Osteochondrosis of the spine is a degenerative-dystrophic lesion of the intervertebral discs, the body of the spine, the ligament apparatus, which destroys the bone and cartilage of the cervical, thoracic and lumbar spine.
The pathology affects the entire motor segment of the spine, disc, and both vertebral bodies, 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 is microtrauma from exercise, unhealthy diet, sedentary lifestyle and even genetic predisposition. If this disease progresses, then the intervertebral disc and adjacent structures suffer first. The central part of the disc changes, which leads to a loss of cushioning properties of the vertebrae, resulting in the formation of cracks and thinning of the fibrous ring.
U. S. statisticians say that the first reason for limiting the activity of people under 45 is pain in the back and neck of the spine. The majority of city dwellers, drivers who spend a significant amount of their time in a sitting position, overloading the 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 influencing the development of the disease.
Risk factors:
- Age. Older people (over 60) are at risk. In people under 35, the disease is rare. Due to age-related changes, disorders occur in the hormonal background of the person, which makes the muscle tissue and the walls of the blood vessels more porous, which means more vulnerable. This provokes metabolic disorders, overloads the intervertebral discs.
- Autoimmune diseases that can perceive cartilage as foreign and begin to destroy it.
- Spinal cord injuries. This is one of the main reasons for the development of osteochondrosis in young people. It is estimated that more than half of people with spinal injuries at a young age suffer from osteochondrosis of the spine in old age.
- Overweight, which reduces the wear of the intervertebral discs. Cartilaginous discs serve as a type of shock absorbers for the spine, which provide its mobility during physical activity, walking, running and more. And protect bone tissue from destruction and the appearance of microcracks. The weight of excess weight makes the load even stronger, which accelerates the destruction of cartilaginous discs.
- Flat legs.
- Genetic predisposition.
- Diseases of the endocrine system that provoke metabolic disorders, which in turn adversely affect the condition of cartilage tissue.
Osteochondrosis can be "inactive" for a long time. Many patients learn about 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 spinal osteochondrosis:
- Circulatory disorders in the intervertebral discs and adjacent structures.
- In particular hormonal and metabolic disorders in the body and intervertebral discs.
- Degradation processes of the pulpal nucleus. At this stage, the structure of the intervertebral disc changes - the nucleus shrinks, the disc itself becomes thinner, the load on the annular fibrosis increases, which leads to various layers, microcracks and sometimes ruptures.
- Intervertebral disc protrusion - the protrusion of intervertebral disc tissue, often to the spinal canal, pinching it, causing severe pain
- Intervertebral hernia. The progression of protrusion leads to rupture of ligaments, change in the height and shape of the disc, which in turn provokes the formation of hernias.
- Compression of radicular arteries.
- Chronic insufficiency of the blood supply to the spinal cord.
Symptoms of spinal osteochondrosis
With the development of osteochondrosis, 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 back pain, numbness of the spine, limited movement, increased pain during exercise
Specific symptoms of osteochondrosis:
- Osteochondrosis of the cervix 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 stress.
- Osteochondrosis of the thoracic region, often accompanied by intercostal neuralgia. There is pain in the chest and ribs.
- Osteochondrosis of the lumbar spine provokes the development of diseases of lumbago, lumbosacral (sciatica) and lumbar sciatica. Sciatica affects the sciatic nerve, there is pain and hypotension in the buttocks, as well as hypotension in the calves.
Symptoms of cervical osteochondrosis:
- Cervicalgia - pain in the cervical spine. The nature of the pain is varied (dull, sharp, worsens when tilting the head and torso, coughing), depending on the factor affecting this part of the spine.
- Cervicobrachialgia - pain in the cervical spine, radiating to the arm, tingling.
- Shoulder-scapular retrosis and retritis - pain in the shoulder joint, in the clavicle, restriction of hand movement from top to bottom.
- Epicondylosis - pain in the elbow joint, limited movement.
- Vertebral artery syndrome - the so-called cervical migraine, pain in the head and cervix, nausea, sometimes vomiting, impaired coordination of movements - staggering when walking, tinnitus.
One of the most common signs of cervical osteochondrosis is impaired circulation, which leads to frequent dizziness, seizures and headaches.
Symptoms of breast osteochondrosis:
- Thoracalgia - chest pain, pain associated with immobility (manifested by prolonged sitting, at night), aggravated by physical activity, deep breathing, cough.
- Heart syndrome.
- Posterior chest wall syndrome - pain in the shoulder blades, pain sensations depend on the position of the body.
- Anterior rock muscle syndrome.
- Trancalgic syndrome - pain in half of the chest.
- Worsening of intercostal neuralgia.
Symptoms of lumbar osteochondrosis:
- Lumbodynia - lower back pain, lumbago. The patient feels discomfort when trying to sit or stand up. The pain is exacerbated by physical activity, coughing, deep breathing, bending.
- Lumbosciatica - pain in the lower back radiating to the legs. There may be paresthesia, tingling in the legs, muscle spasms and joint pain.
- Vascular syndromes - they debut with compression of blood vessels, are not accompanied by pain, there is muscle weakness, cone syndrome - weakness in both legs, pelvic dysfunction.
The symptoms of osteochondrosis in the lumbar spine are varied. This part of the spine is more loaded than others.
Diagnosis of spinal osteochondrosis
At the first back pain, an examination should be performed to determine the source of the pain. Osteochondrosis is a difficult disease to diagnose because the pain can be caused by other pathologies that are not related to the spine. The patient will need consultation with several specialists: neurologist, first of all, orthopedist, 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 most often done in two positions - lying on your back and side. Two different projections of images allow to more accurately determine the presence of pathology. Sometimes an X-ray is taken with the lower jaw down.
- MRI and CT. MRI results are considered more accurate and help to quickly determine the location of segments that have been affected by pathology, the presence or absence of intervertebral hernias and root compression.
- Laboratory tests: a blood test to determine the level of calcium in the blood and the rate of erythrocyte sedimentation. Laboratory tests are prescribed in the first place, recently, based on these results, the doctor refers them to hardware diagnostics.
It is important to differentiate osteochondrosis of the spine in a number of other diseases with a similar clinical picture, for example: neoplasms of the spine of oncological nature, disruption of the integrity of cartilage tissue, inflammation, intermittent claudication, formation of cysts of internal organsurolithiasis, gastritis, pyelonephritis, gastric ulcer, angina pectoris, nervous system disorders. For this purpose, tests 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
Most often the course of this disease is accompanied by neurological complications:
- Stage. Complications caused by protrusion - sharp painful sensations when shooting.
- Stage. Radiculitis, which is characterized by pain syndromes and other symptoms, depending on the location of the radiculitis.
- Stage. Pathology of the roots and spinal nerve, the presence of intervertebral hernias. Muscle paresis often occurs, leading to paralysis of the whole body.
- Stage. Impaired blood circulation and blood supply to the entire spinal cord. Symptoms: constant severe back pain, paralysis of certain muscle groups, ischemic stroke.
Treatment of osteochondrosis of the spine
The process of treatment of any type of osteochondrosis pursues one goal - to relieve pain, prevent 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 the pain syndrome, relaxation and rest, anti-inflammatory drugs (dicloberl, voltaren), injections of antispasmodics, vitamin B, rubbing preparations - immersion of relief, larkspur, etc. are recommended. , may be prescribed until the pain syndrome subsides. physical education and physiotherapy (diadynamic currents, electrophoresis, magnetic therapy).
Conservative treatment takes about two months. In addition to the listed treatment methods, massages, manual therapy, reflexology and extraction can 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 cord roots due to narrowing of the gap between the vertebrae. The principle of surgical treatment is to remove the deformed disc. The postoperative rehabilitation period is approximately six months. Rehabilitation includes exercise, physiotherapy and vitamin intake.
Prevention of osteochondrosis of the spine consists in combating risk factors - maintaining an active lifestyle, exercise, proper nutrition, use of corsets and special belts when loading the back, sleeping on orthopedic mattresses and pillows, avoiding hypoand injuries.