Osteochondrosis is a common degenerative-dystrophic lesion that affects intervertebral discs, adjacent vertebrae and adjacent ligaments.
The disease does not develop immediately, it progresses over many years, while the onset can occur at a fairly young age (18-20 years), and has several stages:
- Stage I – "crack" in the fibrous ring and intradiscal movement of the nucleus pulposus, but no radiological signs yet;
- Stage II – the nucleus pulposus continues to deteriorate, the height of the disc decreases, the fibrous ring "dry", the affected intervertebral joint becomes unstable, and to compensate for this, the back muscles are in constant tension, causing pain and "Overwork", signs of osteochondrosis are visible on X-rays;
- Stage III – the disc ruptures, the prolapsed nucleus pulposus forms a hernia, the stage is characterized by an abundance of neurological symptoms, inflammation and edema;
- Stage IV – Adjacent elements of the joint are involved in the lesion.
Osteochondrosis of the spine can also occur in different parts of the spine and, depending on this, have different names:
- cervical - mostly located between the fifth and seventh cervical vertebrae (the most mobile joints);
- Chest - a variant manifested by pain, which can be confused with diseases of other organs of the chest;
- Lumbar - the most common type due to the greatest mobility of this section and the load on it;
- common - with some sections (for example, cervicothoracic).
Reasons for the development of osteochondrosis
There is no comprehensive theory that fully explains the cause of this disease. It is multifactorial, therefore a predisposition is necessary as a trigger, and for its manifestation - a complex of internal and external stimuli.
Exogenous risk factors:
- excessive stress, physical work, occupational hazards (moving heavy objects) are a common cause of osteochondrosis in men;
- Spinal injuries;
- sharp and uneven jerks, body bends, turns;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on the same shoulder, tilting the head to the ear when talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male sex (osteochondrosis occurs less often in women);
- Overweight and tall;
- Developmental disorders of the musculoskeletal system, weakness of the back muscles;
- bad posture;
- Leg diseases (arthrosis, flat feet);
- Injury of trophism of intervertebral joints;
- Pathologies of internal organs.
Symptoms of osteochondrosis
Typical signs of this disease: pain in the spine and muscles at rest, limitation of movements, "fatigue" of the affected area. The patient tries to "unload" it either by leaning back on a chair, laying on his hands, trying not to stand on his feet for a long time, or by rubbing and kneading it, relieving the muscle tension. Depending on the location, the pain can vary slightly, and new, more specific symptoms are added.
With cervical osteochondrosis, unpleasant sensations will appear in the occipital region or in the neck itself, intensified when you tilt or turn your head. Due to the pinching of the nerve roots, tingling or burning may appear in the fingers and palms, and with more serious damage, restriction in their movement.
But the main danger of the case is that near the spine in this area there are important arteries that supply blood to the brain. Gradually they are squeezed, so this type of osteochondrosis is characterized by dizziness and "spots" in front of the eyes due to insufficient nutrition of the main organ in the body.
Among all types of osteochondrosis, damage to the thoracic region is less common than others and is difficult to diagnose. Pain in this area is similar to heart, pulmonary, esophageal pain or neuralgia. Therefore, patients first turn to cardiologists, gastroenterologists or pulmonologists, long avoiding doctors of the specialization they need, until all other pathologies are excluded, or thoracic osteochondrosis is suspected. The discomfort is located between the shoulder blades, intensified when you bend, you may experience a feeling of a lump in the throat or breathing difficulties and numbness in the chest.
The most common and typical type is lumbar osteochondrosis. Its symptoms are most associated with this disease: excruciating pain in the area of the same name, which intensifies when turning, bending or standing for a long time, and can radiate to one or both legs.
Diagnosis of osteochondrosis
The doctor begins to collect complaints and anamnesis (family, life and illness), which analyzes the presence of predisposition, external and internal risk factors, the relationship of symptoms and progression of the lesion.
The inspection consists of:
- neuro-orthopedic, during which the static and dynamic functions of the spine are assessed (posture, the presence of scoliosis, muscle tone and range of motion of intervertebral joints and limbs);
- neurological – determination of reflex and compression vertebrogenic syndromes, motor and sensory functions, quality of tissue trophism.
The simplest and most accessible instrumental diagnostic method for osteochondrosis of any part of the spine (cervical, thoracic or lumbar) is non-contrast and contrast (discography, venospondylography) X-ray studies that show the narrowing of the intervertebral discs, the level of the hernia. Protrusion, and the condition of the blood vessels. A little less often, more informative magnetic resonance imaging is used, with which you can accurately assess the degree of damage to the intervertebral disc, the size of the hernia, the presence of compression of the spinal cord, roots and surrounding tissues. If MRI is contraindicated, it is replaced by computed tomography, which determines the condition of the spine itself, the spinal canal and ligament calcification.
Treatment of osteochondrosis
First, it is necessary to reduce as many risk factors as possible, discovered by the doctor during the survey. Eliminate axial loads, limit the weight of objects carried, sometimes change traumatic jobs associated with physical work, lose weight if you are overweight, include minimal sports in your daily schedule if you are physically inactive. This will only slightly reduce the degree of pain due to osteochondrosis and the risk of complications, although it hardly slows down its progress.
The treatment must be comprehensive and combine not only drug methods, but also different types of effects on the spinal muscles and the spine itself. You can't just take pills for osteochondrosis alone and hope for healing; All procedures and medications can only be prescribed by a neurologist. The specialist bases his recommendations on each specific case and the individual characteristics of the patient, so that the treatment does not cause more suffering than the disease itself.
For osteochondrosis, exercise therapy is indicated, which is first carried out in a special hospital room, so that the doctor is convinced that the patient is doing the indicated exercises correctly. Different localization of the lesion involves different complexes to maintain the back muscles, improve blood circulation and trophism of the intervertebral discs and vertebrae themselves and reduce their friction.
Therapeutic massage also has a positive effect on the course of the disease in osteochondrosis; Physiotherapy, manual therapy, acupuncture, osteopathy and hardware traction of the spine are done with caution. The course of treatment and its methods are determined by the doctor based on the degree of development of the lesion, the manifestation of pain and the individual characteristics of each specific case.
Prevention of osteochondrosis
If you take timely measures to prevent the development of the disease, then its treatment may never be necessary. This should also be considered comprehensively: reduce the listed risk factors in advance (even before the discomfort appears), try to distribute the load evenly, monitor the posture of childhood, get adequate nutrition with all the necessary vitamins, and regularlyengage in supportive sports (for example swimming).
To prevent the development of osteochondrosis, gymnastics plays an important role: there are special exercises that reduce the load on the spine. You can consult an orthopedist or neurologist about them.
But even ordinary morning exercises help maintain muscle tone, relieve spasms and improve blood circulation, so that the trophism of the interarticular discs is not disturbed. To prevent the development of physical inactivity and sedentary work, it is necessary to periodically warm up and perform exercises indicated for the prevention of osteochondrosis.