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 included in the pathological process - vertebral bodies, intervertebral joints, ligaments and others.
The disease affects people of all ages. Until recently, osteochondrosis was considered the fate of the elderly, but recently there has been an increase in the incidence of this disease among young people. Both women and men get sick equally often.
Why does osteochondrosis occur?
To better understand what osteochondrosis is, it is necessary to briefly consider the causes and mechanism of its occurrence.
The formation of pathological changes in osteochondrosis of the spine is slow. It often takes years from the beginning of the pathological process in the intervertebral cartilage to the onset of the first symptoms of osteochondrosis.
Causes of osteochondrosis
Spinal health is directly affected by many negative factors. If their influence lasts for a long time, then 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 is osteochondrosis is well known to people who lead an inactive lifestyle, who are overweight. Excessive physical activity, injuries to the back and neck, some somatic diseases can also lead to the development of this pathology. And deteriorating heredity and old age are direct factors leading 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 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, irreversible changes often occur in the cartilaginous tissue of the intervertebral disc, followed by its gradual destruction (or destruction).
Then the pathological process spreads to the bone tissue of the vertebrae with the development of its deformation and irreversible changes in the surrounding structures.
The appearance of such modifications 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 adjacent vertebrae. Therefore, in the case of circulatory disorders as a result of insufficient or, conversely, excessive exercise of the spine, the nutrition of cartilage also suffers.
- There are also no nerve fibers in the cartilage. Therefore, in the case of functional overload of the intervertebral disc, the transmission of a nerve impulse that triggers the activation of metabolism will be untimely.
- The ability to self-heal (regenerate) the cartilaginous tissue of the intervertebral disc is slowed down due to its structural features.
There are other factors that clearly contribute to the development of degenerative processes in the cartilage 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. It is characterized by the appearance of cracks on the surface of the disk, different in size and depth. Subsequently, these cracks are transformed into protrusions (hernias).
- Intermediate. 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 violated. The nerve and vascular trunks that pass into his bone canals become vulnerable. Vivid clinical symptoms of the disease develop.
- Extreme. The affected cartilage tissue is replaced by coarser and denser fibrous tissue. At the same time, intervertebral hernias disappear. And the pathological mobility of the vertebrae is replaced by a sharp reduction in their mobility. There is often 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 plays a key role in the choice of methods for the treatment of osteochondrosis.
Clinical manifestations
Signs of osteochondrosis of the spine manifest themselves as changes in the bone tissue of the vertebrae. The patient may not complain for a long time.
The disease is characterized by a chronic course, with the phases of exacerbation and remission alternating.
Exacerbation of osteochondrosis often occurs under the influence of provoking factors: physical exertion, hypothermia, prolonged exposure to an awkward position, such as sleep or work, and others.
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. Compression (compression) of the roots of the spinal nerves by pathologically altered structures of the spine plays a role in the occurrence of this syndrome.
The main sign of the radicular syndrome is the pain, which in a significant number of cases is able to spread (irradiate) in the course of innervation of the respective root. It is characterized by radiating pain from top to bottom. For example, if the lumbar region is affected, the buttocks hurt and give way to the legs.
The intensity of pain increases with rotation of the trunk or neck, physical activity. Pain sensations are characterized as cutting, pulling, burning.
Also, along with the pain syndrome, the affected area often develops symptoms of sensitivity disorder in the form of its increase (hyperesthesia), as well as sensitivity disorders, numbness.
If the disease progresses and the cause of the compression is not eliminated, then hyperesthesia is replaced by hypoaesthesia (decreased sensitivity), which is often accompanied by symptoms of loss of function of the affected spinal 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 in both the limbs and the body. Paretic or paralytic symptoms often occur.
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 reflex spasm or mechanical compression of large vessels passing into 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 limbs. This is often the cause of diagnostic errors.
In addition, various vegetative disorders often develop. They are most pronounced in women (emotional lability, sleep disorders, menstrual disorders, 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 completely unsuccessful for any somatic diseases.
For example, if the chest area is affected, pain behind the sternum may occur, resembling those with angina pectoris. There is often a reflex sensation of heart rhythm.
Diagnostic principles
In addition to the characteristic symptoms, additional research methods play an important role in determining the disease and staging - X-ray of the spine, computed tomography and magnetic resonance imaging.
According to the indications, other methods are performed, such as EEG, ECG, Doppler scan of blood vessels, etc.
Treatment of osteochondrosis
The treatment of osteochondrosis of the spine 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 disease (exacerbation or remission). .
An important role in the treatment of osteochondrosis of the spine is 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 exacerbations
An important condition for the treatment of the disease during this period is the creation of rest on the affected area of the spine. To do this, the patient is prescribed bed rest using various devices to create immobility of the affected spinal segment.
In some cases, hospitalization in the neurology department is required.
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 effect of their use, it is recommended to prescribe blockades of the innervation of the affected area using local anesthetics.
With cervical localization of osteochondrosis, cerebrovascular disorders often develop. Drugs that improve cerebral blood flow are prescribed to reduce such symptoms. It is also necessary to use symptomatic means - relief of nausea and vomiting, improvement of vestibular disorders and others.
In addition, it is advisable to prescribe vitamin preparations (especially group B), antioxidants and some others.
Physiotherapeutic procedures
In osteochondrosis, treatment with physical factors is widely used. Various physiotherapeutic methods are used both during exacerbation and in the remission phase of the disease:
- In the acute period, ultraviolet radiation, electromagnetic field therapy (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 have subsided, the treatment of the disease continues. The aim of such therapy is to reduce the frequency of exacerbations and to promote the regeneration of bone and cartilage tissue of the spine.
Drug treatment prescribed for the acute phase of the disease continues. Chondroprotectors can be used during this period - agents that improve the condition of cartilage.
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 muscular corset. Also, the professional performance of massage movements allows you to relieve muscle spasm, which usually accompanies this pathology.
Therefore, the massage should be performed by a specially trained specialist who knows this method of treatment. Improper or illiterate massage can lead to complications or exacerbation of the disease.
Therapeutic Gymnastics (LFK)
Dosed and specially selected physical exercises are the basis of exercise therapy. The complex of such exercises is chosen by the doctor individually for each patient. The principle of choosing exercises for therapeutic therapy is to reduce physical exertion on the affected area of the spine.
The action of physiotherapeutic exercises is aimed at improving the blood supply and lymph flow to the affected area, strengthening muscle tissue.
These exercises should be done every day. Usually, individual or group sessions with an instructor are held at the beginning, after which the patient can perform a set of exercises on their own at home.
Prevention of exacerbations
Preventive measures to exacerbate 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 case of prolonged static stress (for example working on a computer) to take regular breaks during which you can warm up or a set of exercises recommended by your 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.
- Reduction of overweight and timely correction of concomitant somatic and endocrine pathology is mandatory.
And when the slightest symptoms of spinal disease appear, you should not delay a visit to the doctor. After all, the earlier you start treatment for osteochondrosis of the spine, the better the results.