Osteochondrosis of the spine

Osteochondrosis is a widespread disease of the intervertebral discs, occurring in people of various age groups.Today it is diagnosed in more than 40% of fairly young people under the age of 35, and among the older category it affects 9 out of 10 people.It has several stages of development, and the earlier the pathology is detected, the easier and more effective the treatment is and the lower the risk of developing dangerous complications.

What is osteochondrosis

Intervertebral discs are located between the vertebral bodies and are a kind of shock absorbers that absorb stress when walking or performing other physical activities.They have different sizes depending on their position: in the cervical region the discs are the smallest, and in the lumbar spine they are the largest.

They are all built the same.In the center is the nucleus pulposus, which is the main component of the disc and has high elasticity.It is surrounded by a fibrous membrane and endplates.

Osteochondrosis is a degenerative-dystrophic disease in which there is a change in the shape and size of the intervertebral discs as a result of their abrasion and the preconditions are created for the formation of hernias, deformation of the vertebral bodies, spondylosis and other disorders.

Thinning of the discs is a consequence of malnutrition of the cartilage tissue, which leads to a gradual decrease in its elasticity and increased fragility.

As a result, the discs change position, their height decreases, and microcracks form on their fibrous membrane.This creates serious preconditions for the formation of intervertebral hernias, pinching of spinal roots or blood vessels.

The slightest changes in the condition of the disks lead to disruption of their functions.This is accompanied by pain of varying degrees of intensity.At the same time, prerequisites are created for the development of diseases of internal organs, since the quality of their activity directly depends on the condition of the spine and the conductivity of bioelectric impulses along the nerves.

It can affect one or more intervertebral discs in any part of the spine.Therefore, osteochondrosis is diagnosed:

• cervical spine;
• thoracic spine;
• lumbar spine.

In especially severe cases, the pathological process involves the majority of the intervertebral discs of the spinal column, which is accompanied by discomfort throughout the entire back and an almost complete loss of performance.But most often, osteochondrosis affects the lumbar spine, since it bears the greatest load, as well as the intervertebral discs of the cervical spine due to their high mobility.

Development

During osteochondrosis, 4 stages can be roughly distinguished:

• A decrease in the level of hydration of the disc, which leads to its dehydration and the formation of microcracks.Often at this stage there are still no manifestations of the incipient disease.
• A decrease in the height of the disc, which leads to the appearance of the first symptoms of pathology.At this stage, there is a decrease in the distance between individual segments, which leads to a decrease in the tone of the spinal ligaments and creates the possibility of displacement of the vertebrae from their natural positions, i.e., the development of spondylolisthesis.In such situations, a wave-like course of the disease is most often observed.It can distinguish between periods of exacerbation, accompanied by acute pain, and periods of remission, in which there is no discomfort at all or there is aching pain.
• Deformation of the affected intervertebral disc with the formation of protrusion or prolapse.Sometimes there is involvement of joints in the pathological process, which is manifested by the development of arthrosis or vertebral subluxations.At this stage, the immune system reacts to the processes occurring in the spine by developing aseptic inflammation with swelling of the tissues surrounding the affected spinal-motor segment.In this case, pain occurs regularly, reflex muscle spasms, as well as limitations in mobility, can be observed.In rare cases, signs of neurological deficit (radicular syndrome) already develop as a result of pinching of nerve fibers by the resulting protrusions of intervertebral discs.
• Development of complications.Since the human body has wide compensatory capabilities, when the intervertebral disc loses its ability to perform its functions, the process of osteosynthesis is activated to secure the vertebrae in a stable position.This leads to the formation of bone protrusions - osteophytes - at the edges of the vertebral bodies of the affected spinal motion segment.As a result, due to them, two or more vertebrae firmly fuse together, forming a single conglomerate, i.e. spondylosis develops.This always leads to pinched nerves and the development of acute neurological symptoms in the form of paresis, paralysis and serious disturbances in the functioning of the corresponding internal organs.

Reasons

Today there are many theories for the development of osteochondrosis, including vascular, mechanical, hereditary, hormonal, infectious-allergic and others.But none of them is able to fully explain the mechanism of development of changes in the tissues of the intervertebral discs.Therefore, most likely, they all complement each other.

Thus, a huge number of very diverse factors can lead to the development of osteochondrosis.Among them, the most significant are:

• genetic predisposition;
• regular performance of heavy physical work;
• maintaining a sedentary lifestyle;
• the presence of scoliosis or other spinal deformities;
• suffering from back injuries;
• unbalanced diet, vitamin deficiency;
• infectious diseases;
• metabolic disorders;
• congenital anomalies of the spine (Kimerli anomaly, Chiari anomaly, craniovertebral anomalies, sacralization, lumbarization);
• overweight;
• regular severe stress.

It is believed that the most significant influence on the condition of the intervertebral discs is the constant overload of a certain spinal motion segment.This can be not only performing monotonous hard physical work, but also constant stooping or the habit of sitting for a long time.In such situations, additional stress is placed on the discs, muscles, and ligaments, and other factors only aggravate the situation.

In general, osteochondrosis can be called an almost natural age-related disease, which is an inevitable price to pay for walking upright.

Symptoms

The earliest sign of the development of the disease is the appearance of a crunching sound in the part of the spine where the onset of degenerative-dystrophic changes is observed.It is a consequence of the occurrence of disturbances in the nutrition of the disc and the progression of its dehydration.At this stage, patients almost never seek medical help.Therefore, their daily routine, eating habits and other factors remain the same, which contributes to the worsening of the situation and the transition of the disease to the second stage.

As a result, symptoms typical of osteochondrosis begin to appear:

• severe muscle tension in the affected area on only one or both sides of the spine;
• sharp and aching pains that intensify with every movement and gain intensity over time, becoming unbearable;
• numbness in the arms or legs;
• weakness;
• stiffness of movements, unauthorized limitation of mobility;
• decreased muscle tone up to complete atrophy;
• poor posture;
• surges in blood pressure.

As the pathology progresses, the signs of osteochondrosis worsen.80% of patients experience dull pain in the area of the affected spinal motion segment, which is also characteristic of myositis.

Osteochondrosis of the cervical spine

When the cervical spine is affected, pain tends to radiate to the shoulder girdle, arms, and other manifestations of neurological disorders occur.Patients hold their heads in the least painful position, and if necessary, turn around with their entire body.

Additionally, pathologies of organs that are innervated by the spinal cord region of the cervical spine may develop:

• tinnitus and diseases of the ENT organs;
• dizziness;
• blurred vision;
• migraines;
• irritability and anxiety levels increase;
• sleep problems;
• increased risk of allergic reactions;
• decreased levels of thyroid hormones.

With osteochondrosis of the cervical spine, vertebral artery syndrome and vegetative-vascular dystonia are often additionally diagnosed.

Infection of the cervical spine with osteochondrosis, especially when complicated by protrusions and intervertebral hernias, can lead to pinching of blood vessels.This is fraught with impaired blood supply to the brain, which can be accompanied by attacks of dizziness, loss of consciousness and even a stroke.

Osteochondrosis of the thoracic spine

With osteochondrosis of the thoracic region, which is diagnosed quite rarely, pain occurs in the spine at the level of the shoulder blades and can intensify even when taking deep breaths.They are often felt behind the breastbone, which can be mistaken for heart disease.

When the spinal roots are pinched, the risk of diseases of internal organs increases, in particular:

• bronchi and lungs (asthma, bronchitis, pneumonia, pleurisy);
• gallbladder and its duct, liver (cholecystitis, jaundice, fat absorption disorders);
• pancreas and duodenum (digestive disorders, pain in the left hypochondrium);
• adrenal glands, which affects the overall strength of the immune system and can provoke the development of allergies;
• kidneys (urinary disorders, chronic pyelonephritis, glomerulonephritis, etc.);
• pelvic organs (digestive disorders, gynecological, urological diseases, infertility).

Fact: damage to the intervertebral disc of the 7th thoracic vertebra by osteochondrosis can lead to the development of diabetes mellitus.

Osteochondrosis of the lumbosacral spine

With osteochondrosis of the lumbar region, lumbago, called lumbago, is observed.This is accompanied by burning, unbearable pain that occurs suddenly.Often, patients even find it difficult to sit down, rise and walk, which may indicate the development of radicular syndrome.In such situations, it is easy to notice how they slowly sit down and stand up, trying as much as possible to avoid tilting their torso.

If complications occur, the main danger is pinching the nerves of the cauda equina, as this can lead to impaired control over the processes of bowel and bladder emptying, as well as paralysis of the legs.Also in such cases the following may develop:

• appendicitis;
• diarrhea, constipation;
• pain in the lower abdomen;
• bladder dysfunction;
• impotence;
• pain in the knees, feet, hips or groin area;
• swelling of the legs.

Complications

Osteochondrosis is a possible cause of a huge number of different diseases.Most often, if left untreated, it leads to the formation of protrusion and intervertebral hernia.This in turn can cause:

• discogenic myelopathy, which ends in paresis, muscle atrophy, changes in tendon reflexes, loss of control over urination and defecation, and even paralysis of the limbs;
• radiculopathy;
• scoliotic or other spinal deformity;
• spinal cord infarction due to compression of the artery feeding it;
• stroke due to compression of the occipital artery.

Diagnostics

The appearance of pain in the back and neck should be a reason to contact a neurologist or vertebrologist.The sooner osteochondrosis is diagnosed, the easier and more effective the treatment will be.

To diagnose the disease, the doctor interviews and examines the patient.Based on their results, it is already possible to assume the presence of degenerative changes in the intervertebral discs.But for a final diagnosis, instrumental diagnostic methods are prescribed, including:

• MRI;
• CT;
• x-ray in two projections.

Magnetic resonance imaging provides the most complete information about the condition of intervertebral discs.The procedure is mainly carried out in closed-type devices with a power of 1.5 T.With its help, you can differentiate osteochondrosis from tuberculous spondylitis, osteomyelitis, infectious diseases, etc.

CT scans and x-rays provide information about the bony structures of the spine.Thanks to them, it is possible to detect displacement of the vertebral bodies, the presence of osteophytes and other disorders.

Additionally, the following may be prescribed:

• Ultrasound with Dopplerography of neck vessels;
• electromyography;
• laboratory research.

Treatment of osteochondrosis

Therapy is developed individually for each patient.In this case, the severity of degenerative-dystrophic processes, the presence of complications, the nature of the patient’s work activity and a host of other factors must be taken into account.

All patients must be prescribed a set of measures, since it is impossible to eliminate pathological changes in the intervertebral discs only with the help of medications.Components of conservative therapy for osteochondrosis may include:

• drug therapy;
• osteopathy;
• manual therapy;
• physiotherapy (phonophoresis, ozone therapy, carboxytherapy, pressotherapy, RF currents);
• individual sessions with a rehabilitator.

All patients diagnosed with intervertebral disc dystrophy are advised to reconsider their lifestyle.It is imperative to set aside time for moderate physical activity, especially for representatives of sedentary professions, or, conversely, to think about the possibility of changing professions for people who are forced to lift heavy objects every day.

But in the acute period, complete rest is recommended.It is ensured not only by maintaining bed rest, but also by wearing orthopedic bandages: in case of damage to the cervical spine, a Shants collar is used; in case of osteochondrosis of the lumbar region, it is recommended to wear a corset.

In the first stages of the development of the disease, it is often enough to make adjustments to your lifestyle, engage in exercise therapy and visit a chiropractor.In more advanced cases, drug therapy and physiotherapy are necessarily prescribed.

Never resort to self-medication with dubious means, self-prescription of anti-inflammatory drugs, as well as dubious “healers” who position themselves on the Internet: you can lose not only time, money, but also the remains of your health.

Drug therapy

For osteochondrosis, a complex of medications is prescribed to reduce pain, eliminate inflammation and reflex muscle spasms, improve nerve conduction and activate tissue regeneration processes of intervertebral discs.

Therefore, patients are prescribed:

• NSAIDs – help reduce pain and have an anti-inflammatory effect;
• corticosteroids – exhibit powerful anti-inflammatory properties;
• muscle relaxants – eliminate muscle spasms, which helps reduce back pain;
• B vitamins – provide improved functioning of the nervous system in general and the conduction of nerve impulses along individual nerves in particular;
• vitamin D is a remedy responsible for the condition of bone tissue, as well as for higher brain functions, such as memory, attention, speech;
• chondroprotectors – nourish the intervertebral discs with the compounds necessary for the construction of new fibers of the nucleus pulposus;
• psychotropic drugs – increase the effectiveness of non-steroidal anti-inflammatory drugs and muscle relaxants;
• vascular drugs - improve blood circulation in the tissues surrounding the spine, which ensures a more active supply of nutrients and oxygen to the intervertebral discs;
• Anticonvulsants – used in rare cases to relieve very severe spasms.

For very severe pain, which most often indicates complications, patients can undergo back blockades, which provide an immediate effect.Sometimes corticosteroid hormones are added to the solution to perform the blockade.This additionally leads to a pronounced anti-inflammatory effect.

Blockades are performed under conditions of absolute sterility, which can only be achieved in specialized medical institutions.At the same time, they require special knowledge and skills, so only a highly qualified health worker can competently cope with the task.Otherwise, there is a high risk of infection or damage to the nerve fiber, which will lead to the development of severe complications.

During the blockade, injections are usually given on both sides of the spine in the area where the nerves that cause pain occur.There are several techniques for performing them, among which the specific one is selected by the doctor individually.

But it is advisable to perform blockades no more than 4 times a year.Since with osteochondrosis, attacks of acute, painful pain occur much more often, it is worth first of all directing efforts to eliminate the causes of their occurrence, i.e. the degenerative-dystrophic process in the joint itself.

Manual therapy

Manual therapy sessions are prescribed outside the period of exacerbation of osteochondrosis.They play one of the leading roles in the treatment of the disease, since the competent use of manual techniques on the spine and surrounding tissues helps not only to stop the progression of the pathological process in the intervertebral discs, but also to create the most favorable conditions for their restoration.

In addition, certain techniques can also have a positive effect on the functioning of internal organs.For example, one of the methods is designed, by normalizing the position of each vertebra, to eliminate pressure on the spinal roots, blood vessels and spinal membranes and thereby restore the normal connection of the organ with the nervous system.This makes it possible to eliminate the hidden causes of the development of the above diseases of the heart, bronchi, lungs, kidneys, gastrointestinal tract and reproductive system and leads to complete recovery.

Thanks to the jewelry-precise effect on the spine, not only does blood circulation activate and metabolism accelerates, as with a classic therapeutic massage, but also natural self-healing mechanisms are launched.Elimination of spinal curvatures, incorrect position of the vertebrae and other pathological changes in the spine through manual therapy can further strengthen the immune system, improve overall well-being and significantly improve the quality of life.

Positive changes can be noticed after the first session, and in the future their severity only increases.

Physiotherapy

Physiotherapeutic procedures increase the effectiveness of all other methods of treating osteochondrosis and help reduce pain.Most often used:

• electrophoresis - the use of electric current to ensure the penetration of anesthetics, anti-inflammatory and other agents directly into the site of inflammation, allowing you to quickly obtain a pronounced therapeutic effect;
• Ultrasound therapy - the effect of ultrasound provides an analgesic effect, enhances the intensity of metabolic processes in the area of influence and creates the prerequisites for high-quality restoration of thinned intervertebral discs;
• detensor therapy – involves stretching and massaging the spine on a special ribbed mattress, which activates blood circulation and increases muscle tone;
• traction therapy or spinal traction – is performed using special devices that create a tensile load on the spine, as a result of which the distance between the vertebrae increases and the pressure on the worn intervertebral disc sharply decreases, which allows it to recover more actively.

All procedures are prescribed in courses of 10–15 sessions.When choosing them, they take into account not only the condition of the intervertebral discs, but also the presence of concomitant diseases, since in some of them certain physical effects are contraindicated.

Exercise therapy

Therapeutic exercises for osteochondrosis play a significant role, since correctly selected exercises for damage to different parts of the spine can help form a strong muscle corset and at the same time eliminate increased muscle tone.This will provide good support for the spine and stop the progression of the degenerative process in the intervertebral discs.In addition, exercise therapy helps to activate blood circulation and increase the intensity of metabolic processes.

Drawing up a physical therapy program is the task of a rehabilitation physician.Based on the severity of the spinal lesion, the characteristics of the patient’s physical development, his age and other factors, he will create an optimal set of exercises, the implementation of which will create an optimal load on the muscles and spine.

The first classes must be conducted under the supervision of a doctor.Once the patient learns to perform each exercise correctly, he is allowed to continue practicing at home.It is important to avoid any sudden movements.All exercises are performed daily slowly and smoothly, and the load is increased gradually.But the occurrence of pain during exercise is a good reason to refuse to perform the exercise that provoked it.

Prevention

It is much easier to prevent the development of a disease than to deal with its consequences later.Since osteochondrosis can occur in everyone sooner or later, you should think about the possible risks as early as possible and make every effort to prevent this.Therefore, each person should adhere to the following recommendations:

• avoid physical inactivity, exercise regularly, swim, and during sedentary work, take regular breaks to warm up;
• pay attention to your posture when walking or sitting;
• purchase a high-quality orthopedic mattress and pillow;
• observe the correct technique for lifting weights: with a straight back and bent knees;
• change casual shoes to the most comfortable ones, and leave dress shoes for special occasions;
• eat right so that the body does not experience nutritional deficiencies and the weight remains within normal limits.

There is only one way to avoid the appearance and manifestation of symptoms of osteochondrosis - start taking care of yourself and your health.Since osteochondrosis is not just a disease, but a complex of muscular-tonic and neurodystrophic changes, which are the body’s response to physical inactivity, chronic static tension of the spinal muscles, the environmental situation and chronic neurosis, especially common among city dwellers, swimming in the pool and stretching programs, includingyoga.

Thus, osteochondrosis is a very common disease, but with careful attention to your own health, you can effectively fight it at any age.But ignoring the problem will not lead to anything good and sooner or later will force the patient to lie on the operating table.