Osteochondrosis of the spine is a degenerative-dystrophic lesion of the intervertebral discs, the vertebral body, the ligament apparatus, in which the bone and cartilage tissue of the cervical, thoracic and lumbar spine is destroyed.
The pathology affects the entire motor segment of the spinal column, the disc, both vertebral bodies and adjacent nerve and muscle structures. This disease is often called "the disease of civilization", which is associated with upright posture and stress on the spine every day.
The main cause of spinal osteochondrosis are microtraumas during physical exertion, an unhealthy diet, a sedentary lifestyle and even a genetic predisposition. If this disease progresses, the intervertebral disc and adjacent structures suffer first. The central part of the disc changes, which leads to the loss of the shock-absorbing properties of the vertebra, as a result of which cracks and thinning are formed on the fibrous ring.
American statisticians say that the first reason for limiting the activity of people under 45 is pain in the back and neck. Most urban residents, drivers, who spend a significant portion of their time in a sitting position, recharging the spine, are at risk.
Osteochondrosis is the cause of over 70% of back pain cases. The risk of disease increases with age.
Etiology and pathogenesis of spinal osteochondrosis
Spinal osteochondrosis has a long-term pathogenesis (from several months to decades). It depends on the factors influencing the development of the disease.
Risk factors:
- Age. Older people (over 60) are at risk. In people under 35, the disease is rare. As a result of age-related changes, violations occur in the human hormonal background, which makes muscle tissue and blood vessel walls more porous, which means more vulnerable. This causes metabolic disorders, overloads the intervertebral discs.
- Autoimmune diseases that can perceive cartilage tissue as foreign and begin to destroy it.
- Spinal injuries. This is one of the main reasons for the development of osteochondrosis in young people. More than half of people with spinal injuries at a young age are believed to have osteochondrosis of the spine at an older age.
- Overweight, which reduces wear on the intervertebral discs. The cartilaginous discs serve as a kind of shock absorbers for the spine, which guarantee its mobility during physical activity, walking, running, etc. And they protect the bone tissue from destruction and the appearance of microcracks. The severity of excess weight makes the load even stronger, which accelerates the destruction of cartilage discs.
- Flat feet.
- Genetic predisposition.
- Diseases of the endocrine system, which cause metabolic disorders, which in turn negatively affect the state of the cartilage tissue.
Osteochondrosis can remain in a "dormant state" for a long time. Many patients become aware of the disease in the presence of severe pain, when the dystrophic process in the cartilage tissue has already damaged the nerve roots.
There are such stages in the pathogenesis of osteochondrosis of the spine:
- Violation of blood circulation in the intervertebral discs and adjacent structures.
- Hormonal and metabolic disorders in the body and intervertebral discs, in particular.
- Processes of degradation of the nucleus pulposus. At this stage, the structure of the intervertebral disc changes: the nucleus decreases, the disc itself becomes thinner, the load on the annulus fibrosus increases, which leads to various stratifications, microcracks and sometimes ruptures.
- Protrusion of the intervertebral discs - protrusion of the tissue of the intervertebral discs, often towards the spinal canal, which affects it causing severe pain.
- Intervertebral hernia. The progression of protrusion leads to the destruction of the ligaments, a change in the height and shape of the disc, which in turn causes the formation of hernias.
- Compression of the root arteries.
- Chronic insufficiency of blood supply to the spinal cord.
Symptoms of spinal osteochondrosis
As osteochondrosis develops, pathologies appear in the intervertebral discs and in the cartilage itself, which subsequently overlap and can provoke the appearance of an intervertebral hernia.
Symptoms can be both general and specific, characteristic of pathological changes in cartilage, intervertebral discs and adjacent tissues.
The first sign of osteochondrosis should be called aching back pain, numbness of the spine, limited movement, increased pain during physical exertion.
Specific symptoms of osteochondrosis:
- Cervical osteochondrosis is characterized by impaired blood circulation, which causes dizziness, pain and tinnitus, headache. The brain is poorly enriched with oxygen and nutrients, as a result of which a person experiences a state of stress.
- Osteochondrosis of the thoracic region, often accompanied by intercostal neuralgia. There is pain in the chest and ribs.
- Osteochondrosis of the lumbar spine causes the development of diseases of low back pain, lumbosacral (sciatica) and lumbar sciatica. With sciatica, the sciatic nerve is affected, there is pain and hypotension in the buttocks, as well as hypotension in the calves.
Symptoms of cervical osteochondrosis:
- Cirvicalgia - pain in the cervical spine. The nature of the pain is varied (dull, sharp, aggravated by the tilt of the head and torso, when coughing), depending on the factor affecting this section of the spine.
- Cervicobrachialgia - pain in the cervical spine, which radiates to the hand, numbness.
- Shoulder-scapular arthrosis and retrotritis - pain in the shoulder joint, collarbone, limitation of hand movement from top to bottom
- Epicondylosis: pain in the elbow joint, limited movement.
- Vertebral artery syndrome - the so-called cervical migraine, aching headache and neck pain, nausea, sometimes vomiting, impaired coordination of movements - staggering when walking, tinnitus.
One of the most common signs of cervical osteochondrosis is impaired blood circulation, which leads to frequent dizziness, fainting and headache.
Symptoms of breast osteochondrosis:
- Thoracalgia - chest pain, pain associated with immobility (manifested by prolonged sitting, at night), aggravated by physical activity, deep breathing, cough.
- Cardiac syndrome.
- Posterior chest wall syndrome - pain in the shoulder blade area, pain sensations depend on the position of the body.
- Anterior scalene syndrome.
- Truncalgia syndrome - pain in the middle of the chest.
- Aggravation of intercostal neuralgia.
Symptoms of lumbar osteochondrosis:
- Lumbodynia - pain in the lower back, low back pain. The patient feels discomfort when trying to sit or stand up. The pain intensifies with physical activity, coughing, deep breathing, bending over.
- Lumboischialgia - pain in the lower back, which radiates to the leg. Paresthesia, numbness of the legs, muscle spasms and joint pain can occur.
- Vascular syndromes: they debut with the compression of blood vessels, are not accompanied by pain, there is weakness in the muscles, cone syndrome - weakness in both feet, dysfunction of the pelvic organs.
The symptoms of osteochondrosis in the lumbar spine are different. This part of the spine is loaded more than others.
Diagnosis of spinal osteochondrosis
At first back pain, an examination should be done to determine the source of the pain. Osteochondrosis is a difficult to diagnose disease, as pain can be caused by other pathologies not related to the spine. The patient will need consultations of several specialists: a neurologist, first of all, an orthopedist, a vertebrologist.
Methods for diagnosing osteochondrosis:
- Radiography. It is performed to accurately determine the height of the intervertebral discs or changes in the structure of the vertebrae, changes in the diameter of the holes between the vertebrae. X-rays are often performed in two positions: lying on your back and on your side. Two different image projections allow you to more accurately determine the presence of pathology. Sometimes an x-ray is done with the lower jaw down.
- MRI and CT. The results of MRI are considered more accurate and help to quickly determine the localization of segments that were affected by pathology, the presence or absence of intervertebral hernias, compression of the roots.
- Laboratory tests: blood test to determine the level of calcium in the blood and the sedimentation rate of erythrocytes. Laboratory tests are prescribed by the first, more recently, based on these results, the doctor directs them to hardware diagnostics.
It is important to differentiate osteochondrosis of the spine into a number of other diseases with a similar clinical picture, for example: neoplasms on the spine of an oncological nature, violation of the integrity of cartilage tissue, inflammation, intermittent claudication, formation ofcysts on internal organs, urolithiasis, gastritis, gastric pyelonephritis, angina pectoris, disorders of the nervous system. For this purpose, studies on the digestive system, nervous system and blood circulation can be prescribed. Such diagnostic methods are used: cardiogram, ultrasound examination, electroencephalography, endoscopic examination (digestive organs).
Complications of osteochondrosis
Very often, the course of this disease is accompanied by neurological complications:
- Phase. Complications caused by protrusion - acute painful shooting sensations.
- Phase. Radiculitis, which are characterized by painful syndromes and other symptoms, depending on the localization of the radiculitis.
- Phase. Pathology of the roots and spinal nerve, presence of intervertebral hernias. Muscle paresis often occurs, resulting in whole body paralysis.
- Phase. Violation of blood circulation and blood supply to the entire spinal cord. Symptoms: persistent severe back pain, paralysis of some muscle groups, ischemic stroke of the spinal cord.
Treatment of osteochondrosis of the spine
The treatment process of any type of osteochondrosis pursues one goal: to relieve pain, prevent the destruction and deformation of spinal tissues. Treatment can be conservative or surgical. The type and method of treatment are prescribed individually for each patient, based on the diagnosis (stage, type of disease, general well-being of the patient).
In the acute period of pain syndrome, relaxation and rest, anti-inflammatory drugs (dicloberl, voltaren), injections of antispasmodic mixtures, vitamin B, preparations for rubbing - dip rileaf, larkspur, etc. are recommended. , They can be prescribed as the pain syndrome subsides. physical education and physiotherapy (diadynamic currents, electrophoresis, magnetotherapy).
Conservative treatment lasts about two months. In addition to the listed treatment methods, massage, manual therapy, reflexology and extraction can also be used. The result of conservative treatment directly depends on the persistence and diligence of the patient.
There is also a surgical method of treatment that is used in the presence of intervertebral hernias older than six months, compression of the spinal roots due to a narrowing of the space between the vertebrae. The principle of surgical treatment is to remove the deformed disc. The rehabilitation period after surgery is about six months. Rehabilitation includes physical therapy, physiotherapy, and vitamin intake.
Prevention of osteochondrosis of the spine consists in combating risk factors: maintaining an active lifestyle, playing sports, proper nutrition, using special corsets and belts when loading the back, sleeping on orthopedic mattresses and pillows, avoid hypothermia and injury.