Osteochondrosis is a common degenerative-dystrophic lesion that affects the intervertebral discs, adjacent vertebrae, and nearby ligaments.
This disease does not develop instantly, it develops over years, while its 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 signs yet;
- Stage II – the nucleus pulposus continues to deteriorate, the disc height decreases, the fibrous rings "dry out", the affected intervertebral joints become unstable, and to compensate, the back muscles are in constant tension, causing pain and "overwork", signs of osteochondrosisvisible on x-rays;
- Stage III – the disc ruptures, the prolapsed nucleus pulposus forms a hernia, this stage is characterized by many neurological symptoms, inflammation and edema;
- Stage IV – adjacent joint elements are involved in the lesion.
Spinal osteochondrosis can also occur in different parts of the spine and, depending on this, has 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 chest organs;
- waist - the most common type due to the greatest mobility of this part and the load placed on it;
- general - involving several parts (for example, cervicothoracic).
Reasons for the development of osteochondrosis
There is no comprehensive theory that can fully explain the causes of this disease. It is multifactorial, therefore, a predisposition is needed 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 common causes of osteochondrosis in men;
- spinal cord injury;
- sharp, uneven jerks, body bending, turning;
- sedentary work, lack of physical activity;
- constant repetitive movements (carrying a bag on the same shoulder, tilting the head to the ear when talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male gender (osteochondrosis is less common in women);
- overweight and tall;
- developmental disorders of the musculoskeletal system, weakness of the back muscles;
- poor posture;
- foot diseases (arthrosis, flat feet);
- violation of the trophism of intervertebral joints;
- pathology of internal organs.
Symptoms of osteochondrosis
Typical signs of this disease: pain in the spine and muscles at rest, limitation of movement, "fatigue" of the affected area. The patient tries to "unload" them by leaning back in a chair, leaning on his hands, trying not to stand for a long time, or by rubbing and squeezing them, relieving muscle tension. Depending on the location, the pain may be slightly different, and new, more specific symptoms will be added.
With cervical osteochondrosis, unpleasant sensations will occur in the occipital region or the neck itself, increasing when the head is tilted or turned. Due to pinched nerve roots, tingling or burning may appear in the fingers and palms, and with more serious damage, movement is hampered.
However, the main danger in this case is that near the spine in this area there are important arteries that supply blood to the brain. Gradually it becomes squeezed, so this type of osteochondrosis is characterized by dizziness and "spots" before the eyes due to lack of nutrition in the main organs of the body.
Among all types of osteochondrosis, damage to the thoracic region is less common than other types and difficult to diagnose. Pain in this area is similar to heart, lung, esophageal or neuralgia pain. Therefore, patients first turn to a cardiologist, gastroenterologist or pulmonologist, for a long time avoiding doctors of the specialty they need, until all other pathologies are excluded, or thoracic osteochondrosis is suspected. Discomfort is localized between the shoulder blades, worsened by bending over, you may experience a feeling of a lump in your throat or difficulty breathing, and numbness in the chest.
The most common and most typical type is lumbar osteochondrosis. The symptom most often associated with this disease: aching pain in the area of the same name, which increases 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 predispositions, external and internal risk factors, the relationship of symptoms and the development of lesions.
The inspection consists of:
- neuro-orthopedics, in which the static and dynamic function of the spine is assessed (posture, the presence of scoliosis, muscle tone and range of motion of the intervertebral joints and limbs);
- neurological – determination of vertebrogenic reflex and compression 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 X-ray examination (discography, venospondylography), which reveals the narrowing of the intervertebral discs, the degree of herniation. bulges, and the condition of blood vessels. More informative magnetic resonance imaging is used less frequently, with which you can accurately assess the degree of damage to the intervertebral discs, 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 computer tomography, which determines the condition of the spine itself, the spinal canal, and calcification of the ligaments.
Treatment of osteochondrosis
First of all, it is necessary to reduce as much as possible the risk factors discovered by the doctor during the examination. Eliminate axial loads, limit the weight of objects carried, sometimes change traumatic jobs related to physical work, lose weight if you are overweight, include minimal exercise in your daily schedule if you are not physically active. This will only help to slightly reduce the level of pain from osteochondrosis and the risk of complications, although it will not slow down its progression.
Treatment should be comprehensive and combine not only treatment methods, but also various types of effects on the spinal muscles and the spine itself. You can't just take pills for osteochondrosis 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 sure that the patient is performing the indicated exercises correctly. Different localization of lesions implies different complexes aimed at maintaining the back muscles, improving blood circulation and trophism of the intervertebral discs and the spine itself, as well as reducing their friction.
Therapeutic massage also has a beneficial effect on the course of osteochondrosis, physiotherapy, manual therapy, acupuncture, osteopathy and hardware traction of the spine are carried out with caution. The course of treatment and its methods are determined by the doctor based on the degree of development of the lesion, painful manifestations and the individual characteristics of each particular case.
Prevention of osteochondrosis
If timely measures are taken to prevent the progression of the disease, then treatment may no longer 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, get adequate nutrition with all the necessary vitamins, andregularly do supportive exercise (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 orthopedic doctor or neurologist about this.
But even regular morning exercises will help maintain muscle tone, relieve spasms and improve blood circulation so that the trophism of the inter-articular discs is not disturbed. To avoid the development of physical activity during sedentary work, it is necessary to periodically warm up and perform exercises indicated for the prevention of osteochondrosis.