Osteochondrosis is a common degenerative-dystrophic lesion that affects the intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop immediately, progressing over many years, while the onset can occur at a fairly young age (18-20 years old) and has several stages:
- Stage I – "crack" in the annulus fibrosus and intradiscal movement of the nucleus pulposus, but still no radiological signs;
- Phase 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 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, depending on this, has different names:
- cervical - most often 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 chest organs;
- middle - the most common type due to the greater mobility of this section and the load placed on it;
- common - involving several sections (for example, cervicothoracic).
Causes of 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 cause, and for its occurrence - a complex of internal and external stimuli.
Exogenous risk factors:
- excessive stress, physical work, occupational hazards (moving heavy objects) are a common cause of osteochondrosis in men;
- spinal cord injuries;
- sharp and uneven vibrations, 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 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
Typical signs of this disease: pain in the back and muscles at rest, restriction of movement, "fatigue" of the affected area. The patient tries to either "discharge" it by leaning on a chair, leaning on his hands, trying not to stand for a long time, or by rubbing and cooking, relieving muscle tension. Depending on the location, the pain may change slightly and new, more specific symptoms are added.
With cervical osteochondrosis, unpleasant sensations will occur in the occipital region or in the neck itself, intensifying when you tilt or turn your head. Due to compression of the nerve roots, tingling or burning sensations may appear in the fingers and palms, and with more serious damage, limitation of 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 tight, 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 chest region is less common than others and is difficult to diagnose. Pain in this area is similar to cardiac, pulmonary, esophageal or neuralgia pain. Therefore, patients first turn to cardiologists, gastroenterologists or pulmonologists, avoiding for a long time the doctors of the specialization they need, until all other pathologies are excluded or thoracic osteochondrosis is suspected. The discomfort is localized between the shoulder blades, intensifies when you bend 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. 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 disease), which analyzes the presence of predisposition, external and internal risk factors, symptom relationships and the progression of the lesion.
The inspection 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 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 the narrowing of the intervertebral discs, the level ofhernias. length and condition of blood vessels. A little less often, the more informative magnetic resonance image 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 vertebra itself, 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 severity of objects carried, sometimes change traumatic jobs related to 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 progress.
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 can't just take pills for osteochondrosis and hope for recovery; any procedure and medication 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.
For osteochondrosis, exercise therapy is indicated, which is initially carried out in a special hospital room, so that the doctor is convinced that the patient is performing the indicated exercises correctly. The different localization of the lesion means different complexes aimed at preserving the back muscles, improving blood circulation and trophism of the intervertebral discs and vertebrae themselves, as well as 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 carried out carefully. 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 measures in time to prevent the development of the disease, then its treatment may never be necessary. This should also be treated comprehensively: reduce the listed risk factors in advance (even before the discomfort appears), try to distribute the load evenly, monitor the posture from childhood, get adequate food 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 back. You can consult an orthopedist or neurologist for them.
But even the usual exercises in the morning will help maintain muscle tone, relieve spasms and improve blood circulation so that the trophism of the interarticular discs is not disturbed. 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.