Osteochondrosis is a chronic pathology of the spine, the main cause of which is degenerative changes in the intervertebral disc. As the disease progresses, other structures of the spine are also involved in the pathological process - vertebral bodies, intervertebral joints, ligaments, etc.
The disease affects people of all ages. Until recently, osteochondrosis was considered the fate of the elderly, but recently an increase in the incidence of the disease was revealed in the young. Both women and men get sick just as often.
Why does osteochondrosis occur?
To better understand what osteochondrosis is, it is necessary to dwell briefly on its causes and mechanism of occurrence.
The formation of pathological changes in osteochondrosis of the spine occurs slowly. It often takes years from the onset of the pathological process in the intervertebral cartilage to the onset of the first symptoms of osteochondrosis.
Causes of osteochondrosis
The health of the spine is directly affected by many negative factors. If their influence lasts for a long time, then the result is the appearance of pathological changes in the structures of the spine. And this contributes to the formation of osteochondrosis.
For example, what is osteochondrosis is well known to people who lead an inactive lifestyle, who are overweight. Excessive physical activity, back and neck injuries, certain physical ailments can also lead to the development of this pathology. Both deteriorating heredity and aging 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 poorly studied. It is most likely that this disease is formed on the basis of metabolic disorders that occur in the structures of the spine.
Under the influence of adverse factors, irreversible changes in the cartilaginous tissue of the intervertebral disc often occur, followed by gradual destruction (or destruction).
The pathological process then spreads to the bone tissue of the vertebrae with the development of its deformity and irreversible changes in the surrounding structures.
The appearance of such changes in the intervertebral disc depends directly on its anatomical nuances:
- Cartilage tissue does not have its own blood supply system. Its nutrition is provided by the bone tissue of the adjacent vertebrae. Therefore, in case of disorders of the circulatory system as a result of insufficient or, conversely, excessive physical pressure 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 for self-healing (regeneration) of the cartilaginous tissue of the intervertebral disc is slowed down due to its structural characteristics.
There are also other factors that clearly contribute to the development of degenerative processes in the cartilaginous tissue of the intervertebral discs and to the formation of osteochondrosis.
Stages of pathological changes
Based on current data on the pathogenesis of this pathology, different stages of the degenerative process in the intervertebral disc can be distinguished under conditions. Stages of osteochondrosis of the spine:
- Elementary. The cartilaginous tissue of the disc undergoes structural changes under mechanical influences - it malfunctions. It is characterized by the appearance of cracks on the surface of the disk, different in size and depth. These cracks are then turned into protrusions (hernias).
- Intermediate. It is characterized by the appearance of instability of the affected area of the spine due to abnormal mobility of the vertebrae. In this case, one of the main functions of the spine, the protective one, is disrupted. The nerve and vascular trunks that run in its bone canals become vulnerable. Severe clinical symptoms of the disease develop.
- Finite. The affected cartilage tissue is replaced with thicker and denser fibrous. At the same time, the intervertebral hernias disappear. And the abnormal mobility of the vertebrae is replaced by a sharp restriction of their mobility. There is often narrowing of the spinal canal with the development of compression manifestations of parts of the spinal cord.
Therefore, each stage of the disease is characterized by the presence of its own specific symptoms, which undoubtedly play a key role in the choice of methods for the treatment of osteochondrosis.
Clinical EVENTS
Signs of osteochondrosis of the spine appear as changes in the bone tissue of the vertebrae. The patient may not have any complaints for a long time.
The disease is characterized by a chronic course, with phases of onset and remission replacing each other.
Often, an exacerbation of osteochondrosis occurs under the influence of provoking factors: physical overexertion, 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 location of the pathological process and the severity of the structural changes in the cartilage and bone tissue. All of these symptoms can be grouped into different syndromes. Quite often they are combined.
root syndrome
It occurs in almost all patients with osteochondrosis of the spine. Compression (compression) of the roots of the spinal nerves by pathologically altered structures of the spine plays a role in the occurrence of this syndrome.
The main sign of the root syndrome is the pain, which in a significant number of cases is able to spread (radiation) during the nerve of the corresponding root. It is characterized by pain radiation from top to bottom. For example, if the lumbar region is affected, the buttocks hurt and give way to the leg.
The intensity of the pain increases with the rotation of the torso or neck, physical activity. The sensations of pain are characterized as cutting, pulling, burning.
Also, along with the pain syndrome, in the affected area, often develop symptoms of violation of sensitivity by the type of its increase (hypersensitivity), as well as sensitivity disorders, numbness.
If the disease progresses and the cause of the compression is not eliminated, then hypersensitivity is replaced by hypersensitivity (decreased sensitivity), which is often accompanied by symptoms of loss of function of the affected spinal cord.
spinal syndrome
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 torso. Paretic or paralytic symptoms often form.
Phytovascular syndrome
This syndrome most often develops in the cervical and cervical thoracic localization of vertebral osteochondrosis.
The cause of vascular disorders in osteochondrosis is a reflex spasm or mechanical compression of large vessels that pass into the bony canals of the spine. In this case, various symptoms may develop that resemble an ischemic circulatory disorder of the brain or the main arteries of the limbs. This is often the cause of diagnostic errors.
In addition, various vegetative disorders often develop. They are more intense in women (emotional instability, sleep disorders, menstrual disorders, etc. ).
visceral syndrome
It is characterized by the appearance of pain in the projection of the heart, the organs of the gastrointestinal tract, etc. Often such patients are treated for a long time and completely unsuccessfully for any physical ailments.
For example, if the chest area is affected, pain may appear behind the sternum, similar to those with angina. Often there is a reflex sensation of the heartbeat.
Diagnostic principles
In addition to the characteristic symptoms, additional examination methods play an important role in the diagnosis and staging - spine x-ray, computed tomography and magnetic resonance imaging.
According to indications, other methods are performed, for example, EEG, ECG, Doppler scan of blood vessels, etc.
Treatment of osteochondrosis
Treating osteochondrosis of the spine is a comprehensive approach. When choosing one or another method of treatment, it is necessary to assess the degree of damage to the structures of the spine, the nature and severity of clinical manifestations, as well as the stage of the disease (exacerbation or remission). .
Preventive measures aimed at reducing the incidence of exacerbations of the disease and maintaining the structure of the vertebrae and intervertebral discs also play an important role in the treatment of osteochondrosis of the spine.
Tactics during an outburst
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 using various devices to create immobility in the affected spine.
In some cases, hospitalization in the neurological department is required.
Medical care
To reduce the intensity of pain in osteochondrosis, various drugs are prescribed:
- non-steroidal anti-inflammatory drugs (NSAIDs).
- analgesic;
- muscle relaxants.
In the absence of the result of their use, it is recommended to prescribe blockades of the nerve of the affected area with the use of local anesthetics.
With the 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 medications - relief from nausea and vomiting, improvement of vestibular disorders, etc.
In addition, it is good to prescribe vitamin preparations (especially group B), antioxidants and some others.
Physiotherapy procedures
With osteochondrosis, treatment with natural agents has found wide application. Various physiotherapy methods are used both during the exacerbation and in the remission phase of the disease:
- In the acute period are used ultraviolet radiation, treatment with electromagnetic fields (UHF), dynamic current, etc.
- In the recession phase, electrophoresis with various drugs, induction heat, ultrasound and various types of bath therapy are prescribed.
Tactics in recession
After the acute manifestations of the disease subside, the treatment of the disease continues. The purpose of such treatment is to reduce the incidence of exacerbations and to promote the regeneration of bone and cartilage tissue of the spine.
Medication prescribed for the acute phase of the disease continues. During this period, chondroprotectants can be used - agents that improve the condition of the cartilage.
In addition to physiotherapy methods, massages and physiotherapy exercises are also used.
Massage
The main effect of the massage is to improve blood circulation to the affected area and to strengthen the muscular corset. Also, the professional performance of massage movements allows you to relieve the muscle spasm, which usually accompanies this pathology.
For this massage should be done by a specially trained specialist who knows perfectly this method of treatment. Massage performed incorrectly or illiterately can lead to complications or exacerbation of the disease.
Therapeutic exercise (LFK)
Dosage and specially selected physical exercises are the basis of exercise therapy. The set of such exercises is selected by the doctor individually for each patient. The principle of choosing exercise therapy exercises is to reduce the physical load on the affected area of the spine.
The action of physiotherapy exercises aims to improve blood supply and lymph flow to the affected area, strengthening muscle tissue.
These exercises should be done every day. Usually, in the beginning, individual or group lessons are done with an instructor, then the patient can perform a set of exercises independently at home.
Prevention of exacerbations
The preventive measures of exacerbations of osteochondrosis of the spine aim to eliminate all the provoking factors:
- It is essential to monitor the correct posture and posture during long hours of standing and sitting.
- It is useful for prolonged static stress (for example, computer work) to take regular breaks during which you should warm up or a set of exercises recommended by your doctor.
- Hypothermia should be avoided.
- It is important to sleep properly with osteochondrosis, to take care of a place to sleep - a mattress and a pillow. Ideally, they should be orthopedic.
- Reduction of excess body weight and timely correction of coexisting physical and endocrine pathology is mandatory.
And when the slightest symptoms of spinal disease appear, you should not delay to see a doctor. After all, the earlier you start treatment for osteochondrosis of the spine, the better its results.