Osteochondrosis is a chronic pathology of the spine whose main cause is degenerative changes in the intervertebral disc. With the progression of the disease, other structures of the spinal column are included in the pathological process - vertebral bodies, intervertebral joints, ligaments, etc.
The disease affects people of all ages. Until recently, osteochondrosis was considered common in the elderly, but an increase in the incidence of this disease among young people has recently been discovered. Both women and men get sick equally often.
Why does osteochondrosis occur?
To better understand what osteochondrosis is, it is necessary to briefly look at the causes and mechanism of its occurrence.
The formation of pathological changes in osteochondrosis of the spine takes place slowly. Years often pass from the beginning of the pathological process in the intervertebral cartilage to the appearance of the first symptoms of osteochondrosis.
Causes of osteochondrosis
Many negative factors directly affect the health of the spine. If their influence is carried out for a long time, then the result is the appearance of pathological changes in the structures of the spine. And that contributes to osteochondrosis.
For example, what is osteochondrosis is well known to people who lead an inactive lifestyle, who are overweight. Excessive physical activity, back and neck injuries, some somatic diseases can also lead to the development of this pathology. And difficult heredity and age are direct factors that lead 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. It is most likely that this disease arose on the basis of metabolic disorders that occur in the structures of the spinal column.
Under the influence of harmful 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 on 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 physical stress on the spine, cartilage nutrition suffers.
- There are also no nerve fibers in cartilage. Consequently, with functional overload of the intervertebral disc, the transmission of the 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 characteristics.
There are other factors that clearly contribute to the development of degenerative processes in the cartilaginous tissue of the intervertebral discs and the development 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:
- Basically. Under mechanical influences, the cartilaginous tissue of the disc is subject to structural changes - its dysfunction occurs. It is characterized by the appearance of cracks on the surface of the disk, different sizes and depths. After that, these cracks turn into protrusions (hernias).
- Medium. 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, protective, is disturbed. Nerve and vascular trees that pass through its bony canals become vulnerable. Clear clinical symptoms of the disease are developing.
- Final. The affected cartilage tissue is replaced by coarser and denser fibrous ones. At the same time, intervertebral hernias disappear. And the pathological mobility of the vertebrae is replaced by a sharp restriction of their mobility. Narrowing of the spinal canal often occurs with the development of manifestations of compression of the spinal cord segments.
Thus, 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 appear as changes in the bone tissue of the vertebrae. The patient may not have any problems for a long time.
The disease is characterized by a chronic course, with phases of exacerbation and remission changing.
Worsening of osteochondrosis often occurs under the influence of factors that cause: physical exertion, hypothermia, prolonged exposure to an awkward position, for example, in sleep or at work, etc.
There are many symptoms of this disease, which depend on the localization 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 development of this syndrome.
The main sign of radicular syndrome is pain, which in a significant number of cases can spread (radiation) along the course of innervation of the corresponding root. It is characterized by radiation of pain from top to bottom. For example, if the lumbar region is affected, the buttocks hurt and give the leg.
The intensity of pain increases with the rotation of the torso or neck, physical activity. Painful feelings are characterized as cutting, pulling, burning.
Also, in addition to the pain syndrome, in the affected area often develop symptoms of impaired sensitivity by the type of its increase (hyperesthesia), as well as sensitivity disorders, numbness.
If the disease progresses and the cause of compression is not eliminated, 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 spinal cord compression. The most common cause of such compression is intervertebral hernia.
There is an increasing decrease in sensitivity, reactions to temperature and painful stimuli. Progressive muscle weakness develops in both the limbs and the trunk. Paretic or paralytic symptoms often develop.
Vegetative-vascular syndrome
This syndrome most often develops in the cervical and cervicothoracic localization of osteochondrosis of the spine.
The cause of vascular disorders in osteochondrosis is reflex spasm or mechanical compression of large vessels that pass through the bony canals of the spine. In this case, various symptoms may develop, resembling an ischemic disorder of the circulation of the brain or the main arteries of the extremities. 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 irregularities, 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 absolutely without success from any somatic diseases.
For example, if the thoracic region is affected, pain behind the sternum, similar to those with angina pectoris, may occur. There is often a reflex feeling of the heartbeat.
Diagnostic principles
In addition to the characteristic symptoms, additional examination methods play an important role in determining the disease and staging - X-ray of the spine, computed tomography and magnetic nuclear tomography.
According to the indications, other methods are performed, for example, EEG, ECG, Doppler scan of blood vessels, etc.
Treatment of osteochondrosis
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 (worsening or remission). .
Preventive measures aimed at reducing the frequency of exacerbations of the disease and preserving the structure of the spine and intervertebral discs also play an important role in the treatment of osteochondrosis of the spine.
Tactics during exacerbation
An important condition for the treatment of the disease in this period is the creation of rest in the affected area of the spine. To achieve this, the patient is prescribed bed rest with the use of various devices to create immobility of the affected spinal segment.
In some cases, hospitalization in the neurology department is required.
Treatment
To reduce the intensity of pain in osteochondrosis, various drugs are prescribed:
- nonsteroidal anti-inflammatory drugs (NSAIDs);
- analgesic;
- muscle relaxants.
In the absence of the effect of their use, it is recommended to prescribe blockades of innervation of the affected area with the use of local anesthetics.
Circulatory disorders in the brain often develop with cervical localization of osteochondrosis. To reduce such manifestations, drugs that improve cerebral blood flow are prescribed. It is also necessary to use symptomatic medications - relieving nausea and vomiting, improving vestibular disorders, etc.
In addition, it is advisable to prescribe vitamin preparations (especially group B), antioxidants and some others.
Physiotherapy procedures
In osteochondrosis, treatment with physical factors has found wide application. Different methods of physiotherapy are used both during exacerbation and in the phase of remission of the disease:
- In the acute period, ultraviolet radiation, electromagnetic field treatment (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 remission
After the withdrawal of acute manifestations of the disease, treatment of the disease is continued. The purpose of such therapy is to reduce the frequency of exacerbations and encourage 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, professionally performing massage movements allows you to alleviate muscle spasm, which usually accompanies this pathology.
Therefore, the massage should be performed by a specially trained specialist who is fluent in this method of treatment. Improperly or illiterately performed massage can lead to the development of complications or worsening of the disease.
Therapeutic exercise (LFK)
Dosed and specially selected physical exercises form the basis of exercise therapy. The complex of such exercises is selected by the doctor individually for each patient. The principle of choosing exercise therapy exercises is to reduce the physical load on the affected area of the spine.
The effect of physiotherapy exercises is aimed at improving the flow of blood and lymph to the affected area, strengthening muscle tissue.
These exercises should be done every day. Usually, in the beginning, individual or group classes are held with an instructor, and then the patient can perform a set of exercises at home.
Prevention of exacerbations
Preventive measures of exacerbations of osteochondrosis of the spine are aimed at eliminating all provoking factors:
- It is necessary to follow the correct posture and posture during long standing and sitting.
- It is useful for long-term static stress (for example, working at a computer) to take regular breaks during which you should do a warm-up or a set of exercises recommended by your doctor.
- Hypothermia should be avoided.
- With osteochondrosis, it is important to sleep properly, take care of the place to sleep - mattress and pillow. Ideally, they should be orthopedic.
- Reduction of excess body weight 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.