Why does osteochondrosis occur and how is it treated?

Osteochondrosis is a disease in which degenerative-dystrophic changes are diagnosed in the cartilaginous tissues of the spine, also accompanied by alterations in the structure and functionality of the intervertebral discs.Depending on the location of the damaged tissue, osteochondrosis of the cervical, thoracic and lumbar regions is distinguished.

According to medical statistics, the symptoms of osteochondrosis are observed in 50-90% of the population.The average age of onset of osteochondrosis is 30-35 years.Under unfavorable conditions, signs of osteochondrosis may appear at an earlier stage, especially with prolonged uneven loads on the back, legs and the consequences of injuries.

What is osteochondrosis?

Osteochondrosis is a disease of the spine 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 sign indicating the development of osteochondrosis disease is pain in the neck, back and lumbar region;As it progresses, the pain "radiates" to the arms, chest, shoulders, and upper thighs.With the negative dynamics of osteochondrosis, atrophy of muscle tissue, sensory disturbances and dysfunction of internal organs begin, caused by their compression and displacement.In the absence of timely treatment, osteochondrosis becomes an incurable condition.

Causes of osteochondrosis

The main factor in the development of osteochondrosis is uneven load on the spine.A common cause of improper load distribution is the habit of carrying a bag on one shoulder or in one hand, incorrect sitting position, sleeping on a mattress that is too soft, a high pillow, and wearing anatomically incorrect types of shoes.

Other risk factors are physical inactivity, sedentary lifestyle, excess weight, injuries to the back, lower extremities, flat feet and other disorders of the musculoskeletal system, as well as age-related degenerative processes due to age-related changes in the blood supply to the spine.

The following factors can also influence the etiology of osteochondrosis:

• physical overstrain of the body;
• neuroemotional exhaustion;
• metabolic disorders, poisoning, diseases of the gastrointestinal tract that prevent the full absorption of nutrients;
• occupational risks, in particular, work on vibrating platforms;
• genetic predisposition;
• poor posture during the period of active growth, scoliosis;
• wearing uncomfortable shoes (tight, with heels);
• prolonged and/or regular dehydration;
• poor diet, hypovitaminosis;
• smoking;
• Pregnancy, especially multiple pregnancy, in combination with an undeveloped musculo-ligamentous apparatus (due to a change in the center of gravity of the body).

Stages of development of osteochondrosis.

Osteochondrosis in the dynamics of the disease goes through four stages:

• Osteochondrosis stage 1 (grade) is characterized by the initial stage of pathology in the nucleus pulposus of the intervertebral disc.Due to excessive load, the process of dehydration (dehydration) of the core begins, which causes a decrease in the height of the disc and the appearance of cracks in the annulus fibrosus.Symptoms at this stage are, as a rule, absent;minor discomfort may occur during prolonged stay in an uncomfortable static position or in active movement;
• In stage 2, a decrease in the height of the discs leads to a decrease in the distance between the vertebrae and sagging of the muscles and ligaments of the spine.This causes greater mobility of the vertebrae with the affected discs, which is dangerous due to their displacement or sliding.During the second stage of the disease, aches and pains occur, especially with certain types of loads, movements, positions;
• Osteochondrosis stage 3 (grade) is characterized by the formation of prolapses and bulges of the intervertebral discs, and may be accompanied by subluxations and/or the development of osteoarthritis of the intervertebral joints.With some types of movement, patients feel stiffness, lack of mobility, and a sensation of tingling and numbness in the extremities may occur.At this stage of osteochondrosis, pain is clearly felt in the back, neck, lumbosacral region or coccyx area, depending on the location of the affected discs;
• In stage 4 of osteochondrosis, the body attempts to correct the consequences of vertebral hypermobility and adapt to the impaired functionality of the spine.Osteophytes, new bone formations, improve the fixation of the vertebrae, they form at the contact points between the vertebrae.However, in some cases, osteophytes can pinch nerves and damage vertebrae.Fibrous ankylosis begins in the intervertebral discs and joints.In the absence of microtrauma and pinched nerve roots, the symptoms of the disease disappear.

Symptoms of osteochondrosis

The main symptoms of osteochondrosis are a feeling of discomfort and/or pain in the neck and back.The severity of the sensations and the presence of additional symptoms depend on the stage of the disease.When examining the patient and collecting the history, the specialist makes a primary diagnosis, suggesting the presence of osteochondrosis by a visually detectable curvature of the spine that is observed in the transverse or longitudinal plane of the spine.Pathologies of the intervertebral discs of the cervical and lumbar spine are much more common than degenerative and dystrophic changes in the sternum.

The signs of osteochondrosis felt by the patient include a periodic or permanent feeling of back fatigue, mild or severe pain, depending on the stage of the disease.The pain can be located in the neck, back, chest, shoulder girdle, making movement of the upper extremities difficult and restricting.

The clinical picture of osteochondrosis largely depends on the localization of the pathology, the degree of development of the process and the individual characteristics of the patients.The pathology of the intervertebral discs, displacements, protrusions, hernias and the growth of osteophytes have various consequences.Among the most common are disturbances in normal blood circulation in tissues, pinched nerve endings, dysfunction of the spinal canal, edema, fibrosis of tissues and structures.These consequences can be accompanied by many different symptoms, leading to misdiagnosis of diseases.

The most common and characteristic symptoms of osteochondrosis include the following:

• pain in the back, neck, lower back, shoulder girdle, rib area;
• discomfort, stiffness in body movements that occurs in certain body positions, bending, twisting, increased muscle tension;
• feeling of numbness in the upper and lower extremities;
• muscle and joint discomfort, muscle spasms;
• headaches, dizziness, increased fatigue;
• pain in the heart area;
• altered sensitivity of the hands;
• muscle hypotonia.

The symptoms of osteochondrosis vary depending on the location of the pathology:

• with osteochondrosis of the cervical spine, pain in the neck, arms and shoulder girdle predominates, radiating to the area of the scapula and shoulder;headaches, dizziness, blinking “spots” or spots before the eyes, and tinnitus are noted;
• if the thoracic spine is affected, the pain is localized in the chest, heart, inner surface of the shoulder, armpit area, respiratory discomfort is also observed and difficulty breathing is possible;
• Osteochondrosis of the lumbosacral spine is manifested by lower back pain that radiates to the legs, upper thighs or pelvic organs, often accompanied by sexual dysfunction.

Superficial symptoms (back fatigue, pain) may indicate not only the presence of osteochondrosis, but also the addition of other diseases or the development of other pathological processes and disorders not related to the degeneration of intervertebral discs.The diagnosis of "osteochondrosis" can only be made by a specialist, and self-medication for these symptoms is unacceptable.

Classification of osteochondrosis.

Types of osteochondrosis are distinguished according to several principles.Depending on the location of the pathology, osteochondrosis is distinguished from cervical, thoracic, lumbar, sacral or mixed types of disease.Depending on clinical manifestations, osteochondrosis of various localizations 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 (vegetative-vascular, neurodystrophic, muscle-tonal) are identified;
• If the radicular syndrome test result is positive, discogenic damage to the roots of the cervical spine is diagnosed.

For thoracic level pathology there are:

• for reflex syndromes: thoracalgia with vegetovisceral, neurodystrophic or muscle tonal manifestations;
• due to root – discogenic injury of the roots of the thoracic region.

For osteochondrosis of the lumbosacral level, the following is diagnosed:

• depending on the type of reflex syndrome: lumbago (lumbago), lumbodynia, lumboischialgia with vegetative-vascular, neurodystrophic or muscle-tonal manifestations;
• radicular syndrome indicates discogenic damage to the roots of the lumbosacral region;
• Radicular vascular syndrome indicates radiculoischemia.

Diagnosis of osteochondrosis.

To make a diagnosis, instrumental examination methods are used:

• X-ray examination of the spine;
• myelography;
• neurological examination of sensitivity, reflexes.

Additional methods prescribed to differentiate and clarify the diagnosis and stage of pathology include:

• spine computed tomography (CT);
• nuclear magnetic resonance (MRI);
• magnetic resonance imaging (MRI).

Directions of therapy 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 supportive measures to consolidate the result and prevent relapses.

Therapy for the disease of osteochondrosis is carried out in two directions, depending on the degree of osteochondrosis and the state of health of the patient.Conservative treatment of the disease consists of taking medications and performing a series of exercises.Surgical treatment in almost any situation cannot be the first choice method and is prescribed in the absence of positive dynamics or progression of the disease against the background of long-term conservative therapy.

In addition to medical therapeutic methods, it is necessary to follow general recommendations for osteochondrosis: follow a diet and take the necessary measures for rehabilitation.

Conservative treatment of osteochondrosis.

Conservative therapy is aimed at relieving pain, normalizing the functionality of the spine and preventing negative changes.

Conservative treatment of osteochondrosis includes the following types of therapy:

• drug therapy.Medicines for osteochondrosis are used to relieve pain syndromes, inflammatory processes in tissues and normalize metabolic processes in the body.In case of severe pain syndrome, it is recommended to use pharmacological blockers of nerve endings, which also help to reduce the severity of muscle tonic syndrome.The following types of blocks are distinguished: trigger point block, 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 uses are ultrasonic waves, magnetic fields, low-frequency currents and laser beams;
• methods of physiotherapy (physiotherapy) and kinesitherapy.A set of special exercises, when performed regularly and correctly, help to correct posture, strengthen the muscle corset, ligamentous apparatus, normalize muscle function, reduce compression of nerve fibers and help prevent complications of osteochondrosis.Physiotherapy methods and kinesitherapy procedures are aimed at normalizing metabolic processes, restoring proper nutrition of the intervertebral discs, restoring the location of the vertebrae and discs between them and evenly distributing the load on the musculoskeletal system;
• massage.Manual massage techniques are used to improve blood supply to tissues, relieve muscle spasms and tension, and generally improve blood circulation.Hydromassage as a direction of therapeutic activity, in addition to the listed effects, helps to normalize the functioning of the body's nervous system;
• manual therapy.Manual therapy methods are selected individually.A specific effect on the musculoskeletal system of the body helps to improve blood and lymph circulation, improves metabolism, helps to correct the mobility of the musculoskeletal system, strengthens the immune system and serves as a means of preventing complications of osteochondrosis;
• traction therapy(traction) of the spine using special equipment.The goal of manipulations is to increase the intervertebral space to normal parameters and correct structural disorders of the spine.

Osteochondrosis: drug therapy

In the treatment of osteochondrosis, drugs are aimed at reducing the severity of symptoms, improving the processes of blood supply to tissues and their regeneration.Osteochondrosis cannot be cured with medications alone;Therapy should be combined, including series of exercises, diet and preventive measures.

In the absence of pronounced dystrophic changes and pain, taking medications without a specialist's prescription may be considered unjustified.

Medicines used to relieve pain and treat osteochondrosis:

• anti-inflammatory group;
• antioxidant preparations: vitamins C (in the form of ascorbic acid), E (tocopherol acetate), N (thioctic acid);
• means to improve blood supply to tissues, vitamins of group B (mainly B3);
• preparations for the regeneration and/or prevention of degeneration of cartilage tissue, hyaluronic acid.

Medicines can be prescribed both in the form of ointments, creams for local use for pain, as well as for oral administration and injections.

In case of acute complications, medications are used to block the nerve endings.

Osteochondrosis: dietary nutrition of the patient.

The principles of the diet are based on the need to improve metabolic processes, saturate the body with essential nutrients, vitamins, minerals and include foods rich in antioxidants, polyunsaturated fatty acids and compounds that promote the regeneration of cartilage tissue.The recommended drinking regimen for osteochondrosis is aimed at preventing dehydration of the body, which can negatively affect the affected tissues.It is necessary to eat in small portions, 5-6 times a day.

The basis of the diet is dairy and fermented milk products, lean meats, poultry, fish, fresh vegetables, fruits, nuts and seeds, cereals and mushrooms.It is especially recommended to include meat and fish jellies, jellied meats, jellied dishes in the diet and use extra virgin olive oil without heat treatment (to dress salads).

Preferred food processing methods: steaming, baking, boiling.Limit the intake of flour and confectionery products, fatty foods, spicy, salty, preserved and smoked dishes and condiments, strong meat broths, legumes, sugar and fruits with high sugar content (grapes).During the day it is necessary to drink at least 1.5 liters of liquid, giving preference to clean, mineral water, dried fruit compotes, sugar-free fruit drinks and infusions.You should limit the amount of strong black tea, coffee, sweet carbonated drinks and alcohol.

Complications of osteochondrosis

Non-compliance with the prescribed treatment, prolonged avoidance of the doctor and lack of treatment for osteochondrosis contribute to the progression of the disease and provoke the development of complications, pathologies and new diseases, such as:

• herniated intervertebral disc (spinal hernia);
• outgoing;
• kyphosis;
• radiculitis;
• salt deposits in the intervertebral space;
• spinal cord strokes;
• decreased muscle mass of the extremities, muscle atrophy due to blood supply disorders;
• paralysis of the lower limbs.

Despite the fact that grade 4 osteochondrosis can occur without severe symptoms and pain, advanced osteochondrosis is the most dangerous for the development of serious complications and can lead to patient disability.

Prevention of osteochondrosis

The causes of osteochondrosis are mainly related to lack of attention to the needs of the body, poor nutrition and excessive stress on the body.To prevent the appearance of pathological changes in the spine and slow down the dynamics of existing osteochondrosis, it is recommended to follow the general principles of a healthy lifestyle:

• eliminate the possibility of physical inactivity: moderate sports: exercise, running, swimming, cycling, skiing, gymnastics, non-contact wrestling, etc.;
• When working or doing other activities that involve staying in a static position for a long time, you should take warm-up breaks every 45 minutes to restore blood circulation.If you need to sit for a long time, you need to choose the right chairs, chairs that provide support for the spine, ensure compliance with the standards for the position of hands on the table, feet on the floor or a special support, learn to maintain posture (back straight, shoulders relaxed);
• to sleep at night, you should select an elastic, preferably orthopedic, mattress with a flat surface, avoid high or too flat pillows;
• if necessary, lift and/or carry heavy objects, avoid pulling when lifting weights from a semi-squat position, use special belts that support the lower back;
• Choosing correct orthopedic shoes: with the correct width for the foot, without high heels and their timely replacement will help reduce the load on the spine, this is especially important for women during the period of bearing a child.In summer, you should not miss the opportunity to walk barefoot on uneven surfaces;This strengthens the muscles of the foot and relieves tension from the musculoskeletal system;
• A proper diet and drinking regimen contribute to general health and help maintain normal metabolism;
• If you are prone to increased emotionality, anxiety with a spasmodic reaction of the muscles to stress, it is worth learning relaxation methods, as well as taking regular courses of restorative massages.