Osteochondrosis of the spine is a degenerative-dystrophic lesion of the intervertebral discs, the body of the spine, the ligament 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 "civilization disease", which is associated with upright posture and stress on the spine on a daily basis.
The main cause of spinal osteochondrosis is microtrauma during physical exertion, unhealthy diet, sedentary lifestyle, and even genetic predisposition. If this disease progresses, then the intervertebral disc and adjacent structures suffer first. The central part of the disc changes, leading to a loss of shock-absorbing properties of the vertebrae, resulting in cracks and thinning on the fibrous ring.
U. S. statisticians say the first reason for limiting the activity of people under the age of 45 is back and neck pain. Most city dwellers, drivers, who spend a significant portion of their time in a sitting position, overloading their spine, are in danger.
Osteochondrosis is the cause of more than 70% of cases of back pain. The risk of disease increases with age.
Etiology and pathogenesis of spinal osteochondrosis
Osteochondrosis of the spine has a long-lasting pathogenesis (from several months to decades). It depends on the factors that influence the development of the disease.
Risk factors:
- Age. Older people (over 60) are at risk. In people under the age of 35, the disease is rare. As a result of age-related changes, there is a disturbance in the human hormonal background, which makes muscle tissue and blood vessel walls more porous, which means more vulnerable. It causes metabolic disorders, overloads the intervertebral discs.
- Autoimmune diseases that cartilage tissue can perceive as foreign and begin to destroy.
- Spinal injuries. This is one of the main reasons for the development of osteochondrosis in young people. It is estimated that more than half of people with spinal injuries in their youth suffer from osteochondrosis of the spine in old age.
- Excessive weight, which reduces wear of intervertebral discs. Cartilaginous discs serve as a kind of shock absorbers for the spine, which ensure its mobility during physical activity, walking, running, etc. , These 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 cause metabolic disorders, which in turn negatively affect the condition of cartilage tissue.
Osteochondrosis can be at rest for a long time. Many patients learn about the disease in the presence of severe pain, when the dystrophic process in the cartilaginous tissue has already damaged the nerve roots.
There are such phases in the pathogenesis of spinal osteochondrosis:
- Violation of blood circulation in intervertebral discs and adjacent structures.
- Especially hormonal and metabolic disorders in the body and intervertebral discs.
- Degradation processes of the pulposus nucleus. At this stage, the structure of the intervertebral disc changes - the nucleus shrinks, the disc itself becomes thinner, the load on the annular fibrosus increases, which entails various layers, microcracks, and sometimes rupture.
- Intervertebral disc protrusion - protrusion of intervertebral disc tissue, often towards the spinal canal, hitting it, causing severe pain.
- Intervertebral hernia. Progression of the bulge leads to destruction of the ligaments, changes in the height and shape of the disc, which in turn provokes the formation of hernias.
- Compression of radicular arteries.
- Chronic insufficiency of spinal cord blood supply.
Symptoms of spinal osteochondrosis
As osteochondrosis develops, pathologies appear on the intervertebral discs and in the cartilage itself, which subsequently overlap and can cause 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 painful back pain, numbness of the vertebrae, limited movements, 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 state of stress.
- Osteochondrosis of the chest, often accompanied by intercostal neuralgia. There is pain in the chest and ribs.
- Osteochondrosis of the lumbar spine provokes the development of lumbago, lumbosacral (sciatica) and lumbar sciatica. In sciatica, the sciatic nerve is affected, pain and hypotension in the buttocks are noticed, as well as hypotension in the calf.
Symptoms of cervical osteochondrosis:
- Cirvicalgia - pain in the cervical spine. The nature of the pain is different (dull, sharp, intensified by tilting the head and torso when coughing), depending on the factor that affects this part of the spine.
- Cervicobrachialgia - pain in the cervical spine, radiating to the arm, numbness.
- Shoulder blades and arthritis - pain in the shoulder joint, in the collarbone, restriction of arm movements from top to bottom.
- Epicondylosis - pain in the elbow joint, limited movements.
- Spinal artery syndrome - so-called cervical migraine, headaches and neck pain, nausea, sometimes vomiting, impaired coordination of movements - staggering in gait, 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 prolonged sitting, at night), increased physical activity, deep breathing, coughing.
- Cardiac syndrome.
- Posterior chest wall syndrome - pain in the shoulder blades, feelings of pain depend on body position.
- Anterior scale muscle syndrome.
- Truncalgia syndrome - pain in half of the chest.
- Worsening of intercostal neuralgia.
Symptoms of lumbar osteochondrosis:
- Lumbodynia - lower back pain, lumbago. The patient feels discomfort when trying to sit or stand up. The pain increases with physical activity, coughing, deep breathing, bending.
- Lumboischialgia - pain in the lower back, radiating to the leg. There may be paresthesia, numbness of the legs, muscle cramps and joint pain.
- Vascular syndromes - debut by compression of blood vessels, not accompanied by pain, there is muscle weakness, cone syndrome - weakness of both feet, dysfunction of the pelvic organs.
The symptoms of osteochondrosis in the lumbar spine are different. This part of the spine is loaded more than the 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 difficult-to-diagnose disease because pain can be caused by other pathologies that are not related to the spine. The patient will need consultations of several experts: neurologists, primarily orthopedists, vertebrologists.
Methods for diagnosing 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 usually done in two positions - lying on your back and on your side. Two different image projections allow a more precise determination of the presence of pathology. Sometimes an X-ray is taken with the lower jaw facing down. MRI and CT. Magnetic resonance imaging results are considered more accurate and help to quickly determine the localization of segments affected by pathology, the presence or absence of intervertebral hernias, and root compression.
- Laboratory tests: blood test to determine blood calcium levels and erythrocyte sedimentation rate. Laboratory tests are prescribed first, more recently, based on these results, the doctor directs them to hardware diagnostics.
It is important to distinguish osteochondrosis of the spine in a number of other diseases with a similar clinical picture, for example: neoplasms on the spine of oncological nature, violation of the integrity of cartilage, inflammation, intermittent claudication, cysts on internal organs, urolithiasis, gastritis, pyelonephritis, ulcersstomach, angina pectoris, nervous system disorders. For that 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:
- Phase. Complications caused by bulging - sharp painful sensations of shooting.
- Phase. Radiculitis, which is characterized by pain syndromes and other symptoms, depending on the localization of radiculitis.
- Phase. Root and spinal nerve pathology, presence of intervertebral hernias. Muscle paresis often occurs, resulting in paralysis of the entire body.
- Phase. Violation of blood circulation and supply to the entire spinal cord. Symptoms: persistent severe back pain, paralysis of certain muscle groups, ischemic stroke.
Treatment of osteochondrosis of the spine
The process of treating any type of osteochondrosis strives for one goal - pain relief, prevention of destruction and deformation of the spinal tissue. Treatment can be conservative or surgical. The type and method of treatment are 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, anti-inflammatory drugs (dicloberl, voltaren), injections of antispasmodic mixtures, vitamin B, rubbing preparations - soak rileaf, larkspur, etc. are recommended. , can be prescribed while the pain syndrome subsides. physical education and physiotherapy (diadynamic currents, electrophoresis, magnetotherapy).
Conservative treatment lasts about two months. In addition to the above 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 used in the case of intervertebral hernias older than six months, compression of the spinal cord roots due to 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 - maintaining an active lifestyle, playing sports, proper nutrition, use of corsets and special belts when loading the back, sleeping on orthopedic mattresses and pillows, avoiding hypothermia and injuries.