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.
The pathology affects the entire motor segment of the spine, the disc, both vertebral bodies, and 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, an unhealthy diet, a sedentary lifestyle and even a genetic predisposition. If this disease progresses, the intervertebral disc and adjacent structures 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 in the fibrous ring.
American statisticians say that the number one reason for limiting activity for people under 45 is pain in the thoracic and cervical spine. Most city dwellers, drivers, who spend a significant part of their time sitting, recharging their spine, are at risk.
Osteochondrosis is the cause of more than 70% of cases of back pain. The risk of contracting the disease increases with age.
Etiology and pathogenesis of spinal osteochondrosis
Spinal osteochondrosis has a long-term pathogenesis (from several months to decades). It depends on the factors that affect the development of the disease.
Risk factors:
- Age. Older people (over 60 years old) are at risk. In people under 35 years of age, the disease is rare. As a result of age-related changes, disturbances occur in the human hormonal environment, making 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. More than half of people with spinal injuries at a young age are believed to suffer from spinal osteochondrosis in old age.
- Overweight, which reduces wear on the intervertebral discs. Cartilaginous discs serve as a kind of shock absorbers for the spine, ensuring 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, accelerating the destruction of cartilaginous discs.
- Flat feet.
- genetic predisposition.
- Diseases of the endocrine system, causing metabolic disorders, which in turn negatively affect the state of cartilage tissue.
Osteochondrosis can be in a "latent 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 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 the 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 involves various stratifications, microcracks, and sometimes ruptures.
- Bulging of the intervertebral discs: bulging of the tissue of the intervertebral discs, often towards the spinal canal, impingement on it and causing severe pain.
- Intervertebral hernia. The progression of the protrusion leads to the destruction of the ligaments, a change in the height and shape of the disc, which in turn causes the formation of hernias.
- Compression of the radicular arteries.
- Chronic insufficiency of the blood supply to the spinal cord.
Symptoms of spinal osteochondrosis
As osteochondrosis develops, pathologies appear in the intervertebral discs and in the cartilage itself, which subsequently overlap and can lead to 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 first sign of osteochondrosis should be called back pain, numbness of the vertebral sections, limited movement, increased pain during physical exertion.
Specific symptoms of osteochondrosis:
- Cervical osteochondrosis is characterized by a disturbance of 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 causes the development of diseases of the lumbago, lumbosacral (sciatica) and lumbar sciatica. With sciatica, the sciatic nerve is affected, pain and hypotension are observed in the buttocks, as well as hypotension in the calves.
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 trunk, coughing), depending on the factor affecting this part of the spine.
- Cervicobrachialgia: pain in the cervical spine radiating to the arm, numbness.
- Rearthrosis and shoulder-scapular arthritis: pain in the shoulder joint, in the clavicle, which limits the movement of the arm up and down.
- Epicondilosis: pain in elbow joint, limited movement.
- Vertebral artery syndrome: the so-called cervical migraine, headache and neck pain, nausea, sometimes vomiting, impaired coordination of movements, staggering when walking, tinnitus.
One of the most common signs of cervical osteochondrosis is impaired blood circulation, leading to frequent dizziness, fainting, and headaches.
Symptoms of breast osteochondrosis:
- Thoracalgia: chest pain, pain associated with immobility (manifested by sitting for a long time, at night), aggravated by physical activity, deep breathing, cough.
- Heart 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.
- Trunk syndrome: pain in the middle of the chest.
- Worsening of intercostal neuralgia.
Lumbar osteochondrosis symptoms:
- Lumbodynia - pain in the lower back, lumbago. The patient feels discomfort when trying to sit or stand up. Pain intensifies with physical activity, coughing, deep breathing, bending over.
- Lumboischialgia: pain in the lower back that radiates to the leg. There may be paresthesia, numbness of the legs, muscle spasms, and joint pain.
- Vascular syndromes - begin 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.
The symptoms of osteochondrosis in the lumbar spine are diverse. This part of the spine is more loaded than others.
Diagnosis of spinal osteochondrosis
At the first back pain, an examination should be performed to determine the source of the pain. Osteochondrosis is a disease that is difficult to diagnose, since pain can be caused by other pathologies not associated with the spine. The patient will need consultations from several specialists: a neurologist, first of all, an orthopedist, a vertebrologist.
Methods for the diagnosis of osteochondrosis:
- Radiography. It is carried out 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 allow the presence of pathology to be determined with greater precision. Sometimes an X-ray is taken with the lower jaw down.
- MRI and CT. The MRI results are considered more accurate and help to quickly determine the location of the segments that were affected by pathology, the presence or absence of intervertebral hernias, and root compression.
- Laboratory tests: blood tests to determine the level of calcium in the blood and the erythrocyte sedimentation rate. Laboratory tests are prescribed by the first, more recently, 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 in the spine of an oncological nature, violation of the integrity of cartilage tissue, inflammation, intermittent claudication, formation ofcysts in internal organs, urolithiasis, gastritis, pyelonephritis of the stomach, angina pectoris, disorders of the nervous system. For this, studies of the digestive system, nervous system and blood circulation may be prescribed. The following diagnostic methods are used: cardiogram, ultrasound, electroencephalography, endoscopic examination (digestive organs).
Complications of osteochondrosis
Very often, the course of this disease is accompanied by neurological complications:
- Stage. Complications caused by bulge: sharp painful shooting sensations.
- Stage. Radiculitis, which is characterized by pain syndromes and other symptoms, depending on the location of the radiculitis.
- Stage. Pathology of the roots and spinal nerve, presence of intervertebral hernias. Often, muscle paresis occurs, resulting in paralysis of the entire body.
- Stage. Violation of blood circulation and blood supply to the entire spinal cord. Symptoms: severe and persistent back pain, paralysis of certain muscle groups, ischemic stroke of the spinal cord.
Treatment of osteochondrosis of the spine
The treatment process for any type of osteochondrosis has one goal: to relieve pain, prevent the destruction and deformation of the spinal tissues. Treatment can be conservative or surgical. The type and method of treatment is prescribed individually for each patient, depending on the diagnosis (stage, type of disease, general well-being of the patient).
In the acute period of pain syndrome, relaxation and rest are recommended, anti-inflammatory drugs (dicloberl, voltaren), injections of antispasmodic mixtures, vitamin B, rubbing preparations - dip rileaf, larkspur, etc. can be prescribed. , as the pain syndrome subsides. physical education and physiotherapy (diadynamic currents, electrophoresis, magnetotherapy).
Conservative treatment lasts approximately two months. In addition to the listed treatment methods, massage, manual therapy, reflexology, and extraction can also be used. The outcome of conservative treatment directly depends on the perseverance and diligence of the patient.
There is also a surgical method of treatment that is used in the presence of intervertebral hernias of more than six months, compression of the roots of the spinal cord due to a narrowing of the space 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, physical therapy, and taking vitamins.
The prevention of osteochondrosis of the spine consists of combating risk factors: maintaining an active lifestyle, playing sports, proper nutrition, wearing special corsets and belts when loading the back, sleeping on orthopedic mattresses and pillows, avoid hypothermia and injury.