Osteochondrosis is a chronic pathology of the spine, the main cause of which are degenerative changes in the intervertebral disc. As the disease progresses, other structures of the spine are involved in the pathological process - vertebral bodies, intervertebral joints, ligaments, etc.
The disease affects people of all ages. Until recently, osteochondrosis was considered the fate of the elderly, but recently an increase in the incidence of this disease in the young has been discovered. Both women and men get sick just as often.
Why does osteochondrosis appear?
To better understand what osteochondrosis is, it is necessary to dwell briefly on the causes and mechanism of its occurrence.
The formation of pathological changes in osteochondrosis of the spine occurs 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
Spinal health is directly affected by many negative factors. If their impact is carried out for a long time, then the result of this is the appearance of pathological changes in the structures of the spine. And this contributes to the formation of osteochondrosis.
For example, what osteochondrosis is is 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 aggravated heredity and old age are direct factors leading to the development of degenerative cartilage tissue damage of the discs.
How does osteochondrosis develop?
The mechanism of development (or pathogenesis) of osteochondrosis is still controversial and insufficiently studied. It is very likely that this disease was formed on the basis of metabolic disorders occurring in the structures of the spine.
Under the influence of negative factors, irreversible changes in the cartilage tissue of the intervertebral disc often occur, followed by its gradual destruction (or destruction).
The pathological process then 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 in the intervertebral disc depends directly on its anatomical nuances:
- Cartilage tissue does not have its own blood supply system. Its nutrition is provided by the bone tissue of neighboring vertebrae. Therefore, in the case of circulatory disorders as a result of insufficient stress or conversely excessive physical activity in the spine, cartilage nutrition also suffers.
- There is also no nerve fiber in the cartilage. Consequently, with a functional overload of the intervertebral disc, the transmission of a nerve impulse that triggers metabolism activation will be premature.
- The ability of the intervertebral disc cartilage to self-healing (regeneration) is slowed down due to its structural features.
There are also other factors that clearly contribute to the development of degenerative processes in the cartilaginous tissue of intervertebral discs and the formation of osteochondrosis.
Stages of pathological changes
Based on current data on the pathogenesis of this pathology, conditionally several stages of the degenerative process in the intervertebral disc can be distinguished. Stages of spinal osteochondrosis:
- Elementary. The cartilaginous tissue of the disc undergoes structural changes under mechanical influences - its dysfunction occurs. It is characterized by the appearance of cracks on the surface of the disk, varying in size and depth. These cracks then turn into extensions (hernias).
- Intermediate. 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, the protective one, is concerned. The nerve and vascular trunks flowing into his bone canals become vulnerable. Live clinical symptoms of the disease develop.
- Finally. There is a replacement of the affected cartilage tissue with a thicker and denser fibrosis. At the same time, intervertebral hernias disappear. And the pathological mobility of the vertebrae is replaced by a sharp restriction of their mobility. There is often a narrowing of the spinal canal with the development of manifestations of compression of the spinal cord segments.
Therefore, 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 spinal osteochondrosis appear as changes in the vertebral bone tissue. The patient may not file any complaints for quite some time.
The disease is characterized by a chronic course, with phases of deterioration and remission alternating.
Often, a worsening of osteochondrosis occurs under the influence of provocative factors: physical overload, hypothermia, prolonged exposure to an uncomfortable position, for example, in a dream 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 of these symptoms can be grouped into several syndromes. Very often they are combined.
radicular syndrome
Occurs in almost all patients with osteochondrosis of the spine. In the occurrence of this syndrome plays a role compression (compression) of the roots of the spinal nerves by pathologically altered structures of the spine.
The main sign of radicular syndrome is pain, which in a considerable number of cases is able to spread (radiate) along the course of innervation of the respective root. It is characterized by pain radiation from the top down. For example, if the lumbar region is affected, the buttocks ache and give the leg.
The intensity of the pain increases with the rotation of the trunk or neck, physical activity. Pain sensations are characterized as cutting, pulling, burning.
Also, together with the pain syndrome, in the affected area often develop symptoms of violation of sensitivity according to the type of its increase (hyperesthesia), as well as disorders of sensitivity, numbness.
If the disease progresses and the cause of the compression is not eliminated, then hyperesthesia is replaced by hypoaesthesia (decreased sensitivity), which is often accompanied by symptoms of loss of affected spinal root function.
spinal syndrome
This syndrome develops as a result of spinal cord compression. The most common cause of such compression is an intervertebral hernia.
There is an increasing decrease in sensitivity, reactions to temperature, and pain stimuli. Progressive muscle weakness develops in both limbs and trunk. Paretic or paralytic symptoms often form.
Vegetative-vascular syndrome
This syndrome most often develops in the cervical and cervicothoracic localization of spinal osteochondrosis.
The cause of vascular disorders in osteochondrosis is a reflex spasm or mechanical compression of large vessels that pass into the bony canals of the spine. In this case various symptoms may develop that resemble an ischemic circulation disorder 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 more pronounced in women (emotional lability, sleep disorders, menstrual irregularities, etc. ).
visceral syndromes
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 for any somatic disease.
For example, if the chest region is affected, pain behind the sternum may occur, similar to that with angina pectoris. There is often a reflex sensation of the heartbeat.
Diagnostic principles
In addition to the characteristic symptoms, additional examination methods play an important role in the diagnosis and staging of the disease - spinal radiography, computed tomography and magnetic resonance imaging.
Other methods are performed according to the indications, p. sh. EEG, ECG, doppler scan of blood vessels, etc.
Treatment of osteochondrosis
Spinal osteochondrosis therapy 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 course of the disease (exacerbation or remission). .
An important role in the treatment of osteochondrosis of the spine also play preventive measures aimed at reducing the frequency of exacerbations of the disease and preserving the structure of the vertebrae and intervertebral discs.
Tactics during an irritation
An important condition for the treatment of the disease during this period is the establishment of rest of the affected area of the spine. To do this, the patient is prescribed bed rest with the use of various devices to create immobility in the affected vertebral segment.
In some cases, hospitalization is required in the neurological ward.
Medical treatment
To reduce the intensity of pain in osteochondrosis, various medications are prescribed:
- non-steroidal anti-inflammatory drugs (NSAIDs);
- analgesic;
- muscle relaxants.
In the absence of the effect of their use, it is advisable to prescribe innervation blockades of the affected area with the use of local anesthesia.
With cervical localization of osteochondrosis, circulatory disorders of the brain often develop. To reduce such manifestations, medications that improve cerebral blood flow are prescribed. It is also necessary to use symptomatic means - relief of nausea and vomiting, improvement of vestibular disorders, etc.
In addition, it is advisable to prescribe vitamin preparations (especially group B), antioxidants and some others.
Physiotherapy procedures
With osteochondrosis, treatment with physical factors has found wide application. Different methods of physiotherapy are used both during the exacerbation and in the remission phase of the disease:
- In the acute period, ultraviolet radiation, electromagnetic field (UHF) treatment, diadynamic current, etc. are used.
- In the remission phase, electrophoresis with different drugs, inductotherm, ultrasound and different types of balneotherapy are described.
Tactics in the forgiveness phase
After alleviating the acute manifestations of the disease, treatment of the disease continues. The goal of such therapy is to reduce the frequency of irritations and promote the regeneration of bone and cartilage tissue of the spine.
The drug treatment prescribed for the acute phase of the disease continues. During this period, chondroprotectors can be used - agents that improve the condition of the cartilage.
In addition to physiotherapy methods, massages and physiotherapy exercises are also used.
Massage
The main effect of the massage is to improve blood circulation to the affected area and strengthen the muscle corset. Also, the professional performance of massage movements allows you to relieve muscle spasm, which usually accompanies this pathology.
This is why the massage should be performed by a specially trained specialist who speaks fluently this method of treatment. Improperly performed or illiterate massage can lead to the development of complications or worsening of the disease.
Therapeutic Exercises (LFK)
Specially dosed and selected physical exercises form the basis of exercise therapy. The complex of such exercises is chosen 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 action of physiotherapy exercises aims to improve blood supply and lymphatic flow to the affected area, strengthening muscle tissue.
These exercises should be done daily. Usually, individual or group classes are held first with an instructor, then the patient can perform a set of exercises independently at home.
Prevention of irritations
Preventive measures of exacerbations of osteochondrosis of the spine are aimed at eliminating all provocative factors:
- It is necessary to monitor posture and proper posture during long standing and sitting.
- It is helpful for prolonged static stress (for example, working on the 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.
- It is important to sleep properly with osteochondrosis, take care of a place to sleep - a mattress and a pillow. Ideally, they should be orthopedic.
- Mandatory is the reduction of excess body weight and timely correction of somatic and endocrine pathology.
And when the slightest symptoms of spinal disease appear, you should not delay the visit to the doctor. After all, the earlier you start treatment for osteochondrosis of the spine, the better its results.