Osteochondrosis is a common degenerative-dystrophic change that affects the intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop immediately, it progresses over many years, while it can appear 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 no radiological signs yet;
- II. stage - the nucleus pulposus continues to deteriorate, the height of the intervertebral disc decreases, the fibrous ring "dry out", the affected intervertebral joint becomes unstable, to compensate for this, the back muscles are in constant tension, causing pain, overloading, x-rays show signs of osteochondrosis;
- III. stage - the disc ruptures, the lost nucleus pulposus forms a hernia, the stage is characterized by a multitude of neurological symptoms, inflammation and edema;
- ARC. section - adjacent elements of the joint are affected by the lesion.
Osteochondrosis of the spine can occur in different parts of the spine and has different names depending on it:
- 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 organs of the chest;
- lumbar - the most common type due to the greatest mobility of this section and the load placed on it;
- common - affects several sections (for example, neck-chest).
Causes of osteochondrosis
There is no single comprehensive theory that fully explains the cause of this disease. It is multifactorial, therefore, a tendency is needed 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 common causes 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 your head to your ear when talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male gender (osteochondrosis is less common in women);
- overweight and tall;
- developmental disorders of the locomotor system, weakness of the back muscles;
- poor posture;
- foot diseases (arthrosis, flat feet);
- violation of the trophism of the intervertebral joints;
- pathologies of internal organs.
Symptoms of osteochondrosis
Typical signs of the disease: spine and muscle pain at rest, limited movement, "fatigue" of the affected area. The patient either leans back in the chair, leans on his hands and tries to "unload" it, tries not to stand on his feet for long, or by rubbing, kneading, solves themuscle tension. Depending on the location, the pain may vary slightly, and new, more specific symptoms may appear.
In the case of cervical osteochondrosis, discomfort occurs in the occipital region or in the neck itself, which increases when tilting or turning the head. Pinching of the nerve roots can cause tingling and burning sensations in the fingers and palms, and in case of more severe damage, limited movement may occur.
But the main danger in this case is that near the spine in this area there are important arteries that supply blood to the brain. They pinch gradually, therefore 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 region is less common than others and difficult to diagnose. Pain in this area is similar to cardiac, pulmonary, esophageal or neuralgia. Therefore, patients first of all turn to cardiologists, gastroenterologists or pulmonologists, avoiding the necessary specialists for a long time until all other pathologies are excluded or thoracic osteochondrosis is suspected. The discomfort is localized between the shoulder blades, intensifies when bending, you may feel a lump in the throat or difficulty breathing, as well as numbness in the chest.
The most common and characteristic type is lumbar osteochondrosis. Its symptoms are most often associated with this disease: aching 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 by collecting complaints and anamnesis (family, life and illness), which analyzes the existence of a predisposition, external and internal risk factors, the correlation of symptoms and the progression of the lesion.
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);
- neurological – reflex and compression vertebrogenic syndromes, determination of 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 examinations, which reveal the narrowing of the intervertebral discs and the level of herniation. prominence, as well as the condition of the 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 state of calcification of the vertebrae themselves, the spinal canal, and ligaments.
Treatment of osteochondrosis
First of all, it is necessary to reduce as many risk factors as possible, which the doctor discovers during the assessment. Eliminate axial loads, limit the weight of objects carried, sometimes change the traumatic work associated with physical labor, lose excess weight, and include minimal sports in your daily program if you are physically inactive. This only slightly helps to reduce the amount of pain caused by osteochondrosis and the risk of complications, although it hardly slows down its progression.
Treatment should be comprehensive and combine not only drug methods, but also various effects on the vertebral muscles and the spine itself. You cannot take the tablets against osteochondrosis alone and hope for recovery, all procedures and medicines 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.
In the case of osteochondrosis, exercise therapy is recommended, 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. The different localization of the lesion entails different complexes aimed at maintaining the back muscles, improving the 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, we carefully perform physiotherapy, manual therapy, acupuncture, osteopathy, and hardware traction of the spine. The course and methods of treatment are determined by the doctor based on the degree of development of the lesion, the manifestation of pain and the unique characteristics of each case.
Prevention of osteochondrosis
If you take the necessary measures in time to prevent the development of the disease, you will probably never need treatment. This should also be approached comprehensively: reduce the listed risk factors in advance (even before the onset of discomfort), try to distribute the load evenly, monitor posture from childhood, get adequate food with all the necessary vitamins, and regularly engage in supporting sports (e. g. swimming).
In order to prevent the development of osteochondrosis, gymnastics plays an important role: there are special exercises that reduce the load on the spine. You can contact an orthopedic or neurologist about them.
But even the usual morning exercises help to maintain muscle tone, relieve spasms and improve blood circulation so that the trophism of the interarticular discs does not interfere. In order to avoid the development of physical inactivity during sedentary work, it is necessary to regularly warm up and perform exercises for the prevention of osteochondrosis.