Osteochondrosis is a common degenerative-dystrophic lesion that affects the intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop immediately, it develops over many years, and the onset can occur at a fairly young age (18-20 years old) and consists of 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 fibrous ring "drys 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 X-rayappears in its 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 depending on this, there are 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 organs of the chest;
- lumbar - the most common type due to the greatest mobility of this section and the load placed on it;
- general - involves several sections (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, so a tendency is needed as a trigger, and a complex of internal and external stimuli is needed for its manifestation.
Exogenous risk factors:
- excessive stress, physical labor, occupational hazards (moving heavy objects) are common causes of osteochondrosis in men;
- spinal injuries;
- sharp and uneven bends, body bends, turns;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on the same shoulder, tilting your head to your ear while talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male sex (osteochondrosis occurs less often in women);
- overweight and tall;
- developmental anomalies of the musculoskeletal system, weakness of the back muscles;
- poor posture;
- foot 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, limitation of movements, "fatigue" of the affected area. The patient either leans back in a chair, leans on his hands, tries not to stand for a long time, or rubs and kneads to relieve muscle tension, trying to "loosen" it. Depending on the location, the pain may be slightly different, and new, more specific symptoms are added.
With cervical osteochondrosis, unpleasant sensations will occur in the occipital region or in the neck, intensifying when bending or turning the head. Tingling or burning in the fingers and palms due to the compression of the nerve roots, and with more serious damage, there may be a limitation in their movement.
But the main danger is that in this area there are important arteries that supply blood to the brain near the spinal column. Gradually, they are 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 less common than others and difficult to diagnose. Pain in this area is similar to heart, lung, esophageal pain or neuralgia. Therefore, patients first turn to cardiologists, gastroenterologists or pulmonologists, avoiding the doctors of the specialty they need until all other pathologies are excluded or until thoracic osteochondrosis is suspected. Discomfort is localized between the shoulder blades, intensifies when bending, you may feel a lump in the throat or difficulty breathing, numbness in the chest.
The most common and most typical type is lumbar osteochondrosis. Its symptoms are most often associated with this disease: aching pain in the region of the same name, aggravated 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 a predisposition, external and internal risk factors, the relationship of symptoms and the course of the lesion.
The inspection consists of:
- neuro-orthopedic, where static and dynamic functions of the spine are evaluated (posture, presence of scoliosis, muscle tone and range of motion of intervertebral joints and limbs);
- neurological - determining the quality of reflex and compressive vertebrogenic syndromes, motor and sensory functions, tissue trophism.
The simplest and most accessible instrumental diagnostic method of osteochondrosis of any part of the spine (cervical, thoracic or lumbar) is X-ray studies without contrast and without contrast (discography, venospondylography), which reveal the narrowing of intervertebral discs, the level of rupture. condition of protrusion and blood vessels. A little less often, more informative magnetic resonance imaging is used, with the help of 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 position of the vertebrae, spinal canal and ligament calcification.
Treatment of osteochondrosis
First of all, it is necessary to reduce as many risk factors as possible, which were discovered by the doctor during the survey. Eliminate axial loads, limit the severity of moving objects, sometimes change traumatic work associated with physical labor, lose weight if you are overweight, if you are physically inactive, include minimal sports in your daily schedule. This will only help to slightly reduce the degree of pain and the risk of complications due to osteochondrosis, although it will hardly slow down its development.
Treatment should be comprehensive and should combine not only drug methods, but also different types of effects on the vertebral muscles and the spine itself. You cannot take pills for osteochondrosis on your own and hope to recover, any procedure and medication can only be prescribed by a neurologist. The specialist bases his recommendations on each specific situation and the individual characteristics of the patient, so that the treatment does not cause more suffering than the disease itself.
Exercise therapy for osteochondrosis is indicated, which is initially carried out in a special hospital room so that the doctor can make sure that the patient performs the indicated exercises correctly. 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 friction.
Therapeutic massage also has a beneficial effect on the course of the disease in osteochondrosis, physiotherapy, manual therapy, acupuncture, osteopathy and 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, its treatment may never be necessary. It is also necessary to approach it comprehensively: reduce the listed risk factors in advance (before anxiety appears), try to distribute the load evenly, monitor posture from childhood, have adequate nutrition with all the necessary vitamins, and regularly engage in supportive sports (even, for example, swimming).
Gymnastics 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 neuropathologist about them.
But even ordinary morning exercises will help to maintain muscle tone, eliminate spasms and improve blood circulation, so that the trophism of the interarticular discs is not disturbed. To prevent the development of physical inactivity in sedentary work, it is necessary to periodically warm up and perform the exercises indicated for the prevention of osteochondrosis.