Osteochondrosis of the spine: symptoms and treatment

Osteochondrosis is a widespread disease, it can be found in varying degrees in most people by the age of 35-40. The most likely localization of osteochondrosis is the lower cervical, upper thoracic and lower lumbar spine. The etiology of osteochondrosis, that is, the specific causes and circumstances of its occurrence, is completely unknown. However, hereditary predisposition, age-related changes, injuries and disruption of tissue blood supply have a direct effect.

The main role in the development of the disease is played by changes in the central part of the intervertebral disc, namely dehydration. Recall that the disc consists of the nucleus pulposus and the annulus fibrosus surrounding it. Due to drying out, the plate loses its shock-absorbing functions, which leads to its gradual destruction. Four stages are distinguished in the development of the disease, which differ in certain changes of the disc and adjacent tissues. The severity of osteochondrosis of the spine, symptoms and treatment directly depend on the stage of development of the pathology.

Symptoms and causes of osteochondrosis of the spine

Let's briefly consider the stages of the progression of osteochondrosis from the point of view of anatomical changes.

• First phase. Formation of cracks in the inner layers of the annulus fibrosus and the nucleus pulposus. Penetrating into the fissures, the seed irritates the nerve endings of the fibrous ring;
• Second phase. While further irritation of the annulus fibrosus occurs due to the pathology of the nucleus pulposus, the fixation of the vertebrae deteriorates. The spine has unusual mobility;
• Third stage. Gradual damage to the annulus fibrosus. Beyond the anatomical limits of the annulus fibrosus, the nucleus protrudes (elevation), then ruptures the annulus and forms an intervertebral hernia (extrusion);
• Fourth stage. Degenerative changes spread in the surrounding tissues - vertebrae, ligaments, nerves, blood vessels. As a result of chronic inflammation, the intervertebral disc becomes scarred, leading to fibrosis.

Depending on the location of the spine, there are 3 types of osteochondrosis:

1. cervical osteochondrosis;
2. Thoracic osteochondrosis;
3. Lumbar osteochondrosis.

It is worth noting that some sources distinguish a fourth type - sacral osteochondrosis.

Symptoms

The severity and intensity of the symptoms depends on it
on the degree of damage to the intervertebral disc and surrounding tissues.

Cervical osteochondrosis	Thoracic osteochondrosis	Lumbar osteochondrosis
Aching or sharp pain in a muscle of the neck, or part of the neck, or the entire neck. Severe headache. Nerve root syndrome: pain spreading to the collarbone, shoulder, one arm, etc. Cardiac syndrome that does not resolve with glycerol trinitrate. "Heaviness", weakness or difficulty moving in one arm. Symptoms of basilar artery insufficiency: dizziness, tinnitus, double vision, slurred speech, swallowing problems, hearing loss, loss of consciousness. Paresthesia of the upper limbs: feeling of numbness of the hands (one or both), goosebumps, tingling, false sensation of swelling of the limbs. Selective muscle atrophy and reduced limb reflexes.	The main types of osteochondrosis are considered cervical and lumbar. However, the thoracic spine is exposed to constant stress and is prone to the early development of severe degenerative changes, especially in young people. Due to the peculiarities of the development of changes in the thoracic spine, neurological symptoms appear in the late stages of the disease. In most cases, the disease is associated with an injury (for example, as a result of lifting too much weight). Short or long-term, aching or shooting back pain. Girdle pains in the chest. Pain in the chest wall and pain in the region of the heart. Pain in the muscles of the back that radiates to the buttocks, groin or thigh. Radiating pain in the area of the kidneys or gall bladder. Rigidity of the spine. Pain when moving and bending down. Pain and reduced sensitivity to pressure in the affected area of the spine. Movement disorders, depending on the degree of damage to one or both legs. Insufficiency of internal organs: constipation and urination problems. Drive down.	Anomalies are most often observed in the lumbar spine. Pain in the lower back, groin, thighs, buttocks, legs. The pain often radiates to one leg. Difficulty and stiffness of movements. An increase in body temperature during the acute period. Pain when probing IV-V lumbar vertebrae. Spasms of the back muscles. Weakness of the leg muscles. Changes in the III and IV vertebrae cause pain when bending the knee joint in the supine position. An injury to the V vertebra causes pain on the outside of the leg down to the ball of the foot and leads to loss of sensation. Violation of defecation and urination. Sciatic neuralgia, unilateral or bilateral. Further development of the radicular syndrome can be atrophy of the leg muscles and impairment of reflexes.

We have already mentioned that the etiology of osteochondrosis is not completely known. However, we can name the main causes of osteochondrosis of the spine, which are proven to influence the development of the disease:

• Regular dynamic and static loads of varying intensity on the spine. For example, a loader (carrying weights) or a miner (staying in an unnatural position for hours and a huge physical load), a driver (vibration and sedentary lifestyle) or an office worker (sedentary, sedentary lifestyle);
• back injury;
• Weak physical development or overweight;
• Failure to observe correct posture and bending;
• As a result, flat feet and muscle imbalance lead to an uneven distribution of the load on different parts of the spine;
• genetic characteristics;
• Hypothermia leads to more intense symptoms of osteochondrosis;
• And finally, the human aging process.

Diagnosis of osteochondrosis of the spine

The preliminary diagnosis of the disease (osteochondrosis) is based on the patient's complaints, examination and palpation of the spine. Also, the affected part of the spine can be identified based on the topography of the spread of pain, which can tell exactly where (neck vertebrae, chest, lower back) the compression of the nerves took place.

The main diagnostic method for diagnosing osteochondrosis is X-ray examination. Degenerative changes in the intervertebral joints and discs, narrowing of the intervertebral canal, and sclerotic changes in the spinal tissues can be seen on the X-ray of the spine. At the same time, the recognition of spinal changes (especially in the early stages) is always difficult, since the processes that occur in this case are also typical of many other diseases (tumors, metastases, ankylosing spondylitis, tuberculosis changes).

On frontal radiographs, disc irregularities, growth or sharpening of the uncinate processes can be detected. The height reduction, deformation, disc herniation, osteophytes and other changes in the vertebral body can be noticed in the profile pictures. Small degenerative changes are not visible on plain X-rays, they are detected by contrast X-rays. The most complete information can be given by discography - an X-ray examination with the introduction of a contrast material, directly into the intervertebral disc.

Another examination of the spine is a functional X-ray method. The mobility or immobility of the intervertebral space can be determined thanks to the X-ray taken with maximum bending and extension of the spine.

The most modern and state-of-the-art research methods are computed tomography (hereinafter: CT) and magnetic resonance imaging (hereinafter: MRI). Although the first CT and MRI machines appeared in the 70s and 80s, the technologies are still being actively developed and improved, while they remained quite inaccessible to the population due to the high cost of examinations or the lack of machines in local hospitals.

Methods of treatment of osteochondrosis of the spine

The treatment of osteochondrosis is a long-period complex process. Its purpose is to reduce and eliminate the consequences of changes in the intervertebral disc. Namely, inflammation, tightness, poor blood flow, muscle spasms. Various therapies can help in this process, including the methods of Eastern healers. In the treatment of osteochondrosis, the patient needs complete rest.

Treatment is mostly done with non-invasive methods such as drug therapy, anti-parasitic therapy, exercise therapy and others. They rarely resort to invasive therapy, i. e. surgical intervention. For example, in cases where the intervertebral hernia persists for more than six months and conservative treatment does not give a positive effect.

Osteochondrosis of the spine and its treatment are carried out by doctors of various specialties: neurologist, orthopedist, vertebrologist, chiropractor and others. However, the diagnosis, examinations and studies are usually carried out by a neurologist and a vertebrologist, if such a specialist is available in the office, due to his specialization in spine diseases.

In summary, we can say that the treatment of osteochondrosis is divided into the following main categories:

1. Reduction of pain syndrome;
2. Removal of spasms;
3. Elimination of inflammation;
4. Reduction of tightness;
5. Improved blood flow;
6. Prevention of further deterioration.

Let's take a look at some commonly used treatments, each of which covers one or more of the items listed.

Physiotherapy treatment

The purpose of physiotherapy procedures is to improve blood microcirculation in the area of the affected spine, eliminate pain and relieve edema. In addition, physiotherapy helps to reduce the dose of drugs used. There are dozens of types of physical therapy. Here are some of them:

• Reflexology is the effect on acupuncture points with needles, electricity, and lasers. It helps relieve cramps and improves blood flow;
• Kinesitherapy is a treatment with movement and special physical exercises. In fact, it is therapeutic gymnastics, but in an extended sense. This includes training on simulators, group exercises under the guidance of a doctor, stretching the spine;
• Therapeutic swimming. It allows patients with difficulty to perform exercises with a spinal cord injury. For example, the elderly, overweight or disabled. It is important to note that due to the buoyancy of the water, the loads are evenly distributed on the ridge;
• Therapy with impulse currents, UHF therapy, neurostimulation, magnetotherapy, massage and others.

Acupuncture

A unique method that originated in Eastern medicine. Its essence lies in the use of special very thin needles, which enter special points of the body, literally, under the influence of gravity. These points were discovered by the experience of Eastern healers over thousands of years, and were later proven by official medicine. Acupuncture helps eliminate even unbearable pain, has a positive effect on the nervous system as a whole and on nervous system diseases.

Surgical intervention

Surgery is recommended only if non-invasive treatment has no positive effect or in case of serious complications. The main method of surgical treatment is discectomy - removal of the damaged disc. However, even after surgery performed with minimally invasive methods, rehabilitation takes at least 6 months.

At the same time, surgery does not eliminate the need for regular treatment of osteochondrosis. Because there is always a clear task before surgery to eliminate a specific defect: hernia, deformity, subluxation, etc. The surgery does not affect the general degeneration process of the cartilage tissue of the spine.

Medical treatment

This type of treatment is most effective in the short term. Medicines immediately reduce pain, eliminate inflammation, relieve spasms, etc. However, as soon as they are withdrawn, in the absence of other procedures for the treatment of osteochondrosis, their effect quickly disappears. At the same time, you cannot spend your whole life on drugs, sooner or later your body will have side effects.

Drug treatment can be classified into both primary and secondary treatment. They are often necessary to improve the patient's life. They are used to relieve pain (therapeutic blockade), eliminate inflammation, relieve muscle spasms, and improve blood flow. In recent years, another type of drug - chondroprotectors - has been used more and more often. However, long-term, lasting effects cannot be achieved with medication alone.

Treatment at home

Home treatment of osteochondrosis consists of manual therapy (gym therapy, Shants collar), acupuncture and vacuum therapy. These methods improve blood circulation and reduce muscle and spine congestion. As a result, tissue regeneration is significantly improved.

The listed procedures in combination with drugs provide an effective treatment that relieves unpleasant symptoms and improves the general condition. In this case, special attention should be paid to proper nutrition and control of excess weight.

Physiotherapy

Thanks to gymnastics, the mobility of the vertebrae is restored, the muscles and their circulatory system are strengthened. The latter is of great importance, because the spine is deprived of its blood supply system, and the intervertebral disc can only receive nutrients through the adjacent tissues. In this case, a distinction must be made between therapeutic exercises and any other training.

Manual therapy

One of the most effective methods. Because the manual therapist affects the muscles, ligaments and bones. It improves posture, restores the "normal" structure of the skeleton, and relieves unnecessary muscle tension. Including directly affecting the vertebrae.

Manual therapy of osteochondrosis should be carried out regularly, once a year or more often, depending on the need. It should be known that this is not a one-time, multi-dimensional procedure consisting of 10-20 sessions. Only then will it have a long-term positive effect.