Osteochondrosis is a common degenerative-dystrophic lesion affecting intervertebral discs, adjacent vertebrae and proximal ligaments.
The disease does not develop instantly, it develops 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 annulus fibrosus and intradiscal movement of the nucleus pulposus, but no radiographic signs yet.
- Stage II - the nucleus pulposus continues to deteriorate, the height of the disc decreases, the annulus fibrosus "dry out", the affected intervertebral joint becomes unstable and to compensate for this, the back muscles are in constant tension, causing pain and "overwork"", the 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 a multitude 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 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 greater mobility of this part and the load placed on it.
- common - involving several parts (for example, cervical thorax).
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) is a common cause of osteochondrosis in men.
- spinal cord injuries;
- sharp and uneven jerks, body bends, turns.
- sedentary work, physical inactivity.
- constant repetitive movements (carrying a bag on the same shoulder, leaning 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 posture;
- diseases of the feet (joints, flat feet).
- violation of the trophism of the 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 either "unload" it by leaning back in a chair, resting on his hands, trying not to stand on his feet for a long time, or by rubbing and kneading it, relieving muscle tension. Depending on the location, the pain may 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, which intensify when tilting or turning the head. Due to pinching of the nerve roots, tingling or burning may occur in the fingers and palms, and with more severe damage, limitation of 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. Bites are gradually made, 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 difficult to diagnose. Pain in this area is similar to cardiac, pulmonary, esophageal pain or neuralgia. Therefore, patients first of all turn to cardiologists, gastroenterologists or pulmonologists, avoiding for a long time the doctors of the specialty they need, until all other pathologies are excluded or thoracic osteochondrosis is suspected. The discomfort is located between the shoulder blades, intensifies when you bend over, you may feel a feeling of 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: pain in the area of the same name, which intensifies when you twist, bend or stand for a long time and can radiate to one or both legs.
Diagnosis of osteochondrosis
The doctor begins by collecting complaints and memories (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 evaluated (posture, presence of scoliosis, muscle tone and range of motion of the intervertebral joints and limbs).
- neurological – determination of reflex and compressive spinal syndromes, motor and sensory functions, quality of tissue nutrition.
The simplest and most accessible instrumental diagnostic method for osteochondrosis of any part of the spine (cervical, thoracic or lumbar) is X-ray studies without contrast and with contrast (discography, venospondylography) that reveal stenosis of the intervertebral discs, the level of the herniation. protrusion and the condition of the blood vessels. A little less often, a more informative MRI 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 magnetic resonance imaging is contraindicated, it is replaced by computed tomography, which determines the condition of the vertebrae themselves, the spinal canal and the calcification of the ligaments.
Treatment of osteochondrosis
First of all, it is necessary to reduce as many risk factors as possible, discovered by the doctor during the research. Eliminate axial loads, limit the severity of the objects you carry, sometimes change traumatic tasks related to 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 degree of pain due to osteochondrosis and the risk of complications, although it will hardly slow down its progression.
Treatment must be comprehensive and combine not only drug methods, but also various types of effects on the spinal muscles and the spine itself. You cannot take pills for osteochondrosis on your own and hope for a cure; any procedures and drugs can only be prescribed by a neurologist. The specialist bases his recommendations on each specific case and on 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 performing the indicated exercises correctly. The different localization of the damage implies different complexes aimed at maintaining the back muscles, improving blood circulation and nutrition of the intervertebral discs and 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 traction of spinal material are done carefully. The course of treatment and its methods are determined by the doctor based on the degree of development of the damage, the manifestation of pain and the individual characteristics of each specific case.
Prevention of osteochondrosis
If you take early measures to prevent the development of the disease, then its treatment may never be necessary. This should also be fully approached: reduce the listed risk factors in advance (even before discomfort appears), try to distribute the load evenly, monitor body posture from childhood, get adequate nutrition with all the necessary vitamins andparticipate regularly 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 orthopedic or neurologist about these.
But even the usual morning exercises will help maintain muscle tone, relieve spasms and improve blood circulation, so as not to disturb the trophism of the intervertebral discs. 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.