Osteochondrosis is a common degenerative-dystrophic injury affecting the intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop immediately, it progresses over many years, while the onset 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 there are still no radiological signs;
- Stage II - the nucleus pulposus continues to deteriorate, the height of the disc decreases, the annulus fibrosus "withers", the affected intervertebral joint becomes unstable and to compensate, the back muscles are in constant tension, causing pain and "overfatigue", signs ofosteochondrosis is visible on X-rays;
- III stage – the disc ruptures, the prolapsing 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 appear in different parts of the spine, and depending on this, it has 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 organs of the chest;
- lumbar - the most common type due to the greatest mobility of this section and the load on it;
- frequent - involving several sections (for example, cervicothoracic).
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 needed as a triggering factor, and for its manifestation - a complex of internal and external stimuli.
Exogenous risk factors:
- excessive stress, physical labor, occupational risks (moving heavy objects) are a common cause of osteochondrosis in men;
- spine injuries;
- sharp and uneven kicks, turns of the body, turns;
- sedentary work, lack of physical activity;
- constantly repeating movements (carrying a bag on the same shoulder, tilting the head to 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;
- poor posture;
- foot diseases (arthrosis, flat feet);
- violation of trophism of the intervertebral joints;
- pathologies of internal organs.
Symptoms of osteochondrosis
Characteristic signs of this disease: pain in the spine and muscles at rest, limitation of movements, "fatigue" of the affected area. The patient tries either to "unload" it by leaning back in the chair, leaning 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 canto vary slightly and to add new, more specific symptoms.
With cervical osteochondrosis, unpleasant sensations will appear in the occipital region or the neck itself, which intensify when tilting or turning the head. Due to pinching of the nerve roots, numbness or burning may appear in the fingers and palms, and in more serious damage and 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 pinched, so this type of osteochondrosis is characterized by vertigo 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 chest is less common than others and is difficult to diagnose. Pain in this area is similar to cardiac, pulmonary, esophageal pain or neuralgia. Therefore, patients turn primarily to cardiologists, gastroenterologists or pulmonologists, avoiding doctors of their necessary specialization 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 over, you may feel a lump in the throat or difficulty breathing, tingling 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 analyze the presence of predisposition, external and internal risk factors, the relationship of symptoms and the progression of the lesion.
The check 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 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 a non-contrast and contrast (discography, venospondylography) X-ray examination, which reveals narrowing of the intervertebral discs, the level of the herniation. bulging and the condition of the blood vessels. A little less often, a more informative magnetic resonance image 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 the calcification of the ligaments.
Treatment of osteochondrosis
First of all, it is necessary to reduce as many risk factors as possible, found by the doctor during the examination. Eliminate axial loads, limit the weight of carried objects, sometimes change traumatic jobs 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 should be comprehensive and combine not only medicinal 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, all procedures and drugs 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 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. The different localization of the lesion suggests different complexes aimed at maintaining the back muscles, improving blood circulation and trophicity 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 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 specific case.
Prevention of osteochondrosis
If you take timely measures to prevent the development of the disease, then 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, observe the posture from childhood, get proper nutrition with all the necessary vitamins and regularly engage in supportive sports (for example swimming).
In order to prevent the development of osteochondrosis, an important role is played by gymnastics: there are special exercises that reduce the load on the spine. For them, you can consult an orthopedist or a neurologist.
But even simple morning exercises will help to maintain muscle tone, relieve spasms and improve blood circulation, so that the trophism of the interarticular discs is not disturbed. In order to avoid the development of lack of physical activity during sedentary work, it is necessary to periodically warm up and perform exercises indicated for the prevention of osteochondrosis.