Osteochondrosis is a disease of the spine characterized by degenerative-dystrophic damage to the intervertebral discs, vertebral bodies and ligaments.
Osteochondrosis of the spine is chronic and progressive.The disease does not make itself felt for a long time and symptoms only appear when complications arise.
According to statistics from the World Health Organization, 40-80% of the world's population suffers from osteochondrosis.
The majority of patients are people over 30 years old.However, recently there has been a trend towards rejuvenation of osteochondrosis.Osteochondrosis ranks first among spinal diseases in terms of disability for patients.
Brief anatomy of the spine
The spine performs the main functions - spinal canal, support and movement - and also connects the head, shoulders and pelvic girdle.
The structural unit of the spine is a vertebra.
The 24 vertebrae are connected to each other by intervertebral discs, which serve as shock absorbers for the body.
The spine is divided into five sections: cervical spine, thoracic spine, lumbar spine, sacrum and coccyx.
The normal shape of the spine is S-shaped.
This configuration of the organ allows for even distribution of body weight and load.
Structural and functional elements of the spine
A vertebra is a bone structure that consists of a body, an arch and processes.
The main load falls on the vertebral body, so it is its most massive part.
Important!The arches of adjacent vertebrae form the spinal canal - the container of the spinal cord, blood vessels, spinal nerve roots and fatty tissue.
RibbonsThe 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 vertebral arches.
Vortex processes.The vertebra has 7 processes that extend from the arch: the spinous process, two transverse processes, 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 consisting of a cartilage plate, an anulus fibrosus and a nucleus pulposus.The intervertebral disc connects neighboring vertebrae and thus ensures mobility and stability of 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 sides of the spine and are formed by the articular processes, bodies and stalks of adjacent vertebrae.The roots of the spinal nerve exit through the intervertebral foramina and blood vessels enter.
spinal cord- This is a section of the central nervous system consisting of nerve fibers.The spinal cord has three membranes – soft, arachnoid and hard.The dural spinal cord membrane consists of two sheets that connect and form the dural sac, which is filled with cerebrospinal fluid.
Roots of the spinal nerve- These are conductors of nerve impulses from the spinal cord to the internal organs and vice versa.Each spinal nerve root has vegetative, sensory and nerve fibers in its structure.
Paravertebral muscles- These are the muscles of the spine that support it and provide tilts and rotations of the body.
The functional unit of the spine isMovement segment of the spine, which consists of two adjacent vertebrae, an intervertebral disc, ligaments and muscles.
Pathogenesis (development mechanism) of spinal osteochondrosis
As development progresses, osteochondrosis passesfour stages:
- First stage.Pathological changes do not extend beyond the boundaries of the intervertebral disc.The nucleus pulposus dries out, resulting in a decrease in the height of the intervertebral disc.The fiber ring cannot withstand the load - it tears 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, resulting in instability of the spinal motion segment.The vertebrae can slip and move relative to each other.In this case, spondylolisthesis occurs.
- Third stage.The disease is progressing.This leads to bulging discs and arthrosis of the intervertebral joints, but also of the open joints.
- Fourth stage.At this stage, adaptive reactions in the form of bone growth of the vertebral bodies (osteophytes) are activated.The body thus tries to limit excessive mobility of the vertebrae.Osteophytes damage the roots of the spinal nerves with their sharp edges.A fibrous ankylosis of the intervertebral discs and joints forms and the spine is immobilized.The ankylosis stage is characterized by the disappearance of pain.
What causes osteochondrosis?
Osteochondrosis of the backis a multifactorial disease in which it is impossible to pinpoint a specific cause.
The basis of osteochondrosis is a violation of microcirculation and metabolism in the tissues of the spine, which can arise as a result of incorrect distribution of the load on the spine.
The factors contributing to the development of osteochondrosis include:
- incorrectly formed posture in childhood (scoliosis, kyphosis, kyphoscoliosis, stooping);
- Weakness of the back muscles (incompetent muscular corsets of the spine);
- staying in one position for a long time (working at a computer, working in the office, doing crafts);
- improper lifting of weights;
- physical inactivity and sedentary lifestyle;
- Metabolic pathology, especially deficiency of calcium, phosphorus, calcium, vitamins, magnesium, zinc;
- genetic predisposition to osteochondrosis;
- infectious diseases;
- frequent hypothermia of the body;
- chronic stress;
- hormonal imbalance;
- weight lifting;
- 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 extent 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 manifests itself in reflex and compression syndromes.
Important!The pain syndrome in osteochondrosis occurs due to the pinching of the spinal nerve roots in the intervertebral foramina by osteophytes, cramped muscles and displaced vertebrae.
Osteochondrosis with its symptoms often mimics 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 rule out life-threatening conditions.
Most frequentlySymptoms of osteochondrosis:
- Pain in the neck, lower back, thoracic spine, which can be painful, 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 disordervarious parts of the body at the level of innervation of the pinched nerve;
- crampmuscles of the neck, back, upper and lower extremities;
- migraine-like Headache;
- Painsin the joints of the limbs;
- increased fatigueof physical and mental work;
- Dizziness and unconsciousnesswith a sharp turn of the head (vertebral artery syndrome);
- visual impairment(swimmers in front of the eyes or colored spots);
- decreased hearing acuity, tinnitus;
- Pain in the heart;
- painalong the intercostal spaces;
- reduced blood supplyupper and lower extremities, which is manifested by the coldness of their skin;
- Paresthesia– Tingling, tingling and burning in the spine;
- dry skin;
- Sweating disorder;
- Urinary disorder(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, orthopedist, surgeon and others.
During the conversation, it must be clarified exactly what type of complaint it is, when it occurred and what the patient associates it with.Be sure to check the patient's medical history, profession and whether close relatives suffer from osteochondrosis.
Laboratory tests are not conclusive in this case.A biochemical blood test allows you to pay attention to the content of calcium, phosphorus and other trace elements.
The main place in the diagnosis of osteochondrosis is occupied by instrumental methods such as X-ray of the spine, computed tomography and magnetic resonance imaging.
X-ray examination of the spine is the simplest, most accessible and informative method for diagnosing osteochondrosis.
The obligatory x-ray is carried out in direct and lateral projection 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 spine with the introduction of a contrast agent into the spinal canal.This method is dangerous because allergic reactions to the contrast medium can occur.
With myelography we can examine the internal structure of the spinal canal.The method is valuable for the diagnosis of Schmorl hernias (intervertebral hernias).
Computed and magnetic resonance imaging– these are modern diagnostic procedures that make the soft tissues and bones of the spine visible layer by layer.
These methods are expensive and therefore are used in severe cases, especially for differential diagnosis of osteochondrosis and diseases with similar symptoms.
Since osteochondrosis is often disguised as diseases of the heart, lungs, pleura, stomach, intestines, kidneys and liver, there is a need for differential diagnosis.
For this purpose, the patient may be prescribed an electrocardiogram, an ultrasound scan of the heart and internal organs, a blood test for troponins, an ultrasound scan of blood vessels, a chest x-ray, electroencephalography and others.
Treatment methods for osteochondrosis
Treatment of osteochondrosis can beconservative and surgical.
Important!Initially, comprehensive conservative methods are used and surgical treatment is only resorted to in extreme cases.
Let's consider how to properly treat osteochondrosis.KconservativeTreatment methods for osteochondrosis can be listed:
- drug therapy;
- physiotherapy;
- physiotherapeutic methods;
- manual therapy;
- Massage;
- Acupuncture.
Drug treatmentOsteochondrosis is aimed at relieving pain, relaxing muscles, relieving swelling of nerves and muscles, improving blood circulation and conduction of nerve impulses.The following groups of drugs are used for this purpose:
- 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;
- Diureticsremove 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 medications, which are prescribed when nonsteroidal anti-inflammatory drugs are ineffective.
Therapeutic exercise– These are dosed physical activities that can be carried out both at home and at work to treat and prevent osteochondrosis.
There are many sets of exercises for osteochondrosis.Prescribing exercise therapy and monitoring its implementation is carried out by a qualified specialist - a physiotherapist.
Thanks to properly selected exercise therapy, you can relieve pain, improve mobility and blood circulation in the spine, and stop the progression of the disease.
Physiotherapeutic treatmentOsteochondrosis is carried out by a physiotherapist in special physiotherapy departments of hospitals, sanatoriums and pharmacies.
Physiotherapeutic methods include: electrophoresis, magnetic therapy, laser therapy, mud therapy, balneotherapy, UV irradiation of the affected part of the spine, vibration treatment and others.
Manual therapy– This involves a measured manual action on the spine to restore mobility and prevent the vertebrae and intervertebral discs from shifting.
Manual therapy should only be performed by a qualified chiropractor.
Massage and self-massageWith osteochondrosis, it is carried out to relieve muscle spasms, improve microcirculation in the paravertebral tissue and increase spinal mobility.
acupunctureis a method of treating osteochondrosis that involves injecting thin needles into active points.
Under the influence of needles in the body, the level of the body's own opiates and cortisol, which have anti-inflammatory and pain-relieving effects, increases.
Prevention of osteochondrosis
To maintain your health and keep your spine mobile into old age, adhere to several principles for the prevention of osteochondrosis:
- Pay attention to your posture– Always keep your back straight, do not bend;
- choosecorrect postureto sleep;
- sit properly at the table(Shoulders relaxed, back straight, furniture should fit your height);
- When staying in one position for a long time (working in the office, at the computer, sitting while doing crafts), try every 1-1.5 hoursDo some physical exercise, self-massage of the back, or just get up and walk;
- Distribute the load correctlyon the spine when lifting and carrying various weights;
- wear orthopedic shoes;
- healthy sleepon a flat, hard to medium-firm mattress.It is better to purchase an orthopedic mattress and an orthopedic 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.