Osteochondrosis is a chronic spinal disease whose underlying cause is degenerative changes in the intervertebral discs. As the disease progresses, other structures of the spine are also involved in the pathological process - vertebral bodies, intervertebral joints, ligaments, etc.
This disease affects people of all ages. Until recently, osteochondrosis was thought to be the fate of the elderly, but the disease has recently been found to be increasing in incidence among younger adults. Women and men get sick as often.
Why does osteochondrosis occur?
To better understand what osteochondrosis is, it is necessary to briefly describe the causes and mechanisms of its occurrence.
The pathological changes of spinal osteochondrosis develop slowly. It usually takes several years from the beginning of the pathological process of the intervertebral cartilage to the appearance of the first symptoms of osteochondrosis.
Causes of osteochondrosis
The health of the spine is directly affected by many negative factors. If their effects persist for a long time, the result is pathological changes in the structure of the spine. This contributes to the formation of osteochondrosis.
For example, people who lead an inactive lifestyle and are overweight know what osteochondrosis is. Excessive physical activity, back and neck injuries, and some medical conditions can also contribute to the development of this pathology. The aggravated heredity and aging are the direct factors leading to the degenerative damage of the intervertebral disc cartilage tissue.
How does osteochondrosis develop?
The development (or pathogenesis) mechanism of osteochondrosis remains controversial and understudied. The disease likely develops on the basis of metabolic disturbances that occur in the structure of the spine.
Under the influence of adverse factors, the cartilage tissue of the intervertebral disc often undergoes irreversible changes, followed by gradual destruction (or destruction).
Then, the pathological process also spreads to the bony tissue of the vertebrae with the development of its deformation and irreversible changes of the surrounding structures.
The appearance of this modification in the intervertebral disc is directly dependent on its anatomical nuances:
- Cartilage tissue does not have its own blood supply system. Its nutrition is provided by the bone tissue adjacent to the vertebrae. Therefore, cartilage nutrition can also be affected if circulation is disrupted due to insufficient pressure on the spine or, conversely, excessive physical stress.
- There are also no nerve fibers in cartilage. Therefore, the transmission of nerve impulses that trigger metabolic activation will be inappropriate in the presence of functional overload of the intervertebral disc.
- Due to its structural characteristics, the self-healing (regeneration) ability of the disc cartilage tissue is slowed down.
There are other factors that clearly contribute to the development of degenerative processes in the cartilage tissue of the intervertebral disc and the formation of osteochondrosis.
stage of pathological changes
Based on the current data on the pathogenesis of this pathology, several stages of the disc degenerative process can be conditionally distinguished. Stages of spinal osteochondrosis:
- primary. The cartilage tissue of the intervertebral disc undergoes structural changes under mechanical influence - dysfunction occurs. It is characterized by the appearance of cracks on the surface of the disk, which vary in size and depth. These cracks then turn into protrusions (hernias).
- Middle. It is characterized by instability of the affected area of the spine due to pathological mobility of the vertebrae. In this case, one of the main functions of the spine, the protective function, is disturbed. The trunks of nerves and blood vessels that run in their bony canals become fragile. Distinct clinical symptoms of the disease appear.
- limited. Replace affected cartilage tissue with thicker, denser fibrous tissue. At the same time, the intervertebral hernia disappeared. The pathological mobility of the vertebra is replaced by a sharp limitation of its mobility. Spinal stenosis usually develops as manifestations of spinal cord segmental compression develop.
Therefore, each stage of the disease has the presence of its own specific symptoms, which undoubtedly plays a key role in the choice of treatment for osteochondrosis.
clinical manifestations
Signs of spinal osteochondrosis are changes in the bone tissue of the vertebrae. Patients may not have any complaints for a long time.
The disease is characterized by a chronic course with alternating phases of exacerbation and remission.
Often, the exacerbation of osteochondrosis occurs under the influence of predisposing factors: physical overwork, hypothermia, prolonged exposure to uncomfortable positions, such as in dreams or work.
The symptoms of this disease are numerous, depending on the localization of the pathological process and the severity of structural changes in cartilage and bone tissue. All of these symptoms can be grouped into several syndromes. Many times they are combined.
radiculopathy
It occurs in nearly all patients with spinal osteochondrosis. In the development of this syndrome, the pathologically altered structure of the spine acts on the compression (compression) of the spinal nerve roots.
The main symptom of radiculopathy is pain, which, in a considerable number of cases, can propagate (radiate) along the innervation of the corresponding root. Characterized by pain radiating from top to bottom. For example, if the lumbar region is affected, the hip can ache and succumb to the leg.
The intensity of pain increases with trunk or neck rotation and physical activity. Pain is characterized by cutting, pulling, and baking.
In addition, together with pain syndrome, in the affected area, symptoms of violation of sensitivity of its increased type (hyperesthesia) are often present, as well as hypersensitivity disturbances, numbness.
If the disease progresses and the cause of compression is not removed, hyperesthesia is replaced by hypoesthesia (reduced sensitivity), which is often accompanied by symptoms of loss of function of the affected spinal root.
spine syndrome
This syndrome is the result of spinal cord compression. The most common cause of this compression is an intervertebral hernia.
Sensitivity, responsiveness to thermal and painful stimuli is getting lower and lower. Progressive muscle weakness in the extremities and trunk. Paralysis or paralysis symptoms are often formed.
vegetative vascular syndrome
This syndrome is most commonly seen in cervical and cervicothoracic localization of spinal osteochondrosis.
The cause of vascular disease in osteochondrosis is reflex spasm or mechanical compression of the large vessels passing through the bony canal of the spine. In this condition, various symptoms may occur, similar to ischemic circulatory disturbances in the main arteries of the brain or extremities. This is often the cause of diagnostic errors.
In addition, various plant diseases frequently occur. They are most pronounced in women (mood instability, sleep disturbance, menstrual irregularities, etc. ).
visceral syndrome
It is characterized by pain in the heart, gastrointestinal organs, etc. Often such patients require long-term treatment and are absolutely unsuccessful for any medical disease.
For example, if the chest area is affected, there may be pain behind the breastbone, similar to those with angina. Often there is a reflex feeling of heartbeat.
Diagnostic principles
In addition to characteristic symptoms, other testing methods play an important role in determining disease and staging - spine X-rays, computed tomography and magnetic nuclear tomography.
Other methods such as EEG, ECG, vascular Doppler scan, etc. are performed according to the indication.
Treatment of osteochondrosis
The treatment of spinal osteochondrosis is a comprehensive approach. When choosing one or the other treatment, it is necessary to assess the extent of damage to the spinal structures, the nature and severity of the clinical presentation, and the stage of the disease course (worsening or remission).
Preventive measures aimed at reducing the frequency of disease exacerbations and protecting the vertebral and intervertebral disc structures also play an important role in the treatment of spinal osteochondrosis.
strategies during exacerbations
An important condition for treating the disease during this period is the creation of the remainder of the affected area of the spine. For this, the patient is prescribed bed rest and various devices are used to keep the affected vertebral segment still.
In some cases, hospitalization in a neurology department is required.
medical treatement
To reduce the pain intensity of osteochondrosis, various drugs are prescribed:
- nonsteroidal anti-inflammatory drugs (NSAIDs);
- analgesics;
- Muscle relaxant.
In the absence of the effect of their use, local anesthetics are recommended to block the innervation of the affected area.
Circulatory disturbances to the brain often develop as osteochondrosis localizes in the neck. To reduce this manifestation, drugs that improve cerebral blood flow are prescribed. Symptomatic treatment is also required - relief of nausea and vomiting, improvement of vestibular disorders, etc.
In addition, it is recommended to prescribe vitamin preparations (especially group B), antioxidants, etc.
Physical Therapy Program
For osteochondrosis, the treatment of physical factors has been widely used. Various physical therapy methods are used during the exacerbation and remission phases of the disease:
- In the acute phase, ultraviolet irradiation, electromagnetic field (UHF) therapy, bikinetic current, etc. are used.
- During the remission phase, electrophoresis with various drugs, induction hyperthermia, ultrasound and various types of balneotherapy are prescribed.
Mitigation Phase Strategies
After the acute manifestations of the disease have subsided, the treatment of the disease continues. The purpose of this treatment is to reduce the frequency of exacerbations and promote regeneration of the bone and cartilage tissue of the spine.
Drug therapy prescribed for the acute phase of the disease continued. During this period, chondroprotectants - drugs that improve the condition of cartilage, may be used.
In addition to physiotherapy methods, massage and physiotherapy exercises are used.
massage
The main effect of massage is to improve blood circulation in the affected area and strengthen the muscle corset. In addition, the professional performance of massage movements allows you to relieve muscle spasms, which often accompany this pathology.
This is why massage should be performed by specially trained specialists who are proficient in this treatment. Incorrect or illiterate massage can lead to the development of complications or worsening of the disease.
Therapeutic Exercise (LFK)
Dosage and specially selected physical activity form the basis of exercise therapy. The complex of this exercise is chosen individually by the doctor for each patient. The principle of choosing exercise therapy exercise is to reduce the physical load on the affected part of the spine.
Physiotherapy exercises work to improve blood supply and lymph flow to the affected area and strengthen muscle tissue.
These exercises should be done every day. Typically, first, individual or group lessons are conducted by a coach, and then the patient can perform a set of exercises independently at home.
prevent deterioration
Preventive measures for exacerbation of osteochondrosis of the spine aim to eliminate all predisposing factors:
- Proper posture and posture need to be monitored when standing and sitting for long periods of time.
- For prolonged periods of static stress (for example, working in front of a computer), regular breaks are useful, during which you should do a warm-up or a set of exercises recommended by your doctor.
- Hypothermia should be avoided.
- People with osteochondrosis need to get a good night's sleep and take care of the place to sleep - the mattress and pillow. Ideally, they should be orthopedic.
- Mandatory is the reduction of excess body weight and prompt correction of accompanying somatic and endocrine pathology.
You should not delay seeing your doctor when the mildest symptoms of spinal disease are present. After all, the sooner treatment for osteochondrosis of the spine begins, the better the outcome.