Osteochondrosis is a common degenerative-dystrophic lesion affecting intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop instantly, it progresses over many years, but 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 no radiological findings 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, the back muscles are in constant tension, causing pain and "overwork", signs of osteochondrosis can be seen on the x-ray;
- Stage III - the disc ruptures, the prolapsed nucleus pulposus forms a hernia, the stage is characterized by numerous neurological symptoms, inflammation and edema;
- Stage IV: Neighboring 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, may have different names:
- cervical - located mostly between the fifth and seventh cervical vertebrae (the most mobile joint);
- chest - a variant that occurs with 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;
- common - involves several departments (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, so a predisposition is required as a trigger, and a complex of internal and external stimuli is required for its manifestation.
Exogenous risk factors:
- excessive stress, physical labor, occupational hazards (carrying heavy objects) are a common cause of osteochondrosis in men;
- spinal injuries;
- sharp and irregular jerks, body twists, turns;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on the same shoulder, tilting your head towards your ear while talking on the phone);
- climate conditions.
Endogenous risk factors:
- male gender (osteochondrosis is less common in women);
- overweight and tall;
- developmental abnormalities 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 symptoms of this disease: pain in the spine and muscles at rest, limitation of movements, "fatigue" of the affected area. The patient tries to "unload" it either by leaning on a chair, leaning on his hands, trying not to stand on his feet for a long time, or by relieving muscle tension by rubbing and kneading. Depending on location, pain may vary slightly and new, more specific symptoms are added.
With cervical osteochondrosis, unpleasant sensations will occur in the occipital region or in the neck itself and will intensify when the head is tilted or turned. Tingling or burning in the fingers and palms may occur due to compression of the nerve roots, and restriction of movements may occur with more serious damage.
However, the real danger of the case is that there are important arteries in this area near the spine that supply blood to the brain. They gradually compress, so this type of osteochondrosis is characterized by dizziness and "spots" before the eyes due to malnutrition 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 heart, lung, esophagus pain or neuralgia. Therefore, patients turn primarily to cardiologists, gastroenterologists or pulmonologists and for a long time avoid doctors of the specialty they need 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 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 spread to one or both legs.
Diagnosis of osteochondrosis
The doctor begins by collecting complaints and anamnesis (family, life and disease), analyzing the presence of predisposition, external and internal risk factors, relationship of symptoms and progression of the lesion.
The examination consists of:
- neuro-orthopedic, in which the static and dynamic functions of the spine are evaluated (posture, presence of scoliosis, muscle tone and range of motion of intervertebral joints and limbs);
- Determination of neurological – 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 X-ray studies without contrast and with contrast (discography, venospondylography), which reveal the narrowing of intervertebral discs, the level of hernia. protrusion and condition of blood vessels. Slightly 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 by computed tomography, which determines the condition of the vertebrae, spinal canal and ligament calcification.
Osteochondrosis treatment
First of all, it is necessary to reduce the risk factors discovered by the doctor during the examination as much as possible. Eliminate axial loads, limit the severity of carried objects, replace traumatic work sometimes associated with physical labor, lose weight if you are overweight, include at least sports in your daily schedule if you are not physically active. This will help only slightly reduce the degree of pain and the risk of complications from osteochondrosis, although it hardly slows down its progression.
Treatment should be comprehensive and combine not only drug methods, but also various effects on the vertebral muscles and the spine itself. You cannot take pills for osteochondrosis on your own and hope for recovery, 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 prescribed exercises correctly. Different localization of the lesion means different complexes aimed at protecting the back muscles, improving blood circulation and trophism of the intervertebral discs and vertebrae, 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 carefully performed. The course and methods of treatment are determined by the doctor based on the degree of development of the lesion, the occurrence of pain and the individual characteristics of each case.
Prevention of osteochondrosis
If you take timely measures to prevent the development of the disease, its treatment may never be necessary. This should also be approached comprehensively: reduce the listed risk factors in advance (even before the discomfort appears), try to distribute the load evenly, monitor your posture from childhood, receive adequate nutrition with all the necessary vitamins and regularly engage in supporting 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 these.
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 impaired. To prevent the development of physical inactivity in sedentary work, it is necessary to periodically warm up and perform the exercises specified for the prevention of osteochondrosis.