Osteochondrosis is a common degenerative-dystrophic lesion that affects the intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop immediately, but progresses over many years, while its onset can occur at a fairly young age (18-20 years) and has several stages:
- Stage I – "tearing" in the fibrous ring and intradiscal movement of the nucleus pulposus, but no radiological signs yet;
- Stage II – the nucleus pulposus continues to deteriorate, the height of the intervertebral disc decreases, the fibrous ring "dries out", the affected intervertebral joint becomes unstable, and to compensate for this, the back muscles are constantly under 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 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 have different names depending on this:
- cervical - usually 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 part and the load placed on it;
- often - involving multiple sections (for example, cervicothoracic).
Reasons for the development of osteochondrosis
There is no one all-encompassing theory that fully explains the cause of this disease. It is multifactorial, therefore, a predisposition is needed as a trigger, and for its manifestation - a complex of internal and external stimuli.
Exogenous risk factors:
- excessive stress, physical labor and occupational hazards (moving heavy objects) are a common cause of osteochondrosis in men;
- spinal cord injury;
- sharp and uneven jerks, body bends, bends;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on the same shoulder, tilting your head to your ear during a phone call);
- climate conditions.
Endogenous risk factors:
- male gender (osteochondrosis is less common in women);
- overweight and tall;
- developmental disorders of the musculoskeletal system, weakness of the back muscles;
- bad attitude;
- leg diseases (arthrosis, flat feet);
- violation of trophism of intervertebral joints;
- pathologies of internal organs.
Symptoms of osteochondrosis
Typical symptoms of this disease: pain in the spine and muscles at rest, restriction of movement, "fatigue" of the affected area. The patient tries to "discharge" it by leaning back in a chair, leaning on his hands and trying not to stand on his feet 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 emerge.
With cervical osteochondrosis, unpleasant sensations will occur in the occipital region or the neck itself, which intensify when tilting or turning the head. As a result of compression of the nerve roots, tingling or burning sensations may occur in the fingers and palms, and with more severe damage, limited movement may occur.
But the biggest danger of the matter is that near the spine in this area there are important arteries that supply blood to the brain. Gradually they become pinched, 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.
Of 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 heart, lung, esophageal pain or neuralgia. Therefore, patients turn primarily 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 localized between the shoulder blades, worsens when bending over, you may experience 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. The symptoms are usually associated with this disease: aching pain in the area of the same name, which becomes more severe when twisting, 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 disease), analyzing the presence of predispositions, external and internal risk factors, the relationship between symptoms and progression of the lesion.
The inspection consists of:
- neuro-orthopedic, which assesses the static and dynamic functions of the spine (posture, the presence of scoliosis, muscle tone and range of motion of 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 non-contrast and contrast (discography, venospondylography) X-ray examination that reveals narrowing of the intervertebral discs, the level ofhernia protrusion and the condition of blood vessels. Slightly less often, more informative magnetic resonance imaging is used, which allows you to 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 discovered by the doctor during the examination as possible. Eliminate axial loads, limit the severity of the transported objects, change sometimes traumatic jobs associated with physical labor, lose weight if you are overweight, include minimal sports in your daily schedule if you are physically inactive. This will only help somewhat reduce the degree of pain due to osteochondrosis and the risk of complications, although it will hardly slow its progression.
Treatment should be comprehensive and combine not only drug methods, but also various types of effects on the vertebral muscles and the spine itself. You cannot just take pills for osteochondrosis yourself and hope for a cure; all procedures and medications can only be prescribed by a neurologist. The specialist bases his advice on each specific case and the individual characteristics of the patient, so that the treatment does not cause more suffering than the disease itself.
With 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 localization of the lesion implies different complexes aimed at preserving the back muscles, improving blood circulation and trophism 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, its treatment may never be necessary. This should also be approached comprehensively: reduce the listed risk factors in advance (even before discomfort occurs), try to distribute the load evenly, monitor posture from childhood, receive adequate nutrition with all the necessary vitamins and regularly engage 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 orthopedist or neurologist about this.
But even ordinary 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 prevent the development of physical inactivity with sedentary work, it is necessary to periodically warm up and perform exercises indicated for the prevention of osteochondrosis.