Osteochondrosis is a chronic pathology of the spine, the main cause of which are degenerative changes in the intervertebral disc. With the progression of the disease, other structures of the spine are also involved in the pathological process: vertebral bodies, intervertebral joints, ligaments, etc.
The disease affects people of all ages. Until recently, osteochondrosis was considered the lot of the elderly, but recently an increased incidence of this disease among young people has been revealed. Both women and men get sick equally often.
Why does osteochondrosis occur?
To better understand what osteochondrosis is, it is necessary to dwell briefly on the causes and mechanism of its occurrence.
The formation of pathological changes in osteochondrosis of the spine occurs slowly. Years often pass from the beginning of the pathological process in the intervertebral cartilage to the manifestation of the first symptoms of osteochondrosis.
Causes of osteochondrosis
The health of the spine is directly affected by many negative factors. If their influence is exerted for a long time, the result is the appearance of pathological changes in the structures of the spinal column. And this contributes to the formation of osteochondrosis.
For example, what osteochondrosis is well known to people who lead an inactive lifestyle, who are overweight. Excessive physical activity, back and neck injuries, some somatic diseases can also lead to the development of this pathology. And aggravated heredity and old age are direct factors leading to the development of degenerative damage to the cartilage tissue of the discs.
How does osteochondrosis develop?
The mechanism of development (or pathogenesis) of osteochondrosis is still controversial and not sufficiently studied. It is very likely that this disease is formed on the basis of metabolic disorders that occur in the structures of the spinal column.
Under the influence of adverse factors, irreversible changes often occur in the cartilage tissue of the intervertebral disc, followed by its gradual destruction (or destruction).
The pathological process then also spreads to the bone tissue of the vertebra with the development of its deformation and irreversible alterations of the surrounding structures.
The appearance of such changes in the intervertebral disc directly depends on its anatomical nuances:
- Cartilage tissue does not have its own blood supply system. Its nutrition is provided by the bone tissue of the neighboring vertebrae. Therefore, in the case of circulatory disorders as a result of insufficient or, on the contrary, excessive physical stress on the spine, cartilage nutrition is also affected.
- There are also no nerve fibers in the cartilage. Consequently, with a functional overload of the intervertebral disc, the transmission of a nerve impulse that triggers the activation of the metabolism will be premature.
- The self-healing (regeneration) ability of the cartilage tissue of the intervertebral disc is slowed due to its structural characteristics.
There are also other factors that clearly contribute to the development of degenerative processes in the cartilage tissue of the intervertebral discs and the formation of osteochondrosis.
Stages of pathological changes
Based on current data on the pathogenesis of this pathology, it is possible to conditionally distinguish several stages of the degenerative process in the intervertebral disc. Stages of osteochondrosis of the spine:
- Elementary. The cartilage tissue of the disc undergoes structural changes under mechanical influences - its dysfunction occurs. Characterized by the appearance of cracks on the surface of the disc, different in size and depth. Subsequently, these cracks turn into protrusions (hernias).
- Intermediate. It is characterized by the appearance of instability of the affected area of the spine due to the pathological mobility of the vertebrae. In this case, one of the main functions of the spine, the protective one, is disturbed. The nerve and vascular trunks flowing into its bone channels become vulnerable. Vivid clinical symptoms of the disease develop.
- Finished. There is a replacement of the affected cartilage tissue with a coarser and denser fibrous one. At the same time, intervertebral hernias disappear. And the pathological mobility of the vertebrae is replaced by a sharp limitation of their mobility. Often there is a narrowing of the spinal canal with the development of manifestations of compression of the segments of the spinal cord.
Therefore, each stage of the disease is characterized by the presence of its own specific symptoms, which undoubtedly play a key role in the choice of methods for the treatment of osteochondrosis.
Clinical manifestations
Signs of osteochondrosis of the spine appear as changes in the bone tissue of the vertebrae. The patient may not have complaints for quite a long time.
The disease is characterized by a chronic course, with phases of exacerbation and remission that replace each other.
Often an exacerbation of osteochondrosis occurs under the influence of provoking factors: physical overload, hypothermia, prolonged exposure to an uncomfortable position, for example, in a dream or at work, etc.
There are many symptoms of this disease, which depend on the localization of the pathological process and the severity of structural changes in cartilage and bone tissue. All these symptoms can be grouped into several syndromes. Quite often they are combined.
radicular syndrome
It occurs in almost all patients with osteochondrosis of the spine. In the occurrence of this syndrome, compression (compression) of the roots of the spinal nerves by pathologically altered structures of the spine plays a role.
The main sign of radicular syndrome is pain, which in a significant number of cases is able to spread (irradiation) along the course of the corresponding root innervation. Characterized by the irradiation of pain from top to bottom. For example, if the lower back is affected, the buttock hurts and gives way to the leg.
The intensity of pain increases with rotation of the trunk or neck, physical activity. Pain sensations are characterized by cutting, pulling, cooking.
In addition, along with the pain syndrome, symptoms of violation of sensitivity by the type of increase (hyperesthesia), as well as sensitivity disorders, numbness often develop in the affected area.
If the disease progresses and the cause of the compression is not eliminated, hyperesthesia is replaced by hypoesthesia (decreased sensitivity), which is often accompanied by symptoms of loss of function of the affected spinal root.
spinal syndrome
This syndrome develops due to compression of the spinal cord. The most common cause of this compression is an intervertebral hernia.
There is an increasing decrease in sensitivity, reactions to temperature and pain stimuli. Progressive muscle weakness develops in both the limbs and the trunk. Paretic or paralytic symptoms often form.
Vegetative-vascular syndrome
This syndrome most often develops in the cervical and cervicothoracic localization of spinal osteochondrosis.
The cause of vascular disorders in osteochondrosis is a reflex spasm or mechanical compression of large vessels that pass into the bone canals of the spine. In this case, various symptoms may develop, similar to an ischemic circulatory disorder of the brain or the main arteries of the extremities. This is often the cause of diagnostic errors.
In addition, various vegetative disorders often develop. They are more pronounced in women (emotional lability, sleep disturbances, menstrual irregularities, etc. ).
visceral syndrome
It is characterized by the occurrence of pain in the projection of the heart, organs of the gastrointestinal tract, etc. Often such patients are treated for a long time and absolutely without success for any somatic diseases.
For example, if the thoracic region is affected, pain behind the breastbone, similar to those with angina pectoris, may occur. There is often a reflex sensation of the heartbeat.
Diagnostic principles
In addition to the characteristic symptoms, additional methods of examination play an important role in determining the disease and staging: X-rays of the spine, computed and magnetic nuclear tomography.
According to the indications, other methods are performed, for example, EEG, ECG, Doppler scan of blood vessels, etc.
Treatment of osteochondrosis
Spine osteochondrosis therapy is an integrated approach. When choosing one or another method of treatment, it is necessary to assess the degree of damage to the structures of the spine, the nature and severity of clinical manifestations, as well as the stage of the course of the disease (exacerbation or remission).
An important role in the treatment of osteochondrosis of the spine is also played by preventive measures aimed at reducing the frequency of exacerbations of the disease and preserving the structure of the vertebrae and intervertebral discs.
Tactics during an exacerbation
An important condition for the treatment of the disease during this period is the creation of the rest of the affected area of the spine. To do this, the patient is prescribed bed rest with the use of various devices to create immobility in the affected vertebral segment.
In some cases, hospitalization in the neurological department is necessary.
Medical treatment
To reduce the intensity of pain in osteochondrosis, various drugs are prescribed:
- non-steroidal anti-inflammatory drugs (NSAIDs);
- analgesic;
- muscle relaxants.
In the absence of the effect of their use, it is advisable to prescribe blockages of the innervation of the affected area with the use of local anesthetics.
With cervical localization of osteochondrosis, circulatory disorders of the brain often develop. To reduce such manifestations, drugs are prescribed that improve cerebral blood flow. It is also necessary to use symptomatic remedies: relief from nausea and vomiting, improvement of vestibular disorders, etc.
In addition, it is advisable to prescribe vitamin preparations (especially of group B), antioxidants and some others.
Physiotherapy procedures
With osteochondrosis, treatment with physical factors has found wide application. Various methods of physiotherapy are used both during exacerbation and in the remission phase of the disease:
- In the acute period, ultraviolet irradiation, treatment with electromagnetic fields (UHF), diadynamic current, etc. are used.
- In the phase of remission, electrophoresis with various drugs, inductothermy, ultrasound and various types of balneotherapy are prescribed.
Tactics in remission
After the acute manifestations of the disease subsided, the treatment of the disease continues. The purpose of such therapy is to reduce the frequency of exacerbations and promote the regeneration of bone and cartilage tissue of the spine.
Continue the drug treatment prescribed for the acute phase of the disease. During this period, chondroprotectors, agents that improve the condition of the cartilage, can be used.
In addition to physiotherapy methods, massage and physiotherapy exercises are also used.
Massage
The main effect of the massage is aimed at improving blood circulation in the affected area and strengthening the muscle corset. In addition, the professional execution of massage movements allows you to relieve muscle spasm, which usually accompanies this pathology.
That is why the massage should be performed by a specially trained specialist who is fluent in this method of treatment. Incorrectly performed or illiterate massage can lead to the development of complications or exacerbation of the disease.
Therapeutic Exercise (LFK)
Dosed and specially selected physical exercises form the basis of physical therapy. The complex of such exercises is selected by the doctor individually for each patient. The principle of selecting physical therapy exercises is to reduce the physical load on the affected area of the spine.
The action of physiotherapy exercises is aimed at improving the blood supply and lymphatic flow in the affected area, strengthening the muscle tissue.
These exercises should be done every day. Usually, at the beginning, individual or group lessons are held with an instructor, then the patient can perform a series of exercises independently at home.
Prevention of exacerbations
Preventive measures of exacerbations of osteochondrosis of the spine are aimed at eliminating all provoking factors:
- It is necessary to monitor the correct posture and posture during the long standing and sitting position.
- It is useful in case of prolonged static stress (for example, working on the computer) to take regular breaks during which it is necessary to perform a warm-up or a series of exercises recommended by the doctor.
- Hypothermia should be avoided.
- It is important to sleep properly with osteochondrosis, to take care of a place to sleep - a mattress and a pillow. Ideally, they should be orthopedic.
- Mandatory is the reduction of excess body weight and the timely correction of concomitant somatic and endocrine pathology.
And when the slightest symptoms of a spinal disease appear, you should not delay a visit to a doctor. After all, the earlier treatment of osteochondrosis of the spine is started, the better the results.