Osteochondrosis of the spine is a degenerative-dystrophic lesion of the intervertebral discs, the vertebral body, the ligamentous apparatus, in which the bone and cartilage tissue of the cervical, thoracic and lumbar spine is destroyed.
Pathology affects the entire motor segment of the spine, disc, 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 during physical exertion, unhealthy diet, a sedentary lifestyle and even a genetic predisposition. If this disease progresses, then the intervertebral disc and the structures adjacent to it suffer first. The central part of the disc changes, which leads to the loss of the shock-absorbing properties of the vertebra, as a result of which cracks and thinning are formed on the fibrous ring.
American statisticians say that the first reason for limiting the activity of people under 45 is pain in the dorsal and cervical spine. The majority of urban residents, drivers, who spend a significant part of their time in a sitting position, reloading 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
Spinal osteochondrosis has a long-term pathogenesis of development (from several months to decades). It depends on the factors affecting the development of the disease.
- Age. Elderly people (over 60) are at risk. In people under 35, the disease is rare. As a result of age-related changes, disturbances occur in the human hormonal background, which makes muscle tissue and blood vessel walls more porous, which means more vulnerable. This provokes metabolic disorders, overloads the intervertebral discs.
- Autoimmune diseases that can perceive cartilage tissue as foreign and begin to destroy it.
- Spinal injuries. This is one of the main reasons for the development of osteochondrosis in young people. It is believed that more than half of people with spinal injuries at a young age suffer from spinal osteochondrosis in old age.
- Overweight, which reduces the wear of the intervertebral discs. Cartilaginous discs serve as a kind of shock absorbers for the spine, which ensure its mobility during physical activity, walking, running, etc. , and protect bone tissue from destruction and the appearance of microcracks. The severity of excess weight makes the load even stronger, which accelerates the destruction of cartilaginous discs.
- Flat feet.
- Genetic predisposition.
- Diseases of the endocrine system, which provoke metabolic disorders, which in turn negatively affect the state of the cartilage tissue.
Osteochondrosis can be in a "dormant state" 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:
- Violation of blood circulation in the intervertebral discs and adjacent structures.
- Hormonal and metabolic disorders in the body and intervertebral discs, in particular.
- Degradation processes of the nucleus pulposus. At this stage, the structure of the intervertebral disc changes - the nucleus decreases, the disc itself becomes thinner, the load on the annulus fibrosus increases, which entails various stratifications, microcracks, and sometimes ruptures.
- Protrusion of intervertebral discs - protrusion of the tissue of the intervertebral discs, often towards the spinal canal, impinging on it, causing severe pain.
- Intervertebral hernia. The progression of protrusion leads to the destruction of the ligaments, a change in the height and shape of the disc, which in turn provokes the formation of hernias.
- Compression of radicular arteries.
- Chronic insufficiency of blood supply to the spinal cord.
Symptoms of spinal osteochondrosis
As osteochondrosis develops, pathologies appear in the intervertebral discs and in the cartilage themselves, 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 very first sign of osteochondrosis should be called aching back pain, numbness of the vertebral sections, limited movement, increased pain during physical exertion.
Specific symptoms of osteochondrosis:
- Cervical osteochondrosis 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 a stressful state.
- 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. With sciatica, the sciatic nerve is affected, pain and hypotension in the buttocks, as well as hypotension in the calves, are observed.
Symptoms of cervical osteochondrosis:
- Cirvicalgia - pain in the cervical spine. The nature of the pain is varied (dull, sharp, aggravated by tilting the head and torso, when coughing), depending on the factor affecting this part of the spine.
- Cervicobrachialgia - pain in the cervical spine, radiating to the arm, numbness.
- Shoulder-scapular rearthrosis and rearthritis - pain in the shoulder joint, in the collarbone, limiting the movement of the arm from top to bottom.
- Epicondylosis - pain in the elbow joint, limited movement.
- Vertebral artery syndrome - the so-called cervical migraine, aching head and cervical pains, nausea, sometimes vomiting, impaired coordination of movements - staggering when walking, tinnitus.
One of the most common signs of cervical osteochondrosis is impaired blood circulation, which leads to frequent dizziness, fainting and headaches.
Symptoms of breast osteochondrosis:
- Thoracalgia - pain in the chest, pain associated with immobility (manifested with prolonged sitting, at night), aggravated by physical activity, deep breath, coughing.
- Cardiac 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 discomfort when trying to sit or stand up. The pain intensifies with physical activity, coughing, taking a deep breath, bending over.
- Lumboischialgia - pain in the lower back, radiating to the leg. There may be paresthesia, leg numbness, muscle spasms, and joint pain.
- Vascular syndromes - they debut with compression of blood vessels, are not accompanied by pain, there is weakness in the muscles, cone syndrome - weakness in both feet, dysfunction of the pelvic organs.
Symptoms of osteochondrosis in the lumbar spine are diverse. This part of the spine is loaded more than others.
Diagnosis of spinal osteochondrosis
At the first back pain, an examination should be carried out to determine the source of the pain. Osteochondrosis is a difficultly diagnosed disease, since pain can be caused by other pathologies not related to the spine. The patient will need consultations of several specialists: a neurologist, first of all, an orthopedist, a vertebrologist.
Methods for the diagnosis of 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 on your side. Two different projections of images make it possible to more accurately determine the presence of pathology. Sometimes an x-ray is taken with the lower jaw down.
- MRI and CT. The results of MRI are considered more accurate and help to quickly determine the localization of segments that have been affected by pathology, the presence or absence of intervertebral hernias, and compression of the roots.
- Laboratory tests: blood test to determine the level of calcium in the blood and erythrocyte sedimentation rate. Laboratory tests are prescribed as the very first, and later, on the basis of these results, the doctor directs 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 on the spine of an oncological nature, violation of the integrity of cartilage tissue, inflammation, intermittent claudication, the formation of cysts on internal organs, urolithiasis, gastritis, pyelonephritis, stomach ulcer, angina pectoris, disorders of the nervous system. For this purpose, studies of the digestive system, nervous system, and blood circulation can 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 shooting sensations.
- Stage. Radiculitis, which are characterized by pain syndromes and other symptoms, depending on the localization of radiculitis.
- Stage. Pathology of the roots and spinal nerve, the presence of intervertebral hernias. Often, muscle paresis occurs, resulting in paralysis of the whole body.
- Stage. Violation of blood 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 pursues one goal - to relieve pain, to prevent destruction and deformation of the tissues of the spine. Treatment can be conservative or surgical. The type and method of treatment is 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 are recommended, anti-inflammatory drugs (dicloberl, voltaren), injections of antispasmodic mixtures, vitamin B, preparations for rubbing - dip rileaf, larkspur, etc. , can be prescribed as the pain syndrome subsides. physical education and physiotherapy (diadynamic currents, electrophoresis, magnetotherapy).
Conservative treatment takes about two months. In addition to the listed methods of treatment, massages, manual therapy, reflexology, and extraction can also be used. The result of conservative treatment directly depends on the patient's persistence and diligence.
There is also a surgical method of treatment, which is used in the presence of intervertebral hernias more than six months old, compression of the roots of the spinal cord due to a narrowing of the gap between the vertebrae. The principle of surgical treatment is to remove the deformed disc. The rehabilitation period after surgery is approximately six months. Rehabilitation includes exercise therapy, physiotherapy, and taking vitamins.
Prevention of osteochondrosis of the spine consists in combating risk factors - keeping an active lifestyle, playing sports, proper nutrition, using corsets and special belts when loading the back, sleeping on orthopedic mattresses and pillows, avoiding hypothermia and injuries.