Osteochondrosis is a disease of the spine, characterized by degenerative-dystrophic damage of 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 of the World Health Organization, 40-80% of the world's population suffers from osteochondrosis.
Among the patients, people over 30 years old prevail.However, recently there is a trend of rejuvenation of osteochondrosis.Osteochondrosis ranks first among spine 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, as well as connecting the head, shoulder and pelvic girdle.
The structural unit of the spine is the vertebra.
The 24 vertebrae are connected to each other by the intervertebral discs, which are shock absorbers of the body.
The spine is divided into five parts: cervical, thoracic, lumbar, sacral and coccyx.
The normal shape of the spine is S-shaped.
This configuration of the body allows to evenly distribute body weight and load.
Structural and functional elements of the spine
A vertebra is a bone formation consisting of a body, an arch and processes.
The main load falls on the vertebral body, so it is its most massive part.
It is important!The arches of the adjacent vertebrae form the spinal canal - the spinal cord, blood vessels, spinal nerve roots and fatty tissue.
GardensThe spine is represented by the posterior longitudinal ligament, which connects the vertebrae along the back surface, and the yellow ligament, whose main purpose is to connect the arches of the vertebrae.
Vertebral processes.The spine has 7 processes extending from the arch: spinous process, two transverse, two superior and two inferior articular processes.The ligaments and muscles of the spine are attached to the vertebral processes.Other processes form the intervertebral joints of the spine.
Intervertebral discThe cartilaginous plate is a disc-shaped plate consisting of the annulus fibrosus and the nucleus pulposus.The intervertebral disc connects adjacent vertebrae, ensures mobility and stability of the spine.
Intervertebral jointsformed as a result of the processes of two adjacent vertebrae.The main function of the intervertebral joints is to move the vertebrae relative to each other and ensure flexibility of the spine.
Intervertebral foraminalocated on the sides of the spine and formed by the articular processes, bodies and pedicles of the adjacent vertebrae.Spinal nerve roots exit through the intervertebral foramina and blood vessels enter.
Spinal cord- It is a part of the central nervous system consisting of nerve fibers.The spinal cord has three membranes - soft, arachnoid and hard.The dura spinal membrane consists of two layers that connect and form a dural sac filled with cerebrospinal fluid - cerebrospinal fluid.
Spinal nerve roots- These are conductors of nerve impulses from the spinal cord to internal organs and vice versa.The structure of each spinal nerve root contains autonomic, sensory and nerve fibers.
Paravertebral muscles- these are the muscles of the spine that support it and allow the body to bend and turn.
Functional unit of the spinespinal motion segment, consists of two adjacent vertebrae, one intervertebral disc, ligaments and muscles.
Pathogenesis of spinal osteochondrosis (mechanism of development).
In the process of development, osteochondrosis occursfour stages:
- The first stage.Pathological changes do not extend beyond the boundaries of the intervertebral disc.The nucleus pulposus dries up, which causes a decrease in the height of the intervertebral disc.The fibrous ring cannot withstand the load - it cracks and tears.
- The second stage.Due to the decrease in the height of the intervertebral discs, there is a sagging of the ligaments and muscles of the spine, which causes instability of the movement segment of the spine.Vertebrae can slide and move relative to each other.At this time, spondylolisthesis occurs.
- The third stage.The disease progresses.Protrusion of intervertebral discs and arthrosis of intervertebral joints, as well as uncovertebral joints occurs.
- The fourth stage.At this stage, adaptive reactions are activated in the form of bone growth of vertebral bodies (osteophytes).Thus, the body tries to limit excessive mobility of the vertebra.Osteophytes damage the roots of spinal nerves with their sharp edges.Fibrous ankylosis of the intervertebral discs and joints occurs, the spine becomes immobile.The ankylosis stage is characterized by the disappearance of pain.
What causes osteochondrosis?
Osteochondrosis of the backIt is a multifactorial disease in which one specific cause cannot be identified.
The basis of osteochondrosis is the disruption of microcirculation and metabolism in the tissues of the spine, which can occur as a result of improper distribution of the load on the spine.
Factors contributing to the development of osteochondrosis include:
- malformed posture in childhood (scoliosis, kyphosis, kyphoscoliosis, bending);
- weakness of the back muscles (incompetent muscle corset of the spine);
- staying at one position for a long time (working on a computer, working in an office, doing manual work);
- 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 cord injury;
- overweight and obesity.
Symptoms of osteochondrosis
Chronic osteochondrosis can manifest itself with various symptoms.All this depends on the stage of the disease, the level of damage to the spine and the presence of complications.
Clinically, the disease manifests itself when the degenerative-dystrophic process already reaches the back of the fibrous ring and the posterior longitudinal ligament, then the spinal nerve roots are irritated, compressed, and the transmission of nerve impulses through them is disturbed.
At the same time, compression of the spinal cord and blood vessels occurs, which is manifested by reflex and compression syndromes.
It is important!Pain syndrome during osteochondrosis occurs as a result of compression of the spinal nerve roots in the intervertebral holes by osteophytes, spasmodic 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 comprehensive differential diagnosis of the disease to exclude life-threatening conditions.
The most commonsymptoms of osteochondrosis:
- neck, lower back, thoracic back pain, can be painful, throbbing or in the form of lumbago.The pain spreads 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;
- emotional disturbancedifferent parts of the body at the level of innervation of the pinched nerve;
- spasmmuscles of the neck, back, upper and lower limbs;
- like a migraine headaches;
- painsin 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(flies before the eyes or colored spots);
- decrease in hearing acuity, tinnitus;
- pain in the heart;
- painalong the intercostal spaces;
- decreased blood supplyupper and lower extremities, manifested by coldness of the skin;
- paresthesia- creeping, tingling and burning sensation in the spine;
- dry skin;
- sweating disorder;
- urinary disorder(dysuria, enuresis);
- decreased sexual desire, impotence.
Early diagnosis of osteochondrosis will make its treatment much easier.
Methods of diagnosis of osteochondrosis
A neuropathologist diagnoses osteochondrosis.If necessary, patients can be referred to cardiologists, gastroenterologists, orthopedists, surgeons and others.
During the interview, it is necessary to accurately determine the nature of the complaints, when they arose, and what the patient associated them with.Be sure to check the medical history, the patient's profession and whether close relatives have osteochondrosis.
In this case, laboratory tests 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, for example, radiography of the spine, computer tomography and magnetic resonance imaging.
X-ray examination of the spine is the simplest, most accessible and highly informative method for diagnosing osteochondrosis.
Mandatory radiography is performed in direct and lateral projections of any part of the spine.Osteochondrosis is characterized by the following: a decrease in the height of the intervertebral discs, the presence of osteophytes, osteoporosis and deformation of the spine.
Myelography- This is an X-ray examination of the spine with the introduction of contrast material into the spinal canal.This method is dangerous due to the occurrence of allergic reactions to the contrast.
Myelography allows to study the internal structure of the spinal canal.The method is valuable for diagnosing Schmorl's hernias (intervertebral hernias).
Computer 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 differential diagnosis of diseases with osteochondrosis and similar symptoms.
Since osteochondrosis is often disguised as diseases of the heart, lungs, pleura, stomach, intestines, kidneys, liver, differential diagnosis is needed.
For this purpose, an electrocardiogram, ultrasound examination of the heart and internal organs, blood test for troponins, ultrasound examination of blood vessels, X-ray of the chest, electroencephalography and others can be prescribed to the patient.
Methods of treatment of osteochondrosis
Osteochondrosis can be treatedconservative and surgical.
It is 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.KconservativeOsteochondrosis treatment methods can be listed:
- drug treatment;
- physical therapy;
- physiotherapeutic methods;
- manual therapy;
- massage;
- acupuncture.
Drug treatmentOsteochondrosis aims to relieve pain, relax muscles, relieve swelling of nerves and muscles, improve blood flow and nerve impulse conduction.For this purpose, the following drug groups are used:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors, contains components of cartilage tissue.These preparations protect the cartilages of vertebrae and intervertebral discs from the negative effects of various factors;
- diureticswhich removes excess fluid from the body and relieves swelling of spinal nerve roots and paravertebral muscles;
- muscle relaxantsrelax tight muscles;
- drugs, improvement of metabolism and microcirculation in the tissues of the spine (vitamins B1, B6, B12, C, A and E);
- calcium supplements;
- hormonal drugs, 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.The appointment of exercise therapy and control over its implementation is carried out by a qualified specialist - physical therapy doctor.
Thanks to properly selected exercise therapy, you can relieve pain, improve spinal mobility and blood supply, and stop the progression of the disease.
Physiotherapy treatmentosteochondrosis is carried out by a physiotherapist in special physiotherapy departments of hospitals, sanatoriums and dispensaries.
Physiotherapy methods include: electrophoresis, magnetic therapy, laser therapy, mud therapy, balneotherapy, ultraviolet exposure to the damaged part of the spine, vibration therapy, etc.
Manual therapy– this is a dosed manual blow to the spine to restore the mobility of the spine, 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 eliminate muscle spasm, improve microcirculation in paravertebral tissues and increase spinal mobility.
Acupunctureis a method of treatment of osteochondrosis in which thin needles are inserted into active points.
Under the influence of needles in the body, the level of endogenous opiates and cortisol, which have anti-inflammatory and analgesic effects, increases.
Prevention of osteochondrosis
To keep your health and spine mobile until old age, follow several principles to prevent osteochondrosis:
- watch your posture- always keep your back straight, do not bend;
- choosecorrect posturefor sleep;
- sit properly at the table(shoulders should be relaxed, back straight, furniture should be suitable for your height);
- try every 1-1.5 hours when staying at one position for a long time (working in the office, working at the computer, sitting with manual work)do some physical exercise, self-massage of the back or just getting up and walking;
- distribute the load correctlyin the spine when lifting and carrying various weights;
- wear orthopedic shoes;
- healthy sleepon a flat, hard to medium firm mattress.It is better to buy an orthopedic mattress and pillow.
Osteochondrosis of the spineUnfortunately, it is a chronic progressive disease that cannot be cured.The effectiveness of the treatment directly depends on the time.
Do not self-medicate to avoid worsening your condition.Contact a neurologist at the first signs of osteochondrosis.