Osteochondrosis is a common degenerative-dystrophic lesion affecting the intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop instantly, it progresses for many years, while it can start at a relatively young age (18-20 years) and has several stages:
- Stage I – "cracks" in the fibrous ring and intradiscal movement of the pulp nucleus, but there are no radiological signs yet;
- Stage II - the pulp core continues to disappear, the height of the disc decreases, the fibrous ring "dries up", the damaged intervertebral joint becomes unstable, and to compensate for this, the back muscles are constantly under tension, causing pain and "overwork", X-rays show signs of osteochondrosis;
- Stage III – the disc ruptures, the nucleus of the pulp that has fallen out forms a hernia, the stage is characterized by an abundance of neurological symptoms, inflammation, edema;
- Stage IV – adjacent elements of the joint are involved in the damage.
Spinal osteochondrosis can also occur in different parts of the spine and, depending on it, have different names:
- cervix - usually localized between the fifth and seventh cervical vertebrae (the most mobile joint);
- chest - a variant manifested by pain that can be confused with diseases of other chest organs;
- lumbar - the most common type due to the greatest mobility of this section and the load on it;
- common - involving several departments (for example, neck and chest).
Reasons for the development of osteochondrosis
There is no single comprehensive theory that fully explains the cause of this disease. It is multifactorial, so a tendency is necessary as a trigger, and a complex of internal and external stimuli is necessary for its manifestation.
Exogenous risk factors:
- excessive stress, physical work, 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 while talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male gender (osteochondrosis occurs less often in women);
- overweight and tall;
- abnormalities in the development of the musculoskeletal system, weakness of the back muscles;
- bad posture;
- leg diseases (arthrosis, flat feet);
- violation of intervertebral joint trophism;
- pathologies of internal organs.
Symptoms of osteochondrosis
Typical signs of this disease: pain in the spine and muscles at rest, restriction of movement, "fatigue" of the affected area. The patient tries to "unload" it by leaning on a chair, leaning on his hands, trying not to stand on his feet for a long time, or by rubbing and kneading, releasing muscle tension. Depending on the location, the pain may vary slightly, and new, more specific symptoms appear.
With cervical osteochondrosis, unpleasant sensations will appear in the back of the head or in the neck itself, which will intensify when tilting or turning the head. Pinching of the nerve roots can cause tingling or burning in the fingers and palms, and in more serious cases, 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 blood to the brain. They are gradually compressed, so this type of osteochondrosis is characterized by dizziness and "spots" in front of the eyes due to insufficient nutrition of the main body organ.
Among all types of osteochondrosis, lesions of the chest are rarer than others, which makes them difficult to diagnose. Pain in this area is similar to heart, lung, esophagus or neuralgia. Therefore, patients first turn to cardiologists, gastroenterologists or pulmonologists, avoiding doctors of the specialization they need for a long time, until all other pathologies are eliminated or thoracic osteochondrosis is suspected. Discomfort is localized between the shoulder blades, intensifies when bending over, may feel a lump in the throat or difficulty in breathing, 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 is aggravated by rolling over, bending over 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 diseases), during which he analyzes the predisposition, external and internal risk factors, the relationship of 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, the presence of scoliosis, muscle tone and the 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 method of diagnosing osteochondrosis of any part of the spine (cervical, thoracic or lumbar) is non-contrast and contrast (discography, venospondylography) X-ray studies that reveal the narrowing of intervertebral discs, the level of herniation. protrusion and vascular status. A more informative magnetic resonance examination is used a little less often, which 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 calcification of the ligaments.
Treatment of osteochondrosis
First of all, it is necessary to reduce as many risk factors as possible, which are determined by the doctor during the survey. Eliminate axial loads, limit the weight of the objects you carry, sometimes replace traumatic jobs related to physical labor, lose weight if you are overweight, include as little sports as possible 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 is unlikely to 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 spine itself. You can't just take pills for osteochondrosis and expect recovery, any procedures and drugs 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.
In the case of osteochondrosis, exercise therapy is prescribed, which is first performed in a special hospital room so that the doctor can make sure that the patient performs the indicated exercises correctly. Different localization of the damage means different complexes aimed at supporting the back muscles, improving blood flow and trophism of the intervertebral discs and the vertebrae themselves, reducing their friction.
Therapeutic massage also has a positive effect on the course of osteochondrosis, carefully performed physiotherapy, manual therapy, acupuncture, osteopathy, spinal traction. The course of treatment and its methods are determined by the doctor, taking into account 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, its treatment may never be needed. It should also be looked at in a complex way: reduce the listed risk factors in advance (even before discomfort appears), try to evenly distribute the load, monitor posture from childhood, get proper nutrition with all the necessary vitamins, regularly engage in supportive sports (e. g. , for example, swimming). .
In order 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.
However, even the usual morning exercises will help maintain muscle tone, relieve spasms and improve blood circulation so that the trophism of the interarticular discs is not disturbed. In order to avoid physical inactivity during sedentary work, it is necessary to periodically warm up and perform exercises for the prevention of osteochondrosis.