Osteochondrosis: causes, symptoms, treatment

Osteochondrosis is considered to be the most commonly diagnosed pathology of the spine. Several thousand new cases of the disease are registered every year. Experts attribute this to the sedentary lifestyle of the population.

For the prevention of the development of osteochondrosis, there are special recommendations, compliance with which will reduce the risk of exacerbation of the disease. When the first signs of spinal pathology appear, it is necessary to contact the doctor for diagnosis and subsequent treatment.

structure of the spine

Definition

Osteochondrosis is a degenerative-dystrophic disease of the spine that affects the intervertebral discs. The onset of pathology is possible at any age. Recently, there has been an increase in the detection of osteochondrosis due to the population's inactive lifestyle. Excessive stress on the spine during a sedentary lifestyle, performing hard physical work, with obesity, adversely affects the condition of the intervertebral discs. The combination of predisposing factors leads to a thinning of the surface of the vertebrae, the appearance of cracks and pathological growths. As a result, nutrition and microcirculation in the affected area of the spine are disrupted.

Symptoms of osteochondrosis in the initial stage of the development of the disease are characterized by mild severity. In this regard, there is a late call for medical help. The progression of the process leads to the destruction of the vertebrae, persistent pain syndrome, reduced sensitivity and difficulties in independent movement. To prevent the appearance of a severe stage of the disease, there are preventive recommendations to minimize the number of exacerbations of osteochondrosis of the spine.

There are currently various methods of treating degenerative-dystrophic diseases of the spine. The selection of therapy is carried out exclusively by the attending physician on the basis of a preliminary diagnosis of osteochondrosis.

causes

The main provoking factor in the development of osteochondrosis is the incorrect distribution of the load on the spine. This leads to changes in the structures of the cartilage. As the disease progresses, the vertebrae are destroyed.

In addition to the main cause of the disease, there are provoking factors, the presence of which increases the risk of osteochondrosis of the spine. These include:

  • Inactive lifestyle. Lack of physical activity leads to weakness of the muscle corset. The affected spine is not supported by the back muscles. At the same time, the severity of the clinical symptoms of the disease increases.
  • Scoliosis. The curvature of the spine precedes the development of osteochondrosis. Therefore, it is important to practice school posture.
  • Hard physical work. Daily dragging of heavy objects, lifting weights adversely affects the condition of the spine. Sudden movements can provoke an exacerbation of the disease. In addition, heavy physical activity is the cause of the development of intervertebral hernias.
  • Spine injury. Bruises, concussions, falls on the back increase the possibility of osteochondrosis of the spine.
  • Hormonal imbalance. Metabolic disorders interfere with nutrient absorption.
  • Hereditary burden. The presence of a predisposition to the onset of degenerative-dystrophic diseases increases the risk of developing osteochondrosis of the spine.
  • Frequent hypothermia.
  • Prolonged stay in a state of nervous tension.
  • Pregnancy. Multiple pregnancies shift the center of gravity of the body to a greater extent. With a weak muscular corset, the risk of dystrophic diseases of the spine increases.

neck pain with osteochondrosis

Symptoms

Clinical signs of osteochondrosis depend on the localization of the degenerative-dystrophic process. In accordance with this, there are:

  • Cervical osteochondrosis. It refers to the most frequent localization of the disease due to the high mobility of the vertebrae of the neck.
  • Thoracic osteochondrosis. It is detected less often than in cervical and lumbosacral osteochondrosis.
  • Lumbosacral osteochondrosis. This type of disease accounts for about 50% of all diagnosed cases.
Cervical osteochondrosis Thoracic osteochondrosis Lumbosacral osteochondrosis
Pain syndrome The localization of pain in osteochondrosis of the cervical spine is different. The most common pain syndrome is found in the cervical region, in the upper shoulder girdle. Headache and dizziness may occur. The severity of the clinical sign depends on the degree of degenerative-dystrophic disease of the spine. The severity of the pain can range from aching, pulling to stabbing, sharp. It intensifies with active movements or for a long time in an uncomfortable position. With thoracic osteochondrosis, pain radiates to the lower back, chest, shoulders For lumbosacral osteochondrosis, aching pains in the lower back are characteristic, radiating to the buttock and groin regions. Pain syndrome increases with stress on the spine. With prolonged flexion, the pain does not allow for extension movements.
Altered skin sensitivity The nerve roots are compressed under the influence of destructive vertebrae. There is a feeling of tingling and numbness in the affected area. A one-sided decrease or increase in skin sensitivity appears. These symptoms in thoracic osteochondrosis are expressed quite clearly. Skin sensitivity can be reduced or increased. Pinching of the nerve roots due to vertebral dystrophy leads to reduced sensitivity in the lumbar region, gluteal and lower extremities. This clinical sign can be expressed as an increase or decrease in skin sensitivity.
Muscle weakness A symptom of muscle weakness occurs due to compression of the spinal roots. Movement disorders appear in the arms and shoulders. Most often, the injury is one-sided. The defeat of the thoracic spine causes a weakening of the muscular corset. The muscles of the abdomen, lower limbs and back are most often affected. A decrease in muscle tone is accompanied by a decrease in tendon reflexes, a thinning of the muscle mass of the lower extremities. With the development of osteochondrosis, muscle atrophy occurs.
Circulatory disorders Vertebral artery syndrome occurs when an artery that supplies the brain becomes blocked. This is due to the unstable position of the vertebrae in the cervical spine. Symptomatic vertebral artery syndrome is manifested by dizziness, headache, nausea, heaviness in the head, tinnitus. Also, a lumpy feeling in the throat and reduced swallowing are extremely rare. Pain in the thoracic spine causes vascular spasm in the lower extremities. Symptomatically, this is expressed in "crawling banners", a tingling sensation and numbness in the legs. Osteochondrosis of the lumbosacral spine is characterized by impaired microcirculation in the affected area. This leads to whitening of the skin of the legs. In the future, seams develop, itchy pains in the lower limbs.
Vegetative disorders Compression of nerve fibers in the cervical spine leads to increased sweating of the skin, a change in its color. As the disease progresses, there are sharp burning pains in the extremities, edema syndrome. Pain in the thoracic spine causes vascular spasm in the lower extremities. Symptomatically, this is expressed in "crawling banners", a tingling sensation and numbness in the legs. This clinical symptom occurs due to compression of the nerve roots. In this regard, the lower limb acquires a bluish tint, sweating increases.

Degrees

The severity of clinical symptoms, as well as the methods of treatment of osteochondrosis of the spine, depend on the degree of its development. In accordance with this, there are:

Stage Clinical symptoms What happens to the spine?
The first The preclinical phase of spinal osteochondrosis does not present specific clinical symptoms. There may be slight discomfort in the back, fatigue with excessive physical exertion. In this regard, the detection of osteochondrosis in the first stage is extremely rare. Pathological changes in the spine are just starting to form. Their determination is possible with instrumental research.
The second one Severe pain appears in the affected area of the spine. It does not go away without taking painkillers. The pain syndrome increases with physical exertion. It is accompanied by stiffness of movements and limited mobility. This stage is accompanied by trophic disorders in the vertebrae. Their fibers begin to break down as the height of the intervertebral disc decreases. Such changes contribute to the compression of the nerve roots and blood vessels.
Third The pain syndrome becomes more intense. Irradiation of pain appears in other parts of the spine. Symptoms not only worsen with physical exertion, but also with prolonged standing or sitting. Sensitivity disorders may appear at this stage of spinal osteochondrosis. Protrusion appears due to the destruction of the fibrous ring of the vertebrae. The process spreads to the nerve fibers, causing them to pinch. Further development of the disease leads to hernia. In the third stage, the vertebrae can be displaced relative to each other.
Fourth Acute pain syndrome makes it difficult to move independently. There is a stable impairment of sensitivity, depending on the affected segment of the spine. The fourth stage of osteochondrosis is chronic and occurs with frequent relapses. The degree of degenerative-dystrophic processes reaches its maximum. There is irreversible destruction of the vertebrae and their displacement relative to each other. The chronic form of osteochondrosis is accompanied by the appearance of bone growths on the vertebrae, which lead to compression of the nerves and blood vessels.

Effects

Lack of treatment for osteochondrosis of the spine and failure to comply with the recommendations for its prevention contribute to the development of complications. This situation significantly worsens the prognosis for recovery. The main complications of osteochondrosis include:

  • Formation of hernia. It refers to the most commonly diagnosed complications of osteochondrosis. A herniated disc forms as a result of the displacement of the disc core outside the fibrous ring. The severity of the symptoms depends on the size and location of the formation. Most often, the hernia is complicated by the lumbosacral spine.
  • The appearance of the protrusions. This condition precedes the formation of a hernia of the spine. The protrusions arise in connection with trophic disorders in the vertebral region. This leads to a decrease in its height, elasticity and the appearance of cracks.
  • Radiculitis. Inflammation of the roots of the spinal cord occurs due to their pinching. Radiculitis is accompanied by severe pain and severe limitation of mobility. Also, sensory disturbances can occur.
  • Muscle atrophy of the limbs. A decrease in the muscle mass of the limbs occurs due to a violation of their blood supply.
  • Paralysis of the lower limbs. A severe degree of osteochondrosis is accompanied by severe degenerative-dystrophic changes of the vertebrae. This leads to pinching of the nerve roots. The extreme degree of reduced sensitivity of the limbs is their paralysis.
  • Spinal stroke. However, there is rarely a tendency to "rejuvenate" this diagnosis. Violation of blood circulation in the spine due to osteochondrosis can lead to the development of ischemia of the spinal cord.

The development of complications of osteochondrosis of the spine occurs quite often due to the late search for medical assistance. In this regard, experts recommend undergoing a diagnostic study in the presence of the first signs of the disease.

symptoms of osteochondrosis of the spine

Diagnostics

To identify the presence of osteochondrosis of the spine, specialists use laboratory and instrumental diagnostic methods. Among these are:

  • Collection of complaints and disease history. The main clinical manifestations of osteochondrosis, the time of onset of symptoms and predisposing factors for the development of the disease are clarified.
  • Inspection. Posture is examined to detect the presence of curvature of the spine. Next, the skin is examined to detect skin hyperemia in the affected area. With the help of palpation of the paravertebral points of the spine, the segment of the lesion is determined. A tingling with a needle is used to detect a violation of sensitivity.
  • X-ray examination. This method of studying osteochondrosis of the spine is one of the standard diagnostic measures. With its help, it is possible to determine the presence of narrowing of the intervertebral cracks, hernias and a decrease in the height of the vertebral disc.
  • CT, MRI. MRI is considered to be the most informative method of diagnosing vertebral disc herniation. With the help of MRI, the localization of the hernia and its size are determined.

The modern hospital has a full range of diagnostic tests needed to identify osteochondrosis of the spine. The latest equipment allows you to accurately diagnose the affected area, as well as the presence or absence of complications of degenerative-dystrophic disease. Based on the data obtained, experienced neurologists and vertebrologists prescribe an individual therapy, selected based on the stage of the disease.

Treatment

Treatment for degenerative-dystrophic diseases of the spine depends on the affected area. Common to all types of osteochondrosis is the following treatment:

  1. Pharmacological therapy.
  2. Physiotherapy.
  3. Massage.
  4. Physiotherapy.

Treatment for osteochondrosis aims to relieve symptoms. This is achieved thanks to the analgesic and anti-inflammatory action of drugs. The composition of osteochondrosis therapy includes:

  • Drug. To achieve an analgesic and anti-inflammatory effect, drugs from the NSAID group (non-steroidal anti-inflammatory drugs) are prescribed. Non-steroidal anti-inflammatory drugs can be used in the form of tablets, injectable or in the form of topical ointments. To relieve muscle spasm in osteochondrosis of the cervical spine, muscle relaxants are prescribed. Drugs in this group relieve muscle hypertonia that occurs in response to pain syndrome. In addition, the use of the chondroprotector course is included in the complex drug treatment of the disease. Their goal is to restore joint and cartilage tissue. Drugs of the chondroprotective group prevent further destruction of the vertebrae.
  • Physiotherapy. Complex therapy of osteochondrosis of the cervical spine includes physiotherapeutic procedures. To do this, appoint: Electrophoresis. Under the influence of a weak current, the transdermal penetration of the analgesic into the body occurs. Magnetotherapy. The procedure involves exposing the neck area to a low frequency magnetic field. Due to this, an analgesic and anti-inflammatory effect is achieved. Paraffin wraps. Therapeutic compresses are done to relieve pain and reduce inflammation.
  • Massage. The purpose of massage of the cervical neck area is to improve blood circulation in the affected area, relieve muscle tone and restore the trophism of the spine. Neck massage is contraindicated in the acute period. It must be included in the complex of treatment of osteochondrosis during the period when the clinical symptoms subside. The massage technique should be gentle and gentle, rough and painful movements are excluded.
  • Physiotherapy. Gymnastics of the cervical spine reduces the risk of the onset and exacerbation of osteochondrosis. Due to the systematic implementation of physical therapy exercises, the neck muscles are strengthened, the mobility of the vertebrae improves, and muscle spasm is relieved.

To relieve the symptoms of cervical osteochondrosis, orthopedic products are used. These include:

  • Orthopedic pillow. Incorrect head position during sleep causes an exacerbation of osteochondrosis of the cervical spine. In order to minimize this risk of recurrence, the use of an orthopedic pillow is recommended. The height and stiffness are selected individually based on the preference of the sleeping position.
  • Orthopedic mattress. In addition to an orthopedic pillow, you need to choose a comfortable mattress. The choice is made based on the stage of the disease. It is necessary to take into account the rigidity and filling of the orthopedic mattress.
  • Corset. To relieve pain in osteochondrosis of the spine, it is recommended to wear a support corset. In addition, the use of this orthopedic product is indicated for injuries, spinal surgery. The duration of wearing a corset is determined by the doctor based on the stage of the disease.
  • Shants collar. It is used for osteochondrosis of the cervical spine. The primary indication for the use of the collar is vertebral artery syndrome. The selection of the collar is made according to the required stiffness and the height of the neck. Wearing a Shants collar relieves the headache, dizziness and noise in the head that occurs when the cervical spine is affected.

The above funds are designed to relieve the symptoms of the disease and minimize the number of exacerbations of osteochondrosis of the spine. The choice of orthopedic products is made based on the localization of the disease and the degree of its development. Fundraising recommendations are provided by the attending physician after a diagnostic study.

Operative treatment

The main type of surgery for osteochondrosis of the cervical spine is discectomy. Its essence lies in the removal of the destroyed intervertebral disc with further immobile fixation of the adjacent vertebrae by fusion. In this case, the surgical operation will prevent the further development of the degenerative-dystrophic process.

An operation called a microdiscectomy is very similar to a discectomy. It is performed using a special microscope. In the disc, the surgeon creates a small incision through which a fragment of the nucleus pulposus is removed. At the same time, the tissues are minimally damaged, which reduces the risk of complications after the operation.

In some cases, a discectomy is performed using an endoscope. It is performed with a single-level lesion of a fragment of the spine. During the operation, the tissues are practically not damaged, and the patient is discharged only a couple of days after the operation.

Sometimes a laminectomy is performed along with a discectomy, which involves the removal of a piece of bone tissue. Such an operation leads to the formation of a gap, due to which the patient's pressure on the nerve decreases and, as a result, the pain syndrome disappears.

Laminectomy is a complex operation.

physiotherapy for the treatment of osteochondrosis

Rehabilitation after surgery

The operation under the osteochondrosis treatment program is one of the most complex surgical interventions. It is accompanied by a high risk of complications, including infections, damage to the meninges.

With an anterior cervical approach, there is a risk of injury to the airway, voice, or esophagus. In cases where spondylosis has not been performed, fusion of the vertebrae is very difficult.

Even after a successful operation, it is necessary to monitor the patient's condition in a hospital setting. How long it will take to spend within the hospital walls, doctors determine individually for each patient. It is necessary to understand that spinal surgery is the most difficult surgery, therefore, after it is performed, a person must be under the supervision of doctors around the clock.

The rehabilitation period also includes various physiotherapy procedures and physiotherapy exercises.

Prevention

In order to minimize the risk of exacerbation of osteochondrosis of the spine, it is necessary to adhere to the recommendations for the prevention of the disease. These include:

  • Active lifestyle. Regular and adequate physical activity is required to strengthen the muscle corset. This relieves the load on the spine. Sports activities improve the mobility of the vertebrae, which is necessary to prevent the exacerbation of osteochondrosis.
  • Massage. Degenerative-dystrophic disease of the spine causes muscle spasms. To eliminate the symptom and reduce the risk of exacerbation, it is necessary to regularly undergo a course of massage. An experienced masseur chooses massage tactics depending on the affected area and the presence of concomitant pathologies.
  • Weight control. Excess weight puts additional stress on the spine, increasing the severity of symptoms. Therefore, a timely fight against obesity is needed.
  • Fighting posture disorders from early childhood. Scoliosis is a predisposing factor in the development of spinal osteochondrosis. Most often, the curvature of the spine is observed from early childhood. Prevention of scoliosis is carried out from the school desk. This measure minimizes the risk of developing osteochondrosis.
  • Balanced and rational nutrition. A complete menu is needed to achieve two goals. The first is to ensure an adequate supply of minerals, vitamins and trace elements. The inclusion in the diet of foods rich in calcium, protein, magnesium is necessary for the prevention of destructive diseases of the spine, muscle spasms. The second goal of a balanced and balanced diet is the control of excess weight, which negatively affects the condition of the spine.
  • Work regime. In the presence of pathology of the spine, it is necessary to limit hard physical work. If this is not possible, use a support brace to relieve stress on the spine. When sitting for a long time, it is recommended to periodically interrupt to do light physical exercises.

These preventive measures will help reduce the possibility of osteochondrosis of the spine occurring or recurring.