Osteochondrosis is a disease of the spine, characterized by degenerative-dystrophic damage to the intervertebral discs, vertebral bodies and ligaments.
Osteochondrosis of the spine has a chronic progressive course.The disease does not make itself felt for a long time, and symptoms appear only when complications arise.
According to statistics from the World Health Organization, 40-80% of the world's population suffers from osteochondrosis.
Among the patients, people over the age of 30 predominate.But recently there has been a trend towards rejuvenation of osteochondrosis.Osteochondrosis ranks first among spinal diseases in terms of disability among patients.
Brief anatomy of the spine
The spine performs the main functions: the spinal cord canal, support and movement, and also connects the head, shoulders and pelvic girdles.
The structural unit of the spinal column is a vertebra.
The 24 vertebrae are connected to each other by intervertebral discs, which are the body's shock absorbers.
The spinal column is divided into five sections: cervical, thoracic, lumbar, sacral and coccyx.
The normal shape of the spine is S-shaped.
This configuration of the organ allows you to evenly distribute body weight and load.
Structural and functional elements of the spinal column
A vertebra is a bone formation consisting 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 adjacent vertebrae form the spinal canal: the receptacle of the spinal cord, blood vessels, spinal nerve roots, and fatty tissue.
LigamentsThe spinal column is represented by the posterior longitudinal ligament, which connects the vertebrae along the back surface, and the ligamentum flavum, the main purpose of which is to connect the arches of the vertebrae.
Vertebral processes.The vertebra has 7 processes extending from the arch: the spinous process, two transverse articular processes, two superior and two inferior.Ligaments and muscles of the spine are attached to the spinous processes.Other processes form the intervertebral joints of the spine.
Intervertebral discit is a disc-shaped plate consisting of a cartilaginous plate, an anulus fibrosus and a 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 to move the vertebrae relative to each other and provide flexibility to the spine.
Intervertebral holesthey are located on the lateral sides of the spinal column and are formed by the articular processes, bodies and peduncles of adjacent vertebrae.The roots of the spinal nerves exit through the intervertebral holes and blood vessels enter them.
Spinal cord- This is a section of the central nervous system made up of nerve fibers.The spinal cord has three membranes: soft, arachnoid and hard.The spinal dural membrane consists of two sheets that connect and form the dural sac, filled with cerebrospinal fluid - cerebrospinal fluid.
Roots of the spinal nerves- These are conductors of nerve impulses from the spinal cord to the internal organs and vice versa.Each spinal nerve root has autonomous, sensory and nerve fibers in its structure.
Paravertebral muscles- these are the muscles of the spine that support it and provide inclinations and rotations of the body.
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 phases:
- First phase.Pathological changes do not extend beyond the borders of the intervertebral disc.The nucleus pulposus dries out, which leads to a decrease in the height of the intervertebral disc.The fibrous ring cannot withstand the load: it breaks and tears.
- Second phase.Due to the decrease in the height of the intervertebral discs, failure of the ligaments and muscles of the spine occurs, which leads to instability of the movement segment of the spine.The vertebrae can slide and move relative to each other.In this case, spondylolisthesis is formed.
- Third phase.The disease is progressing.Protrusion of the intervertebral discs and arthrosis of the intervertebral joints, as well as non-vertebral joints, occur.
- Fourth phase.In this phase, adaptive reactions are activated in the form of bone growth of the vertebral bodies (osteophytes).Therefore, the body tries to limit excessive mobility of the vertebrae.Osteophytes with their sharp edges damage the roots of the spinal nerves.Fibrous ankylosis of the intervertebral discs and joints forms and the spine is immobilized.The ankylosis stage 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 pinpoint a specific cause.
The basis of osteochondrosis is a violation of microcirculation and metabolism in the tissues of the spine, which can occur due to incorrect 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, stooping);
- weakness of the back muscles (incompetent muscle corset of the spine);
- stay in the same position for a long time (work at the computer, work in the office, do crafts);
- improper weight lifting;
- sedentary lifestyle and sedentary lifestyle;
- metabolic pathology, in particular deficiency 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 injury;
- overweight and obesity.
Symptoms of osteochondrosis
Chronic osteochondrosis can manifest itself with various symptoms.It all depends on the stage of the disease, the level of spinal damage and the presence of complications.
Clinically, the disease manifests itself when the degenerative-dystrophic process has already reached the posterior part of the fibrous ring and the posterior longitudinal ligament, then the roots of the spinal nerves are irritated, pinched, and the conduction of nerve impulses through them is interrupted.
At the same time, compression of the spinal cord and blood vessels occurs, which is manifested by reflex and compression syndromes.
Important!Pain syndrome in osteochondrosis occurs due to pinching of the roots of the spinal nerves in the intervertebral holes by osteophytes, muscle spasms and displacement of the vertebrae.
Osteochondrosis with its symptoms often imitates acute coronary syndrome, pleurisy, acute pancreatitis, hepatic and renal colic, acute appendicitis and adnexitis.
Therefore, it is important to conduct a thorough differential diagnosis of the disease to exclude life-threatening conditions.
More commonsymptoms of osteochondrosis:
- pain in the neck, lower back, thoracic spine, which may be painful, throbbing or in the form of low back pain.The pain radiates to the head, upper and lower extremities, shoulder blades, heart and stomach.The pain syndrome increases after physical activity, sneezing, laughing, coughing or remaining in the same position for a long time;
- sensory disorderdifferent parts of the body at the level of innervation of the pinched nerve;
- spasmmuscles of the neck, back, upper and lower limbs;
- similar to migraine heachache;
- painsin the joints of the limbs;
- increase in fatiguefrom physical and mental work;
- dizziness and loss of consciousnesswith a sharp rotation of the head (vertebral artery syndrome);
- visual impairment(floaters before the eyes or colored spots);
- decreased hearing acuity, tinnitus;
- pain in the heart;
- painalong the intercostal spaces;
- decreased blood supplyupper and lower extremities, which is manifested by coldness of the skin;
- paresthesia– sensations of tingling, tingling and burning in the spine;
- dry skin;
- sweating disorder;
- urinary disorder(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 arose and what the patient associates them with.Be sure to check the patient's medical history, profession, and whether any close relatives suffer from osteochondrosis.
Laboratory tests in this case are not informative.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 x-ray of the spine, computed tomography and magnetic resonance imaging.
X-ray examination of the spine is the simplest, most accessible and highly informative method of diagnosing osteochondrosis.
Mandatory radiography is performed in direct and lateral projections of the desired part of the spine.Osteochondrosis is characterized by: decrease in the height of the intervertebral discs, presence of osteophytes, osteoporosis and deformity 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 you to study the internal structure of the spinal canal.The method is useful for diagnosing 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 more severe cases, especially for the differential diagnosis of osteochondrosis and diseases with similar symptoms.
Since osteochondrosis is often masked by diseases of the heart, lungs, pleura, stomach, intestines, kidneys, liver, a differential diagnosis is necessary.
For this purpose, the patient may be prescribed an electrocardiogram, an ultrasound examination of the heart and internal organs, a blood test for troponins, an ultrasound examination of blood vessels, a chest x-ray, electroencephalography and others.
Treatment methods for osteochondrosis
Treatment of osteochondrosis can beconservative and surgical.
Important!First of all, comprehensive conservative methods are used and surgical treatment is resorted to only in extreme cases.
Let's consider how to properly treat osteochondrosis.KconservativeTreatment methods for osteochondrosis can be listed:
- drug therapy;
- physical therapy;
- physiotherapeutic methods;
- manual therapy;
- massage;
- acupuncture.
Pharmacological treatmentOsteochondrosis is aimed at relieving pain, relaxing muscles, relieving swelling of nerves and muscles, improving blood flow and conduction of nerve impulses.For this purpose, the following groups of drugs are used:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors, which include components of cartilaginous tissue.These drugs protect the cartilage of the vertebrae and intervertebral discs from the negative effects of various factors;
- diureticswhich remove excess fluids from the body and relieve swelling of the roots of the spinal nerves and paravertebral muscles;
- muscle relaxantsrelax cramped muscles;
- drugs, improving metabolism and microcirculation in the tissues of the spine (vitamins B1, B6, B12, C, A and E);
- calcium supplements;
- hormonal drugs, which are prescribed when nonsteroidal anti-inflammatory drugs are ineffective.
Therapeutic exercise– these are dosed physical activities that can be carried out both at home and at work for the treatment and prevention of osteochondrosis.
There are many sets of exercises for osteochondrosis.Prescribing physical therapy and monitoring its implementation is carried out by a qualified specialist, a physiotherapy doctor.
Thanks to properly selected physical 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, exposure to ultraviolet rays of the affected part of the spine, vibration treatment and others.
Manual therapy– it is a measured manual impact on the spine to restore its mobility, eliminate the displacement of the 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 preserve your health and ensure that your spine remains mobile until old age, adhere to several principles for the prevention of osteochondrosis:
- watch your posture– always keep your back straight, don't slouch;
- choosecorrect postureto sleep;
- sit correctly at the table(relaxed shoulders, straight back, furniture suited to your height);
- during a long stay in one position (working in the office, at the computer, sitting doing manual labor), try every 1-1.5 hoursdo some exercise, self-massage of the back or simply get up and walk;
- distribute the load correctlyon the spine when lifting and carrying various weights;
- wear orthopedic shoes;
- healthy sleepon a flat, firm to medium-firm mattress.It is better to purchase 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 timeliness.
Do not self-medicate so as not to worsen your condition.At the first signs of osteochondrosis, contact a neurologist.