Osteochondrosis is a disease of the spinal column, which is characterized by degenerative-dystrophic damage to the intervertebral discs, vertebral bodies and ligaments.
Osteochondrosis of the spine has a chronic progressive course.The disease does not make itself felt for a long time, and symptoms appear only when complications arise.
According to statistics from the World Health Organization, 40-80% of the world's population suffers from osteochondrosis.
Among the patients, people over 30 years predominate.But, recently there has been a trend towards rejuvenation of osteochondrosis.Osteochondrosis ranks first among spinal diseases in terms of disability among patients.
Brief anatomy of the spine
The spine performs the main functions - the spinal cord canal, support and movement, and also connects the head, shoulder and pelvic girdles.
The structural unit of the spine is a vertebra.
The 24 vertebrae are connected to each other by intervertebral discs, which are the shock absorbers of the body.
The spine is divided into five sections: cervical, thoracic, lumbar, sacral and coccyx.
The normal shape of the spine is S-shaped.
This configuration of the organ makes it possible to evenly distribute body weight and load.
Structural and functional elements of the spinal column
A vertebra is a bone formation that consists of a body, an arch and processes.
The main load falls on the vertebral body, so this is its most massive part.
Important!The arches of adjacent vertebrae form the spinal canal - the receptacle of the spinal cord, blood vessels, spinal nerve roots and adipose tissue.
LigamentsThe spine is represented by the posterior longitudinal ligament, which connects the vertebrae along the posterior surface, and the yellow ligament, the main purpose of which is to connect the arches of the vertebrae.
Vertebral processes.The vertebra has 7 processes that extend from the arch: the spinous process, two transverse, two superior and two inferior articular processes.Ligaments and muscles of the spine are attached to the spinous processes.Other processes form the intervertebral joints of the spine.
Intervertebral discis a disc-shaped plate that consists of a cartilaginous plate, anulus fibrosus and nucleus pulposus.The intervertebral disc connects adjacent vertebrae, providing mobility and stability to the spine.
Intervertebral jointsformed by the processes of two adjacent vertebrae.The main function of the intervertebral joints is to move the vertebrae relative to each other and provide flexibility to the spine.
Intervertebral foraminaare located on the lateral sides of the spine and are formed by the articular processes, bodies and pedicles of adjacent vertebrae.The spinal nerve roots exit through the intervertebral foramina and blood vessels enter.
Spinal cord- This is a section of the central nervous system that consists of nerve fibers.The spinal cord has three membranes - soft, arachnoid and hard.The dura spinal membrane consists of two sheets that connect and form the dural sac, filled with cerebrospinal fluid - cerebrospinal fluid.
Spinal nerve roots- These are conductors of nerve impulses from the spinal cord to the internal organs and vice versa.Each spinal nerve root has autonomic, sensory and nerve fibers in its structure.
Paravertebral muscles- these are the muscles of the spine that support it and provide tilts and turns of the body.
The functional unit of the spine isspinal motion segment, which consists of two adjacent vertebrae, an intervertebral disc, ligaments and muscles.
Pathogenesis (mechanism of development) of spinal osteochondrosis
In the process of development, osteochondrosis passesfour stages:
- First stage.Pathological changes do not extend beyond the boundaries of the intervertebral disc.The nucleus pulposus dries out, which leads to a decrease in the height of the intervertebral disc.The fibrous ring cannot withstand the load - it cracks and tears.
- Second stage.Due to a decrease in the height of the intervertebral discs, sagging of the ligaments and muscles of the spine occurs, which leads to instability of the spinal motion segment.The vertebrae can slip and move relative to each other.In this case, spondylolisthesis is formed.
- Third stage.The disease is progressing.Protrusion of the intervertebral discs and arthrosis of the intervertebral joints, as well as uncovertebral joints, occur.
- Fourth stage.At this stage, adaptive reactions are activated in the form of bone growths of the vertebral bodies (osteophytes).Thus, the body tries to limit excessive mobility of the vertebrae.Osteophytes with their sharp edges damage the roots of the spinal nerves.Fibrous ankylosis of the intervertebral discs and joints is formed, and the spine is immobilized.The ankylosis stage is characterized by the disappearance of pain.
What leads to osteochondrosis?
Osteochondrosis of the backis a multifactorial disease in which it is impossible to single out one specific cause.
The basis of osteochondrosis is a violation of microcirculation and metabolism in the tissues of the spine, which can arise due to improper distribution of the load on the spine.
The factors that contribute to the development of osteochondrosis include the following:
- improperly formed posture in childhood (scoliosis, kyphosis, kyphoscoliosis, stoop);
- weakness of the back muscles (incompetent muscular corset of the spine);
- staying in one position for a long time (working at a computer, working in an office, doing handicrafts);
- improper lifting of weights;
- physical inactivity and sedentary lifestyle;
- metabolic pathology, especially lack of calcium, phosphorus, calcium, vitamins, magnesium, zinc;
- genetic predisposition to osteochondrosis;
- infectious diseases;
- frequent hypothermia of the body;
- chronic stress;
- hormonal imbalance;
- weightlifting;
- spinal injury;
- overweight and obesity.
Symptoms of osteochondrosis
Chronic osteochondrosis can manifest itself with various symptoms.It all depends on the stage of the disease, the level of spinal damage and the presence of complications.
Clinically, the disease manifests itself when the degenerative-dystrophic process has already reached the posterior part of the fibrous ring and the posterior longitudinal ligament, then the spinal nerve roots are irritated, pinched and the conduction of nerve impulses through them is disrupted.
At the same time, compression of the spinal cord and blood vessels occurs, which is manifested by reflex and compression syndromes.
Important!Pain syndrome in osteochondrosis occurs due to pinching of the spinal nerve roots in the intervertebral foramina by osteophytes, spasmed muscles, and displaced vertebrae.
Osteochondrosis with its symptoms often imitates acute coronary syndrome, pleurisy, acute pancreatitis, hepatic and renal colic, acute appendicitis and adnexitis.
Therefore, it is important to conduct a thorough differential diagnosis of the disease to exclude life-threatening conditions.
Most commonsymptoms of osteochondrosis:
- pain in the neck, lower back, thoracic spine, which can be aching, throbbing or in the form of lumbago.The pain radiates to the head, upper and lower limbs, shoulder blades, heart, and stomach.The pain syndrome increases after physical activity, sneezing, laughing, coughing or staying in one position for a long time;
- sensory disturbancedifferent parts of the body at the level of innervation of the pinched nerve;
- spasmmuscles of the neck, back, upper and lower extremities;
- migraine-like headaches;
- achesin the joints of the limbs;
- increased fatiguefrom physical and mental labor;
- dizziness and loss of consciousnesswith a sharp turn of the head (vertebral artery syndrome);
- visual impairment(floaters before the eyes or colored spots);
- decreased hearing acuity, tinnitus;
- pain in the heart;
- painalong the intercostal spaces;
- decreased blood supplyupper and lower extremities, which is manifested by coldness of their skin;
- paresthesia– crawling, tingling and burning sensations in the spine;
- dry skin;
- sweating disorder;
- urinary disturbance(dysuria, enuresis);
- decreased sexual desire, impotence.
Early diagnosis of osteochondrosis will greatly facilitate its treatment.
Methods for diagnosing osteochondrosis
A neuropathologist diagnoses osteochondrosis.If necessary, patients can be referred for consultation to a cardiologist, gastroenterologist, orthopedic doctor, surgeon and others.
During the interview, it is necessary to accurately determine the nature of the complaints, when they arose, and what the patient associates them with.Be sure to check the medical history, the patient’s profession, and whether any close relatives have osteochondrosis.
Laboratory tests in this case are uninformative.By conducting a biochemical blood test, you can pay attention to the level of calcium, phosphorus and other trace elements.
The main place in the diagnosis of osteochondrosis is occupied by instrumental methods, such as radiography of the spine, computed tomography and magnetic resonance imaging.
X-ray examination of the spine is the simplest, most accessible and highly informative method for diagnosing osteochondrosis.
Obligatory radiography is carried out in direct and lateral projections of the desired part of the spine.Osteochondrosis is characterized by: a decrease in the height of the intervertebral discs, the presence of osteophytes, osteoporosis, and spinal deformity.
Myelography- This is an X-ray examination of the spinal column with the introduction of a contrast agent into the spinal canal.This method is dangerous due to the occurrence of allergic reactions to the contrast.
Myelography allows us to study the internal structure of the spinal canal.The method is valuable for diagnosing Schmorl's hernias (intervertebral hernias).
Computed and nuclear magnetic tomography– these are modern diagnostic methods that visualize the soft tissues and bones of the spine layer by layer.
These methods are expensive, so they are used in severe cases, especially for the differential diagnosis of osteochondrosis and diseases with similar symptoms.
Since osteochondrosis is often disguised as diseases of the heart, lungs, pleura, stomach, intestines, kidneys, liver, there is a need for differential diagnosis.
For this purpose, the patient may be prescribed an electrocardiogram, ultrasound examination of the heart and internal organs, a blood test for troponins, ultrasound examination of blood vessels, chest radiography, electroencephalography and others.
Treatment methods for osteochondrosis
Treatment of osteochondrosis can beconservative and surgical.
Important!First of all, comprehensive conservative methods are used, and surgical treatment is resorted to only in extreme cases.
Let's consider how osteochondrosis can be properly treated.TOconservativeTreatment methods for osteochondrosis can be listed:
- drug therapy;
- physical therapy;
- physiotherapeutic methods;
- manual therapy;
- massage;
- acupuncture.
Drug treatmentOsteochondrosis is aimed at relieving pain, relaxing muscles, relieving swelling of nerves and muscles, improving blood flow and conduction of nerve impulses.For this purpose, the following groups of drugs are used:
- nonsteroidal anti-inflammatory drugs;
- chondroprotectors, which include components of cartilage tissue.These drugs protect the cartilage of the vertebrae and intervertebral discs from the negative effects of various factors;
- diureticswhich remove excess fluid from the body and relieve swelling of the spinal nerve roots and paravertebral muscles;
- muscle relaxantsrelax cramped muscles;
- drugs, improving metabolism and microcirculation in the tissues of the spine (vitamins B1, B6, B12, C, A and E);
- calcium supplements;
- hormonal drugs, which are prescribed when non-steroidal anti-inflammatory drugs are ineffective.
Therapeutic exercise– these are dosed physical activities that can be performed both at home and at work for the treatment and prevention of osteochondrosis.
There are many sets of exercises for osteochondrosis.Prescription of exercise therapy and monitoring of its implementation is carried out by a qualified specialist - a physical therapy doctor.
Thanks to properly selected exercise therapy, you can relieve pain, improve mobility and blood supply to the spine, and stop the progression of the disease.
Physiotherapeutic treatmentosteochondrosis is carried out in special physiotherapy departments of hospitals, sanatoriums, and dispensaries by a physiotherapist.
Physiotherapeutic methods include: electrophoresis, magnetic therapy, laser therapy, mud therapy, balneotherapy, ultraviolet exposure to the affected part of the spine, vibration treatment and others.
Manual therapy– this is a dosed manual impact on the spine to restore its mobility, eliminate displacement of the vertebrae and intervertebral discs.
Manual therapy should only be performed by a qualified chiropractor.
Massage and self-massagefor osteochondrosis, it is performed to relieve muscle spasm, improve microcirculation in paravertebral tissues and increase spinal mobility.
Acupunctureis a method of treating osteochondrosis in which thin needles are injected into active points.
Under the influence of needles in the body, the level of endogenous opiates and cortisol increases, which have anti-inflammatory and analgesic effects.
Prevention of osteochondrosis
To maintain your health and your spine to remain mobile until old age, adhere to several principles for the prevention of osteochondrosis:
- watch your posture– always keep your back straight, do not slouch;
- choosecorrect posturefor sleep;
- sit correctly at the table(shoulders relaxed, back straight, furniture should suit your height);
- during a long stay in one position (working in an office, at a computer, sitting at handicrafts), try every 1-1.5 hoursdo a little physical exercise, self-massage of the back, or just get up and walk;
- distribute the load correctlyon the spine during lifting and carrying various weights;
- wear orthopedic shoes;
- healthy sleepon a flat, hard to medium-hard mattress.It is better to purchase an orthopedic mattress and pillow.
Osteochondrosis of the spineis a chronic progressive disease that, unfortunately, cannot be cured.The effectiveness of treatment directly depends on its timeliness.
Do not self-medicate so as not to worsen your condition.At the first signs of osteochondrosis, contact a neurologist.