Osteochondrosis is a common degenerative-dystrophic lesion that affects the intervertebral discs, adjacent vertebrae and surrounding ligaments.
The disease does not develop immediately, progresses over several years, while the onset can occur at a fairly early 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 degenerate, the disc height decreases, the fibrous ring "dries up", the affected intervertebral joint becomes unstable, and to compensate for this, the back muscles remain in constant tension, leading toThere is pain and " overwork", signs of osteochondrosis appear on the X-ray;
- Stage III – the disc ruptures, the prolapsed nucleus pulposus forms a hernia, the stage is characterized by an abundance of neurological symptoms, swelling and edema;
- Stage IV – Adjacent elements of the joint are involved in the lesion.
Osteochondrosis of the spine can also occur in different parts of the spine and has different names depending on it:
- Cervical – often localized between the fifth and seventh cervical vertebrae (the most mobile joint);
- Chest - a type manifested by pain, which can be confused with diseases of other organs of the chest;
- Lumbar – the most common type due to the greatest mobility of this section and the load placed on it;
- General – involving multiple sections (for example, cervicothoracic).
Reasons for the development of osteochondrosis
There is no single comprehensive theory that could fully explain the cause of this disease. It is multifactorial, therefore, a predisposition is necessary as a trigger, and for its manifestation – a complex of internal and external stimuli.
Exogenous risk factors:
- Excessive stress, physical exertion, 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 towards your ear while talking on the phone);
- climatic conditions.
Endogenous risk factors:
- Male gender (osteochondrosis occurs less often in women);
- overweight and tall;
- Developmental abnormalities of the musculoskeletal system, weakness of the back muscles;
- poor posture;
- Foot diseases (arthrosis, flat feet);
- Violation of trophism of intervertebral joints;
- Deformity of internal organs.
Symptoms of osteochondrosis
Typical symptoms of this disease: pain in the spine and muscles at rest, decreased activity, "fatigue" of the affected area. The patient either leans back on a chair, leans on his hands, tries not to stand on his feet for a long time. Tries to "get it off" by rubbing or kneading it, relieving muscle tension. Depending on the location, the pain may vary slightly, and new, more specific symptoms are added.
With cervical osteochondrosis, unpleasant sensations will arise in the occipital region or the neck itself, which will intensify when tilting or turning the head. Tingling or burning sensation may appear in the fingers and palms due to compression of the nerve roots, and with more severe damageThere may be restrictions in their movement.
But the main danger of this case is that in this area near the spine there are important arteries that supply blood to the brain. Gradually they begin to prick, so this type of osteochondrosis leads to insufficient nutrition of the main organ in the body. This causes dizziness and "spots" before the eyes.
In all types of osteochondrosis, damage to the thoracic region is less common than others and is difficult to diagnose. Pain in this region is similar to cardiac, pulmonary, esophageal pain or neuralgia. Therefore, patients first consult cardiologists. , turn to a gastroenterologist or pulmonologist, avoiding doctors of those specializations for a long time, until all other pathologies are excluded, or thoracic osteochondrosis is suspected. Discomfort between the shoulder bladesIs localised, worsens on bending, you may experience a lump in the throat or difficulty breathing and numbness in the chest.
The most common and most characteristic type is lumbar osteochondrosis. Its symptoms are often associated with this disease: pain in the area of the same name, which intensifies when turning, bending or standing for a long time and extends to one or both legs. Can spread.
Diagnosis of osteochondrosis
The doctor begins by collecting complaints and history (family, life and illness), analyzing predispositions, the presence of external and internal risk factors, the relationship of symptoms and the progression of the lesion.
Inspection includes:
- Neuro-orthopedic, during which the static and dynamic functions of the spine are evaluated (posture, presence of scoliosis, muscle tone and range of motion of the intervertebral joints and limbs);
- Neurological - reflex and compression vertebrogenic syndrome, determination of the quality of motor and sensory functions, 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 that reveal narrowing of the intervertebral disc, hernialReveals. protrusion, and the condition of blood vessels. Slightly less often, more informative magnetic resonance imaging is used, with which you can determine 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 prohibited, it is replaced by computed tomography, which determines the condition of the vertebrae, spinal canal and ligament calcifications themselves.
Treatment of osteochondrosis
First of all, it is necessary to reduce as much as possible the risk factors discovered by the doctor during the survey. Remove axial loads, limit the severity of objects, replace sometimes painful jobs associated with physical labor, if your weightIf it is high, lose weight, if you are physically inactive then include minimal sports in your daily schedule. This will only help to slightly reduce the degree of pain caused by osteochondrosis and the risk of complications, although it will also slow down its progression. will hardly slow down.
Treatment should be comprehensive and include not only drug methods, but also a variety of effects on the vertebral muscles and spinal column. You cannot 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.
For osteochondrosis, exercise therapy is indicated, which is first carried out in a special hospital room so that the doctor is convinced that the patient is performing the indicated exercises correctly. Different localization of the lesion implies back muscles. It consists of various complexes aimed at maintaining, improving blood circulation and trophism of intervertebral discs and vertebrae and reducing 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 depending on the degree of development of the lesion, the manifestation of pain and the individual characteristics of each specific case. Are.
Osteochondrosis prevention
If you take timely measures to prevent the development of the disease, its treatment may never be necessary. This should also be comprehensively considered: reduce the listed risk factors in advance (before the discomfort appearsAlready), try to distribute the load evenly, monitor posture from childhood, get adequate nutrition with all the necessary vitamins, and regularly engage in supporting sports (for example, swimming).
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 orthopedic surgeon or neurologist about these.
But general morning exercises will also help maintain muscle tone, relieve cramps and improve blood circulation so that the trophism of the interarticular disc is not disturbed. To avoid the development of physical inactivity in sedentary work, periodicallyIt is necessary to warm up and do the exercises prescribed for the prevention of osteochondrosis.