Osteochondrosis is a common degenerative-dystrophic lesion affecting the intervertebral discs, adjacent vertebrae and ligaments.
The disease does not develop immediately, it develops over many years, and the onset can occur at a young age (18-20 years old) and consists of 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 core pulp continues to deteriorate, the height of the disc decreases, the fibrous ring "dry", the damaged intervertebral joint becomes unstable, and to compensate for this, the back muscles are constantly tense, causing pain and "overwork", X-rays show signs of osteochondrosis;
- Stage III - the disc ruptures, the prolapsed nucleus pulposus forms a hernia, the stage is characterized by a large number of neurological symptoms, inflammation and swelling;
- Stage IV - adjacent elements of the joint are affected by the injury.
Osteochondrosis of the spine can occur in different parts of the spine and has different names accordingly:
- cervical - usually localized between the fifth and seventh cervical vertebrae (the most mobile joint);
- chest - a variant that appears with pain that can be confused with diseases of other organs of the chest;
- the waist is the most common type due to the maximum mobility of the section and the load placed on it;
- general - includes several sections (for example, cervicothoracic).
Reasons for the development of osteochondrosis
There is no complete theory that fully explains the cause of this disease. It is multifactorial, therefore, it is necessary to treat it as a trigger, and for its appearance - a complex of internal and external stimuli.
Exogenous risk factors:
- excessive stress, physical work, occupational hazards (moving heavy objects) are common causes of osteochondrosis in men;
- spinal injuries;
- sharp and uneven swings, body bends and twists;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on one shoulder, tilting the head to the ear while talking on the phone);
- climatic conditions.
Endogenous risk factors:
- male gender (osteochondrosis is rare in women);
- overweight and tall;
- disorders of the development of the musculoskeletal system, weakness of the back muscles;
- ugly appearance;
- foot diseases (arthrosis, flat feet);
- trophism of intervertebral joints;
- Pathology of internal organs.
Symptoms of osteochondrosis
Typical symptoms of this disease are: pain in the spine and muscles at rest, limitation of movements, "scattering" of the affected area. The patient leans on a chair, leans on his hands, tries not to stand on his feet for a long time, or relieves muscle tension, rubs, and tries to get off the dough. Depending on the location, the disease changes a little, and new, special symptoms are added.
With cervical osteochondrosis, unpleasant sensations appear in the nape of the neck or in the neck itself, which are aggravated when the head is bent or turned. Pinching of the nerve roots may cause tingling or burning in the fingers and palms, and may limit their movement with serious damage.
But the main danger of the work is that in this area near the spine 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, lesions of the chest region are less common than others and difficult to diagnose. Pain in this area is similar to heart, lung, esophagus or neuralgia. Therefore, patients are primarily referred to cardiologists, gastroenterologists, or pulmonologists, who avoid doctors of the necessary specialty for a long time, until all other pathologies are eliminated, or there is no doubt about thoracic osteochondrosis. The discomfort is localized between the shoulder blades, intensifies when you bend down, you may experience a feeling of a sore throat or difficulty breathing, and enlargement of the chest.
The most common and most typical type is lumbar osteochondrosis. Its symptoms are often associated with this disease: pain in the same area that radiates to one or both legs, worsens when turning, bending, or standing for a long time.
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, correlation 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, presence of scoliosis, muscle tone and range of motion of intervertebral joints and legs);
- determination of neurological - 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 without contrast (discography, venospondylography), which determine the narrowing of the intervertebral discs and the level of herniation. origin, condition of blood vessels. A slightly smaller, more informative magnetic resonance imaging is used, with the help of which it is possible to accurately assess the degree of damage to the intervertebral disc, the size of the hernia, the presence of compression of the spinal cord, vessels and surrounding tissues. If there is a contraindication to MRI, it is replaced by computed tomography, which determines the position of the vertebrae, the spinal canal, and calcification of the ligaments.
Treatment of osteochondrosis
First of all, it is necessary to reduce the risk factors as much as possible, identified by the doctor during the study. Eliminate axial loads, limit the weight of transported objects, change traumatic jobs that are sometimes associated with physical labor, lose excess weight, if you are not physically active, include a minimum of sports in your daily schedule. It helps to slightly reduce the degree of pain due to osteochondrosis and the risk of complications, but cannot slow down its progression.
Treatment should be comprehensive and include not only drug methods, but also various types of effects on the spinal muscles and the spinal cord itself. You cannot take anti-osteochondrosis pills on your own and hope for recovery, various 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 the treatment does not cause more suffering than the disease itself.
Exercise therapy for osteochondrosis is indicated, which is primarily carried out in a special room in the hospital, so the doctor is sure that the patient is performing the indicated exercises correctly. Any localization of lesions means different complexes aimed at maintaining the muscles of the back, improving blood circulation and trophism of intervertebral discs and vertebrae, as well as reducing their friction.
Therapeutic massage also has a good 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 of treatment and its methods are determined by the doctor depending on the degree of development of the disease, the appearance of the disease and the individual characteristics of each specific case.
Prevention of osteochondrosis
If timely measures are taken to prevent the development of the disease, treatment may never be necessary. It is also necessary to take a comprehensive approach: reduce the risk factors listed in advance (before discomfort occurs), try to evenly distribute the load, control posture from childhood, adequate nutrition with all the necessary vitamins and regularly engage in supportive sports (for example, in waterswimming).
Gymnastics plays an important role in preventing the development of osteochondrosis: there are special exercises that reduce the load on the spine. You can consult an orthopedist or a neurologist about them.
But regular morning exercises also help to maintain muscle tone, relieve spasms and improve blood circulation, so the trophism of the interarticular discs is not disturbed. In order to prevent the development of physical immobility in sedentary work, it is necessary to perform periodic warm-up and exercises indicated for the prevention of osteochondrosis.