Osteochondrosis is a common degenerative-dystrophic lesion that affects the intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop immediately, it progresses over many years, while the onset can occur 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 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 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 bursts, 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, 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 part and the load placed on it;
- usually - includes several parts (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 labor, occupational hazards (moving heavy objects) are a common cause of osteochondrosis in men;
- spine injuries;
- sharp and uneven spasms, bending of the body, turns;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on the same shoulder, tilting the head to the ear when talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male sex (osteochondrosis occurs less often in women);
- overweight and tall;
- developmental abnormalities of the musculoskeletal system, weakness of the back muscles;
- bad posture;
- foot diseases (arthrosis, flat feet);
- trophism injury 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 movements, "fatigue" in the affected area. The patient tries to "unload" it by leaning on the chair, leaning on the hands, trying not to standlong on the legs or by rubbing and kneading, releasing 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 will intensify when tilting or turning the head. Due to compression of the nerve roots, tingling or burning may occur in the fingers and palms, with 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 the brain with blood. 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.
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 cardiac, pulmonary, esophageal pain or neuralgia. Therefore, patients first of all turn to cardiologists, gastroenterologists or pulmonologists, for a long time avoiding doctors from the necessary specialization, 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 shortness of breath and stiffness 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), 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 evaluated (posture, presence of scoliosis, muscle tone and range of motion of the intervertebral joints and limbs);
- neurological – determination of reflex and compressive 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 contrast (discography, venospondylography) that reveal narrowing of the intervertebral discs, the level of herniation. bulging and the condition of the blood vessels. A little less often, a more informative magnetic resonance 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, discovered by the doctor during the survey. Eliminate axial loads, limit the weight of transported objects, 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. 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 must be comprehensive and combine not only drug methods, but also various types of effects on the spinal muscles and the spinal column itself. You cannot just take pills for osteochondrosis alone and hope for healing; any procedures and drugs can be prescribed only 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.
Exercise therapy is indicated for osteochondrosis, which is first carried out in a separate hospital room so that the doctor can make sure that the patient performs the specified exercises correctly. The different localization of the lesion implies different complexes aimed at maintaining 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 spinal 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 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 distribute the load evenly, follow the posture from childhood, get adequate nutrition with all the necessary vitamins andregularly 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 for them.
But even ordinary morning exercises will help maintain muscle tone, relieve spasms and improve blood circulation so as not to disturb the trophism of the interarticular discs. To avoid the development of physical inactivity during sedentary work, it is necessary to periodically warm up and perform exercises indicated for the prevention of osteochondrosis.