Osteochondrosis of the spine is a degenerative-dystrophic lesion of the intervertebral discs, the vertebral body and the ligamentous 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 spine, the intervertebral disc, both vertebral bodies and neighboring nerve and muscle structures. This disease is often referred to as the "disease of civilization" associated with upright posture and stress on the spine every day.
The main cause of osteochondrosis of the spine is microtrauma from physical exertion, unhealthy diet, a sedentary lifestyle, and even genetic predisposition. As this disease progresses, the first thing that is affected is the disc and adjacent structures. The central part of the disc changes, which leads to the loss of the shock-absorbing properties of the vortex, as a result of which cracks and thinning form on the fiber ring.
American statisticians say that the first reason people under 45 years of age limit activity is pain in the back and cervical spine. Most city dwellers, drivers who spend a significant amount of their time sitting and reloading their spine, are at risk.
Osteochondrosis is the cause of more than 70% of back pain cases. The risk of the disease increases with age.
Etiology and pathogenesis of spinal osteochondrosis
Osteochondrosis of the spine has a long-term pathogenesis (from several months to decades). It depends on the factors that affect the development of the disease.
Risk factors:
- Age. Older people (over 60) are at risk. The disease is rare in people under the age of 35. As a result of age-related changes, disorders occur in the human hormonal background, making muscle tissue and blood vessel walls more porous and therefore more vulnerable. This leads to metabolic disorders, overloads the intervertebral discs.
- Autoimmune diseases that perceive cartilage tissue as foreign and can destroy it.
- spinal injuries. This is one of the main reasons for developing osteochondrosis in young people. It is believed that more than half of people with spinal injuries at a young age have osteochondrosis of the spine in old age.
- Overweight, which reduces wear on the intervertebral discs. Cartilage discs act as a kind of shock absorber for the spine, ensuring its mobility during physical activity, walking, running, etc. , and protecting the bone tissue from destruction and the appearance of microcracks. The severity of being overweight makes the load even stronger, which accelerates the destruction of cartilage discs.
- Flat feet.
- Genetic predisposition.
- Diseases of the endocrine system that cause metabolic disorders, which in turn have a negative effect on the condition of the cartilage tissue.
Osteochondrosis can be in a "dormant state" for a long time. Many patients find out about the disease when the pain is severe, when the dystrophic process in the cartilage tissue has already damaged the nerve roots.
There are stages in the pathogenesis of spinal osteochondrosis:
- Injury to the blood supply to the intervertebral discs and adjacent structures.
- In particular, hormonal and metabolic disorders in the body and in the intervertebral discs.
- Degradation processes of the nucleus pulposus. At this stage, the structure of the intervertebral disc changes - the nucleus decreases, the intervertebral disc itself becomes thinner, the load on the annulus fibrosus increases, which results in various layers, microcracks, and sometimes cracks.
- Protrusion of intervertebral discs - protrusion of the tissue of the intervertebral discs, often in the direction of the spinal canal, hits it and causes severe pain.
- intervertebral hernia. The progression of the protrusion leads to the destruction of the ligaments, a change in the height and shape of the intervertebral disc, which in turn provokes the formation of hernias.
- Compression of the radicular arteries.
- Chronic insufficiency of the 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 cause the appearance of an intervertebral hernia.
Symptoms can be both general and specific and characteristic of pathological changes in the cartilage, intervertebral discs and adjacent tissues.
The very first sign of osteochondrosis should be described as painful back pain, numbness of the vertebral sections, restricted mobility and increased pain during physical exertion.
Specific symptoms of osteochondrosis:
- Cervical osteochondrosis is characterized by impaired blood circulation, which causes dizziness, pain and tinnitus as well as headaches. The brain is poorly enriched with oxygen and nutrients, as a result of which a person experiences a state of stress.
- Osteochondrosis of the chest region, often accompanied by intercostal neuralgia. There is pain in the chest and ribs.
- Osteochondrosis of the lumbar spine leads to the development of diseases of lumbago, lumbosacral (sciatica) and lumbar sciatica. With sciatica, the sciatic nerve is affected, there is pain and hypotension in the buttocks, and hypotension in the calves.
Symptoms of cervical osteochondrosis:
- Cirvicalgia - pain in the cervical spine. The nature of the pain is different (dull, sharp, aggravated by tilting the head and trunk when coughing) depending on the factor affecting that part of the spine.
- Cervicobrachialgia - pain in the cervical spine radiating to the arm, numbness.
- shoulder-scapula rearthrosis and rearthritis - pain in the shoulder joint, in the collarbone, which restricts the movement of the arm from top to bottom.
- Epicondylosis - pain in the elbow joint, restricted movement.
- Vertebral artery syndrome - so-called cervical migraines, headache and pain in the cervix, nausea, sometimes vomiting, impaired coordination of movements - staggering when walking, tinnitus.
One of the most common signs of cervical osteochondrosis is impaired blood flow, which leads to frequent dizziness, fainting and headaches.
Symptoms of breast osteochondrosis:
- Thoracic pain - chest pain, pain related to immobility (manifested by prolonged sitting at night), aggravated by physical activity, deep breath, cough.
- heart syndrome.
- Posterior chest wall syndrome - pain in the area of the shoulder blades, pain sensations depend on the position of the body.
- Anterior scalene muscle syndrome.
- Truncalgic Syndrome - pain in half of the chest.
- aggravation of intercostal neuralgia.
Symptoms of lumbar osteochondrosis:
- Lumbodynia - pain in the lower back, lumbago. The patient feels uncomfortable when trying to sit or stand up. The pain increases with exercise, coughing, deep breathing, and bending over.
- Lumboischialgia - pain in the lower back that radiates to the leg. Paresthesia, numbness in the legs, muscle cramps and joint pain can occur.
- Vascular syndromes - they occur with compression of blood vessels, are not accompanied by pain, there is muscle weakness, cone syndrome - weakness in both feet, dysfunction of the pelvic organs.
The symptoms of osteochondrosis in the lumbar spine are varied. This part of the spine is more stressed than others.
Diagnosis of osteochondrosis of the spine
When the first pain in the back, an examination should be carried out to determine the cause of the pain. Osteochondrosis is a difficultly diagnosed disease because pain can be caused by other pathologies unrelated to the spine. The patient must be consulted by several specialists: first of all, a neurologist, an orthopedic surgeon or a vertebrate.
Methods of 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 mostly taken in two positions - lying on your back and lying on your side. Two different projections of images make it possible to more accurately determine the presence of a pathology. Sometimes an x-ray is taken with the lower jaw facing down.
- MRI and CT. MRI results are considered more accurate and help to quickly determine the location of segments affected by pathology, the presence or absence of intervertebral hernias, and compression of the roots.
- Laboratory tests: blood test to determine the calcium level in the blood and the sedimentation rate of the erythrocytes. From the start, more recently, laboratory tests are passed on from the doctor to hardware diagnosis based on these results.
It is important to distinguish osteochondrosis of the spine in a number of other diseases with a similar clinical picture, e. g. B. oncological neoplasms of the spine, violation of the integrity of cartilage tissue, inflammation, intermittent claudication, formation of cysts on the internal organs, urolithiasis, gastritis, pyelonephritis, gastric ulcer, angina pectoris, disorders of the nervous system. For this purpose, examinations of the digestive system, nervous system, and blood circulation may be prescribed. The following diagnostic methods are used - cardiogram, ultrasound, electroencephalography, endoscopic examination (digestive organs).
Complications of osteochondrosis
The course of this disease is usually accompanied by neurological complications:
- stage. Complications from projection - sharp painful shooting sensations.
- stage. Radiculitis, which, depending on the location of the radiculitis, is characterized by pain syndromes and other symptoms.
- stage. Pathology of the roots and spinal nerve, the presence of intervertebral hernias. Muscle palsy often occurs, leading to paralysis of the entire body.
- stage. Violation of circulation and blood supply to the entire spinal cord. Symptoms: persistent severe back pain, paralysis of certain muscle groups, ischemic stroke of the spinal cord.
Treatment of osteochondrosis of the spine
The process of treating any type of osteochondrosis has one goal - to relieve pain, prevent destruction and deformation of the spinal tissue. Treatment can be conservative or surgical. The type and method of treatment is prescribed for each patient individually, based on the diagnosis (stage, type of disease, general well-being of the patient).
In the acute phase of the pain syndrome, relaxation and rest are recommended. Anti-inflammatory drugs (Dicloberl, Voltaren), injections of antispasmodic mixtures, vitamin B, preparations for rubbing - Dip Rileaf, Larkspur, etc. can be prescribed when the pain syndrome subsides. Physical education and physiotherapy (diadynamic currents, electrophoresis, magnetotherapy).
Conservative treatment takes about two months. In addition to the treatment methods listed, massage, manual therapy, reflexology and extraction can also be used. The outcome of conservative treatment directly depends on the patient's perseverance and care.
There is also a surgical method of treatment that is used for intervertebral hernias more than six months old where the roots of the spinal cord are compressed due to narrowing of the gap between the vertebrae. The principle of surgical treatment is to remove the deformed disc. The rehabilitation period after the operation is approximately six months. Rehabilitation includes exercise therapy, physical therapy, and the intake of vitamins.
Prevention of osteochondrosis of the spine consists in combating risk factors - maintaining an active lifestyle, exercising, eating right, using corsets and special belts when loading the back, sleeping on orthopedic mattresses and pillows, avoiding hypothermia and injuries.