Osteochondrosis is a common degenerative-dystrophic lesion that affects intervertebral discs, adjacent vertebrae and adjacent ligaments.
The disease does not develop immediately, progressing for many years, while it can begin at a fairly young age (18-20 years) and has several stages:
- Stage I – "cracks" in the fibrous ring and intradiscal movement of the pulp core, but there are no radiological signs yet;
- Stage II – the nucleus pulposus continues to deteriorate, the height of the disc decreases, the ring of fibers "dries up", the affected intervertebral joint becomes unstable, and to compensate, the back muscles are in constant tension, causing pain and "excessive work", X-rays show signs of osteochondrosis;
- Stage III – the disc ruptures, the fallen pulp core forms a hernia, the stage is characterized by an abundance of neurological symptoms, inflammation, edema;
- Stage IV – adjacent joint elements are involved in the damage.
Spinal osteochondrosis can also occur in different parts of the spine, and depending on it, it has different names:
- cervical - most often localized between the fifth and seventh cervical vertebrae (the most mobile joint);
- chest - a variant that manifests itself with pain that can be confused with diseases of other chest organs;
- lumbar - the most common type due to the greatest mobility of this section and the load placed on it;
- often - includes several sections (for example, cervical and thoracic).
Reasons for the development of osteochondrosis
There is no single comprehensive theory that fully explains the cause of this disease. It is multifactorial, so a predisposition is needed as a trigger, and a complex of internal and external stimuli is needed for its manifestation.
Exogenous risk factors:
- excessive stress, physical work, occupational diseases (moving heavy objects) is a common cause of osteochondrosis in men;
- spinal injuries;
- sharp and uneven thrusts, body bends, turns;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on one shoulder, leaning your head to your ear while talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male gender (osteochondrosis occurs less often in women);
- overweight and tall;
- anomalies of the development of the musculoskeletal system, weakness of the back muscles;
- poor posture;
- foot diseases (arthrosis, flat feet);
- violation of intervertebral joint trophism;
- pathologies of internal organs.
Symptoms of osteochondrosis
Characteristic signs of this disease: pain in the spine and muscles at rest, restriction of movement, "fatigue" of the affected area. The patient tries either to "unload" it, leaning back in a chair, leaning on his hands, trying not to stand on his feet for a long time, or by rubbing and kneading, reducing 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 nape of the neck or in the neck itself, which will intensify when bending or turning the head. Due to compression of the nerve roots, tingling or burning may appear in the fingers and hands, and with more serious damage, limitations of their movements.
But the main danger is that near the spine in this area there are important arteries that supply blood to the brain. Gradually, they become compressed, 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 chest are less common than others and are difficult to diagnose. Pain in this area is similar to pain in the heart, lungs, esophagus or neuralgia. Therefore, patients first turn to cardiologists, gastroenterologists or pulmonologists, avoiding doctors of the 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, there may be a feeling of a lump in the throat or difficulty breathing, as well as numbness in the chest.
The most common and typical type is lumbar osteochondrosis. Its symptoms are most often associated with this disease: a burning pain in the area of the same name, which worsens 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 diseases), which analyzes the presence of predisposition, external and internal risk factors, the relationship of symptoms and the progression of the lesion.
The test consists of:
- neuro-orthopedic, during which static and dynamic functions of the spine are assessed (posture, 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 method of instrumental diagnosis of osteochondrosis of any part of the spine (cervical, thoracic or lumbar) is non-contrast and contrast (discography, venospondylography) X-ray studies that reveal the narrowing of intervertebral discs, the level of herniation. protrusion and vascular position. Slightly less often, more informative magnetic resonance is used, with the help of which 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 can be accurately assessed. If MRI is contraindicated, it is replaced by computed tomography, which determines the condition of the vertebrae themselves, the calcification of the spinal canal and ligaments.
Treatment of osteochondrosis
First, it is necessary to reduce as many risk factors as possible, which the doctor discovers during the survey. Eliminate axial loads, limit the weight of transported objects, sometimes change traumatic jobs related to physical labor, lose weight if you are overweight, include a minimum of sports in your daily schedule if you are physically inactive. This will only slightly help to reduce the degree of pain caused by 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 different types of effects on the spinal muscles and the spine itself. Osteochondrosis tablets cannot be taken alone and hope for healing, all 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.
In the case of osteochondrosis, exercise therapy is indicated, which is first carried out in a special hospital room, so that the doctor is sure that the patient performs the indicated exercises correctly. Different localization of damage means different complexes aimed at maintaining the back muscles, improving blood circulation and trophism of the intervertebral disc and the vertebrae themselves, as well as reducing their friction.
Therapeutic massage also has a beneficial effect on the course of the disease of osteochondrosis, physiotherapy, manual therapy, acupuncture, osteopathy, spinal apparatus are performed cautiously. 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 its treatment may not be necessary. It should also be approached comprehensively: in advance (even before the appearance of discomfort), reduce the listed risk factors, try to evenly distribute the load, follow the posture from childhood, get adequate nutrition with all the necessary vitamins and regularly engage in supportive sports (for example, swimming).
Exercise plays an important role in preventing the development of osteochondrosis: there are special exercises that reduce the load on the spine. You can consult an orthopedist or a neurologist about them.
But even the usual morning exercises will help maintain muscle tone, relieve spasms and improve blood circulation so that the trophism of the inter-articular discs is not disturbed. To avoid the formation of physical inactivity in sedentary work, it is necessary to periodically warm up and perform exercises indicated for the prevention of osteochondrosis.