Osteochondrosis is a chronic pathology of the spine, whose root cause 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 fate of the elderly, but recently an increase in the incidence of this disease among young people has been revealed. Both women and men get sick with the same frequency.
Why does osteochondrosis occur?
To better understand what osteochondrosis is, it is necessary to briefly address the causes and mechanism of its occurrence.
The formation of pathological changes in osteochondrosis of the spine occurs slowly. Many years pass from the beginning of the pathological process in the intervertebral cartilage to the manifestation of the first symptoms of osteochondrosis.
Causes of osteochondrosis
Spine health is directly affected by many negative factors. If its influence is carried out for a long time, the result of this 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 that lead to the development of degenerative damage to the cartilaginous tissue of the discs.
How does osteochondrosis develop?
The mechanism of development (or pathogenesis) of osteochondrosis is still controversial and poorly studied. It is more likely that 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 occur in the cartilaginous tissue of the intervertebral disc, followed by its gradual destruction (or destruction).
The pathological process 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 provided by the bone tissue of neighboring vertebrae. Therefore, in case of circulatory disorders as a result of insufficient or, conversely, excessive physical stress on the spine, cartilage nutrition also suffers.
- 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 metabolism will be untimely.
- The self-healing (regeneration) ability of the cartilaginous tissue of the intervertebral disc is delayed due to its structural characteristics.
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 in 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, different in size and depth. Subsequently, these fissures are transformed into protrusions (hernias).
- Intermediary. It is characterized by the appearance of 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 one, is disturbed. The nerve and vascular trunks that run in its bony canals become vulnerable. Vivid clinical symptoms of the disease develop.
- Finite. There is a replacement of the cartilaginous tissue affected by a coarser and denser fibrous tissue. At the same time, intervertebral hernias disappear. And the pathological mobility of the vertebrae is replaced by a marked restriction of their mobility. Often there is a narrowing of the spinal canal with the development of manifestations of compression of the spinal cord segments.
Therefore, each stage of the disease is characterized by the presence of its own specific symptoms, which undoubtedly plays a key role in the choice of osteochondrosis treatment methods.
Clinical manifestations
The signs of osteochondrosis of the spine appear as changes in the bone tissue of the vertebrae. The patient may not have complaints for a long time.
The disease is characterized by a chronic course, with phases of exacerbation and remission replacing 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 location of the pathological process and the severity of structural changes in cartilage and bone tissue. All these symptoms can be grouped into several syndromes. They are often combined.
radicular syndrome
It occurs in almost all patients with osteochondrosis of the spine. In the occurrence of this syndrome, compression (compression) of the spinal nerve roots 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 innervation of the corresponding root. Characterized by radiating pain from top to bottom. For example, if the lower back is affected, the buttock hurts and gives way to the leg.
Pain intensity increases with trunk or neck rotation, physical activity. Pain sensations are characterized as cutting, pulling, baking.
Also, along with the pain syndrome, in the affected area, symptoms of violation of sensitivity by the type of increase (hyperesthesia) often develop, as well as sensitivity disorders, numbness.
If the disease progresses and the cause of compression is not eliminated, hyperesthesia is replaced by hypoesthesia (decreased sensation), which is usually accompanied by symptoms of loss of function of the affected spinal root.
spinal syndrome
This syndrome develops as a result of spinal cord compression. 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 in both the limbs and the trunk. Paretic or paralytic symptoms are often formed.
vegetative-vascular syndrome
This syndrome usually develops at the cervical and cervicothoracic location of spinal osteochondrosis.
The cause of vascular disorders in osteochondrosis is a reflex spasm or mechanical compression of large vessels passing in the bony 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 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 these patients are treated for a long time and absolutely unsuccessfully for any somatic diseases.
For example, if the thoracic region is affected, pain may occur behind the sternum, similar to that with angina pectoris. There is often a reflex sensation of the heartbeat.
diagnostic principles
In addition to the characteristic symptoms, complementary examination methods play an important role in determining the disease and staging - spinal X-ray, CT and MRI.
According to the indications, other methods are performed, for example, EEG, ECG, Doppler scan of blood vessels, etc.
Osteochondrosis treatment
Spinal osteochondrosis therapy is an integrated approach. When choosing one or another treatment method, it is necessary to assess the degree of damage to the structures of the spine, the nature and severity of the 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 rest in the affected area of the spine. To do this, the patient is prescribed bed rest with the use of various devices to create immobility to the affected vertebral segment.
In some cases, hospitalization in the neurological department is necessary.
Medical treatment
To reduce the intensity of pain in osteochondrosis, several drugs are prescribed:
- non-steroidal anti-inflammatory drugs (NSAIDs);
- analgesic;
- muscle relaxants.
In the absence of the effect of its use, it is advisable to prescribe blocks of the innervation of the affected area with the use of local anesthetics.
With the cervical location of osteochondrosis, circulatory disorders of the brain often develop. To reduce such manifestations, drugs that improve cerebral blood flow are prescribed. 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. Several physiotherapy methods are used both during the 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, indothermia, ultrasound and various types of balneotherapy are prescribed.
Tactics in the remission phase
After the disappearance of the acute manifestations of the disease, the treatment of the disease continues. The aim of this 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 - 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 massage is aimed at improving blood circulation in the affected area and strengthening the muscular corset. In addition, the professional performance of massage movements allows you to relieve muscle spasm, which usually accompanies this pathology.
That's why massage should be performed by a specialist who is specially trained and fluent in this treatment method. Massage performed incorrectly or illiterate 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 selecting exercise therapy exercises is to reduce the physical load on the affected area of the spine.
The action of physiotherapeutic exercises aims to improve blood supply and lymphatic flow to the affected area, strengthening muscle tissue.
These exercises should be done every day. Usually, at the beginning, individual or group classes are carried out with an instructor, then the patient can perform a set of exercises independently at home.
Prevention of exacerbations
Preventive measures of exacerbations of osteochondrosis of the spine aim to eliminate all provoking factors:
- It is necessary to monitor correct posture and posture for a long time while standing and sitting.
- It is helpful for prolonged static stress (eg working at a computer) to take regular breaks during which you should warm up or do a series of exercises recommended by your doctor.
- Hypothermia must be avoided.
- It is important to sleep properly with osteochondrosis, 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 timely correction of concomitant somatic and endocrine pathology.
And when the slightest symptoms of spinal disease appear, you shouldn't delay visiting the doctor. After all, the sooner the treatment of osteochondrosis of the spine is started, the better your results will be.