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 chronically progressive course.The disease is not felt for a long time, and symptoms appear only when complications occur.
According to statistics from the World Health Organization, 40-80% of the world's population suffers from osteochondrosis.
The majority of patients are over 30 years old.But recently there has been a tendency to revive osteochondrosis.Osteochondrosis ranks first among spine diseases in terms of disability among patients.
Brief anatomy of the spine
The spine performs the main functions - the canal of the spinal cord, support and movement, and also connects the head, shoulder and pelvic girdles.
The structural unit of the spine is a vertebra.
The 24 vertebrae are connected to each other by intervertebral discs, which are the shock absorbers of the body.
The spine is divided into five sections: cervical, thoracic, lumbar, sacrum and coccyx.
The normal shape of the spine is S-shaped.
This configuration of the instrument makes it possible to distribute body weight and load evenly.
Structural and functional elements of the spine
A vertebra is a bone formation consisting of a body, an arch and processes.
The main load falls on the vertebral body, so this is its most voluminous part.
Great!The arches of the adjacent vertebrae form the spinal canal - the receptacle for the spinal cord, blood vessels, spinal nerve roots and fatty tissue.
LinksThe spine is represented by the posterior longitudinal ligament, which connects the vertebrae along the posterior 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 extending from the arch: the 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 discit is a disc-shaped plate consisting of a cartilaginous plate, anulus 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 together and provide flexibility to the spine.
Intervertebral foraminathey are located on the lateral sides of the spine and are formed by the articular processes, bodies and pedicles of the adjacent vertebrae.The spinal nerve roots exit through the intervertebral foramina and the blood vessels enter.
Spinal cord- This is a part of the central nervous system that consists of nerve fibers.The spinal cord has three membranes - soft, arachnoid and dura.The spinal membrane of the dura consists of two sheets that connect and form the dura sac, filled with cerebrospinal fluid - cerebrospinal fluid.
Spinal nerve roots- These are conduits of nerve impulses from the spinal cord to the internal organs and vice versa.Each spinal nerve root has autonomic, sensory and nerve fibers in its structure.
Paraspinal 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 isrange of motion of the spine, consisting of two adjacent vertebrae, an intervertebral disc, ligaments and muscles.
Pathogenesis (mechanism of development) of vertebral osteochondrosis
In the process of development, osteochondrosis passesfour stages:
- First stage.Pathological changes do not extend beyond the boundaries of the intervertebral disc.The nucleus pulposus dries up, which leads to a decrease in the height of the intervertebral disc.The fibrous ring cannot withstand the load - it cracks and tears.
- Second stage.Due to the decrease in the height of the intervertebral discs, there is a relaxation of the ligaments and muscles of the spine, which leads to instability of the movement part of the spine.Vertebrae can slide and move around each other.In this case, spondylolisthesis is formed.
- Third stage.The disease progresses.Lumps of the intervertebral discs and articulations of the intervertebral joints appear, as well as exposed joints.
- Fourth stage.At this stage, adaptive reactions are activated in the form of bony growths of the vertebral bodies (osteophytes).Thus, the body tries to limit the excessive mobility of the vertebrae.Osteophytes with their sharp edges damage spinal nerve roots.Fibrous ankylosis of the intervertebral discs and joints is formed and the spine becomes immobilized.The ankylosis stage is characterized by the disappearance of pain.
What leads to osteochondrosis?
Osteochondrosis of the backit is a multifactorial disease in which it is impossible to single out a specific cause.
The basis of osteochondrosis is the violation of microcirculation and metabolism in the tissues of the spine, which can occur due to improper distribution of the load on the spine.
Factors that contribute to the development of osteochondrosis include the following:
- improperly formed 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 weight lifting.
- physical inactivity and sedentary life.
- 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 posterior part of the annulus fibrosus and the posterior longitudinal ligament, then the roots of the spinal nerves are irritated, pinch, 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 compressive syndromes.
Great!The pain syndrome in osteochondrosis occurs due to pinching of the spinal nerve roots in the intervertebral foramina by osteophytes, torn muscles and displaced vertebrae.
Osteochondrosis with its symptoms often mimics acute coronary syndrome, pleurisy, acute pancreatitis, hepatic and renal colic, acute appendicitis, and adexitis.
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, in the waist, in the thoracic part of the spine, which can be pain, throbbing or in the form of a lumbar.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 disturbancedifferent parts of the body at the level of innervation of the pinched nerve.
- spasmmuscles of the neck, back, upper and lower limbs.
- which resembles a migraine headaches;
- 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(floats in front of the eyes or colored spots).
- reduced hearing acuity, tinnitus;
- heart pain;
- painalong the intercostal spaces.
- reduced blood supplyupper and lower limbs, manifested by coldness of their skin.
- paraesthesia– crawling, tingling and burning sensation in the spine.
- dry skin;
- sweating disorder;
- urinary disorder(dysuria, enuresis);
- decreased sexual desire, impotence.
Early diagnosis of osteochondrosis will greatly facilitate its treatment.
Methods for the diagnosis of osteochondrosis
A neuropathologist diagnoses osteochondrosis.If necessary, patients can be referred for consultation to a cardiologist, gastroenterologist, orthopedist, surgeon and others.
During the interview, it is necessary to accurately determine the nature of the complaints, when they arose and what the patient associates them with.Be sure to check the patient's medical history, occupation, and whether any close relatives have osteochondrosis.
Laboratory tests in this case are not informative.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 organic methods, such as X-ray of the spine, computed tomography and magnetic resonance imaging.
X-ray of the spine is the simplest, most accessible and highly informative method for diagnosing osteochondrosis.
Mandatory X-ray is performed in direct and lateral views 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 of the spine with the introduction of a contrast agent into the spinal canal.This method is dangerous due to the occurrence of allergic reactions to the contrast.
Myelography allows us to study the internal structure of the spinal canal.The method is valuable for the diagnosis of Schmorl's hernias (intervertebral hernias).
Computed and nuclear magnetic resonance imaging– 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 and others.
Treatment methods for osteochondrosis
The treatment of osteochondrosis can beconservative and surgical.
Great!First of all, comprehensive conservative methods are used, and surgical treatment is resorted to only in extreme cases.
Let's consider how osteochondrosis can be properly treated.KconservativeOsteochondrosis treatment methods can be listed:
- drug therapy;
- Physiotherapy;
- physical therapy methods?
- manual therapy;
- massage;
- acupuncture.
Pharmaceutical treatmentOsteochondrosis aims to relieve pain, relax muscles, relieve nerve and muscle swelling, improve blood flow and treat nerve impulses.For this purpose, the following groups of drugs are used:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors, which include components of cartilaginous 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 paraspinal muscles.
- muscle relaxantsrelax tight muscles.
- drugs, improvement of metabolism and microcirculation in spinal tissues (vitamins B1, B6, B12, C, A and E).
- calcium supplements;
- hormonal drugs, which are prescribed when non-steroidal anti-inflammatory drugs are ineffective.
Therapeutic exercise– these are dosed physical activities that can be performed both at home and at work for the treatment and prevention of osteochondrosis.
There are many sets of exercises for osteochondrosis.The prescription of the exercise therapy and the monitoring of its application is carried out by a specialized specialist - a doctor of physical therapy.
Thanks to correctly selected exercise therapy, you can relieve pain, improve mobility and blood supply to the spine and stop the progression of the disease.
Physiotherapy treatmentOsteochondrosis is carried out in special physiotherapy departments of hospitals, sanatoriums and clinics by a physiotherapist.
Physiotherapy methods include: electrophoresis, magnetic therapy, laser therapy, mud therapy, bath therapy, exposure to ultraviolet radiation on the affected part of the spine, vibration therapy and others.
Manual therapy– this is a dosed manual impact on the spine to restore its mobility, eliminate the displacement of the vertebrae and intervertebral discs.
Manual therapy should only be performed by a qualified chiropractor.
Massage and self-massagefor osteochondrosis, it is carried out to relieve muscle spasm, improve microcirculation in the paraspinal tissues and increase the mobility of the spine.
Acupunctureis a method of treating osteochondrosis in which fine needles are injected into active points.
Under the influence of needles on the body, the level of endogenous opiates and cortisol increases, which have anti-inflammatory and analgesic effects.
Prevention of osteochondrosis
To maintain your health and keep your spine mobile into old age, follow several principles to prevent osteochondrosis:
- watch your posture– always keep your back straight, don't bend.
- choosecorrect postureto sleep
- sit properly at the table(shoulders relaxed, back straight, furniture should match your height).
- during a long stay in one position (working at a desk, at a computer, sitting in crafts), try every 1-1.5 hoursdo some physical exercise, self-massage of the back, or just get up and walk.
- distribute the load correctlyin the spine when lifting and carrying various weights.
- wear orthopedic shoes;
- healthy sleepin a flat, hard to medium hard layer.It is better to buy an orthopedic mattress and pillow.
Osteochondrosis of the spineit is a chronic progressive disease that unfortunately cannot be cured.The effectiveness of treatment directly depends on its timeliness.
Do not self-medicate so as not to worsen your condition.At the first signs of osteochondrosis, contact a neurologist.