Osteochondrosis is a chronic pathology of the spine, the root cause of which is 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 older people, but recently an increase in the incidence of this disease in young people has been revealed. Women and men get sick equally often.
Why does osteochondrosis occur?
In order to better understand what osteochondrosis is, it is necessary to briefly dwell 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 onset of the pathological process in the intervertebral cartilage to the manifestation of the first symptoms of osteochondrosis.
Causes of osteochondrosis
Spinal health 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 spine. And this contributes to the formation of osteochondrosis.
For example, what osteochondrosis is 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 lesions of the cartilaginous tissue of the discs.
How does osteochondrosis develop?
The mechanism of development (or pathogenesis) of osteochondrosis is still controversial and insufficiently studied. Most likely, this disease is formed on the basis of metabolic disorders that occur in the structures of the spine.
Under the influence of adverse factors, often irreversible changes in the cartilaginous tissue of the intervertebral disc occur, 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 changes in 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 ensured by the bone tissue of the neighboring vertebrae. Therefore, in case of circulatory disorders resulting from insufficient or, conversely, excessive physical stress on the spine, cartilage nutrition also suffers.
- There are also no nerve fibers in the cartilage. Therefore, with a functional overload of the intervertebral disc, the transmission of a nerve impulse triggering the activation of metabolism will be untimely.
- The self-healing (regeneration) ability of the cartilaginous tissue of the intervertebral disc is slowed down due to its structural features.
There are also other factors that clearly contribute to the development of degenerative processes in the cartilaginous tissue of the intervertebral discs and the formation of osteochondrosis.
Stages of pathological changes
Based on current data on the pathogenesis of this pathology, several stages of the degenerative process of the intervertebral disc can be conditionally distinguished. Stages of osteochondrosis of the spine:
- Elementary. The cartilaginous tissue of the disc undergoes structural changes under mechanical influences - its dysfunction occurs. Characterized by the appearance of cracks on the surface of the disk, which differ 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, that of protection, is disturbed. The nerve and vascular trunks that run through its bone channels become vulnerable. Vivid clinical symptoms of the disease develop.
- Finished. There is a replacement of the affected cartilage tissue with coarser and denser fibrous tissue. At the same time, intervertebral hernias disappear. And the pathological mobility of the vertebrae is replaced by a strong restriction 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 treatment methods for osteochondrosis.
Clinical manifestations
Signs of osteochondrosis of the spine appear as changes in the bone tissue of the vertebrae. The patient may have no complaints for a long time.
The disease is characterized by a chronic course, the phases of exacerbation and remission replacing each other.
Often an exacerbation of osteochondrosis occurs under the influence of provoking factors: physical overstrain, 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 location 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. Very 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 impaired 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 (radiate) along the innervation of the corresponding root. Characterized by radiating pain from top to bottom. For example, if the lumbar region 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 as cutting, pulling, stinging.
Also, along with the pain syndrome, in the affected area, symptoms of violation of sensitivity by the type of its increase (hyperesthesia) often develop, as well as disturbances of sensitivity, numbness.
If the disease progresses and the cause of the compression is not eliminated, the hyperesthesia is replaced by hypoesthesia (decreased sensitivity), which is often accompanied by symptoms of loss of function of the affected vertebral root.
spinal syndrome
This syndrome develops as a result of compression of the spinal cord. The most common cause of such compression is an intervertebral hernia.
There is an increasing decrease in sensitivity, reactions to temperature and pain stimuli. Progressive muscle weakness develops both in the limbs and in the trunk. Paretic or paralytic symptoms are often formed.
Vegetative-vascular syndrome
This syndrome most often develops in the cervical and cervico-thoracic localization of spinal osteochondrosis.
The cause of vascular disorders in osteochondrosis is a reflex spasm or mechanical compression of large vessels passing through the bone canals of the spine. In this case, various symptoms may develop, resembling an ischemic circulatory disorder of the brain or the main arteries of the extremities. This is often the cause of misdiagnosis.
In addition, various vegetative disorders often develop. They are more pronounced in women (emotional instability, sleep disorders, menstrual irregularities, etc. ).
visceral syndrome
It is characterized by the appearance of pain in the projection of the heart, organs of the gastrointestinal tract, etc. Often such patients are treated for a long time and unsuccessfully for all somatic diseases.
For example, if the chest region is affected, pain behind the breastbone may occur, resembling that of angina. Often there is a reflex sensation of the heartbeat.
Diagnostic principles
In addition to characteristic symptoms, additional methods of examination play an important role in determining the disease and staging - x-ray of the spine, computerized nuclear and magnetic tomography.
Depending on the indications, other methods are performed, for example, EEG, ECG, Doppler scanning of blood vessels, etc.
Treatment of osteochondrosis
Spinal 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 developmentdisease (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 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 of the affected vertebral segment.
In some cases, hospitalization in the neurology department is necessary.
Medical treatment
To reduce the intensity of pain in osteochondrosis, various drugs are prescribed:
- nonsteroidal anti-inflammatory drugs (NSAIDs);
- analgesic;
- muscle relaxants.
In the absence of an effect from their use, it is advisable to prescribe blockades 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 these manifestations, drugs are prescribed to improve cerebral blood flow. It is also necessary to use symptomatic remedies - relief of 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 remission phase, electrophoresis with various drugs, inductothermy, ultrasound and various types of balneotherapy are prescribed.
Tactics in the Remission Phase
After the acute manifestations of the disease disappear, 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 in the spine.
Drug treatment prescribed for the acute phase of the disease continues. During this period, chondroprotectors can be used - agents that improve the condition of cartilage.
In addition to physiotherapy methods, massage and physiotherapy exercises are also used.
Massage
The main effect of 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 spasms, which usually accompany this pathology.
That is why the massage should be performed by a specially trained specialist who is familiar with this method of treatment. Improperly or illiterately performed 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 exercise therapy. The complex of such exercises is selected by the doctor individually for each patient. The principle of selection of exercise therapy exercises is to reduce the physical load on the affected area of the spine.
The action of physiotherapy exercises is aimed at improving blood supply and lymphatic flow in the affected area, strengthening muscle tissue.
These exercises should be done every day. Usually, at first, individual or group lessons are held with an instructor, and then the patient can perform a series of exercises independently at home.
Prevention of exacerbations
Preventive measures for exacerbations of osteochondrosis of the spine are aimed at eliminating all provoking factors:
- It is necessary to monitor the correct posture and posture during prolonged standing and sitting.
- It is useful in the event of prolonged static stress (for example, working in front of a computer) to take regular breaks during which you will have to do a warm-up or a series of exercises recommended by your doctor.
- Hypothermia should be avoided.
- It is important to sleep well with osteochondrosis, to take care of a place to sleep - a mattress and a pillow. Ideally, they should be orthopedic.
- Reduction of excess weight and timely correction of concomitant somatic and endocrine pathology are mandatory.
And when the slightest symptoms of the disease of the spine appear, you should not delay to consult a doctor. After all, the earlier the treatment of osteochondrosis of the spine is started, the better its results.