Osteochondrosis of the spine
Osteochondrosis of the spine is a degenerative—dystrophic lesion of the intervertebral discs, vertebral body, ligamentous apparatus, in which the bone and cartilage tissues of the cervical, thoracic and lumbar spine are destroyed.
The content of the article:
Etiology and pathogenesis of spinal osteochondrosis
Symptoms of osteochondrosis of the spine
Diagnosis of osteochondrosis of the spine
Complications of osteochondrosis
Treatment of osteochondrosis of the spine
Osteochondrosis of the spine
Pathology affects the entire motor segment of the spine, the disc, both vertebral bodies, adjacent nerve and muscle structures. This disease is often called the “disease of civilization”, which is associated with walking upright and loading on the spine every day.
The main cause of osteochondrosis of the spine is microtrauma during physical exertion, improper nutrition, sedentary lifestyle and even genetic predisposition. If this disease progresses, then the intervertebral disc and adjacent structures suffer first of all. The central part of the disc is modified, which leads to the loss of the shock-absorbing properties of the vertebra, as a result of which cracks and thinnings form on the fibrous ring.
American statisticians say that the first reason for limiting the activity of people under 45 is pain in the spinal and cervical spine. The majority of urban residents and drivers who spend a significant part of their time in a sitting position, rebooting the spine, are at risk.
The cause of more than 70% of cases of back pain is osteochondrosis. With age, the risk of the disease increases.
Etiology and pathogenesis of spinal osteochondrosis
Osteochondrosis of the spine has a long pathogenesis of development (from several months to decades). It depends on the factors influencing the development of the disease.
Risk factors:
Age. This risk group includes elderly people (over 60). In people under 35 years of age, the disease is rare. Due to age-related changes, disorders occur in the hormonal background of a person, which makes muscle tissue and blood vessel walls more porous, and therefore 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. It is believed that more than half of people with spinal injuries at a young age suffer from osteochondrosis of the spine in old age.
Overweight, which reduces the wear period of intervertebral discs. Cartilaginous discs serve as a kind of shock absorbers of the spine, which ensure its mobility during physical exertion, walking, running, etc. and protect the bone tissue from destruction and the appearance of microcracks. The weight of excess weight makes the load even stronger, which accelerates the process of destruction of cartilage discs.
Flat feet.
Genetic predisposition.
Diseases of the endocrine system that provoke metabolic disorders, which in turn negatively affects the condition 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 such stages of the pathogenesis of osteochondrosis of the spine:
Circulatory disorders in the intervertebral discs and adjacent structures.
Violation of the hormonal background and metabolism in the body and intervertebral discs, in particular.
Degradation processes of the pulpous nucleus. 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 entails various stratifications, microcracks, and sometimes ruptures.
Intervertebral disc protrusion is the protrusion of intervertebral disc tissue, often towards the spinal canal, pinching it, causing severe pain.
Intervertebral hernias. The progression of protrusion leads to the destruction of ligaments, changes in the height and shape of the disc, which in turn provokes the formation of hernias.
Compression of the radicular arteries.
Chronic insufficiency of blood supply to the spinal cord.
Symptoms of osteochondrosis of the spine
As osteochondrosis develops, pathologies arise in the intervertebral discs and in the cartilages themselves, which subsequently overlap each other and can provoke the appearance of an intervertebral hernia.
Symptoms can be both general and specific, characteristic of pathological changes in cartilage, intervertebral discs, adjacent tissues.
The very first sign of osteochondrosis should be called aching back pain, numbness of the vertebral parts, limited movement, increased pain during physical exertion.
Specific symptoms of osteochondrosis:
Cervical osteochondrosis is characterized by circulatory disorders, 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 region provokes the development of lumbago, lumbosacral (sciatica) and lumbar sciatica. Sciatica affects the sciatic nerve, there is pain and hypotension in the buttocks, as well as hypotension in the calves.
Symptoms of cervical osteochondrosis:
Cirvicalgia — pain in the cervical region. The nature of the pain is varied (dull, sharp, increases with head and trunk tilts, with coughing), depends on the factor of influence on this part of the spine.
Cervicobrachialgia — pain in the cervical spine, giving to the arm, numbness.
Shoulder-scapular hyperarthritis and overarthritis — pain in the shoulder joint, in the collarbone, restriction of arm movement from top to bottom.
Epicondylosis — pain in the elbow joint, limited movement.
Vertebral artery syndrome is the so—called cervical migraine, aching headaches and neck pains, nausea, vomiting at times, impaired coordination of movements — staggering when walking, tinnitus.
One of the most common signs of cervical osteochondrosis is a violation of blood circulation, which leads to frequent dizziness, fainting and headaches.
Symptoms of thoracic osteochondrosis:
Thoracalgia is pain in the chest, pain is associated with immobility (manifested during prolonged sitting, at night), increases with physical activity, deep breathing, coughing.
Cardialgic syndrome.
Posterior chest wall syndrome — pain in the shoulder blades, pain sensations depend on the position of the body.
Anterior stair muscle syndrome.
Trunkalgic syndrome — pain in half of the chest.
Aggravation of intercostal neuralgia.
Symptoms of lumbar osteochondrosis:
Lumbalgia — pain in the lower back, lumbago. The patient feels discomfort when trying to sit down or stand up. The pain increases with physical activity, coughing, deep breathing, bending.
Lumboishialgia — pain in the lower back, giving in the leg. There may be paresthesia, numbness of the leg, muscle spasms, joint pain.
Vascular syndromes — they make their debut with vascular compression, are not accompanied by pain, there is weakness in the muscles, cone syndrome — weakness in both feet, violations of the functionality of the pelvic organs.
The symptoms of osteochondrosis in the lumbar region are diverse. This part of the spine is loaded more than others.
Diagnosis of osteochondrosis of the spine
At the first back pain, it is necessary to conduct an examination to determine the source of pain. Osteochondrosis is a difficult to diagnose disease, since pain can be caused by other pathologies unrelated to the spine. The patient will need consultations from several specialists: a neurologist, first of all, an orthopedist, a vertebrologist.
Methods of 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. Radiography is most often done in two positions — lying on your back and on your side. Two different projections of the images allow you to more accurately determine the presence of pathology. Sometimes an X-ray is taken with the lower jaw lowered.
MRI and CT. MRI results are considered more accurate and help to quickly determine the localization of segments that have been affected by pathology, the presence or absence of intervertebral hernias, compression of the roots.
Laboratory tests: a blood test to determine the level of calcium in the blood and the rate of erythrocyte sedimentation. Laboratory tests are prescribed the very first, longer, already on the basis of these results, the doctor directs 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 on the spine of an oncological nature, violation of the integrity of cartilage tissue, inflammatory processes, intermittent lameness, formation of cysts on internal organs, urolithiasis, gastritis, pyelonephritis, stomach ulcer, angina pectoris, disorders of the nervous system. For this purpose, studies of the digestive organs, nervous system, and blood circulation can be prescribed. Such 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:
Stage. Complications caused by protrusion — sharp pain shooting sensations.
Stage. Sciatica, which are characterized by pain syndromes and other symptoms depending on the localization of sciatica.
Stage. Pathology of the roots and spinal nerve, the presence of intervertebral hernias. Muscle paresis often occurs, causing paralysis of the whole body as a result.
Stage. Violation of blood circulation and blood supply to the entire spinal cord. Symptoms: persistent severe back pain, paralysis of certain muscle groups, ischemic stroke of the spinal cord.
Treatment of osteochondrosis of the spine
The process of treating any kind of osteochondrosis pursues one goal — to numb, prevent the destruction and deformation of spinal tissues. Treatment can be conservative or surgical. The type and method of treatment is 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 are recommended, anti—inflammatory drugs (dicloberl, voltaren), injections of antispasmodic mixtures, vitamin B, preparations for rubbing – deep relief, larkspur, etc. as the pain syndrome weakens, a course of physical therapy and physiotherapy (diadynamic currents, electrophoresis, magnetotherapy) can be prescribed.
The use of conservative methods of treatment lasts about two months. In addition to the listed methods of treatment, massages, manual therapy, reflexology, extraction can also be used. The result of conservative treatment directly depends on the patient’s perseverance and diligence.
There is also a surgical method of treatment, which is used in the presence of intervertebral hernias more than six months old, compression of the spinal cord roots due to a decrease in 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 physical therapy, physical therapy, taking vitamins.
Prevention of osteochondrosis of the spine consists in combating risk factors — maintaining an active lifestyle, playing sports, proper nutrition, using corsets and special belts with back loads, sleeping on orthopedic mattresses and pillows, avoiding hypothermia and injuries.
