Osteochondrosis is a common degenerative-dystrophic lesion affecting intervertebral discs, adjacent vertebrae, and adjacent ligaments.
The disease does not develop immediately but progresses over many years. The onset can occur at a relatively young age (18-20 years) and progresses in several stages:
- Stage I – "tears" 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 intervertebral disc decreases, the fibrous ring "dries out", the affected intervertebral joint becomes unstable and, to compensate, the back muscles are under constant tension, which leads to pain and "overload", which can be seen on x-raysto recognize signs of osteochondrosis;
- Stage III - the intervertebral disc ruptures, the prolapsed nucleus pulposus forms a hernia, the stage is characterized by a plethora of neurological symptoms, inflammation and edema;
- Stage IV – adjacent articular elements are affected by the lesion.
Osteochondrosis of the spine can also occur in different parts of the spine and has different names depending on this:
- cervical – most often located between the fifth and seventh cervical vertebrae (the most mobile joint);
- Breast – a variant that manifests itself as pain and can be confused with diseases of other chest organs;
- Lumbar vertebrae – the most common type due to the greatest mobility of this section and the load placed on it;
- common – involved in multiple sections (e. g. cervicothoracic).
Reasons for the development of osteochondrosis
There is no comprehensive theory that fully explains the cause of this disease. It is multifactorial, therefore it requires a predisposition as a trigger and a complex of internal and external stimuli for its manifestation.
Exogenous risk factors:
- Excessive stress, physical work and occupational risks (moving heavy objects) are a common cause of osteochondrosis in men.
- vertebral acid injuries;
- sharp and uneven shocks, body bends, turns;
- sedentary work, physical inactivity;
- constant, repetitive movements (carrying a bag on the same shoulder, tilting the head toward the ear while talking on the phone);
- Climatic conditions.
Endogenous risk factors:
- male gender (osteochondrosis occurs less often in women);
- overweight and tall;
- Developmental disorders of the musculoskeletal system, weakness of the back muscles;
- bad posture;
- Leg diseases (arthrosis, flat feet);
- Violation of trophism of the intervertebral joints;
- Pathologies of internal organs.
Symptoms of osteochondrosis
Typical signs of this disease: pain in the spine and muscles at rest, limitation of movement, "tiredness" of the affected area. The patient tries to "unload" it either by leaning back on a chair, leaning on his hands andtrying not to stand on your feet for long periods of time, or by rubbing and kneading it to relieve muscle tension. Depending on the location, the pain may vary slightly and new, more specific symptoms may arise.
With cervical osteochondrosis, unpleasant sensations occur in the back of the head or in the neck itself, which increase when tilting or turning the head. Due to the pinching of the nerve roots, there may be tingling or burning in the fingers and palms and, if the damage is more severe, there may be restricted movement.
However, the main danger 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" in front of the eyes due to insufficient nutrition of the main organ in the body.
In all types of osteochondrosis, damage to the chest area is less common than in others and is difficult to diagnose. Pain in this area is similar to heart, lung, esophageal pain or neuralgia. Therefore, patients first turn to cardiologists, gastroenterologists or pulmonologists and avoid doctors in the specialty they need for a long time until all other pathologies are ruled out or thoracic osteochondrosis is suspected. The discomfort is localized between the shoulder blades, increases when bending over, there may be a feeling of a lump in the throat or difficulty breathing, as well as numbness in the chest.
The most common and typical form is lumbar osteochondrosis. Its symptoms are most often associated with this disease: aching pain in the eponymous area, which increases when turning, bending or standing for a long time and can radiate to one or both legs.
Diagnosis of osteochondrosis
The doctor first collects complaints and anamnesis (family, life and illness), which analyzes the presence of a predisposition, external and internal risk factors, the relationship between symptoms and progression of the lesion.
The inspection consists of:
- Neuroorthopedics, in which the static and dynamic functions of the spine are assessed (posture, presence of scoliosis, muscle tone and range of motion of the intervertebral joints and limbs);
- Neurological – determination of 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 (discography, venospondylography) X-ray studies, which reveal narrowing of the intervertebral discs, the level of rupture, protrusion and the condition of blood vessels. Slightly less often, more informative magnetic resonance imaging is used, which allows you to 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 ligamentous calcification.
Treatment of osteochondrosis
First of all, it is important to reduce as many risk factors as possible, which the doctor identifies during the examination. Eliminate axial loads, limit the weight of objects carried, sometimes change traumatic jobs associated with physical work, lose weight if you are overweight, include minimal sports in your daily schedule if you are physically inactive. This only slightly reduces the extent of pain from osteochondrosis and the risk of complications, but hardly slows its progression.
Treatment must be comprehensive, combining not only drug methods, but also various types of effects on the vertebral muscles and the spine itself. You can't just take pills for osteochondrosis on your own and hope for a cure; all procedures and medications can only be prescribed by a neurologist. The specialist bases his recommendations on the individual 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 initially carried out in a special hospital room so that the doctor is satisfied that the patient is performing the specified exercises correctly. Different localization of the lesion implies different complexes aimed at preserving the back muscles, improving blood circulation and trophism of the intervertebral discs and vertebrae themselves, and reducing their friction.
Therapeutic massage also has a positive effect on the course of the disease in 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, the severity of pain and the individual characteristics of each case.
Prevention of osteochondrosis
If you take timely measures to prevent the development of the disease, treatment may never be necessary. This should also be approached comprehensively: reduce the listed risk factors in advance (even before symptoms appear), try to distribute the load evenly, monitor posture from childhood, receive adequate nutrition with all the necessary vitamins and exerciseregular supportive sports (e. g. swimming).
In order to prevent the development of osteochondrosis, gymnastics plays an important role: there are special exercises that relieve the load on the spine. For this you can consult an orthopedist or neurologist.
But even ordinary morning exercises help maintain muscle tone, relieve spasms and improve blood circulation, so the trophism of the intervertebral discs is not disturbed. To avoid the development of physical inactivity during sedentary work, it is necessary to regularly warm up and perform exercises suitable for the prevention of osteochondrosis.