Osteochondrosis is a common degenerative dystrophic lesion that affects intervertebral discs, adjacent vertebrae and nearby ligaments.
The disease does not develop instantly, progressing over many years, although the onset can occur at a fairly young age (18-20 years) and has several stages:
- Stage I – "fissures" in the fibrous ring and intradiscal movement of the nucleus pulposus, but still without radiological signs;
- 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 for this, the back muscles are in constant tension, causing pain and "overwork", signs of osteochondrosis are visible on x-rays;
- Stage III – the disc ruptures, the prolapse of the nucleus pulposus forms a hernia, the stage is characterized by an abundance of neurological symptoms, inflammation and edema;
- Stage IV – adjacent elements of the joint are involved in the injury.
Osteochondrosis of the spine can also occur in different parts of the spine and, depending on this, have different names:
- cervical - most often located between the fifth and seventh cervical vertebrae (the most mobile joint);
- chest - a variant that manifests itself as pain, which can be confused with diseases of other chest organs;
- lumbar - the most common type due to the greater mobility of this section and the load placed on it;
- common - involving several sections (e. g. cervicothoracic).
Reasons for the development of osteochondrosis
There is no comprehensive theory that completely explains the cause 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 work, occupational hazards (moving heavy objects) are common causes of osteochondrosis in men;
- Spine injuries;
- sudden and irregular jerks, bending of the body, turning;
- sedentary work, physical inactivity;
- constant repetitive movements (carrying a bag on the same shoulder, tilting your head to your ear when talking on the phone);
- climate conditions.
Endogenous risk factors:
- male sex (osteochondrosis occurs less frequently in women);
- overweight and tall;
- developmental anomalies of the musculoskeletal system, weakness of the back muscles;
- poor posture;
- leg diseases (arthrosis, flat feet);
- violation of the trophism of intervertebral joints;
- pathologies of internal organs.
Osteochondrosis symptoms
Typical signs of this disease: pain in the spine and muscles at rest, limitation of movement, "fatigue" in the affected area. The patient tries to "unload" it by leaning back in the chair, leaning on his hands, trying not to stand for too long, or by rubbing and kneading, relieving muscle tension. Depending on the location, the pain may vary slightly and new, more specific symptoms may be added.
With cervical osteochondrosis, unpleasant sensations will occur in the occipital region or in the neck itself, intensifying when tilting or turning the head. Due to compression of the nerve roots, tingling or burning may appear in the fingers and palms and, in the case of more serious injuries, restriction of 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. Little by little they become compressed, which is why this type of osteochondrosis is characterized by dizziness and "spots" before the eyes due to insufficient nutrition of the main organ of 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, esophageal pain, 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 excluded or thoracic osteochondrosis is suspected. The discomfort is located between the shoulder blades, intensifies when bending over, you may feel a lump in your throat or difficulty breathing and numbness in your chest.
The most common and typical type is lumbar osteochondrosis. Its symptoms are most often associated with this disease: pain in the region of the same name, which intensifies 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 illness), which analyzes the presence of predisposition, external and internal risk factors, list of symptoms and progression of the injury.
Inspection consists of:
- neuroorthopedic, during which the static and dynamic functions of the spine are assessed (posture, presence of scoliosis, muscle tone and range of movement of intervertebral joints and limbs);
- neurological – determination of 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) are non-contrast and contrast-enhanced X-ray studies (discography, venospondylography) that reveal narrowing of the intervertebral discs, hernia level protrusion and the condition of blood vessels. A little less often, a more informative MRI is used, with 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, 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 ligament calcification.
Treatment of osteochondrosis
First of all, it is necessary to reduce as many risk factors discovered by the doctor during the examination as possible. Eliminate axial loads, limit the gravity of transported objects, 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 will only help to slightly reduce the degree of pain due to osteochondrosis and the risk of complications, although it will hardly slow down its progression.
Treatment should be comprehensive and combine not only medicinal 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 expect a cure; 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 can be sure that the patient is correctly performing the indicated exercises. The different location of the injury implies different complexes that aim to maintain the back muscles, improve blood circulation and trophism of the intervertebral discs and the vertebrae themselves and reduce 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 carried out with caution. The course of treatment and its methods are determined by the doctor based on the degree of evolution of the injury, the manifestation of pain 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. This must 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, receive adequate nutrition with all the necessary vitamins and regularly play sports support (e. g. 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 them.
But even ordinary morning exercises help maintain muscle tone, relieve spasms and improve blood circulation, so the trophism of the interarticular discs is not disturbed. To avoid the development of a sedentary lifestyle during sedentary work, it is necessary to carry out periodic warm-ups and perform exercises recommended for the prevention of osteochondrosis.