Osteoporosis

At osteoporosis the density and durability of bone decreases. This metabolic disorder accompanies many diseases. The key moment in development of pathology – decrease of calcium content in bone tissue. As a result durability of bones decreases, more often there are fractures, even at small mechanical influences. Generally elderly people are affected with osteoporosis.

First the osteoporosis externally isn’t shown. More often deficiency of calcium arises in the bones carrying large load – backbone, femoral, humeral.

Pain is the first clinical sign of backbone osteoporosis. First it is aching, local, doesn’t extend anywhere. Later on with degeneration of vertebrae pain changes gaining radicular character.

Because of vertebrae changes human height sometimes decreases by some centimeters. There are deformations of backbone, physiological flexures, especially thoracic kyphosis, are enlarged, there is an expressed slouch or hump. Scoliosis (lateral curvatures) are frequent. Fractures arise at insignificant influences – jerks, kicks, falling.

Signs of calcium deficiency become perceptible: cramp in sural muscles at night, unstable arterial pressure, digestive disturbances, endocrine disorders (diabetes mellitus), decrease of immunity, memory impairment. There are cosmetic defects: deformation of teeth, fragility of fingernails and hair, decrease of skin elasticity.

Treatment of osteoporosis is based on restore of calcium deficiency. Classical calcium salts are not very effective, but there are a lot of new effective medicines.

Backbone Osteomyelitis

Backbone osteomyelitis (spondylitis) is a serious infectious disease menacing to the patient’s life, requiring a complicated long-term treatment. Most often the causative agent is a golden staphylococcus.

Dorsodynia is the main clinical symptom of backbone osteomyelitis.

The disease usually begins acutely, with dorsodynia and high temperature. It can proceed, disguising as pleurisy, pneumonia, pyelonephritis, radiculitis.

Chronic osteomyelitis can independently develop or from the acute form. Radiculalgia, sub-febrile temperature, general satisfactory condition of the patient is typical for it. The acute period of the disease proceeds for 2-8 weeks.

Backbone osteomyelitis is treated with antibiotics, selecting them individually, within three-four weeks. Deintoxication and correction of immunity is carried out. The patient has to observe bed rest or semi-strict bed rest. Sometimes anesthesia, bracing of body with a corset is required.

As the diagnosis is often made with delay, on late terms a surgical treatment is required. It is prescribed if:

- suppurative focus is located in the body of vertebra or intervertebral disk;

- development of nervous depressions even if inflammatory process subsides;

- fistulas form of osteomyelitis (formation of opened passages on along which pus flows out);

- inefficiency of conservative treatment.

Opening and drainage of nidus or modern surgical techniques are carried out when operation through a small puncture in a skin with a local anesthesia is applied. Stabilizing surgeries are carried out with implantation of titanic structures. At effective treatment the affected vertebrae knit and there comes convalescence.

Falling Of Kidney

Falling of kidney is a state at which it is displaced down from normal position, leaves its connective tissue bed.

The patient usually applies to the doctor with complaints to dorsodynia. Blood from urinary tract can be discharged.

The right kidney falls more often for many times than the left. Women have this disease more often. At young age the falling of kidney can be caused with abrupt weight loss or excessive sports activities. Injuries, especially falling from big height may Lead to falling of kidney.

The initial stage doesn’t give the expressed clinical picture. But at falling of kidney more than on 7 cm dull transient aches, with diffusion to lumbar area are observed. Pain arises owing to kidney capsule stretching.

Pain develops at exercise stresses, releases at rest or horizontal position when the kidney again takes the natural place in renal bed. Fall of a right kidney may be followed by feeling of heaviness in right subcostal area.

In future kidney almost completely leaves from under ribs, but after taking a horizontal position comes back to its place. The clinical symptomatology becomes more intensive. Intensity of pains increases, they become similar to those at renal colic, arise at small exercise stresses and abrupt change of body position. Stagnation of blood in kidney leads to emergence of erythrocytes and protein in urine.

At progressing of the disease kidney falls down to a small pelvis. Pain becomes persistent and extends to inguinal area, is followed by nausea and vomiting. Intensity of pain doesn’t depend on position of the patient any more. Complications develop: pyelonephritis, hydronephrosis, and arterial hypertension.

Myositis

Myositis is an inflammatory lesion of muscles. Skeletal musculation which the person controls randomly, not unstrained involuntary muscles of internals are affected.

More often myositis develops because of infections. Angina, flu, pneumonia, meningitis are complicated by myositis. At diffusion of infection in the organism in muscles suppurated focuses are formed. Penetration of infection can happen because of trauma with damage of skin or usual intramuscular injection made without sterility observance.

Also excessive exercise stresses, cold, vibration lead to myositis.

Symptoms of myositis are similar to signs of any inflammation – pain, reddening, and swelling. The movements of muscle are held down and painful. Muscles of back are more often than others are affected with myositis. The pain arising thus needs to be distinguished from accompanying lesions of backbone and nervous roots. At first pain is not acute, aching, develops only at movements and palpation of muscles. Later on pain becomes more intensive and persistent. Intensifying of pain is followed by temperature increase, local and general (fever). Emergence of fever is a sign of purulent myositis. Locally at purulent myositis there is a “fluctuation” under skin when pressing.

The volume of movements in muscles decreases, the skin and nervous fibers are often affected. At chronic myositis sometimes there is “shrinkage” of muscles because of irreversible atrophic changes.

Treatment of myosites depends on its cause. Usually apply anesthetics and anti-inflammation medicines are applied. They kill pain and fever, but don’t eliminate the myositis cause. At infectious myosites it is necessary to apply antibiotics if the pyesis developed; surgery is necessary.

Intercostal neuralgia

Neuralgia is a pain which extends along a nervous fiber. Intercostal nerves come from spinal roots of thoracic department. At their structure there are sensitive and motive fibers. Intercostal nerves go in the bottom of each rib to intercostal muscles, diaphragm, and musculation of abdominal wall.

Intercostal neuralgia develops more often as a complication of osteochondrosis at disk hernia.

The leading symptom of intercostal neuralgia is pain. Pain may be persistent, aching or sharp, attack-like. Often it extends to heart, breast bone, under scapula. Therefore stenocardia is quite often mistakenly diagnosed. Intercostal neuralgia becomes more intensive at full inspiration, at change of body position, pressing on breast.

Pain causes a stress and can cause rising of arterial pressure, stenocardia attack, arrhythmia. Pain becomes more intensive at action of provocative factors – frigorisms, stress, physical activity, long stay in one posture.

Time pain becomes more intensive at respiration, the patient spares his thorax, doesn’t take deep breaths. It leads to lung congestion. There is a tussis and pain becomes more intensive.

Muscles of back are strained; there is erubescence and unpleasant feelings along the nerve: numbness, burning sensation, cold. Owing to constant pain patient cannot sleep and perform work.

Medicines kill pain at intercostal neuralgia. Use anti-inflammation drugs: tablets, injections and ointments.

Blockade with novocaine or other local anesthetic gives good effect. Anesthesia comes quickly, but has a short-term effect.

Intervertebral Hernia

Intervertebral disk is a cartilaginous layer between vertebrae. Disks provide mobility of bond of vertebrae and shock absorption. At some diseases the intervertebral disk is displaced. Slipped disk is also considered an intervertebral hernia.

The main reason of intervertebral hernia is osteochondrosis. Disks become thinner, lose flexibility, the content of water in them decreases. The thinned cartilage is more sensitive to influences; the disk can slip even at small loads. Besides weight lifting, the abrupt movements, jerks, vibration, falling, long sitting can become a starting factor. The probability of developing of disk hernias grows with age, at physical work, excessive body weight.

Rachiocampsis also leads to formation of disk hernias. Tuberculosis, trauma or tumor of backbone can be complicated by hernia.

More often hernias are formed in lumbar department. The loin experiences the greatest loading. Disk hernias develop in the neck because of large volume and complexity of movements.

At small expression of hernia there are pains owing to irritation of nervous roots. Further slipping, usually in the back direction, to the spinal channel, causes a persistent pain syndrome. The jelly-like core of disk can flow out completely out of limits of the broken-off connective tissue capsule, and connection between vertebrae loses flexibility.

At first in lumbar department pain is local. At abrupt intervertebral disk slipping the lumbago (lumbago) is possible. Further nervous roots are involved and pain becomes more intensive, extends along sciatic nerve in breech, femurs, sheens, feet. Sensitivity in feet decreases, movements are limited.

Lumbago (shooting pains)

Lumbago is known to people for the sharp pain as if shooting a back since olden times. He cannot straighten himself up, remains in the compelled incurvated posture. It stiffens in posture in which he was found by pain. Pain can extend to breeches, hips, the patient cannot choose painless posture, it is difficult for him to stand and to go.

It is possible to reduce pain to certain extent without assistance. It is necessary to lay down on a rigid bed on back or to put a mattress on the floor. It is desirable that feet were raised and bowed in knees and hips. They can be put on pillows or blankets. Having bent knees, the patient can relax larger muscles in his backbone.

At absence of treatment pain remains from several days to three weeks, a chronic pain syndrome which is difficult to treat is sometimes develops in future.

Lumbago is met in people of any age, but is unusual to children. Mechanical changes in intervertebral disks, muscles, joints, ligaments, nervous fibers can be the cause. Body extensions with its turning as if cleaning snow is a large load on backbone bottom. It is difficult to define, what tissues are damaged; doctor and patient can only find often the most painful point and establish that the slightest movement causes pain in it.

For treatment of lumbago acupuncture is effective.

In the first few days treatments the confinement to bed is recommended. It is better to lie on back, having slightly raised feet and having put them on an eminence. The bent feet allow relaxing back muscles. Analgesic and anti-inflammatory drugs remove pain.

Lordosis

Lordosis is an excessive rachiocampsis in lumbar department exceeding physiological norm. Osteochondrosis, damage and a dysgraphia of vertebrae bone tissue, vertebrae dislocation as sliding, disk hernias, injuries of loin muscles, vertebrae fractures become the causes of lordosis. Emergence of lordosis is promoted with osteoporosis owing to disturbance of calcium exchange, vertebrae tuberculosis, and tumors in backbone, myopathy and myositis.

So-called secondary lordoses originate not from a backbone. They develop at diseases of hip joints or platy podia and for this reason the center of gravity moves.

In children lordosis is a consequence of birth trauma, rachitis, and rapid growth of backbone at weakness of back muscles.

Increase of lumbar flexure becomes perceptible on late durations of gestation. After successful labors everything comes back to norm.

At lordosis the patient’s posture changes. Protruding belly and breeches, head is bended forward, hollow breast. Deformation of backbone leads to osteochondrosis, disk hernias.

Subjectively lordosis is followed with back pains – pulling, aching. In some time pains become more intensive, the volume of movement decreases, sensitivity in feet worsens, walking causes trouble. Hip and knee joints suffer, there is an arthrosis. Deformation of backbone leads to increasing of intra-abdominal pressure and digestive disorders, in women – to disturbances of a menstrual cycle, infertility.

Anti-inflammation, anesthetizing cartilage protectors are used. The remedial gymnastics strengthen muscles and ligaments, fix the bent backbone. Exercises are supplemented with massage.

Kyphosis

Kyphosis is a pathological spinal curvature from behind. In normal state there is a flexure in thoracic department, but at a kyphosis it becomes too expressed and leads to various disturbances.

In development of kyphosis heredity, illnesses of central nervous system are important: poliomyelitis, children’s cerebral palsy. Kyphosis and complication of vertebrae fracture in thoracic department arise.

At rachitis, osteoporosis and some endocrine illnesses there is calcium deficiency in organism, durability of vertebrae decreases and they are deformed.

Children and young men have a postural kyphosis, because of wrong posture, at continuous disturbances of posture against rapid growth of skeleton and weakness of muscles. Backbone operations can be complicated by kyphosis. At advanced age there are degenerative changes in vertebrae. Kyphosis also causes lesion of vertebrae tuberculosis and tumors.

Kyphosis is shown from slightly noticeable slouch to a big hump. There is an arched kyphosis (round back) and elbow kyphosis (gibbosity). The bowed back, sunken breast, protruding abdomen, pulled-in shoulders attract attention. The vertical axis of the body and the center of gravity is displaced. Because of excessive load on feet the platy-podia, arthritis in feet joints is formed.

There is an osteochondrosis in backbone; intervertebral disks with formation of hernias are affected. Radiculitis is their consequence. The patient is disturbed by a thorax pain and shoulder girdle, arms, sensitive and motion disturbances. Limited flexibility of thorax leads to respiratory failure. Increased pressure in abdominal cavity promotes diseases of gastrointestinal tract.

Ischias

Ischias is a lumbosacral radiculitis with an inflammation of sciatic nerve. The sciatic nerve begins from an iliosacral joint, from cluneal area goes down a femur.

Ischias develops as a complication of backbone diseases. Complications of osteochondrosis  hernia of intervertebral disks, growth of osteal tissues (osteophytes) are the most frequent causes, which lead to infringement and inflammation of nerves roots.

The main symptom of ischias is ischialgia, pain along sciatic nerve. It begins in loin, passes to breech, femur, back surface of shin, and foot sole. Pain is paroxysmal, character burning, pricking, and shooting. Its emergence is connected to provocative factors – exercise stresses, frigorism, sharp movements, stresses, intestinal constipations.

Sensitivity is broken. The patient has feeling of numbness, burning sensation, pricking, crawling of goose bumps. The movements of feet are limited.

Pain increases at tension – bending of head and neck, at lifting the bended knees.

In the absence of treatment there is a persistent lameness, a muscular atrophy.

Pain and inflammation is released with anti-inflammation medicines. These are tablets, injections and ointments. Local blockade with anesthetics give fast but short-term effect.

Physiotherapeutic procedures and physiotherapy sometimes wearing of a special corset is prescribed. Massage strengthens the affected muscles and liquidates developments of stagnation. The line of backbone should not be pressed. But at manual therapy such action is carried out, intervertebral intervals extend, the restrained nerves are released.