Osteochondrosis is a common degenerative-dystrophic lesion affecting intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop instantly, progressing 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 fibrous ring and intradiscal movement of the nucleus pulposus, but there are no radiological signs yet;
- Stage II – the nucleus pulposus continues to deteriorate, the height of the disc decreases, the fibrous ring "dries out", 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, have different names:
- cervical - most often localized 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 organs of the chest;
- lumbar - the most common type due to the greatest mobility of this section and the load placed on it;
- common - involving several sections (for example, cervicothoracic).
Reasons for the development of osteochondrosis
There is no one 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;
- spinal injuries;
- sharp and uneven jerks, body bends, 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 frequently in women);
- overweight and tall;
- developmental abnormalities of the musculoskeletal system, weakness of the back muscles;
- poor 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, limitation in movements, "fatigue" of the affected area. The patient tries to either "unload" it by 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 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 occur in the occipital region or the neck itself, intensifying when tilting or turning the head. Due to pinching of the nerve roots, tingling or burning may appear in the fingers and palms, and with more serious damage, restriction in their movement.
But the main danger of the case is that near the spine in this area there are important arteries that supply blood to the brain. Gradually they become pinched, so this type of osteochondrosis is characterized by dizziness and "spots" before 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 is 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, long avoiding doctors of the specialization they need, until all other pathologies are excluded, or thoracic osteochondrosis is suspected. Discomfort is localized between the shoulder blades, intensifies when bending over, you may experience a feeling of a lump in the throat or difficulty breathing, and 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 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 of symptoms and progression of the lesion.
The inspection consists of:
- neuro-orthopedic, during which the static and dynamic functions of the spine are assessed (posture, the 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 narrowing of the intervertebral discs, the level of hernial protrusion, and the condition of the blood vessels. A little less often, more informative magnetic resonance imaging 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 with computed tomography, which determines the condition of the vertebrae themselves, the spinal canal, and ligament calcification.
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 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 vertebral muscles and the spinal column itself. You can’t just take pills for osteochondrosis on your own and hope for healing; any 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.
For osteochondrosis, exercise therapy is indicated, which is first carried out in a special hospital room so that the doctor is convinced that the patient is performing 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 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 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, monitor posture from childhood, receive adequate nutrition with all the necessary vitamins, and regularly 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 about them.
But even ordinary morning exercises 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.