Osteochondrosis is a common degenerative-dystrophic injury that affects the intervertebral discs, adjacent vertebrae, and nearby ligaments.
The disease does not develop instantly, but progresses over many years, while the onset can occur at a fairly early 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;
- 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, causing pain and " overwork", 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 large number of neurological symptoms, inflammation and edema;
- Stage IV: Adjacent elements of the joint are involved in the injury.
Osteochondrosis of the spine can also occur in different parts of the spine and, depending on this, has different names:
- cervical: located most frequently 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;
- lumbar - the most common type due to the greater mobility of this section and the load applied to it;
- common: involves several sections (e. g. , cervicothoracic).
Reasons for the development of osteochondrosis.
There is no comprehensive theory that completely 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 and uneven jerks, bending of the body, 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);
- weather conditions.
Endogenous risk factors:
- male gender (osteochondrosis occurs less often in women);
- tall and overweight;
- abnormalities of the development of the musculoskeletal system, weakness of the back muscles;
- poor posture;
- leg diseases (osteoarthritis, flat feet);
- violation of 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 movement, "fatigue" of the affected area. The patient tries to "unload" it by lying on a chair, leaning on his hands, trying not to stand 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 occur 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 appear in the fingers and palms, and in case of more serious damage, restriction of their movements.
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. Little by little they become pinched, so this type of osteochondrosis is characterized by dizziness and "spots" before the eyes due to insufficient nutrition of the main organ of the body.
Among all types of osteochondrosis, damage to the thoracic region is less common than others and is difficult to diagnose. Pain in this area is similar to heart, lung, esophageal, or neuralgia pain. 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 thoracic osteochondrosis is suspected. The discomfort is located between the shoulder blades, intensifies when bending over, you may experience a feeling of a lump in your 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), in which the presence of predisposition, external and internal risk factors, the relationship of symptoms and the progression of the injury are analyzed.
The inspection consists of:
- neuroorthopedic, 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 extremities);
- 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 X-ray studies without contrast and with contrast (discography, venospondylography), which reveal narrowing of the intervertebral discs , the level of the hernia. protrusion and the state of 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 herniation, the presence of compression of the spinal cord, roots and surrounding tissues . If MRI is contraindicated, it is replaced by CT, which determines the condition of the vertebrae, spinal canal, and calcification of the ligaments.
Osteochondrosis treatment
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 gravity of carried objects, sometimes change traumatic work associated with 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 slightly reduce the degree of pain due to osteochondrosis and the risk of complications, although it will hardly stop its progression.
Treatment should be comprehensive and combine not only pharmacological methods, but also various types of effects on the vertebral muscles and the spine itself. You can't just take pills for osteochondrosis and hope for healing; any procedures and medications 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.
Exercise therapy is indicated for osteochondrosis, which is first carried out in a special room in the hospital so that the doctor is convinced that the patient is correctly performing the indicated exercises. The different localization of the injury 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 spinal hardware traction are performed with caution. The course of treatment and its methods are determined by the doctor based on the degree of development of the injury, 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 risk factors listed in advance (even before discomfort appears), try to distribute the load evenly, monitor posture from childhood, receive proper nutrition with all vitamins necessary and practice supportive sports regularly (for example). 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 orthopedist or neurologist about them.
But even regular morning exercises will help 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 perform periodic warm-ups and perform exercises indicated for the prevention of osteochondrosis.