Osteochondrosis is a disease of the spine, which is characterized by degenerative-dystrophic damage to the intervertebral discs, vertebral bodies and ligaments.
Osteochondrosis of the spine has a chronic progressive course.The disease is not felt for a long time and symptoms appear only when complications arise.
According to the statistics of the World Health Organization, 40-80% of the world's population suffers from osteochondrosis.
People over 30 years of age predominate among the sick.But recently there has been a trend towards rejuvenation of osteochondrosis.Osteochondrosis ranks first among spinal diseases in terms of patient disability.
Brief anatomy of the spine
The spine performs the main functions - spinal cord channel, support and movement, and also connects the head, shoulder and pelvic girdle.
The structural unit of the spine is the vertebra.
The 24 vertebrae are interconnected by intervertebral discs, which are the shock absorbers of the body.
The spine is divided into five sections: cervical, thoracic, lumbar, sacral and coccyx.
The normal shape of the spine is S-shaped.
This body configuration allows for even distribution of body weight and load.
Structural and functional elements of the spine
A vertebra is a bony formation that consists of a body, arch and processes.
The main load falls on the body of the vertebrae, so this is its most massive part.
important!The arcs of the adjacent vertebrae form the spinal canal - a container for the spinal cord, blood vessels, spinal nerve roots and fatty tissue.
LigamentsThe vertebral column is represented by the posterior longitudinal ligament, which connects the vertebrae on the back surface, and the yellow ligament, the main purpose of which is to connect the arches of the vertebrae.
Vertebral processes.The vertebra has 7 processes that extend from the arch: spinous process, two transverse, two superior and two inferior articular processes.The ligaments and muscles of the spine are attached to the spinous processes.Other processes form the intervertebral joints of the spine.
Intervertebral discis a disc-shaped plate that consists of a cartilage plate, annulus fibrosus, and 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 foraminaare located on the lateral sides of the spine and are formed by the articular processes, bodies and handles of adjacent vertebrae.The roots of the spinal nerves exit through the intervertebral foramina and blood vessels enter.
Spinal cord- It is a part of the central nervous system that consists of nerve fibers.The spinal cord has three membranes - soft, arachnoid and dura.The dura mater consists of two sheets that join together to form a dural sac filled with cerebrospinal fluid - cerebrospinal fluid.
The roots of the spinal nerves- These are conductors of nerve impulses from the spinal cord to the internal organs and vice versa.Each root of the spinal nerve has in its structure autonomic, sensory and nerve fibers.
Paravertebral muscles- these are the muscles of the spine that support it and provide tilts and turns 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 stages:
- First stage.Pathological changes do not go beyond the borders of the intervertebral disc.The nucleus pulposus dries up, which leads to a decrease in the height of the intervertebral disc.The fibrous ring does not withstand the load - it cracks and tears.
- Second stage.Due to the decrease in the height of the intervertebral discs, there is a sagging of the ligaments and muscles of the spine, which leads to instability of the movement segment of the spine.Vertebrae can slide and move relative to each other.In this case, spondylolisthesis is formed.
- Third stage.The disease progresses.Protrusion of the intervertebral discs and arthrosis of the intervertebral joints, as well as uncovertebral joints, occur.
- Fourth stage.At this stage, adaptive reactions are activated in the form of bone growths of the vertebral bodies (osteophytes).In this way, the body tries to limit the 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 is formed, and the spine is immobilized.The stage of ankylosis is characterized by the disappearance of pain.
What causes osteochondrosis?
Osteochondrosis of the backis a multifactorial disease in which it is impossible to single out one specific cause.
The basis of osteochondrosis is a violation of microcirculation and metabolism in the tissues of the spine, which can occur due to an incorrect distribution of the load on the spine.
Factors that contribute to the development of osteochondrosis include the following:
- malformed posture in childhood (scoliosis, kyphosis, kyphoscoliosis, stooping);
- weakness of the muscles of the back (incompetent muscle corset of the spine);
- staying in one position for a long time (working on a computer, working in an office, doing crafts);
- improper lifting of weights;
- lack of physical activity and a sedentary lifestyle;
- metabolic pathology, especially lack 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 cord 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 damage to the spine and the presence of complications.
Clinically, the disease manifests itself when the degenerative-dystrophic process has already reached the back 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 disturbed.
At the same time, compression of the spinal cord and blood vessels occurs, which is manifested by reflex and compression syndromes.
important!The pain syndrome of osteochondrosis occurs due to pinching of the spinal nerve roots in the intervertebral openings by osteophytes, spasmodic muscles and displaced vertebrae.
Osteochondrosis with its symptoms often mimics 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.
The most commonsymptoms of osteochondrosis:
- pain in the neck, lower back, chest, which can be pains, throbbing or in the form of lumbago.The pain radiates to the head, upper and lower limbs, shoulder blades, heart and stomach.The pain syndrome increases after physical activity, sneezing, laughing, coughing or staying in one position for a long time;
- sensory disturbancesdifferent parts of the body at the level of innervation of the pinched nerve;
- spasmthe muscles of the neck, back, upper and lower limbs;
- migraine-like headache;
- painsin the joints of the limbs;
- increased fatiguefrom physical and mental work;
- dizziness and loss of consciousnesswith a sharp turn of the head (vertebral artery syndrome);
- visual impairment(floating before the eyes or colored spots);
- reduced hearing acuity, tinnitus;
- pain in the heart;
- painalong the intercostal spaces;
- reduced blood supplyupper and lower limbs, which is manifested by coldness of their skin;
- paresthesia– crawling, tingling and burning in the spine;
- dry skin;
- sweating disorder;
- urination disorder(dysuria, enuresis);
- decreased sexual desire, impotence.
Early diagnosis of osteochondrosis will greatly facilitate its treatment.
Methods of diagnosing osteochondrosis
A neuropathologist diagnosed osteochondrosis.If necessary, patients can be referred for consultation with a cardiologist, gastroenterologist, orthopedist, surgeon, etc.
During the interview, it is necessary to accurately determine the nature of the complaints, when they occurred and what the patient associates them with.Do not forget to check the medical history, the profession of the patient and whether any of the close relatives has osteochondrosis.
Laboratory studies in this case are uninformative.By conducting 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 radiography of the spine, computer tomography and nuclear magnetic resonance.
X-ray examination of the spine is the simplest, most affordable and highly informative method for diagnosing osteochondrosis.
Mandatory radiography is performed in a direct and lateral projection of the desired part of the spine.Osteochondrosis is characterized by: a decrease in the height of the intervertebral discs, the presence of osteophytes, osteoporosis and deformation of the spine.
Myelography- This is an X-ray examination of the spine with the introduction of a contrast substance into the spinal canal.This method is dangerous due to the occurrence of allergic reactions to the contrast.
Myelography allows us to examine the internal structure of the spinal canal.The method is valuable for the diagnosis of 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 severe cases, especially for the differential diagnosis of osteochondrosis and diseases with similar symptoms.
Since osteochondrosis is often disguised as diseases of the heart, lungs, pleura, stomach, intestines, kidneys, liver, there is a need for differential diagnosis.
For this purpose, the patient may be prescribed an electrocardiogram, ultrasound examination of the heart and internal organs, blood test for troponins, ultrasound examination of blood vessels, chest x-ray, electroencephalography, etc.
Methods of treatment of 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 look at how to properly treat osteochondrosis.KconservativeTreatment methods for osteochondrosis can be listed:
- drug therapy;
- physical therapy;
- physiotherapy methods;
- manual therapy;
- massage;
- acupuncture.
Drug 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:
- nonsteroidal anti-inflammatory drugs;
- chondroprotectors, which include components of cartilage tissue.These drugs protect the cartilage of the vertebrae and intervertebral discs from the negative effects of various factors;
- diureticswhich remove excess fluid from the body and relieve swelling of spinal nerve roots and paravertebral muscles;
- muscle relaxantsrelax tight muscles;
- medicines, improvement of 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.
Physical therapy– these are dosed physical exercises that can be performed both at home and at work for the treatment and prevention of osteochondrosis.
There are many complexes of exercises for osteochondrosis.Prescribing training therapy and monitoring its implementation is carried out by a qualified specialist - a doctor of physiotherapy.
Thanks to the correctly selected training therapy, you can relieve pain, improve the mobility and blood supply of the spine and stop the progression of the disease.
Physiotherapy treatmentosteochondrosis is carried out in special physiotherapy departments of hospitals, sanatoriums and dispensaries by a physiotherapist.
Physiotherapy methods include: electrophoresis, magnetic therapy, laser therapy, mud therapy, balneotherapy, ultraviolet irradiation of the affected part of the spine, vibration therapy, etc.
Manual therapy– this is a dosed manual impact on the spine to restore its mobility, eliminate displacement of the vertebrae and intervertebral discs.
Manual therapy should only be performed by a qualified chiropractor.
Massage and self-massagein 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 the needles in the body, the level of endogenous opiates and cortisol increases, which have an anti-inflammatory and analgesic effect.
Prevention of osteochondrosis
To preserve your health and your spine remains mobile until old age, follow several principles for the prevention of osteochondrosis:
- watch your posture– always keep your back straight, do not slouch;
- choosecorrect posturefor sleep;
- sit properly at the table(shoulders relaxed, back straight, furniture should match your height);
- during a long stay in one position (working in an office, on a computer, sitting at crafts), try every 1-1.5 hoursdo some physical exercise, self-massage on the back, or simply getting up and walking;
- properly distribute the loadof the spine during lifting and carrying various weights;
- wear orthopedic shoes;
- sound sleepon a flat, firm to medium firm mattress.It is better to buy an orthopedic mattress and pillow.
Osteochondrosis of the spineis a chronic progressive disease that unfortunately cannot be cured.The effectiveness of the treatment depends directly on its timeliness.
Do not self-medicate so as not to worsen your condition.At the first signs of osteochondrosis, contact a neurologist.