Osteochondrosis is a common degenerative-dystrophic lesion that affects intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop immediately, progresses over many years, while the onset can occur at a fairly young age (18-20 years) and has several stages:
- Stage I - "cracks" in the fibrous ring and intradiscal movement of the nucleus pulposus, but there are no radiological signs yet;
- Phase II - the nucleus pulposus continues to deteriorate, the height of the disc decreases, the fibrous ring "dry out", the affected intervertebral joint becomes unstable, and to compensate for this, the back muscles are in constant tension, causing pain and "overtime", are signs of osteochondrosis 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, has different names:
- cervical - most often located between the fifth and seventh cervical vertebra (the most mobile joint);
- chest - a variant manifested by pain, which can be confused with diseases of other organs of the chest;
- lower back - the most common type due to the greatest mobility of this section and the load on it;
- common - involves several sections (for example, cervicothoracic).
Causes of 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) is a common cause of osteochondrosis in men;
- spinal cord injuries;
- sharp and uneven jerks, body bends, twists;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on the same shoulder, tilting your head to your ear when talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male gender (osteochondrosis occurs less often in women);
- overweight and tall;
- developmental abnormalities of the musculoskeletal system, weakness of the back muscles;
- bad attitude;
- bone diseases (arthrosis, flat feet);
- violation 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 in movements, "fatigue" of the affected area. The patient either tries to "unload" it by leaning back in a chair, leaning on his hands, trying not to stand on his feet for a long time, or by rubbing and kneading it to relieve muscle tension. Depending on the location, the pain may vary slightly and new, more specific symptoms may be added.
With cervical osteochondrosis, unpleasant sensations will arise in the occipital region or the neck itself, which intensifies when the head is tilted or turned. Due to pinching of the nerve roots, tingling or burning may occur in the fingers and palms, and with more serious injuries, limitation 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 of the body.
Among all types of osteochondrosis, injuries to the thoracic region are less common than others and are difficult to diagnose. Pain in this area is similar to heart, lung, esophageal pain or neuralgia. Therefore, patients turn first of all to cardiologists, gastroenterologists or pulmonologists, avoiding for a long time doctors with the specialization they need, until all other pathologies are excluded or thoracic osteochondrosis is suspected. Discomfort is localized between the shoulder blades, intensifies when bending, you may experience a feeling of a lump in the throat or difficulty breathing and numbness in the chest.
The most common and most typical type is lumbar osteochondrosis. Its symptoms are most often associated with this disease: aching pain in the area of the same name, which increases when turning, bending or standing for a long time, and can radiate 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 between symptoms and progression of the lesion.
The inspection consists of:
- neuro-orthopedic, where the static and dynamic functions of the spine are assessed (position, 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 reveal narrowing of the intervertebral discs, the level of hernial protrusion, and the conditionof 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 vertebrae themselves, the spinal canal and ligament calcification.
Treatment of osteochondrosis
First of all, it is necessary to reduce as many risk factors as possible, discovered by the doctor during the examination. Eliminate axial loads, limit the severity of objects carried, change sometimes 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 help to reduce the degree of pain due to osteochondrosis and the risk of complications, although it is unlikely to slow down the development.
The treatment must be comprehensive and combine not only drug methods, but also different types of effects on the vertebral muscles and the spine itself. You can't just take pills against osteochondrosis alone and hope for a cure; any procedure and medication can only be prescribed by a neurologist. The specialist doctor 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 osteochondrosis, exercise therapy is indicated, which is first carried out in a special hospital room, so that the doctor is convinced that the patient performs the specified exercises correctly. Different localization of the lesion implies different complexes aimed at maintaining the back muscles, improving blood circulation and trophism of the intervertebral discs and the vertebrae themselves 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 hardware traction of the spine are performed 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 case.
Prevention of osteochondrosis
If you take timely measures to prevent the development of the disease, its treatment may never be necessary. This should also be approached comprehensively: reduce the listed risk factors in advance (even before discomfort appears), try to distribute the load evenly, monitor posture from childhood, receive adequate nutrition with all the necessary vitamins and regularly participate in supportive sports (e. g. 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 to maintain muscle tone, relieve spasms and improve blood circulation, so that the trophism of the interarticular discs is not disturbed. To avoid the development of physical inactivity in sedentary work, it is necessary to periodically warm up and perform exercises indicated for the prevention of osteochondrosis.