Osteochondrosis is a disease that diagnoses degenerative-dystrophic changes in the cartilaginous tissues of the spine, accompanied by disorders in the structure and functionality of intervertebral discs. Depending on the location of the damaged tissues, osteochondrosis of the cervical, thoracic and lumbar regions is isolated. According to medical statistics, the symptoms of osteochondrosis are observed in 50-90% of the population. The average age of osteochondrosis is 30-35 years. Under adverse conditions, signs of osteochondrosis can also appear in the earlier period, especially with prolonged uneven loads on the back, legs, and the consequences of injuries.
- What is osteochondrosis?
- Causes of osteochondrosis
- Stages of development of osteochondrosis
- Symptoms of osteochondrosis
- Classification of osteochondrosis
- Diagnosis of osteochondrosis
- Therapy directions for osteochondrosis
- Conservative treatment of osteochondrosis
- Osteochondrosis: drug therapy
- Osteochondrosis: dietary nutrition of the patient
- Complications of osteochondrosis
- Prevention of osteochondrosis
What is osteochondrosis?
Osteochondrosis is a disease of the vertebral column in which degenerative and dystrophic lesions of the intervertebral discs occur. With the development of osteochondrosis, degenerative-dystrophic lesions spread to the tissues of the vertebrae.
The main symptom that indicates the development of osteochondrosis is pain in the neck, back, lumbar region, with the progression of pain “gives” to the arms, chest, shoulders, upper thigh, etc. sensitivity disorders, as well as dysfunction of the internal organs, provoked by their compression, displacement. In the absence of timely treatment, osteochondrosis develops to an incurable state.
Causes of osteochondrosis
The main factor in the development of osteochondrosis is an uneven load on the spine. Habits of carrying the bag on one shoulder or in one hand, incorrect sitting posture, sleeping on an overly soft mattress, high pillow, wearing anatomically incorrect types of shoes are a frequent cause of improper distribution of the load.
Additional risk factors include hypodynamia, sedentary lifestyle, overweight, injuries of the back, lower extremities, flat feet and other disorders of the musculoskeletal system, as well as age-related degenerative processes with age-related changes in the blood supply to the spine.
The following factors may also play a role in the etiology of osteochondrosis:
- physical overstrain of the body;
- neuro-emotional exhaustion;
- metabolic disorders, poisoning, diseases of the gastrointestinal tract, preventing full absorption of nutrients;
- professional risks, in particular, work on vibration platforms;
- genetic predisposition;
- poor posture during active growth, scoliosis;
- wearing uncomfortable shoes (close, heels);
- prolonged and / or regular dehydration of the body;
- poor diet, hypovitaminosis;
- pregnancy, especially multiple pregnancy, in combination with an undeveloped muscular-ligamentous apparatus (due to a shift in the center of gravity of the body).
Stages of development of osteochondrosis
Osteochondrosis in the dynamics of the disease goes through four stages:
- Stage 1 osteochondrosis (degree) is characterized by the initial stage of pathology in the pulpal nucleus of the intervertebral disc. Due to the excessive load, the process of dehydration (dehydration) of the nucleus begins, which leads to a decrease in the disk height parameter and the occurrence of fibrous ring cracks. Symptoms at this stage, as a rule, are absent, there may be slight discomfort during a long stay in an uncomfortable static posture, active movement, etc.;
- in stage 2, a decrease in the height of the disks leads to a decrease in the distance between the vertebrae and sagging of the vertebral muscles and ligaments. This causes an increased mobility of the vertebrae with the affected discs, which is dangerous by their displacement or slipping. In the second stage of the disease, discomfort occurs, pain, especially with certain types of stress, movements, positions;
- osteochondrosis stage 3 (degree) is characterized by the formation of prolapses and protrusions of intervertebral discs, may be accompanied by subluxation and / or development of arthrosis of intervertebral joints. In some types of movement, patients feel stiffness, lack of mobility, a feeling of tingling, numbness may occur in the limbs. At this stage of osteochondrosis, pain in the back, neck, lumbosacral or coccyx region is clearly felt, depending on the location of the affected discs;
- in stage 4 of osteochondrosis, the body tries to correct the consequences of hypermobility of the vertebrae and adapt to the functional impairment of the spinal column. Osteophytes, new bone formations that improve the fixation of the vertebra are formed at the contact points of the vertebrae. However, in some cases, osteophytes can cause nerve infringements, injure the vertebrae. In the intervertebral discs and joints, fibrous ankylosis begins. In the absence of microtraumas and infringements of the nerve roots, the symptoms of the disease subside.
Symptoms of osteochondrosis
The main symptoms of osteochondrosis – a feeling of discomfort and / or pain in the neck, back. The severity of sensations and the presence of additional symptoms depend on the stage of the disease. When examining a patient and collecting anamnesis, a specialist conducts a primary diagnosis, suggesting the presence of osteochondrosis on the visually detectable curvature of the spine, observed in the transverse or longitudinal plane of the spinal column. Pathologies of intervertebral discs of the cervical and lumbar spine are much more common than degenerative and dystrophic changes in the sternum.
Signs of osteochondrosis felt by the patient include a periodic or permanent feeling of fatigue of the back, erased or expressed, depending on the stage of the disease, pain syndrome. The pain can be localized in the neck, back, chest, shoulder girdle, complicate, constrain the movement of the upper limbs.
The clinical picture of osteochondrosis largely depends on the localization of the pathology, the degree of development of the process, the individual characteristics of the patients. The pathology of intervertebral discs, displacement, protrusion, hernia, and an increase in osteophytes lead to various consequences. Disturbances of normal blood circulation in the tissues, pinching of nerve endings, dysfunction of the spinal canal, edema, fibrosis of tissues and structures are among the most common.
Such consequences can be accompanied by many different symptoms, leading to the misdiagnosis of diseases.
The most common and characteristic symptoms of osteochondrosis include the following:
- pain in the back, neck, lower back, shoulder girdle, rib region;
- discomfort, stiffness of body movements arising from certain body positions, bends, turns, increased muscular tension;
- numbness of the upper and lower limbs;
- muscle and joint discomfort, muscle spasms;
- headaches, dizziness, fatigue;
- pain in the heart;
- impaired hand sensitivity;
Symptoms of osteochondrosis vary depending on the location of the pathology:
- in osteochondrosis of the cervical spine, pains in the neck, arms, shoulder girdle, radiating to the shoulder and shoulder area, prevail; there are headaches, dizziness, flickering “fly” or spots before the eyes, tinnitus;
- in case of lesions of the thoracic spine, pain is localized in the chest, heart, inner shoulder, underarm, breathing discomfort is also noted, shortness of breath is possible;
- osteochondrosis of the lumbosacral spine is manifested by lower back pain radiating to the legs, upper thighs or pelvic organs, often associated with sexual dysfunction.
Superficial symptoms – back fatigue, pain – may indicate not only the presence of osteochondrosis, but also the accession of other diseases or the development of other pathological processes and disorders not associated with dystrophy of intervertebral discs. The diagnosis of osteochondrosis can be made only by a specialist, and self-treatment for such symptoms is unacceptable.
Classification of osteochondrosis
Types of osteochondrosis are distinguished according to several principles. Depending on the localization of the pathology, osteochondrosis of the cervical, thoracic, lumbar, sacral, or mixed, combined types of the disease are distinguished. According to the clinical manifestations, osteochondrosis of different localization is divided into subtypes depending on the identified symptoms and the clinical picture as a whole.
Osteochondrosis of the cervical spine:
- depending on the type of reflex syndrome, cervicalgia, cervicocranialgia, cervicobrachialgia with various manifestations (vascular, neurodystrophic, musculo-tonal) are detected;
- with a positive test result for radicular syndrome diagnose discogenic damage to the roots of the cervical spine.
For pathology of the thoracic level, the following are distinguished:
- for reflex syndromes – thorakalgia with vegetovisteralnymi, neurodystrophic or muscle-tonal manifestations;
- on the radicular – discogenous lesion of the thoracic roots.
When osteochondrosis of the lumbosacral level is diagnosed:
- depending on the type of reflex syndrome – lumbago (backache), lumbodynia, lumbar scars with vegetovascular, neurodystrophic or muscular-tonal manifestations;
- radicular syndrome indicates discogenous damage to the roots of the lumbosacral;
- Root-vascular syndrome indicates radiculoischemia.
Diagnosis of osteochondrosis
Instrumental examination methods are used for diagnosis:
- X-ray examination of the spinal column;
- Neurological examination of sensitivity, reflexes.
Additional methods assigned to differentiate and refine the diagnosis, the stage of pathology, include:
- computed tomography of the spine (CT);
- nuclear magnetic resonance (NMR);
- magnetic resonance imaging (MRI).
Therapy directions for osteochondrosis
Treatment is based on an integrated approach and, depending on the stage, lasts from 1 to 3 months of intensive therapy and 1 year of supporting measures to consolidate the result and prevent relapse.
Therapy of the disease osteochondrosis is carried out in two directions, depending on the degree of osteochondrosis and the patient’s state of health. Conservative treatment of the disease consists of taking medication, performing a set of exercises. Surgical treatment in almost any situation cannot be the first choice method and is prescribed in the absence of positive dynamics, progression of the disease against the background of long-term conservative therapy.
In addition to medical therapies, it is necessary to follow general recommendations for osteochondrosis: follow a diet, take measures necessary for rehabilitation.
Conservative treatment of osteochondrosis
Conservative therapy aims to relieve pain, normalize the functionality of the spinal column and prevent negative changes.
The following treatments are included in the conservative treatment of osteochondrosis:
- Drug therapy. Drugs for osteochondrosis are used to relieve pain syndromes, inflammatory processes in tissues and normalize metabolic processes of the body. In cases of severe pain syndrome, the use of drug blockages of nerve endings is recommended, which also contribute to a reduction in the severity of muscular-tonic syndrome. The following types of blockades are distinguished: blockade of trigger points, intraosseous, facet, paravertebral, epidural;
- physiotherapy methods. Physiotherapeutic procedures help reduce pain, increase the effect of medications, and are also used during the rehabilitation period. The most common application of ultrasonic waves, magnetic fields, low frequency currents, laser beams, etc.,
- methods of physical therapy (physical therapy) and kinesitherapy. The complex of special exercises with regular and correct performance contributes to the correction of posture, strengthens the muscular system, ligaments, normalizes muscle function, reduces the compression of nerve fibers and helps prevent complications of osteochondrosis. The methods of physical therapy and kinesitherapy procedures are aimed at normalizing metabolic processes, restoring full nutrition of intervertebral discs, restoring the location of the vertebrae and discs between them, evenly distributing the load in the locomotor apparatus;
- massage. Manual massage techniques are used to improve the blood supply to the tissues, relieve muscle spasms and clamps, and generally improve blood circulation. Hydro massage as a direction of therapeutic activity in addition to the listed effects contributes to the normalization of the nervous system of the body;
- manual therapy. Methods of manual therapy are selected individually. Acupressure on the musculoskeletal system of the body helps to improve blood circulation, lymph circulation, improves metabolism, helps to correct mobility of the musculoskeletal system, strengthens the immune system, and serves to prevent complications of osteochondrosis;
- therapy by traction (extension) of the spine using special equipment. The purpose of manipulation is to increase the intervertebral space to normal parameters, the correction of violations of the structure of the spinal column.
Osteochondrosis: drug therapy
In the treatment of osteochondrosis, drugs are aimed at reducing the severity of symptoms, improving the blood supply to the tissues and their regeneration. Osteochondrosis is impossible to cure only with medication, therapy should be combined, include exercise complexes, diet, preventive measures.
In the absence of pronounced dystrophic changes and pain, taking medications without prescribing a specialist can be considered unwarranted.
Drugs used to relieve pain and treat osteochondrosis:
- anti-inflammatory group: ibuprofensoderzhaschie drugs, (Ibuprofen, Nurofen), Karipazim, Pantogematogen, Reoprin and so on;
- antispasmodic drugs: Baclofen, Drotaverinum (Drotaverin, No-Spa), Miolastan, Sirdalud, etc.;
- antioxidant drugs: vitamins C (as ascorbic acid), E (tocopherol acetate), N (thioctic acid);
- means for improving the blood supply to tissues: Actovegin, Theonikol, Trental, group B vitamins (mainly B3);
- preparations for the regeneration and / or prevention of cartilage degeneration: Aflutop, Diacerin, Piascledine, hyaluronic acid.
Preparations can be prescribed both in the form of ointments, creams for local use in case of pain, as well as for oral administration and in the form of injections.
In case of acute complications, medications are used for the medical blockade of nerve endings.
Osteochondrosis: dietary nutrition of the patient
The principles of diet are based on the need to improve metabolic processes, saturate the body with essential nutrients, vitamins, minerals, include foods high in antioxidants, polyunsaturated fatty acids, compounds that promote the regeneration of cartilage tissue. The drinking regimen recommended for osteochondrosis is aimed at preventing dehydration that can adversely affect the affected tissues.
Eating is necessary fractional, 5-6 times a day.
The basis of the diet consists of dairy and dairy products, lean meats, poultry, fish, fresh vegetables, fruits, nuts and seeds, cereals, mushrooms. It is especially recommended to include meat and fish jelly, aspic, aspic, as well as the use of extra virgin olive oil without temperature treatment (for dressing salads, etc.).
Food processing methods are preferable: steamed, roasting, boiling.
Limit the intake of flour and confectionery products, fatty foods, spicy, salty foods and seasonings, canned and smoked foods, strong meat broths, legumes, sugar and fruits with its high content (grapes).
During the day, it is necessary to consume at least 1.5 liters of liquid, preferring pure and mineral water, dried fruit compotes, unsweetened fruit drinks, and herbal teas. It is necessary to limit the amount of strong black tea, coffee, sugary carbonated beverages, alcohol.
Complications of osteochondrosis
Failure to follow the prescribed treatment, prolonged avoidance of the doctor and the lack of treatment of osteochondrosis contributes to the progression of the disease and provokes the development of complications, pathologies and new diseases, such as:
- hernia of intervertebral discs (spinal hernia);
- salt deposits in the intervertebral space;
- spinal cord strokes;
- decrease in muscle mass of the limbs, muscle atrophy due to circulatory disorders;
- lower limb paralysis.
Despite the fact that grade 4 osteochondrosis can proceed without severe symptoms and pain, running osteochondrosis is the most dangerous for the development of serious complications and can lead to disability of the patient.
Prevention of osteochondrosis
The causes of osteochondrosis are mainly related to the lack of attention to the requirements of the body, malnutrition, excessive loads on the body. To prevent the onset of pathological changes in the spine and to contain the dynamics of already existing osteochondrosis, it is recommended to adhere to the general principles of a healthy lifestyle:
- exclusion of hypodynamic abilities: moderate exercise: exercise, jogging, swimming, biking, skiing, gymnastics, non-contact wrestling, etc.
- when working or having any other type of activity associated with a long stay in a static posture, you should take breaks to warm up every 45 minutes to restore blood circulation. If you need to sit for a long time, you should choose the right chairs, chairs with the support of the spine, monitor compliance with standards for the position of hands on the table, feet on the floor or a special stand, learn to hold your posture (even back, relaxed shoulders);
- for a night’s sleep, you must choose an elastic, better orthopedic mattress with a flat surface, avoid high or too flat pillows;
- if necessary, lift and / or carry heavy objects, avoid jerking, lifting weights from the half-prissed position, use special belts supporting the lower back;
- the choice of orthopedic correct footwear: with the appropriate foot width, without high heels and its timely replacement will help reduce the load on the spine, this is especially important for women during the childbearing period. In the summer, you should not neglect the opportunity to walk barefoot on an uneven surface, it strengthens the muscles of the foot and relieves tension from the musculoskeletal system;
- good diet, drinking regimen promotes general health and helps maintain normal metabolism;
- with a tendency to heightened emotionality, anxiety with a muscular spasmodic reaction to stress, you should learn relaxation techniques, as well as regularly take a general strengthening massage course.