Osteochondrosis is a common degenerative-dystrophic lesion affecting the intervertebral discs, adjacent vertebrae and neighboring ligaments.
The disease does not develop instantly, progressing 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 there are no radiological signs yet;
- Stage II – the nucleus pulposus continues to deteriorate, the height of the disc decreases, the annulus fibrosus "dries out", the affected intervertebral joint becomes unstable, and to compensate for this, the back muscles are in constant tension, causingpain and "overwork", signs of osteochondrosis are visible on x-rays;
- Stage III – disc ruptures, prolapsed nucleus pulposus forms a herniation, 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 - most often located between the fifth and seventh cervical vertebra (the most mobile joint);
- chest - a variant manifested by pain that can be confused with diseases of other chest organs;
- lumbar - the most common type due to the greater mobility of this section and the load applied to it;
- common – involving multiple sections (e. g. , cervicothoracic).
Reasons for the development of osteochondrosis
There is no overarching 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, uneven jerks, curvatures of the body, turns;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on the same shoulder, tilting the head towards the ear when talking on the phone);
- weather conditions.
Endogenous risk factors:
- male gender (osteochondrosis is less common in women);
- overweight and tall;
- abnormalities in the development of the musculoskeletal system, weakness of the back muscles;
- bad position;
- leg diseases (osteoarthritis, 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 either tries to "unload" it by leaning on a chair, leaning on his hands, trying not to stand for a long time, or by rubbing and kneading it, thereby relieving 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 occur in the occipital region or in the neck itself, intensifying when tilting or turning the head. Due to pinching of the nerve roots, tingling or burning may appear in the fingers and palms, and in case of more severe damage, restriction of their movements.
But the main danger of this case is that near the spine, in this area, there are important arteries that supply the brain with blood. Gradually, they pinch themselves, 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, lesions of the thoracic region are less common than others and difficult to diagnose. Pain in this area is similar to heart, lung, esophageal pain, or neuralgia. Therefore, patients first turn to cardiologists, gastroenterologists or pulmonologists, avoiding doctors of the specialization they need for a long time, until all other pathologies are excluded or osteochondrosisthoracic is suspected. The discomfort is localized between the shoulder blades, intensifies when bending over, you may feel a feeling of a lump in the 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: 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 presence of predisposition, external and internal risk factors, the relationship between symptoms and the evolution of the lesion.
The control 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 movement of the joints and intervertebral limbs);
- neurological – determination of vertebrogenic reflex and compression syndromes, motor and sensory functions, quality of tissue trophism.
The simplest and most accessible instrumental method of diagnosing 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 the protruding hernia 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 herniation, the presence of compression of the spinal cord, roots and tissuessurroundings. If MRI is contraindicated, it is replaced by CT, which determines the condition of the vertebrae themselves, the spinal canal and ligament calcifications.
Treatment of osteochondrosis
First of all, it is necessary to reduce the risk factors discovered by the doctor during the investigation as much as possible. Eliminate axial loads, limit the gravity of objects carried, sometimes change traumatic tasks related to physical work, lose weight if you are overweight, include a minimum of sports in your daily schedule if you are physically inactive. This will only help to slightly reduce the degree of pain from osteochondrosis and the risk of complications, although it will hardly slow down its progression.
Treatment should be comprehensive and combine not only drug methods, but also various types of effects on the spinal muscles and the spine itself. You cannot just take pills for osteochondrosis yourself and hope for recovery: 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 correctly performing the indicated exercises. Different locations of the lesion involve different complexes aimed at maintaining the muscles of the back, 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 osteochondrosis: physiotherapy, manual therapy, acupuncture, osteopathy and hardware traction of the spine are practiced with caution. The course of treatment and its methods are determined by the doctor depending 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, its treatment may never be necessary. This should also be approached comprehensively: reduce the listed risk factors in advance (even before the onset of discomfort), try to evenly distribute the load, monitor posture from childhood, receive adequate nutritionwith all the necessary vitamins and regularly practice 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 will 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.