Osteochondrosis of the spine: symptoms and treatment

Osteochondrosis is a widespread disease, at the age of 35-40 it is found in varying degrees in most people. The most likely localization of osteochondrosis is the lower cervical, upper thoracic and lower lumbar parts of the spine. The etiology of osteochondrosis, i. e. the specific causes and conditions of its occurrence, is completely unknown. However, there is a direct influence of hereditary predisposition, age changes, injuries and tissue blood supply disorders.

Changes in the central part of the intervertebral disc, i. e. dehydration, play a major role in the development of the disease. Let us recall that the disc consists of the nucleus pulposus and the annulus fibrosus around it. Due to desiccation, the disc loses its cushioning functions, which leads to its gradual destruction. There are four stages in the development of the disease, which are distinguished by certain changes in the disc and adjacent tissues. The severity of spinal osteochondrosis, symptoms and treatment directly depend on the degree of development of the pathology.

Symptoms and causes of osteochondrosis of the spine

Let's briefly consider the stages of progression of osteochondrosis in terms of anatomical changes.

• The first stage. Formation of cracks in the inner layers of the fibrous ring and in the nucleus pulposus. Penetrating into the cracks, the core irritates the nerve endings of the fibrous ring;
• The second stage. While further irritation of the annulus fibrosus occurs due to the pathology of the nucleus pulposus, the fixation of the vertebrae deteriorates. There is unusual mobility of the spine;
• The third phase. Gradual damage to the annulus fibrosus. The nucleus protrudes (protrusion) beyond the anatomical limits of the fibrous ring, and then the ring ruptures and an intervertebral hernia (extrusion) occurs;
• The fourth stage. Degenerative changes spread to the surrounding tissues - vertebrae, ligaments, nerves, blood vessels. As a result of chronic inflammation, scarring occurs on the intervertebral disc, which leads to the development of fibrosis.

Depending on the location in 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 symptoms depends on
on the degree of damage to the intervertebral disc and surrounding tissues.

Cervical osteochondrosis	Thoracic osteochondrosis	Lumbar osteochondrosis
Aching or sharp pain in one muscle of the neck, or part of the neck, or the whole neck. Severe headaches. Nerve root syndrome: pain spreading to the collarbone, shoulder, one arm, etc. Cardiac syndrome, which does not stop with taking glycerol trinitrate. "Heaviness", weakness or impaired movement in one of the arms. Symptoms of basilar artery insufficiency: dizziness, tinnitus, double vision, speech disorder, 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 under constant stress and is prone to the early development of gross degenerative changes, especially in young people. Due to the peculiarity of the development of changes in the thoracic spine, neurological symptoms are manifested in the late stage of the disease. In most cases, the disease occurs with an injury (for example, as a result of lifting too much weight). Short-term or long-term, aches or shooting pains in the back. Dangerous chest pains. Chest pain and heart pain. Pain in the muscles in the back, spreading to the buttocks, groin or thighs. Radiating pain in the kidney or gall bladder area. Spinal stiffness. Pain when moving and bending. Pain and impaired sensitivity to pressure in the affected area of the spine. Movement disorders, depending on the degree of damage to one or both legs. Internal organ failure: constipation and problems urinating. Slouch.	Anomalies are most often observed in the lumbar spine. Pain in the lower back, can occur in the groin, thighs, buttocks, lower legs. Often the pain spreads to one of the legs. Heaviness and stiffness of movement. Increase in body temperature in the acute period. Pain when probing IV-V lumbar vertebrae. Back muscle spasms. Leg muscle weakness. Changes in the vertebrae numbered III and IV cause pain when bending the knee joint in the supine position. Damage to the V vertebra leads to pain in the outer part of the leg up to the foot and loss of sensation. Violation of defecation and urination. Sciatic neuralgia, unilateral or bilateral. Further development of radicular syndrome can be leg muscle atrophy and impaired reflexes.

It was mentioned earlier that the etiology of osteochondrosis is not fully known. However, we can list the main causes of osteochondrosis of the spine, with a proven effect on the development of the disease:

• Regular dynamic and static loads of the spine of varying intensity. For example, the work of a loader (carrying weights) or a miner (being in unnatural positions for hours and a huge physical load), a driver (vibrations and a sedentary lifestyle) or an office worker (a sedentary lifestyle;
• back injury;
• Poor physical development or overweight;
• Failure to maintain proper posture and stoop;
• Flat feet and muscle imbalance as a result lead to an uneven distribution of load on different parts of the spine;
• genetic characteristics;
• Hypothermia leads to more intense symptoms of osteochondrosis;
• And finally, the process of human aging.

Diagnosis of osteochondrosis of the spine

A preliminary diagnosis of the disease (osteochondrosis) is made based on the patient's complaints, his examination and palpation of the spine. Also, the affected part of the spine can be identified by the topography of the spread of pain, which can tell exactly where (in the cervical vertebrae, chest, lower back) nerve compression has occurred.

The main diagnostic method for diagnosing osteochondrosis is an X-ray examination. An X-ray of the spine shows degenerative changes in the intervertebral joints, discs, narrowing of the intervertebral canal, and sclerotic changes in the tissues of the spine. At the same time, recognizing lesions of the spine (especially in the early stages) is always difficult, because the processes that occur in this case are characteristic of a number of other diseases (tumors, metastases, ankylosing spondylitis, tuberculosis lesions).

On frontal X-rays, plate irregularities, enlargement or sharpening of the uncinate processes are detected. In the profile pictures, height reduction, shape change, disc herniation, osteophytes and other changes in the vertebral body are noticeable. Small degenerative changes are not visible on a plain X-ray, and an X-ray examination with contrast is done to detect them. The most complete information can be provided by discography - an X-ray examination with the introduction of a contrast agent through a puncture directly into the intervertebral disc.

Another study of the spine is the functional X-ray method. Thanks to the x-ray taken with maximum flexion and extension of the spine, it is possible to determine the mobility or immobility of the intervertebral space.

The most modern and state-of-the-art research methods are computerized tomography (hereinafter referred to as CT) and magnetic resonance imaging (hereinafter referred to as MRI). Although the first CT and MRI machines appeared in the 70s and 80s, the technologies are still being actively developed and perfected, while remaining quite inaccessible to the general population due to the high costs of examinations or the lack of machines in local hospitals.

Methods of treatment of osteochondrosis of the spine

Treatment of osteochondrosis is a long-term periodic complex process. It is aimed at reducing and eliminating the consequences of changes in the intervertebral disc. Namely, inflammation, tightness, poor blood flow, muscle spasms. Many types of therapy can help in this process, including the methods of oriental healers. In the treatment of osteochondrosis, the patient needs complete rest.

Treatment is mainly carried out by non-invasive methods, such as drug therapy, antiparasitic therapy, exercise therapy, etc. Invasive therapy, ie surgical operations, is rarely resorted to. For example, in cases where the intervertebral hernia lasts longer 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, appointment of tests and studies are usually carried out by a neurologist, as well as a vertebrologist, if a doctor of such a specialty is available in the clinic, due to his specialization in diseases of the spine.

Summarizing, 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. Removal of inflammation;
4. Reduction of squeezing;
5. Improved blood flow;
6. Preventing further deterioration.

Let's look at the most commonly used treatments, each covering one or more of the items on this list.

Physiotherapy treatment

Physiotherapy procedures are aimed at improving blood microcirculation in the area of the affected spine, removing pain and eliminating edema. Also, physiotherapy helps to reduce the doses of the drugs used. There are dozens of types of physiotherapy. Here are some of them:

• Reflexology is the effect on acupuncture points with needles, electricity, laser. It helps relieve spasms and improve blood flow;
• Kinesitherapy is treatment through movement and special physical exercises. In fact, this is therapeutic gymnastics, but in an expanded sense. This includes training on simulators, exercises in groups under the guidance of a doctor, spinal stretching;
• Therapeutic swimming. It makes it possible to perform exercises with spinal damage for those patients who find it difficult to perform them. For example, elderly people, people who are overweight or have motor disabilities. It is important to note that due to the lifting force of the water, there is an even distribution of the load on the spine;
• Impulse current therapy, UHF therapy, neurostimulation, magnetotherapy, massage, etc.

Acupuncture

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

Surgical intervention

Surgery is indicated only if there is no positive effect of non-invasive treatment or in case of severe complications. The main method of surgical treatment is discectomy - removal of the damaged disc. However, even after surgery with minimally invasive methods, rehabilitation will last at least 6 months.

At the same time, the operation will not eliminate the need for regular treatment of osteochondrosis. Since before surgery there is always a clear task of removing a certain defect: hernia, deformity, subluxation, etc. The operation does not affect the general process of degeneration of the cartilaginous tissue of the spine.

Treatment

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

Medicines can be classified as primary and secondary treatment. They are often necessary to improve the patient's life. They are used for pain relief (therapeutic blockade), removal of inflammation, relief of muscle spasms, improvement of blood flow. In recent years, another type of medicine - chondroprotectors - has been increasingly used. However, the drugs alone cannot achieve a long lasting effect.

Treatment at home

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

The mentioned procedures in combination with medicines provide an effective treatment that relieves unpleasant symptoms and improves the general condition. In that case, special attention should be paid to proper nutrition and regulation 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, the spinal cord is deprived of a blood supply system and the intervertebral disc can receive nutrients only through the adjacent tissues. In this case, it is necessary to distinguish therapeutic exercises from any other training.

Manual therapy

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

Manual therapy of osteochondrosis should be carried out regularly, from once a year to several, depending on the need. It should be noted that this is not a one-time procedure, it is multidimensional, lasting 10-20 sessions. Only then will it have a positive long-term effect.