Osteochondrosis is a common degenerative-dystrophic lesion that affects intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop immediately, it progresses for many years, while the onset can occur at a fairly young age (18-20 years) and has several stages:
- Stage I – "cracks" in the fibrous ring and intradiscal displacement of the nucleus pulposus, but no radiological signs yet;
- Phase II – the nucleus pulposus continues to deteriorate, the height of the disc decreases, the annulus fibrosus "dries up", the affected intervertebral joint becomes unstable, and to compensate, the back muscles are in constant tension, causing pain and "overwork", signsosteochondrosis is visible on X-rays;
- III stage – the disc ruptures, the prolapsed nucleus pulposus forms a hernia, the stage is characterized by an abundance of neurological symptoms, inflammation and edema;
- IV stage – adjacent elements of the joint are affected by the lesion.
Osteochondrosis of the spine can also occur in different parts of the spine and, depending on it, has different names:
- cervical - most often localized 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 greatest mobility of this section and the load on it;
- common - which include several compartments (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 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 common causes of osteochondrosis in men;
- spinal injuries;
- sharp and uneven jerks, bending of the body, turns;
- 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);
- climatic conditions.
Endogenous risk factors:
- male sex (osteochondrosis occurs less often in women);
- obese and tall;
- abnormalities in the development of the musculoskeletal system, weakness of the back muscles;
- bad posture;
- leg diseases (arthrosis, flat feet);
- violation of trophism of intervertebral joints;
- pathologies of internal organs.
Symptoms of osteochondrosis
Typical signs of this disease: pain in the spine and muscles at rest, restriction of movement, "fatigue" of the affected area. The patient tries to "unload" it by reclining in a chair, leaning on his arms, trying not to stand on his feet for a long time, orrubs and kneads 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 appear in the occipital region or the neck itself, which are intensified when leaning or turning the head. Due to the pinching of the nerve roots, tingling or burning may occur in the fingers and palms, and in the case of more serious damage, their movement may be limited.
But the main danger of the case is that near the spine in this area there are important arteries that supply the brain with blood. They are gradually 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 in the body.
Among all types of osteochondrosis, damage to the thoracic region is rarer than others and difficult to diagnose. Pain in this area is similar to pain in the heart, lungs, esophagus or neuralgia. Therefore, patients first of all turn to cardiologists, gastroenterologists or pulmonologists, avoiding for a long time the doctors of the specialization they need, until all other pathologies or suspicion of thoracic osteochondrosis have been ruled out. The discomfort is localized between the shoulder blades, intensifies when bending, there may be a feeling of a lump in the throat or difficulty breathing, 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 spread 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 progression of the lesion.
The inspection 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 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 studies that reveal the narrowing of the intervertebral discs, the level of the herniated spine. protrusion and condition of blood vessels. More informative magnetic resonance is used somewhat less often, 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 magnetic resonance imaging 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, which the doctor discovered during the survey. Eliminate axial loads, limit the weight of objects carried, sometimes change traumatic jobs associated with physical labor, lose weight if you are overweight, include minimal sports in your daily schedule if you are physically inactive. It will only slightly reduce the degree of pain due to osteochondrosis and the risk of complications, although it will hardly slow down its progression.
Treatment must be comprehensive and combine not only drug methods, but also different types of action on the spinal muscles and the spinal column itself. You can't 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 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 can make sure that the patient performs the mentioned exercises correctly. The different localization of the lesion implies different complexes aimed at maintaining the back muscles, improving the 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, 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 its treatment may never be necessary. This should also be approached comprehensively: reduce the listed risk factors in advance (even before discomfort appears), try to evenly distribute the load, monitor posture from childhood, receive adequate nutrition with all the necessary vitamins and regularly engage in accompanying 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 them.
But even simple morning exercises will help maintain muscle tone, relieve spasms and improve blood circulation so that interarticular disc trophism is not disturbed. In order 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.