Osteochondrosis -degenerative-dystrophic damage to the tissues of the spine, characterized by damage to the intervertebral discs, adjacent articular surfaces and vertebral bodies, the ligamentous apparatus of the spine.
Most often, the pathological processes in osteochondrosis first affect the bones and ligaments. The fact that the disease has already begun, we usually learn when complications appear: pain, sensory disturbances, muscle atrophy, disruption of internal organs.
Who suffers from osteochondrosis?
Today, 40 to 90% of the world population suffers from osteochondrosis. Most often, the disease affects people over the age of 30. However, the first symptoms of osteochondrosis can appear in adolescence.
Stages of development of osteochondrosis of the spine
- The first stage in the development of osteochondrosis.
Dehydration of the nucleus pulposus begins. This leads to a decrease in the height of the disc. Cracks appear in the fibrous ring, but the pathological process does not go beyond the intervertebral disc.
- The second stage in the development of osteochondrosis.
As a result of a decrease in disc height, the attachment points of muscles and ligaments belonging to two adjacent vertebrae come closer. Therefore, the muscles and ligaments sag. This can lead to excessive mobility of the two vertebrae relative to each other, eg. instability of the motor-vertebral segment is formed. This stage is characterized by the sliding or displacement of the vertebrae relative to each other with the formation of spondylolisthesis.
- The third stage in the development of osteochondrosis.
During this period, the most pronounced morphological changes occur, mainly affecting the intervertebral discs themselves: prolapses and protrusions of the discs are formed. The articular apparatus of the vertebral - motor segment also suffers. In the intervertebral joints and non-vertebral joints, subluxations occur, osteoarthritis is formed.
- The fourth stage in the development of osteochondrosis.
At this stage, adaptive changes occur in the affected segments of the spine. The body tries to overcome the excessive mobility of the vertebrae, to immobilize the spine to maintain its supporting and protective functions. In this regard, marginal bone growths appear on the adjacent surfaces of the vertebral bodies, in other words, osteophytes. An osteophyte grown "in the wrong place" causes microtrauma to the nerve root. In the fourth stage, the processes of fibrous ankylosis usually begin in the intervertebral discs and joints. Eventually, the motor-vertebral segment turns out to be, as it were, walled up in a shell: the clinical manifestations subside.
Causes of osteochondrosis
In each of the numerous existing theories of the development of osteochondrosis, various causes responsible for the onset of the disease are accepted, for example, mechanical injuries, hereditary predisposition or metabolic disorders. A particular difficulty in determining the cause of osteochondrosis is due to the fact that this disease can occur in both the elderly and young people, both physically fit and less trained. There is a widespread belief that the cause of osteochondrosis is the deposition of salts in the spine: presumably on X-rays, the salt can be seen in the form of "growths" or "hooks" on the vertebrae. If during the movement there is a creak and a creak in the joints, as if sand was poured between them, for many patients the only reason for this condition is the notorious "salt deposition". Such misconceptions are by no means harmless: the correct idea of ways to treat a disorder can be determined on the basis of an analysis of the causes that caused it.
The term "osteochondrosis" comes from the Greek roots osteon - "bone" and chondr - "cartilage". The ending "-oz" means that the bone and cartilage disease is not associated with inflammatory processes, it is of a degenerative-dystrophic nature, that is, the basis of the disease is a malnutrition of the tissues and, consequently, the degeneration of its structure. Like all living tissues, the bone tissue of the vertebrae and the cartilage tissue of the intervertebral discs are in constant reorganization and self-renewal. Under the influence of regular physical exertion, they acquire strength and elasticity, and in the absence of loads, the strength of the tissues decreases.
This is due to the peculiarities of nutrition and blood supply to bone and cartilage tissues. The discs of adults do not have their own vessels; they receive nutrients and oxygen from nearby tissues. Therefore, for proper nutrition of the discs, it is necessary to activate blood circulation in the tissues surrounding the discs. And this can only be achieved through intense muscle work.
Based on its composition, the intervertebral disc can be divided into two parts: this is the gelatinous core that gives elasticity to the disc, located in the center, and the strong fibrous ring that surrounds it. Due to the deterioration of nutrition of the intervertebral discs, the complex structure of the biopolymeric compounds that make up the nucleus pulposus is destroyed. The moisture content in the gelatinous core decreases and becomes more brittle. If exposed to even minor overloads, the gelatinous core can disintegrate into fragments. This leads to an even greater decrease in its elasticity. There is also a decrease in the strength of the fibrous disc rings. All these factors create the basis and are the cause for the development of osteochondrosis.
To restore the function of the spinal column, it is necessary to heal the damage to the intervertebral disc, mobilize the compensatory capacities of the spine, as well as the entire musculoskeletal system, and not the reabsorption of "saline deposits" or the elimination of "spines" on the vertebrae. When performing an X-ray examination after the end of the treatment, it can be seen that the vertebrae have not changed shape. And the notorious "thorns" are not the cause of osteochondrosis, but a consequence of adaptive processes. The marginal growths increase the area of the supporting surface of the vertebral body. By increasing the area, the specific pressure decreases, which makes it possible to compensate for the decrease in strength and elasticity of the intervertebral disc.
Degenerative-dystrophic changes occurring in the spine are accompanied by calcification (calcification) of damaged discs, individual sections of joint ligaments, cartilage, capsules. This process can only be called salt deposition. Therefore, this is not the cause of osteochondrosis, but only a consequence and the final stage of the above process.
Reverse development of structural changes in the spine is almost impossible. But keeping them to a minimum is a real challenge. If no effort is made to keep the spine in the same condition obtained with the treatment, the pain may recur.
Clinical manifestations of osteochondrosis
The clinical manifestations of osteochondrosis are very diverse. They depend on the stage of development of osteochondrosis. The main clinical symptoms of osteochondrosis occur when the pathological process extends to the posterior part of the fibrous ring and the posterior longitudinal ligament. Depending on the stage of degeneration of the intervertebral discs, irritation, compression or impaired conduction of the roots of the spinal cord, compression of the vessels or the spinal cord occur. Various neurological syndromes develop: reflex and compression.
The main cause of pain in osteochondrosis is the so-called nerve root irritation. In this case, circulatory disorders occur, edema occurs, and in the future fibrosis of the surrounding structures may develop, which is accompanied by an increase in the sensitivity of the roots to various influences (movements in the affected segment of the spine, etc. ).
Vascular disorders in osteochondrosis are often associated with reduced vasomotor innervation. Mechanical compression of blood vessels by osteophytes is also possible, for example in the cervical spine.
Symptoms of osteochondrosis
One of the features of spinal osteochondrosis that aggravates the process is its too broad symptomatology. The disease can manifest itself in completely different parts of the body. It can be pain or numbness in the extremities or discomfort and pain in the internal organs. At the same time, often a person does not in any way associate pain in the region of the heart, abnormalities in the functioning of the genital organs, headache, pain and numbness of the legs with osteochondrosis and in general with the spine, addressing the "treatment" directly of the symptoms of osteochondrosis with the help of various types of painkillers, all kinds of advertised drugs, dietary supplements and other methods. But this path only aggravates the situation. Osteochondrosis continues to develop, and the treatment methods used, at best, simply do not lead to significant improvements, except to temporarily relieve pain and, at worst, can further damage the body.
Therefore, it is important to carefully analyze your condition and the changes that occur in it. It is necessary to start moving in the right direction: to consult a doctor in a timely manner, undergo the necessary diagnostics and only after determining the correct diagnosis, begin treatment under the supervision of the attending physician.
The main symptoms of osteochondrosis include, first of all, back pain and discomfort. At the same time, the pains can be of a periodic, unstable nature, now appearing, then disappearing. But even the first sensation of discomfort or pain in the spine should make you think. The appearance of the first pains is a signal to at least pay attention to it, try to remember why they appeared. This can be caused by lifting a heavy object, sudden movement, falling, etc.
Another symptom of osteochondrosis is the accompanying discomfort or back pain with pain and numbness in the extremities (arms or legs). The pain most often radiates to the left limb, that is, to the left arm or leg. In addition, pain can manifest itself in the region of the heart, in the back and not only in the region of the spine, but for example in the ribs, etc. It is especially important in this case to pay attention to the nature of the pain change depending on the patient's actions, comparing the sensations of pain in the back with pain, for example, in the leg. If the patient has been sitting for a long time and has pain or numbness in the foot, discomfort in the lower back, and after some warm-up or walking, the pain has disappeared, then this will be an indirect sign of lumbar osteochondrosis of the spine. . The same picture can be with the neck and arm. In summary, we can say that the main symptoms of osteochondrosis include back pain and discomfort. In the event that these symptoms coincide with pain in other parts of the body, osteochondrosis can be complicated by protrusion, herniated disc, with a pinched nerve.
In addition, I would like to draw attention to the fact that even with the appearance of the first pain in the spine, it is necessary to pay special attention to this malaise. After all, osteochondrosis can manifest itself weakly or not manifest itself at all for a long time. At the same time, it will continue to successfully develop in the spine, leading to the degradation of an increasing number of discs. Therefore, a timely visit to a doctor will allow to diagnose osteochondrosis at an earlier stage, which will facilitate its treatment.
Osteochondrosis and saline deposition
Osteophytes, or hooked growths of the vertebrae, appear to reduce the load on the intervertebral discs. In this case, the appearance of osteophytes impairs the mobility of the intervertebral joints.
The common opinion in everyday life that salt deposition is the main cause of osteochondrosis is incorrect. Therefore, the treatment of osteochondrosis with a salt-free diet does not make sense.
The most common complaints of osteochondrosis of the spine
The most common complaints in osteochondrosis are the following:
- Discomfort in various parts of the spine. The pain can range from mild, dull, drawing to severe, sometimes very intense and unbearable - with low back pain.
- Increased fatigue at work, both physical and mental.
- Sensory impairment of the limbs and various parts of the body, cold sensation in the arms or legs.
- Pain that radiates to the legs, along the nerve trunks.
- Pain that radiates to the scapula, shoulder, as well as pain in the neck and back of the head.
- A frequent companion of cervical osteochondrosis are headache, dizziness. Often there is an increase in visual fatigue or a decrease in visual acuity.
- With the defeat of the lumbar-sacral region, disorders of the reproductive system are common - various sexual dysfunctions. Therefore, in most men, after treatment, there is an increase in sexual potency. In women, the normal functioning of the lumbosacral area increases the likelihood of conception and contributes to a comfortable pregnancy.
Osteochondrosis Diagnosis
To diagnose osteochondrosis, it is necessary to collect an anamnesis. In this case, it is crucial to establish the patient's complaints. Some symptoms of osteochondrosis are quite typical. Others, on the other hand, need to be differentiated from the signs of other diseases. It is important that the nervous, vascular and trophic disorders occurring in osteochondrosis can simulate various diseases, such as angina pectoris, gastritis, gastric ulcer, acute surgical diseases of the abdominal organs. Therefore, in order to avoid misdiagnosis and subsequent prescription of the wrong treatment, each symptom must be subjected to a detailed analysis.
When collecting the medical history, including the patient's complaints, the history of the current disease and the life of the patient, the doctor pays attention to his age, since osteochondrosis most often develops in older people and the evolution of symptoms from the time of their occurrence until the patient goes to the doctor. For osteochondrosis, slow development is characteristic, in which periods of exacerbation are periodically replaced by periods of remission. Further research methods are prescribed to clarify the diagnosis.
X-ray examinations for osteochondrosis
The most accessible and at the same time quite informative method of diagnosing osteochondrosis is X-ray examination. There are several types of X-ray methods for diagnosing this disease:
Plain x-ray of the spine is the simplest x-ray method for diagnosing osteochondrosis. Its essence lies in obtaining an x-ray of the spine as a whole or its individual segments. Most often, sighting radiography is performed: based on the symptoms of the disease and the patient's complaints, the location of the spinal injury is determined. On the X-ray image of the spinal segment affected by osteochondrosis, a decrease in the thickness (atrophy) of the intervertebral discs can be seen, which is manifested in the form of a decrease in the space between the vertebrae, the appearance of bone outgrowths of the bodies vertebral - osteophytes, partial dissolution - resorption of the bone tissue of the vertebral body, a change in the shape of the spinal segment, for example, smoothing of the lumbar lordosis.
Myelography is a more complex and dangerous diagnostic method. During this examination, a certain amount of contrast fluid is injected into the spinal canal. The risk of this method of examination is the possibility of allergic reactions to the contrast agent or the risk of damage to the spinal cord during puncture of the spinal canal. Thanks to myelography, it is possible to determine the internal structure of the spinal canal. This method is particularly informative for the determination of spinal hernias.
Computed tomography and magnetic resonance imaging are the most modern, but also the most expensive and difficult to access methods for diagnosing osteochondrosis. These diagnostic methods are usually used when it is necessary to distinguish between osteochondrosis and other diseases of the spine, which have similar symptoms, for example, tumors of the spinal canal.
For a comprehensive assessment of the patient's condition, it is mandatory to conduct a neurological examination of the patient with osteochondrosis. Thanks to a neurological consultation it is possible to clarify the localization and the degree of motor and sensory disturbances.
Treatment of osteochondrosis
The clinic provides effective treatment for all forms of osteochondrosis. The treatment is carried out on an outpatient basis. Treatment is based on a comprehensive program aimed at quickly eliminating the underlying syndrome and the cause of suffering. As part of complex therapy, the following methods can be used:
- acupuncture;
- vacuum therapy;
- gentle manual therapy techniques (post-isometric relaxation);
- laser therapy;
- pharmacopuncture;
- dry traction;
- magnetopuncture;
- electrical stimulation and other methods of treatment.
On average, the course of treatment is 10-15 sessions, and the elimination of acute pain syndrome is from 1 to 3 sessions.
The sooner the treatment is started, the better the result!
Is complete elimination of osteochondrosis real?
It depends on the form of the disease, the severity, correctness and timeliness of treatment. A complete cure is only possible in the initial stages.
But it is possible to prevent exacerbations of osteochondrosis, not to experience pain for years. If a person has had osteochondrosis, but now feels no discomfort, this does not mean that it has passed without a trace. There may be changes in the spine.
The main task is to suspend the development of the disease and do everything possible so that some of the pathological changes in the spine disappear, the symptoms disappear or subside (back pain, cold and numbness of the arms, legs, headache, etc. ).