Osteochondrosis is a disease of the spine, which is characterized by degenerative-dystrophic damage to the intervertebral discs, vertebral bodies and ligaments.
Osteochondrosis of the spine has a chronic progressive course.The disease is not felt for a long time and symptoms appear only when complications appear.
According to the statistics of the World Health Organization, 40-80% of the world's population suffers from osteochondrosis.
The majority of patients are over 30 years old.But recently there has been a tendency towards the renewal of osteochondrosis.Osteochondrosis ranks first among spine diseases in terms of disability in patients.
Brief anatomy of the spine
The spine performs the main functions - the canal of the spinal cord, support and movement, and also connects the head, shoulders and pelvic girdle.
The structural unit of the spine is a vertebra.
The 24 vertebrae are connected to each other by intervertebral discs, which are the shock absorbers of the body.
The spine is divided into five sections: cervical, thoracic, lumbar, sacral and coccyx.
The normal shape of the spine is S-shaped.
This configuration of the body makes possible the equal distribution of body weight and load.
Structural and functional elements of the spine
A vertebra is a bone formation that consists of a body, an arch and processes.
The main load falls on the vertebral body, so this is its most massive part.
Important!The arches of the adjacent vertebrae form the spinal canal - the socket of the spinal cord, blood vessels, spinal nerve roots and adipose tissue.
ligamentsThe spine is represented by the posterior longitudinal ligament, which connects the vertebrae along the back surface, and the yellow ligament, whose main purpose is to connect the vertebral arches.
Vertebral processes.The vertebra has 7 processes extending from the arch: the spinous process, two transverse processes, two superior and two inferior articular processes.The ligaments and muscles of the spine are attached to the spinous processes.Other processes form the intervertebral joints of the spine.
Intervertebral discis a disc-shaped plate consisting of a cartilage plate, anulus fibrosus and nucleus pulposus.The intervertebral disc connects adjacent vertebrae, providing mobility and stability to the spine.
Intervertebral jointsformed by the processes of two adjacent vertebrae.The main function of the intervertebral joints is the movement of the vertebrae in relation to each other and ensuring the flexibility of the spine.
Intervertebral foraminaare located on the lateral sides of the spine and are formed by the articular processes, bodies and pedicles of adjacent vertebrae.Spinal nerve roots exit through the intervertebral foramina and blood vessels enter.
Spinal cord- This is a section of the central nervous system that consists of nerve fibers.The spinal cord has three membranes - soft, arachnoid and hard.The dura spinal membrane consists of two sheets that connect and form the dural sac, filled with cerebrospinal fluid - cerebrospinal fluid.
Spinal nerve roots- These are conductors of nerve impulses from the spinal cord to internal organs and vice versa.Each spinal nerve root has autonomic, sensory and nerve fibers in its structure.
Paravertebral muscles- these are the muscles of the spine that support it and provide animation and body curves.
The functional unit of the spine isspinal motion segment, which consists of two adjacent vertebrae, an intervertebral disc, ligaments and muscles.
Pathogenesis (mechanism of development) of spinal osteochondrosis
In the process of development, osteochondrosis passesfour stages:
- The first stage.Pathological changes do not extend beyond the borders of the intervertebral disc.The nucleus pulposus dries up, which leads to a decrease in the height of the intervertebral disc.The fibrous ring cannot withstand the load - it cracks and tears.
- The second stage.Due to the decrease in the height of the intervertebral discs, the ligaments and muscles of the spine sag, which leads to instability of the spinal movement segment.The beads can slide and move relative to each other.In this case, spondylolisthesis is formed.
- The third stage.The disease is progressing.Prolongation of the intervertebral discs and arthrosis of the intervertebral joints, as well as uncovered joints, appear.
- The fourth stage.In this phase, adaptive reactions are activated in the form of bone growths of the vertebral bodies (osteophytes).Thus, the body tries to limit excessive mobility of the vertebrae.Osteophytes with their sharp edges damage the roots of spinal nerves.Fibrous ankylosis of the intervertebral discs and joints is formed, and the spine is immobile.The ankylosis phase is characterized by the disappearance of pain.
What leads to osteochondrosis?
Osteochondrosis of the backit is a multifactorial disease in which it is impossible to single out a specific cause.
The basis of osteochondrosis is a violation of microcirculation and metabolism in the tissues of the spine, which can arise due to improper distribution of the load on the spine.
Factors that contribute to the development of osteochondrosis include the following:
- improperly formed posture in childhood (scoliosis, kyphosis, kyphoscoliosis, bending);
- weakness of the back muscles (incompetent muscular corset of the spine);
- staying in one position for a long time (computer work, office work, manual work);
- improper weight lifting;
- physical inactivity and sedentary lifestyle;
- metabolic pathology, especially the lack of calcium, phosphorus, calcium, vitamins, magnesium, zinc;
- genetic predisposition to osteochondrosis;
- infectious diseases;
- frequent hypothermia of the body;
- chronic stress;
- hormonal imbalance;
- weight lifting;
- spinal cord injury;
- overweight and obesity.
Symptoms of osteochondrosis
Chronic osteochondrosis can appear with different symptoms.It all depends on the stage of the disease, the level of damage to the spine and the presence of complications.
Clinically, the disease is manifested when the degenerative-dystrophic process has already reached the back of the fibrous ring and the posterior longitudinal ligament, then the nerve roots of the spine are irritated, compressed and the transmission of nerve impulses through them is disrupted.
At the same time, compression of the spinal cord and blood vessels occurs, which is manifested by reflex and compression syndromes.
Important!The pain syndrome in osteochondrosis occurs due to compression of the nerve roots of the spinal column in the intervertebral foramen by osteophytes, muscle spasms and displaced vertebrae.
Osteochondrosis with its symptoms often mimics acute coronary syndrome, pleurisy, acute pancreatitis, hepatic and renal colic, acute appendicitis and adnexitis.
Therefore, it is important to perform a complete differential diagnosis of the disease to exclude life-threatening conditions.
The most commonsymptoms of osteochondrosis:
- pain in the neck, lower back, thoracic spine, which can be painful, throbbing or in the form of lumbago.The pain radiates to the head, upper and lower limbs, shoulder blades, heart and stomach.The pain syndrome increases after physical activity, sneezing, laughing, coughing or staying in one position for a long time;
- sensory disturbancedifferent parts of the body at the level of innervation of the suppressed nerve;
- spasmsmuscles of the neck, back, upper and lower extremities;
- similar to migraine headache;
- COLICin the joints of the limbs;
- increased fatiguefrom physical and mental work;
- dizziness and loss of consciousnesswith a sharp turn of the head (vertebral artery syndrome);
- visual impairment(floats before the eyes or colored spots);
- decreased hearing acuity, tinnitus;
- pain in the heart;
- painalong the intercostal spaces;
- decrease in blood supplyupper and lower extremities, which is manifested by the coldness of their skin;
- paresthesia– creeping, tingling and burning sensations in the spine;
- dry skin;
- sweating disorder;
- urinary disturbance(dysuria, enuresis);
- decreased sexual desire, impotence.
Early diagnosis of osteochondrosis will greatly facilitate its treatment.
Methods for diagnosing osteochondrosis
A neuropathologist diagnoses osteochondrosis.If necessary, patients can be referred for consultation to a cardiologist, gastroenterologist, orthopedic doctor, surgeon and others.
During the interview, it is necessary to accurately determine the nature of the complaints, when they appeared and what the patient relates them to.Be sure to check the patient's medical history, profession and whether any close relatives have osteochondrosis.
Laboratory tests in this case are uninformative.By carrying out a biochemical blood test, you can pay attention to the level of calcium, phosphorus and other trace elements.
The main place in the diagnosis of osteochondrosis is occupied by instrumental methods, such as radiography of the spine, computed tomography and magnetic resonance.
X-ray examination of the spine is the simplest, most accessible and most informative method for diagnosing osteochondrosis.
Mandatory radiography is performed in direct and lateral projections of the desired part of the spine.Osteochondrosis is characterized by: a decrease in the height of the intervertebral discs, the presence of osteophytes, osteoporosis and deformation of the spine.
Myelography- This is an X-ray examination of the spine with the introduction of a contrast agent into the spinal canal.This method is dangerous due to the occurrence of allergic reactions to the contrast.
Myelography allows us to study the internal structure of the spinal canal.The method is valid for the diagnosis of Schmorl's hernias (intervertebral hernias).
Computed and nuclear magnetic tomography– these are modern diagnostic methods that visualize the soft tissues and bones of the spine layer by layer.
These methods are expensive, so they are used in severe cases, especially for the differential diagnosis of osteochondrosis and diseases with similar symptoms.
Since osteochondrosis is often disguised as a disease of the heart, lungs, pleura, stomach, intestines, kidneys, liver, there is a need for differential diagnosis.
For this purpose, the patient can be prescribed electrocardiogram, ultrasound examination of the heart and internal organs, blood test for troponins, ultrasound examination of blood vessels, chest X-ray, electroencephalography and others.
Methods of treatment of osteochondrosis
Treatment of osteochondrosis can beconservative and surgical.
Important!First of all, comprehensive conservative methods are used, and surgical treatment is used only in extreme cases.
Let's consider how osteochondrosis can be properly treated.KCONSERVATIVEOsteochondrosis treatment methods can be listed:
- drug therapy;
- physical therapy;
- physiotherapeutic methods;
- manual therapy;
- massage;
- acupuncture.
Drug treatmentOsteochondrosis aims to relieve pain, relax muscles, relieve swelling of nerves and muscles, improve blood flow and conduct nerve impulses.For this, the following groups of drugs are used:
- nonsteroidal anti-inflammatory drugs;
- chondroprotectors, which include components of cartilage tissue.These drugs protect the cartilage of the vertebrae and intervertebral discs from the negative effects of various factors;
- diureticswhich remove excess fluid from the body and relieve swelling of the spinal nerve roots and paravertebral muscles;
- muscle relaxantsrelax tight muscles;
- dope, improvement of metabolism and microcirculation in spinal tissues (vitamins B1, B6, B12, C, A and E);
- calcium supplements;
- hormonal drugs, which are prescribed when non-steroidal anti-inflammatory drugs are ineffective.
Therapeutic exercises– these are dosed physical activities that can be performed both at home and at work for the treatment and prevention of osteochondrosis.
There are many groups of exercises for osteochondrosis.The prescription of exercise therapy and monitoring of its implementation is carried out by a qualified specialist - a doctor of physical therapy.
Thanks to properly selected exercise therapy, you can relieve pain, improve mobility and blood supply to the spine and stop the progression of the disease.
Physiotherapy treatmentosteochondrosis is performed in special physiotherapy departments of hospitals, sanatoriums and dispensaries by a physiotherapist.
Physiotherapy methods include: electrophoresis, magnetic therapy, laser therapy, mud therapy, balneotherapy, ultraviolet exposure to the affected part of the spine, vibration treatment and others.
Manual therapy– This is a dosed manual impact on the spine to restore its mobility, to eliminate displacement of vertebrae and intervertebral discs.
Manual therapy should only be performed by a qualified chiropractor.
Massage and self-massagefor osteochondrosis, it is performed to relieve muscle spasm, improve microcirculation in the paravertebral tissues and increase the mobility of the spine.
Acupunctureis a method of treating osteochondrosis in which thin needles are injected into active points.
Under the influence of needles in the body, the level of endogenous opiates and cortisol increases, which have anti-inflammatory and analgesic effects.
Prevention of osteochondrosis
To maintain your health and mobile spine into old age, observe some principles for the prevention of osteochondrosis:
- watch your attitude- always keep your back straight, do not bend;
- Selectthe right attitudefor sleep;
- sit correctly at the table(shoulders relaxed, back straight, furniture should fit your height);
- during a long stay in one position (office work, at the computer, sitting with manual labor), try every 1-1.5 hoursdo some physical exercise, self-massage your back, or just get up and walk;
- distribute the load correctlyon the back when lifting and holding various weights;
- wear orthopedic shoes;
- healthy sleepon a flat, firm to moderately firm mattress.It is better to buy an orthopedic mattress and pillow.
Osteochondrosis of the spineit is a chronic progressive disease that, unfortunately, cannot be cured.The effectiveness of treatment directly depends on its duration.
Do not self-medicate in order not to worsen your condition.At the first signs of osteochondrosis, contact a neurologist.