Osteochondrosis of the spine is a degenerative-dystrophic damage to the intervertebral discs, vertebral body, ligament apparatus, which destroys the cervical, thoracic and lumbar bone and cartilage tissue.
Pathology affects the entire motor segment of the spine, the disc, both the vertebral bodies and the adjacent nerve and muscle structures. This disease is often called the "disease of civilization", which is associated with posture and stress in the spine every day.
The main causes of spinal osteochondrosis are microtrauma due to physical stress, unhealthy diet, sedentary lifestyle and even genetic predisposition. If the disease develops, the intervertebral disc and adjacent structures are primarily affected. The central part of the disc changes, which leads to a loss of the shock-absorbing properties of the vertebrae, resulting in cracks and thinning in the fibrous ring.
American statisticians say that the first reason that limits the activity of people under the age of 45 is dorsal and cervical back pain. Most city dwellers and drivers who spend a significant portion of their time sitting, loading their spine, are at risk.
Osteochondrosis is the cause of more than 70% of back pain cases. The risk of disease increases with age.
Etiology and pathogenesis of spinal osteochondrosis
There is a long-term pathogenesis of spinal osteochondrosis (from several months to decades). It depends on the factors that affect the development of the disease.
- Age. Older people (over 60) are at risk. The disease is rare in people under 35 years of age. As a result of age-related changes, a person's hormonal background becomes disturbed, which makes the muscle tissue and vascular walls more porous, which makes them more sensitive. It causes metabolic diseases, overloads the intervertebral discs.
- Autoimmune diseases that 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 who suffer from spinal injuries at a young age suffer from osteochondrosis of the spine in old age.
- Overweight, which reduces the wear of intervertebral discs. Cartilage discs, physical activity, walking, running, etc. It acts as a kind of shock absorber for the spine, which provides mobility over time, protects bone tissue from destruction and micro-cracks. Excess weight increases the load, which accelerates the destruction of cartilage discs.
- Straight legs.
- Genetic predisposition.
- Diseases of the endocrine system that cause metabolic disorders, which adversely affect the condition of cartilage tissue.
Osteochondrosis can be "inactive" for a long time. Many patients learn about the disease when there is severe pain when the dystrophic process in the cartilage tissue damages the nerve roots.
There are the following stages in the pathogenesis of spinal osteochondrosis:
- Disorders of blood circulation in the intervertebral discs and adjacent structures.
- Hormonal and metabolic diseases, especially in the body and intervertebral discs.
- Pulposus nucleus fission processes. At this stage, the structure of the intervertebral disc changes - the nucleus shrinks, the disc itself becomes thinner, the load on the ring fibrosis increases, which leads to various stratification, micro-cracks and sometimes fractures.
- Dislocation of the intervertebral discs - the tissue of the intervertebral discs often extends into the spinal canal, causing severe pain.
- Intervertebral hernia. Progression of the protrusion leads to damage to the ligaments, a change in the height and shape of the disc, which leads to the formation of a hernia.
- Compression of radicular arteries.
- Chronic insufficiency of blood supply to the spinal cord.
Symptoms of spinal osteochondrosis
As osteochondrosis develops, pathologies appear in the intervertebral discs and cartilage that overlap and can lead to the appearance of an intervertebral hernia.
Symptoms can be both general and specific, and are characteristic of pathological changes in cartilage, intervertebral discs, and adjacent tissues.
The first sign of osteochondrosis should be low back pain, numbness of the spine, limited movement, increased pain during physical exertion.
Specific symptoms of osteochondrosis:
- Cervical osteochondrosis is characterized by circulatory disorders, which cause dizziness, pain and tinnitus, headaches. The brain is poorly enriched with oxygen and nutrients, resulting in a stressful situation.
- Osteochondrosis of the thoracic region, often accompanied by intercostal neuralgia. There is pain in the chest and ribs.
- Lumbar osteochondrosis causes the development of lumbago, lumbosacral (sciatica) and lumbar sciatica. Sciatica affects the sciatic nerve, pain and hypotension in the thighs, as well as hypotension in calves.
Symptoms of cervical osteochondrosis:
- Cirvicalgia - cervical low back pain. The nature of the pain varies depending on the factor that affects this part of the spine (dull, sharp, aggravated by bending the head and torso).
- Cervicobrachialgia - cervical low back pain, arm radiation, numbness.
- Shoulder-scapular rheumatism and rearthritis - pain in the shoulder joint, collarbone, limiting the movement of the arm from top to bottom.
- Epicondylosis - pain in the elbow joint, limited mobility.
- Vertebral artery syndrome - so-called cervical migraine, aching headache and neck pain, nausea, sometimes vomiting, loss of coordination - confusion while walking, tinnitus.
One of the most common symptoms of cervical osteochondrosis is circulatory disorders, which often lead to dizziness, fainting and headaches.
Symptoms of thoracic osteochondrosis:
- Thoracalgia - chest pain, pain associated with inactivity (manifested by sitting at night for a long time), aggravated by physical activity, deep breathing, cough.
- Heart syndrome.
- Posterior chest wall syndrome - pain in the shoulder blades, pain sensations depend on the condition of the body.
- Anterior skeletal muscle syndrome.
- Trunkalgic syndrome - pain in the chest.
- Complications of intercostal neuralgia.
Symptoms of lumbar osteochondrosis:
- Lumbodynia - low back pain, lumbago. The patient feels discomfort when trying to sit or stand. The pain is aggravated by physical activity, coughing, deep breathing, bending.
- Lumboischialgia - pain in the lower back, spreads to the legs. There may be paresthesia, numbness of the legs, muscle spasms and joint pain.
- Vascular syndromes - occur with constriction of blood vessels, are not accompanied by pain, weakness in the muscles, cone syndrome - weakness in both legs, impaired pelvic function.
The symptoms of lumbar osteochondrosis are different. This part of the spine is loaded more than others.
Diagnosis of osteochondrosis of the spine
In the first low back pain, an examination should be performed to determine the source of the pain. Osteochondrosis is a difficult disease to diagnose because pain can be caused by other pathologies not related to the spine. The patient will need to consult several specialists: a neurologist, primarily an orthopedist, a vertebrologist.
Methods of diagnosing osteochondrosis:
- Radiography. This is done 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. X-rays are performed in a maximum of two positions - stretching the back and side. Two different image projections allow to more accurately determine the presence of pathology. Sometimes an X-ray is taken with the lower jaw down.
- MRI and CT. MRI results are considered more accurate and help to quickly determine the location of the affected segments of the 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 rate. Laboratory tests are prescribed by the first based on these results, and the doctor directs them to the diagnostics of the device.
It is important to distinguish spinal osteochondrosis in a number of other diseases with a similar clinical picture, for example: oncological spinal neoplasm, violation of cartilage tissue integrity, inflammation, interstitial claudication, formation of cysts in internal organs, urolithiasis, syphilis, gastritis, pyelonephritisdisorders. For this purpose, studies related to the digestive system, nervous system and blood circulation can be scheduled. The following diagnostic methods are used - cardiogram, ultrasound, electroencephalography, endoscopic examination (digestive organs).
Complications of osteochondrosis
Often the course of this disease is accompanied by neurological complications:
- Stage. Complications caused by the protrusion - a sharp painful burning sensation.
- Stage. Radiculitis characterized by pain syndromes and other symptoms depending on the localization of radiculitis.
- Stage. Pathology of roots and spinal nerves, the presence of intervertebral hernias. Muscle paresis often occurs, resulting in paralysis of the whole body.
- Stage. Disorders of blood circulation and blood supply to the entire spinal cord. Symptoms: persistent severe low back pain, paralysis of certain muscle groups, ischemic stroke.
Treatment of osteochondrosis of the spine
The treatment of any type of osteochondrosis has one goal - to reduce pain, prevent the destruction and deformation of spinal tissues. Treatment can be conservative or surgical. The type and method of treatment is determined individually for each patient according to the diagnosis (stage, type of disease, general well-being of the patient).
Relaxation and rest are recommended in the acute period of pain syndrome, as the pain syndrome decreases, anti-inflammatory drugs (dicloberl, voltaren), injections of antispasmodic mixtures, vitamin B, rubbing preparations - dipping rileaf, larkspur, etc. physical education and physiotherapy (diadynamic currents, electrophoresis, magnetotherapy).
Conservative treatment takes about two months. In addition to the treatments listed, massage, manual therapy, reflexology and extraction can also be used. The outcome of conservative treatment directly depends on the patient's perseverance and diligence.
In the presence of intervertebral hernias that last more than six months, there is also a surgical treatment used to compress the spinal cord due to the narrowing of the space between the spinal cord. The principle of surgical treatment is the removal of the deformed disc. The postoperative rehabilitation period is about six months. Rehabilitation includes exercise therapy, physiotherapy and vitamin intake.
Prevention of osteochondrosis of the spine involves combating risk factors - leading an active lifestyle, exercising, eating properly, using corsets and special belts when loading the spine, sleeping on orthopedic mattresses and pillows, avoiding hypothermia and injuries.