Osteochondrosis is a chronic pathology of the spine, the root cause of which is degenerative changes in the intervertebral disc. With the progression of the disease, other structures of the spinal column are also involved in the pathological process - the vertebral bodies, intervertebral joints, ligaments, etc.
The disease affects people of all ages. Until recently, osteochondrosis was considered the lot of the elderly, but recently there has been an increase in the incidence of this disease among young people. Both women and men get sick equally often.
Why does osteochondrosis occur?
In order to better understand what osteochondrosis is, it is necessary to briefly dwell on the causes and mechanism of its occurrence.
The formation of pathological changes in osteochondrosis of the spine occurs slowly. Years often pass from the beginning of the pathological process in the intervertebral cartilage to the manifestation of the first symptoms of osteochondrosis.
Causes of osteochondrosis
The health of the spine is directly affected by many negative factors. If their influence is carried out for a long time, then the result of this is the appearance of pathological changes in the structures of the spine. And this contributes to the formation of osteochondrosis.
For example, what osteochondrosis is is well known to people who lead an inactive lifestyle, who are overweight. Excessive physical activity, back and neck injuries, some somatic diseases can also lead to the development of this pathology. And aggravated heredity and old age are direct factors leading to the development of degenerative damage to the cartilaginous tissue of the discs.
How does osteochondrosis develop?
The mechanism of development (or pathogenesis) of osteochondrosis is still controversial and insufficiently studied. It is most likely that this disease is formed on the basis of metabolic disorders that occur in the structures of the spinal column.
Under the influence of adverse factors, often irreversible changes in the cartilaginous tissue of the intervertebral disc occur, followed by its gradual destruction (or destruction).
The pathological process then also spreads to the bone tissue of the vertebra with the development of its deformation and irreversible changes in the surrounding structures.
The appearance of such modifications in the intervertebral disc directly depends on its anatomical nuances:
- Cartilage tissue does not have its own blood supply system. Its nutrition is provided by the bone tissue of neighboring vertebrae. Therefore, in case of circulatory disorders as a result of insufficient or, conversely, excessive physical load on the spine, the nutrition of the cartilage also suffers.
- There are also no nerve fibers in the cartilage. Consequently, with a functional overload of the intervertebral disc, the transmission of a nerve impulse that triggers the activation of metabolism will be untimely.
- The ability to self-heal (regenerate) the cartilaginous tissue of the intervertebral disc is slowed down due to its structural features.
There are also other factors that clearly contribute to the development of degenerative processes in the cartilaginous tissue of the intervertebral discs and the formation of osteochondrosis.
Stages of pathological changes
Based on current data on the pathogenesis of this pathology, several stages of the degenerative process in the intervertebral disc can be conditionally distinguished. Stages of osteochondrosis of the spine:
- Elementary. The cartilaginous tissue of the disc undergoes structural changes under mechanical influences - its dysfunction occurs. Characterized by the appearance of cracks on the surface of the disk, different in size and depth. Subsequently, these cracks are transformed into protrusions (hernias).
- Intermediate. It is characterized by the appearance of instability of the affected area of the spinal column due to pathological mobility of the vertebrae. In this case, one of the main functions of the spine, the protective one, is disturbed. Nerve and vascular trunks that run in its bone canals become vulnerable. Vivid clinical symptoms of the disease develop.
- Finite. There is a replacement of the affected cartilage tissue with a coarser and more dense fibrous one. At the same time, intervertebral hernias disappear. And the pathological mobility of the vertebrae is replaced by a sharp restriction of their mobility. Often there is a narrowing of the spinal canal with the development of manifestations of compression of the segments of the spinal cord.
Therefore, each stage of the disease is characterized by the presence of its own specific symptoms, which undoubtedly plays a key role in the choice of methods for treating osteochondrosis.
Signs of osteochondrosis of the spine appear as changes in the bone tissue of the vertebrae. The patient may not present any complaints for quite a long time.
The disease is characterized by a chronic course, with phases of exacerbation and remission replacing each other.
Often, an exacerbation of osteochondrosis occurs under the influence of provoking factors: physical overstrain, hypothermia, prolonged exposure to an uncomfortable position, for example, in a dream or at work, etc.
There are many symptoms of this disease, which depend on the localization of the pathological process and the severity of structural changes in cartilage and bone tissue. All these symptoms can be grouped into several syndromes. Quite often they are combined.
It occurs in almost all patients with osteochondrosis of the spine. In the occurrence of this syndrome, compression (compression) of the roots of the spinal nerves by pathologically altered structures of the spine plays a role.
The main sign of radicular syndrome is pain, which in a significant number of cases is capable of spreading (irradiation) along the course of innervation of the corresponding root. Characterized by radiating pain from top to bottom. For example, if the lumbar region is affected, the buttock hurts and gives to the leg.
The intensity of pain increases with the rotation of the trunk or neck, physical activity. Pain sensations are characterized as cutting, pulling, baking.
Also, along with the pain syndrome, in the affected area, symptoms of a violation of sensitivity by the type of its increase (hyperesthesia) often develop, as well as sensitivity disorders, numbness.
If the disease progresses and the cause of compression is not eliminated, then hyperesthesia is replaced by hypoesthesia (decrease in sensitivity), which is often accompanied by symptoms of loss of function of the affected spinal root.
This syndrome develops as a result of compression of the spinal cord. The most common cause of such compression is an intervertebral hernia.
There is an increasing decrease in sensitivity, reactions to temperature and pain stimuli. Progressive muscle weakness develops in both the limbs and the trunk. Paretic or paralytic symptoms are often formed.
This syndrome most often develops in the cervical and cervicothoracic localization of osteochondrosis of the spine.
The cause of vascular disorders in osteochondrosis is a reflex spasm or mechanical compression of large vessels passing in the bone canals of the spine. In this case, various symptoms may develop, resembling an ischemic circulatory disorder of the brain or the main arteries of the extremities. This is often the cause of diagnostic errors.
In addition, various vegetative disorders often develop. They are most pronounced in women (emotional lability, sleep disorders, menstrual irregularities, etc. ).
It is characterized by the occurrence of pain in the projection of the heart, organs of the gastrointestinal tract, etc. Often such patients are treated for a long time and absolutely unsuccessfully for any somatic diseases.
For example, if the thoracic region is affected, pain behind the sternum may occur, resembling those with angina pectoris. Often there is a reflex sensation of the heartbeat.
In addition to the characteristic symptoms, additional examination methods play an important role in determining the disease and staging - X-ray of the spine, computed and magnetic nuclear tomography.
According to indications, other methods are performed, for example, EEG, ECG, Doppler scanning of blood vessels, etc.
Treatment of osteochondrosis
Therapy of osteochondrosis of the spine is an integrated approach. When choosing one or another method of treatment, it is necessary to assess the degree of damage to the structures of the spinal column, the nature and severity of clinical manifestations, as well as the stage of the course of the disease (exacerbation or remission).
An important role in the treatment of osteochondrosis of the spine is also played by preventive measures aimed at reducing the frequency of exacerbations of the disease and preserving the structure of the vertebrae and intervertebral discs.
Tactics during an exacerbation
An important condition for the treatment of the disease during this period is the creation of rest of the affected area of the spine. To do this, the patient is prescribed bed rest with the use of various devices to create immobility to the affected vertebral segment.
In some cases, hospitalization in the neurological department is required.
To reduce the intensity of pain in osteochondrosis, various medications are prescribed:
- non-steroidal anti-inflammatory drugs (NSAIDs);
- muscle relaxants.
In the absence of the effect of their use, it is advisable to prescribe blockades of the innervation of the affected area with the use of local anesthetics.
With cervical localization of osteochondrosis, circulatory disorders of the brain often develop. To reduce such manifestations, drugs are prescribed that improve cerebral blood flow. It is also necessary to use symptomatic remedies - relief of nausea and vomiting, improvement of vestibular disorders, etc.
In addition, it is advisable to prescribe vitamin preparations (especially group B), antioxidants and some others.
In osteochondrosis, treatment with physical factors has found wide application. Various methods of physiotherapy are used both during exacerbation and in the remission phase of the disease:
- In the acute period, ultraviolet irradiation, treatment with electromagnetic fields (UHF), diadynamic current, etc. are used.
- In the remission phase, electrophoresis with various drugs, inductothermia, ultrasound and various types of balneotherapy are prescribed.
Tactics in the remission phase
After the acute manifestations of the disease subside, the treatment of the disease continues. The purpose of such therapy is to reduce the frequency of exacerbations and promote the regeneration of bone and cartilage tissue of the spine.
The drug treatment prescribed for the acute phase of the disease continues. During this period, chondroprotectors can be used - agents that improve the condition of the cartilage.
In addition to physiotherapy methods, massage and physiotherapy exercises are also used.
The main effect of the massage is aimed at improving blood circulation in the affected area and strengthening the muscle corset. Also, the professional performance of massage movements allows you to relieve muscle spasm, which usually accompanies this pathology.
That is why massage should be carried out by a specially trained specialist who is fluent in this method of treatment. Incorrectly or illiterately performed massage can lead to the development of complications or exacerbation of the disease.
Therapeutic exercise (LFK)
Dosed and specially selected physical exercises form the basis of exercise therapy. The complex of such classes is selected by the doctor individually for each patient. The principle of selection of exercise therapy exercises is to reduce the physical load on the affected area of the spine.
The action of physiotherapy exercises is aimed at improving blood supply and lymph flow to the affected area, strengthening muscle tissue.
These exercises should be done every day. Usually, at first, individual or group classes are held with an instructor, then the patient can perform a set of exercises independently at home.
Prevention of exacerbations
Preventive measures of exacerbations of osteochondrosis of the spine are aimed at eliminating all provoking factors:
- It is necessary to monitor the correct posture and posture during long standing and sitting.
- It is useful for prolonged static stress (for example, working at a computer) to take regular breaks during which you should do a warm-up or a set of exercises recommended by your doctor.
- Hypothermia should be avoided.
- It is important to sleep properly with osteochondrosis, take care of a place to sleep - a mattress and a pillow. Ideally, they should be orthopedic.
- Mandatory is the reduction of excess body weight and timely correction of concomitant somatic and endocrine pathology.
And when the slightest symptoms of spinal disease appear, you should not delay visiting a doctor. After all, the earlier treatment of osteochondrosis of the spine is started, the better its results.