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 are destroyed.
The pathology affects the entire motor segment of the spine, the disc, both vertebral bodies and the adjacent nervous and muscular structures. This disease is often called "disease of civilization", which is associated with erect posture and spine stress 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 the disease progresses, the intervertebral disc and the structures adjacent to it will suffer first. The central part of the disc changes, which leads to the loss of the shock absorbing properties of the vertebra, resulting in the formation of cracks and thinning in the fibrous ring.
American statisticians say the first reason for limiting the activity of people under 45 is the pain in the dorsal and cervical spine. Most urban residents, 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 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. The elderly (over 60 years old) are at risk. In people under 35, the disease is rare. As a result of age-related changes, disturbances in the human hormonal background occur, which makes muscle tissue and blood vessel walls more porous, which means more vulnerable. This causes metabolic disorders, overloads the intervertebral discs.
- Autoimmune diseases that may 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. It is believed that more than half of people with spinal injuries at a young age suffer from spinal osteochondrosis in old age.
- Excess weight, which reduces the wear of intervertebral discs. Cartilaginous discs act as a kind of shock absorber for the spine, which guarantee its mobility during physical activity, walking, running etc. and protect bone tissue from destruction and the appearance of micro-cracks. The gravity of excess weight makes the load even stronger, which accelerates the process of destruction of the cartilaginous discs.
- Flat feet.
- Genetic predisposition.
- Diseases of the endocrine system that cause metabolic disorders that, in turn, negatively affect the state of cartilage tissue.
Osteochondrosis can be in a "dormant 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 osteochondrosis of the spine:
- Violation of blood circulation in the intervertebral discs and adjacent structures.
- Hormonal and metabolic disorders in the body and intervertebral discs, in particular.
- Pulpous nucleus degradation processes. At this stage, the structure of the intervertebral disc changes - the nucleus decreases, the disc itself becomes thinner, the load on the fibrous ring increases, which leads to several stratifications, microfissures and, sometimes, ruptures.
- Protrusion of intervertebral discs - protrusion of the tissue of intervertebral discs, usually towards the spinal canal, colliding with it, causing severe pain.
- Intervertebral hernia. The progression of the protrusion leads to the destruction of the ligaments, change in the height and shape of the disc, which in turn causes the formation of hernias.
- Compression of the root arteries.
- Chronic insufficiency of 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 cause the appearance of an intervertebral hernia.
Symptoms can be 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 in the vertebral sections, limited movement, 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, which results in a state of stress.
- 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 low back pain, lumbosacral (sciatica) and lumbar sciatica. In sciatica, the sciatic nerve is affected, there is pain and hypotension in the buttocks, as well as hypotension in the calves.
Symptoms of cervical osteochondrosis:
- Cervical pain - pain in the cervical spine. The nature of the pain is varied (monotonous, acute, aggravated by the inclination of the head and trunk, when coughing), depending on the factor that affects this part of the spine.
- Cervicobraquialgia - pain in the cervical spine, radiating to the arm, numbness.
- Shoulder-scapular reartrose and reartritis - pain in the shoulder joint, in the clavicle, limiting the movement of the arm from top to bottom.
- Epicondylosis - pain in the elbow joint, limited movement.
- Vertebral artery syndrome - the so-called cervical migraine, headaches and neck pain, nausea, sometimes vomiting, impaired movement coordination - staggering when walking, tinnitus.
One of the most common signs of cervical osteochondrosis is impaired blood circulation, which causes dizziness, fainting and frequent headaches.
Symptoms of breast osteochondrosis:
- Chest pain - pain in the chest, pain associated with immobility (which manifests with prolonged sitting at night), aggravated by physical activity, deep breathing, coughing.
- Cardiac syndrome.
- Posterior chest wall syndrome - pain in the area of the shoulder blades, the sensations of pain depend on the position of the body.
- Anterior scalene muscle syndrome.
- Truncalgic syndrome - pain in the middle of the chest.
- Worsening of intercostal neuralgia.
Symptoms of lumbar osteochondrosis:
- Lumbodynia - pain in the lower back, lumbago. The patient feels discomfort when trying to sit or stand. The pain increases with physical activity, coughing, deep breathing, curvature.
- Lumboischialgia - pain in the lower back, radiating to the leg. There may be paresthesia, numbness in the legs, muscle spasms and joint pain.
- Vascular syndromes - start with compression of blood vessels, are not accompanied by pain, there is weakness in the muscles, cone syndrome - weakness in both feet, dysfunction of Organs pelvic organs.
The symptoms of osteochondrosis in the lumbar spine are diverse. This part of the column is more loaded than others.
Diagnosis of spinal osteochondrosis
In the first back pain, an examination should be done to determine the source of the pain. Osteochondrosis is a disease that is difficult to diagnose, as pain can be caused by other pathologies not related to the spine. The patient will need consultations with several specialists: a neurologist, first of all, an orthopedist, a vertebrologist.
Methods for the diagnosis of 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 make it possible to more accurately determine the presence of pathology. Sometimes an x-ray is taken with the jaw down.
- MRI and CT. The results of magnetic resonance imaging are considered more accurate and help to quickly determine the location of the segments that were affected by the pathology, the presence or absence of intervertebral hernias and root compression.
- Laboratory tests: blood test to determine the level of calcium in the blood and the rate of erythrocyte sedimentation. Laboratory tests are prescribed by the first, more recently, based on these results, the doctor directs them to the hardware diagnosis.
It is important to differentiate osteochondrosis of the spine in several other diseases with a similar clinical picture, for example: neoplasms in the spine of an oncological nature, violation of the integrity of the cartilaginous tissue, inflammation, intermittent claudication, formation of cysts in Organs internal organs, urolithiasis, gastritis, pyelonephritis, angina pectoris, disorders of the nervous system. Therefore, 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 of the time, the course of this disease is accompanied by neurological complications:
- Stage. Complications caused by protrusion - strong 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, the 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: strong and persistent back pain, paralysis of some muscle groups, ischemic stroke of the spinal cord.
Treatment of spinal osteochondrosis
The process of treating any type of osteochondrosis has one goal - to relieve pain, prevent the destruction and deformation of spinal tissues. Treatment can be conservative or surgical. The type and form 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 pain syndrome, relaxation and rest, anti-inflammatory drugs (dicloberl, voltaen), injections of antispasmodic mixtures, vitamin B, rubbing preparations - dip rileaf, larkspur, etc. are recommended. , can be prescribed as the pain syndrome decreases. physical education and physiotherapy (diadynamic currents, electrophoresis, magnetotherapy).
Conservative treatment takes about two months. In addition to the treatment methods listed, massages, manual therapy, reflexology and extraction can also be used. The outcome of conservative treatment depends directly on the patient's persistence and diligence.
There is also a surgical method of treatment that is used in the presence of intervertebral hernias older than six months, compression of the spinal cord roots due to the narrowing of the space between the vertebrae. The principle of surgical treatment is the removal of the deformed disc. The rehabilitation period after surgery is approximately six months. Rehabilitation includes exercise therapy, physical therapy and vitamin intake.
The prevention of osteochondrosis of the spine consists of combating risk factors - maintaining an active lifestyle, playing sports, adequate food, wearing special corsets and belts to carry the back, sleeping on orthopedic mattresses and pillows, avoiding hypothermia andinjuries.