Degenerative disc disease

The intervertebral disc is a complex structure. The prevalence of back and neck pain associated with degenerative disc changes are major epidemiological problems. Back pain is the second cause of moving the patient to medical examinations. Over 80% of patients experienced at least one episode of back pain and 5% of the chronic problems.Of all the connective tissues of the intervertebral disc suffers most important changes related to virtsa. In the third decade of life is replaced with the nucleus pulposus and fibrocartilaj distinction between the core and ring disappears. Proteoglicanii, water and protein noncolagenice decrease and increase the concentration of collagen. Increased collagen is most pronounced in the lumbar spine.As people grow old and suffer microtraume macrotraume which cause changes in body homeostasis, biochemical forces alter and redistribute the column. Natural progression of spinal degeneration precedes the movement once the elements anatomical, biochemical, radiological and clinical features.
Patients typically describe pain discogenica a traumatic event triggers a forced flexion or excessive movement totatie. Pain and weakness occur in the legs, buttocks and numbness in his fingers.Discogenica pain is exacerbated by activities that classical discs loaded with difficulty, as the seat, lifting the sitting position, lifting in the morning, lumbar flexion, rotation, vibration, coughing, sneezing, laughter and Valsalva maneuver. Discogenica is described as chronic pain.
Medications are an integral part of treatment. There are a variety of medications prescribed to help patients with sequelae. Several types of drugs are helpful in treating pain discogenice: analgesics, muscle relaxants, sedatives, corticosteroids, anticonvulsants, antidepressants, antihistamines.NSAIDs are based therapy. They are effective by reducing the biological effects of inflammation and pain. Their management should be monitored for adverse effects and gastropathy, renal toxicity, hypertension, liver disorders and hemorrhage.
Surgery is occasionally performed. Many therapeutic modalities for degenerative disc disease have not been studied yet. Surgery is indicated for patients with lumbar radiculopathy with persistent pain, weakness, or progressive symptoms that do not improve with physical therapy.Treatment is by nature conservative. Regimens are most commonly used NSAIDs, physical therapy and lifestyle changes.Lumbar spine immobilization is the standard conservative therapy for these patients. Immobilization restricts motion and reduce nerve irritation.
Causes and Risk Factors
The cause of degenerative disc disease is unknown. Some theories cite fiber ring cracks induced trauma as an event trigger.Other theories suggest that lumbar disc degeneration is a natural process of aging, these theories do not explain the disease occurs in young people. So because of this condition is multifactorial.Various genetic, environmental, autoimmune, inflammatory, trauma, infection alone or in various combinations result in the initiation process of lumbar degeneration.Discogenica pain is exacerbated by activities that classical discs loaded with difficulty, as the seat, lifting the sitting position, lifting in the morning, lumbar flexion, rotation, vibration, coughing, sneezing, laughter and Valsalva maneuver.