexes.

Spondyloarthrosis of the facet joints

This is one of the manifestations of spondyloarthrosis, the degenerative-dystrophic processes of which can affect the facet joints and the vertebral-costal joints. An isolated variant of spondyloarthrosis of the facet joints is extremely rare; as a rule, there is a combined lesion of the paravertebral joints.

Ankylosing spondylosis

Better known as Bechterew's disease. It most often affects men, and at a young age (20-30 years). In addition to the joints of the spine, it also affects the joints of the arms and legs: the spine becomes stiff and deformed. The progression of this disease is steady, chronic. The condition significantly worsens over the years, so the disease requires mandatory treatment, sometimes even surgery.

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Polysegmental spondyloarthrosis

A serious pathology in which several parts of the spine are affected simultaneously: lumbar, sacral, thoracic and cervical. Treatment of such a disease is laborious and lengthy, and the manifestations of the disease are multi-symptom. Here there is a combined clinic of damage to several parts of the spinal column.

Dysplastic spondyloarthrosis

The term "dysplastic" is used when they want to emphasize the nature of the pathology. Dysplastic spondyloarthrosis is accompanied by a violation of the structure of the joints, a change in their shape, size, structure. Dysplasia is not a diagnosis, it is only a manifestation of another disease, in this case, spondyloarthrosis.

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Diagnosis of spondyloarthrosis

The disease is diagnosed based on the clinical picture, as well as radiological and tomographic indicators.

X-ray examination of deforming pathology of facet joints presents certain difficulties, because in X-ray images taken in the anteroposterior projection, there is a superposition of joints on other osteoformations (articular costal heads, transverse processes, etc.). This is especially noticeable in the thoracic and cervical spine. To solve this problem, in addition to standard X-ray images, atypical patient positions are used (using oblique, three-quarter projections), as well as computed tomography - layer-by-layer visualization of the picture.

In the presence of inflammatory processes in the lesion, the radioisotope scanning method is used. This method is the registration of radioactive radiation from the patient's body after a radioactive drug is introduced into the body (usually intravenously). As a rule, attention is paid to the uniformity of the distribution of the substance throughout the body, which helps in detecting inflammation and determines the exact localization of the lesion.

Additional tests, such as vascular ultrasound, may also be prescribed, or consultations with other specialists may be conducted.

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Treatment of spondyloarthrosis

Methods of treating spondyloarthrosis are mainly conservative. They are aimed at relieving painful symptoms and increasing the mobility of the affected area of the spine. Non-steroidal anti-inflammatory drugs are usually prescribed to reduce pain. There are quite a lot of them, but the most popular are diclofenac, ketonal, xefocam, ketorol, etc. Among the new generation drugs, we can highlight Celebrex, Nise, Movalis.

In the remission stage, massage, gentle gymnastic exercises, and swimming pool exercises are recommended. All this helps to strengthen the muscular corset of the spinal column and allows preserving the motor functions of the spine.

In case of muscle tone disorders and severe pain, isometric (static) exercises are recommended.

In elderly patients (or in other cases when active muscle strengthening measures are contraindicated), physiotherapy methods are often used. In addition to drug therapy, magnetic therapy, ion galvanization procedures with anesthetics (lidocaine or novocaine), and the method of sinusoidal modulated currents are used to relieve pain. Phonophoresis with hydrocortisone is also popular: this procedure perfectly relieves swelling and inflammation.

Since the main etiological factor in the formation of spondyloarthrosis is damage to the structure of the intervertebral discs, the method of structure-modifying therapy has recently become widespread. This method involves the use of glucosamine sulfate and chondroitin sulfate - these are substances that can slow down the processes of cartilage tissue degeneration. This method can be used already at the initial stages of the disease.

Treatment of cervical spondyloarthrosis, as well as other parts of the spine, is currently impossible without the use of chondroprotectors. These are drugs that help restore damaged articular cartilage. Such drugs can be used orally, in the form of injections or ointments.

One of the representatives of chondroprotective ointments is chondroxide - an external preparation that improves the exchange of calcium and phosphorus in cartilage tissue, inhibits the degenerative process, and promotes the restoration of the cartilaginous surface of the joint. The preparation also has an analgesic and anti-inflammatory effect.

Chondroxide is also used as a medicinal component of phonophoresis, which accelerates the elimination of pain and symptoms of spinal stiffness.

Recently, the use of the medicinal patch Nanoplast forte has become popular. This is an analgesic anti-inflammatory drug that improves blood flow in the affected area. It is used both in the acute and latent stages of the process. The patch is glued to the affected area of the back, it is possible at night. Usually, the patch is not removed for 12 hours: the acute process is usually stopped by using the patch for 4-5 days.

In severe advanced cases, surgical treatment methods may be used. These include:

• minimally invasive method – destruction of nerve endings with radiofrequency beams. This procedure does not eliminate the main problem, but significantly alleviates the pain syndrome;
• hemilaminectomy method – surgical excision of a section of the vertebral arch that compresses the nerve endings.

Treatment of spondyloarthrosis with folk remedies

Traditional medicine involves the use of various ointments, compresses, decoctions and baths from medicinal plants. Such remedies can bring real benefits if combined with traditional medicine methods: the use of medications, manual therapy, physiotherapy, etc.

Treatment of spondyloarthrosis at home involves the use of the following methods and means:

• therapeutic bath. It is recommended to take a bath at a water temperature of up to 40 C. Use 150 g of sea or rock salt per 50 liters of water;
• medicinal decoction. Boil a mixture of parsley and celery leaves (200 g) for 8 minutes in 0.5 l of water. Add lemon juice and honey to taste to the resulting decoction, drink in small sips throughout the day;
• medicinal infusion. Mix equal parts of juniper, flaxseed, mint, hop cones, oregano, calendula, pour into a thermos and pour boiling water over it overnight. Drink three times a day half an hour before meals;
• medicinal tinctures. Tinctures from chestnut fruits and pine nuts are effective. Tinctures are made with vodka and kept for up to 40 days. Take a teaspoon before meals three times a day;
• medicinal compress. Take 100 g of calendula per 0.5 l of vodka or alcohol lotion, leave in a dark place for 14 days. Use as compresses or rubbing;
• medicinal ointment. Equal parts of coriander, mint, birch buds and dandelion roots are boiled for 5 minutes, infused and filtered (6 tablespoons of the mixture per glass of boiling water). The decoction is mixed with 100 g of nutria fat, or vegetable or butter. Lubricate the affected area at night;
• therapeutic heat. Apply bags of hot sand, heated salt or freshly boiled chicken eggs to the affected area;
• fir oil. Ready oil, sold in pharmacies. Used as a massage ointment, or for internal use (100 ml of milk with a teaspoon of oil).

Massage for spondyloarthrosis can be light and gentle during an exacerbation, using anti-inflammatory external preparations (diclak-gel, diclofenac ointment, diclophyte, viprosal). At the stage of symptom relief, you can use massage with honey:

• honey massage. For the massage, use natural honey heated to 40 C, which is applied to the skin, pressed hard with the palm and then abruptly torn off the palm from the skin surface. In this way, we kind of press the honey into the skin and immediately extract it. After the session, the honey must be washed off with a decoction of herbs: mint, lemon balm, oregano, calendula. The procedures are carried out every other day for 14-20 days.

Physiotherapy for spondyloarthrosis

The effect of treatment procedures for spondyloarthrosis can be achieved with a comprehensive approach, including therapeutic exercise. It helps reduce pain, stabilizes muscle tone, and facilitates back mobility.

When starting exercises for spondyloarthrosis, you need to warm up, gradually performing more complex exercises.

The specificity of performing exercises during an exacerbation of the disease is to perform exercises in periods between attacks of pain, alternating them with other therapeutic measures.

The starting position is usually chosen based on the characteristics of the disease in each specific case. The most acceptable position is considered to be lying on the back, side or stomach. The affected part of the spine should not be overloaded, the movements should not be sharp and fast. If pain occurs during the exercise, the exercise should be stopped.

Gymnastics for spondyloarthrosis:

• We lie on our backs, hands behind our heads. We bend our legs at the knees, our hands at the elbows, we close them together and return to the starting position.
• We lie on our backs, bending our right leg at the knee. We try to bend, lifting the pelvic area and leaning on the head and foot, we return to the starting position.
• We stand on our knees, leaning on our elbows. Inhaling, we round our back and lower our head. Exhaling, we return to the starting position.
• We lie on our backs, hands behind our heads. We pull our legs bent at the knees to our stomachs, clasp our knees with our hands and press our head to them, and return.

During the exercises, you need to try to breathe deeply, perform the exercises measuredly and slowly.

An exercise to fix the correct posture also has a good effect: take a stick (length about 1 m) and put it behind your back horizontally, holding it with the inner surfaces of your elbow joints. You should move in this way several times a day for 25-30 minutes.

Nutrition for spondyloarthrosis

The diet for spondyloarthrosis should be fractional, with meals taken every 3 hours.

The following are excluded or limited in use:

• grapes (also wine or juice);
• strong meat broth, fatty meat, lard;
• legumes (beans, peas);
• sorrel;
• refined products;
• spices, salt, sugar.

It is recommended to eat vegetables (salads, grilled vegetables, stewed dishes), fruits (salads, juices, baked apples and pears), lean meat, dark bread, berries (especially sea buckthorn), greens, dairy products.

If you are overweight, you need to limit your caloric intake and completely eliminate simple carbohydrates: sugar, sweets, cookies, cakes, pastries. Along with this, it would be a good idea to increase your physical activity, walk more, move, and do physical exercises.

Once every 7-10 days you can have a fasting day on cottage cheese, milk, kefir, vegetables or apples.

In general, the diet should be dairy and plant-based, with limited animal proteins (meat, fish, eggs), fatty foods and table salt.

By the way, joint diseases are much less common among vegetarians than among adherents of traditional nutrition. This is especially true for lacto-vegetarians.

It is also important to drink enough fluids: this should be pure water or herbal tea, but in no case Coca-Cola or energy drinks.

Prevention and prognosis of spondyloarthrosis

The prognosis for spondyloarthrosis is relatively favorable. Timely treatment of the pathology helps prevent the development of serious consequences.

Preventive measures for the disease are based on reducing the load on the spinal column. What should be done:

• maintain normal body weight;
• avoid excessive strain on the spine or lifting heavy objects;
• beware of spinal injury;
• monitor your posture, both while walking and while sitting;
• you should sleep on a semi-hard mattress, the pillow should be small (exclude soft feather beds and large high pillows);
• be physically active, go swimming;
• eat right and drink enough clean water.

If you sit for a long time, try to change your position every 10-15 minutes, and every half hour you should, if possible, get up and stretch, walk around the room, and distract yourself.

Disability in spondyloarthrosis is not excluded. If the disease is advanced, there are certain neurological symptoms, as well as signs of limitations in physical and motor activity that interfere with the patient's full life, an expert decision can be made to determine the appropriate disability group.

The spine is a very important part of the body. It is the protection and support of the spinal cord, which performs vital functions of the body. It is the skeleton for the passage of many nerves and vessels. Spondyloarthrosis of the spine is a pathology that makes its changes to the vertebral structure. To prevent this, it is necessary to monitor the health of the back, take care of it and avoid overloads.