Osteochondrosis is a common degenerative-dystrophic lesion that affects the intervertebral discs, adjacent vertebrae, and adjacent ligaments.
The disease does not develop instantly, it progresses over many years, and the onset can occur at a fairly young age (18-20 years) and has several stages:
- Stage I – "cracks" in the annulus fibrosus and intradiscal movement of the nucleus pulposus, but there are no radiological signs yet;
- Stage II - the nucleus pulposus continues to deteriorate, the height of the disc decreases, the fibrous annulus "drys up", the damaged intervertebral joint becomes unstable, and to compensate for this, the back muscles are under constant tension, which causes pain and overwork", X-rays show signs of osteochondrosis;
- Stage III – the disc ruptures, the protruding pulpous nucleus forms a hernia, the stage is characterized by a multitude of neurological symptoms, inflammation and swelling;
- Stage IV – the damage involves elements surrounding the joint.
Osteochondrosis of the spine can also occur in different parts of the spine and, therefore, has different names:
- Cervical - most often located between the fifth and seventh cervical vertebrae (the most mobile joint);
- Chest - a variant manifested by pain, which can be confused with diseases of other chest organs;
- Lumbar - the most common type due to the great mobility of this section and the load placed on it;
- General - includes several departments (for example, cervicothoracic).
Reasons for the development of osteochondrosis
There is no single comprehensive theory that fully explains the cause of this disease. It is multifactorial, therefore, a predisposition is necessary as a cause, and a complex of internal and external stimuli is necessary for its manifestation.
Exogenous risk factors:
- Excessive stress, physical work, occupational hazards (moving heavy objects) are frequent causes of osteochondrosis in men;
- spine injuries;
- sharp and uneven jerking, bending of the body, twisting;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on the same shoulder, leaning the head to the ear while talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male gender (osteochondrosis is less common in women);
- overweight and tall;
- Developmental disorders of the musculoskeletal system, weakness of the back muscles;
- bad posture
- foot diseases (arthrosis, flat feet);
- trophic disorders of intervertebral joints;
- Pathologies of internal organs.
Symptoms of osteochondrosis
Typical signs of this disease: pain in the spine and muscles at rest, restriction of movement, "fatigue" of the affected area. The patient tries to "unload" it either by leaning on a chair, leaning on his hands, trying not to stand on his feet for a long time, or by rubbing and kneading, relieves muscle tension. Depending on the location, the pain may vary slightly and new, more specific symptoms may be added.
During cervical osteochondrosis, unpleasant sensations occur in the occipital region or the neck itself, which are intensified when the head is bent or turned. Due to stretching of the nerve roots, tingling or burning may appear in the fingers and palms, and in case of more serious damage, their movement may be limited.
But the main danger of the case is that in this area near the spine there are important arteries that supply blood to the brain. They gradually shrink, so this type of osteochondrosis is characterized by dizziness and "spots" in front of the eyes due to insufficient nutrition of the main organ of the body.
Among all types of osteochondrosis, damage to the chest area is less common than others and difficult to diagnose. Pain in this area is similar to heart, lung, esophagus or neuralgia. Therefore, patients first refer to cardiologists, gastroenterologists or pulmonologists, long avoiding the doctors of the specialty they need, until all other pathologies are excluded, or there is a suspicion of thoracic osteochondrosis. The discomfort is localized between the shoulder blades, gets stronger when bending over, you may feel a lump in your throat or difficulty breathing and numbness in the chest.
The most common and typical type is lumbar osteochondrosis. Its symptoms are most often associated with this disease: a sharp pain in the area of the same name, which worsens when turning, bending or standing for a long time, and can spread to one or both legs.
Diagnosis of osteochondrosis
The doctor begins by collecting complaints and anamnesis (family, life and illness), which analyzes the presence of predisposition, external and internal risk factors, the relationship of symptoms and the progression of the damage.
The inspection consists of:
- neuro-orthopedic, during which the static and dynamic functions of the spine are assessed (posture, presence of scoliosis, muscle tone and range of motion of intervertebral joints and limbs);
- Determination of neurological - reflex and compressive vertebrogenic syndromes, motor and sensory functions, 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 reveal the narrowing of intervertebral discs, the level of herniation. Protrusion and condition of 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 calcification of the ligaments.
Treatment of osteochondrosis
First of all, it is necessary to reduce as many risk factors as possible, which were discovered by the doctor during the survey. Eliminate axial loads, limit the weight of objects carried, sometimes replace traumatic jobs associated with physical labor, lose weight if you are overweight, include minimal sports in your daily schedule if you are physically inactive. This will only help to slightly reduce the quality of pain and the risk of complications due to osteochondrosis, but it will hardly slow down its progress.
Treatment should be comprehensive and combine not only drug methods, but also different types of effects on the spinal muscles and the spinal column itself. You cannot take anti-osteochondrosis pills on your own and hope for a cure; Any procedure and medication can be prescribed only 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.
In the case of osteochondrosis, exercise therapy is shown, which is first performed in a special room in the hospital, so that the doctor can make sure that the patient performs the indicated exercises correctly. Different localization of damage involves different complexes aimed at maintaining back muscles, improving blood circulation and trophism of the intervertebral discs and vertebrae, and reducing their friction.
Therapeutic massage also has a beneficial effect on the course of the disease in osteochondrosis; Physiotherapy, manual therapy, acupuncture, osteopathy and spinal traction are performed with caution. The course of treatment and its methods are determined by the doctor according to the degree of damage development, 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. It should also be approached in a complex way: reduce the listed risk factors in advance (even before the appearance of discomfort), try to evenly distribute the load, observe the posture from childhood, get adequate nutrition with all the necessary vitamins and regularly engage in supportive sports (for example, swimming).
Exercise plays an important role in preventing the development of osteochondrosis: there are special exercises that reduce the load on the spine. You can consult an orthopedist or a neurologist about them.
But even ordinary morning exercises will help maintain muscle tone, relieve spasms and improve blood circulation, so as not to disturb the trophism of the inter-articular discs. To prevent the development of physical inactivity in sedentary work, it is necessary to periodically warm up and perform the exercises specified for the prevention of osteochondrosis.