Why does osteochondrosis occur and how is it treated?

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

According to medical statistics, 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 period, especially with prolonged uneven loads on the back, legs and as a result of injuries.

What is osteochondrosis?

Osteochondrosis is a disease of the spine in which degenerative and dystrophic lesions of the intervertebral disc occur.With the development of osteochondrosis, degenerative-dystrophic lesions spread to the vertebral tissue.

The main signs that indicate the development of osteochondrosis are 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, provoked by their compression and displacement, begin.If there is no timely treatment, osteochondrosis develops into an incurable condition.

Causes of osteochondrosis

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

Additional risk factors include physical inactivity, sedentary lifestyle, overweight, injuries to the back, lower legs, 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 play a role in the etiology of osteochondrosis:

• physical fatigue of the body;
• neuro-emotional fatigue;
• metabolic disorders, poisoning, diseases of the gastrointestinal tract that prevent the full absorption of nutrients;
• occupational risks, in particular, working on vibrating platforms;
• genetic predisposition;
• poor posture during the period of active growth, scoliosis;
• wearing uncomfortable shoes (tight, heels);
• prolonged and/or constant dehydration;
• poor diet, hypovitaminosis;
• smoking;
• pregnancy, especially multiple pregnancy, in combination with an underdeveloped muscle-ligament apparatus (due to the shift of the body's center of gravity).

Stages of development of osteochondrosis

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

• Stage 1 (degree) of osteochondrosis is characterized by the initial stage of pathology in the nucleus pulposus of the intervertebral disc.Due to the excessive load, the process of dehydration (dehydration) of the nucleus begins, which leads to a decrease in the height of the disc and the appearance of cracks in the fibrous ring.Symptoms at this stage, as a rule, are not present;minor discomfort may occur during a long stay in an uncomfortable static position or active movement;
• in stage 2, the decrease in disc height leads to a decrease in the distance between the vertebrae and slackening of the muscles and ligaments of the spine.This causes increased mobility of the vertebrae with the affected disc, which is dangerous due to displacement or slippage.During the second stage of the disease, discomfort and pain occur, especially with certain types of loads, movements, positions;
• Stage 3 osteochondrosis (degree) is characterized by the formation of intervertebral disc prolapse and protrusion, and may be accompanied by subluxations and / or the development of intervertebral joint arthrosis.With some types of movement, the patient feels stiffness, lack of movement, and tingling and numbness may occur in the limbs.At this stage of osteochondrosis, pain is clearly felt in the back, neck, lumbosacral area or coccyx area, depending on the location of the affected disc;
• in the 4th stage of osteochondrosis, the body tries to correct the consequences of hypermobility of the vertebrae and adapt to the dysfunction of the spine.Osteophytes, the formation of new bone, improving the fixation of the vertebrae, are formed at the point of contact between the vertebrae.However, in some cases, osteophytes can cause pinched nerves and injure the vertebrae.Fibrous ankylosis begins in the intervertebral discs and joints.In the absence of microtraumas and pinched nerve roots, the symptoms of the disease subside.

Symptoms of osteochondrosis

The main symptoms of osteochondrosis are discomfort and/or pain in the neck and back.The severity of the sensation and the presence of additional symptoms depend on the stage of the disease.When examining the patient and collecting the anamnesis, the specialist conducts the primary diagnosis, suggesting the presence of osteochondrosis by visually detectable curvature of the spine observed in the transverse or longitudinal plane of the spinal column.Pathology of the intervertebral discs of the cervical and lumbar spine is more common than degenerative and dystrophic changes in the sternum.

Symptoms of osteochondrosis that patients feel include a feeling of periodic or permanent back fatigue, mild or severe pain, depending on the stage of the disease.The pain can be localized in the neck, back, chest, shoulder girdle, making it difficult and limiting the movement of the upper body.

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 patient.Intervertebral disc pathology, displacement, protrusion, hernia and osteophyte growth lead to various consequences.Among the most common are disorders of normal blood circulation in tissues, pinched nerve endings, spinal canal dysfunction, edema, tissue and structural fibrosis.Such consequences can be accompanied by many different symptoms, which lead to a misdiagnosis of the disease.

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 occur in certain body positions, bending, twisting, increased muscle tension;
• numbness in the upper and lower extremities;
• muscle and joint discomfort, muscle spasms;
• headache, dizziness, increased fatigue;
• pain in the heart area;
• impaired hand sensitivity;
• muscle hypotonia.

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 scapula and shoulder area;headache, dizziness, flashing "spots" or spots in front of the eyes, and tinnitus are observed;
• if the thoracic spine is affected, pain is localized in the chest, heart, inner surface of the shoulder, armpit area, respiratory discomfort is also observed, shortness of breath is possible;
• Osteochondrosis of the lumbosacral spine is manifested by lower back pain radiating 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 that are not related to intervertebral disc degeneration.The diagnosis of "osteochondrosis" can only be made by a specialist, and self-medication for such symptoms is unacceptable.

Classification of osteochondrosis

Types of osteochondrosis are distinguished according to several principles.Depending on the location of the pathology, cervical, thoracic, lumbar, sacral or mixed osteochondrosis, the type of combined disease is distinguished.According to clinical manifestations, osteochondrosis of various localization is divided into subtypes depending on the identified symptoms and the overall clinical picture.

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 test results for radicular syndrome are positive, discogenic damage to the roots of the cervical spine is diagnosed.

For thoracic level pathology there are:

• for reflex syndrome - thoracalgia with vegetovisceral, neurodystrophic or muscle-tonal manifestations;
• by radicular lesions - discogenic 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 established to differentiate and clarify diagnoses and pathological stages include:

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

Therapeutic instructions 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 results and prevent relapse.

Therapy for osteochondrosis is carried out in two directions, depending on the degree of osteochondrosis and the patient's state of health.Conservative treatment of this disease consists of taking medicines and doing a set of exercises.Surgical treatment in almost all cases cannot be the first choice method and is prescribed if there is no positive dynamics or progression of the disease against the background of long-term conservative therapy.

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

Conservative treatment of osteochondrosis

Conservative therapy aims to relieve pain, normalize spinal function and prevent negative changes

Conservative treatment of osteochondrosis includes the following types of therapy:

• drug therapy.Medicines for osteochondrosis are used to relieve pain syndrome, inflammatory processes in tissues and normalize metabolic processes of the body.In the case of severe pain syndrome, it is recommended to use drug blockade on the nerve endings, which also helps to reduce the severity of muscle-tonic syndrome.The following types of blockade are distinguished: blockade of trigger points, intraosseous, facet, paravertebral, epidural;
• physiotherapy methods.Physiotherapy procedures help reduce pain, increase the effect of drugs, and are also used during the recovery period.The most common uses are ultrasonic waves, magnetic fields, low-frequency currents, and laser beams;
• physical therapy methods (physical therapy) and kinesitherapy.A set of special exercises, when performed regularly and correctly, helps correct posture, strengthens the muscle corset, ligament apparatus, normalizes muscle function, reduces compression of nerve fibers and helps prevent osteochondrosis complications.Exercise therapy methods and kinesitherapy procedures aim to normalize metabolic processes, restore adequate nutrition of the intervertebral discs, restore the location of the vertebrae and discs between them, and distribute the load uniformly in the musculoskeletal system;
• massageManual massage techniques are used to increase 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.The targeted effect on the body's musculoskeletal system helps improve blood circulation, lymph circulation, improves metabolism, helps correct the mobility of the musculoskeletal system, strengthens the immune system, and serves as a means of preventing osteochondrosis complications;
• attraction therapy(traction) of the spine using special equipment.The purpose of the manipulation is to increase the intervertebral space to normal parameters and correct the structural disorders of the spine.

Osteochondrosis: drug therapy

In the treatment of osteochondrosis, drugs are aimed at reducing the severity of symptoms, improving the process of blood supply to tissues and their regeneration.Osteochondrosis cannot be cured by taking medicine alone;therapy must be combined, including a set of exercises, diet, and preventive measures.

In the absence of significant dystrophic changes and pain, taking drugs without a specialist's prescription can be considered inappropriate.

Medicines used to relieve pain and treat osteochondrosis:

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

The drug can be prescribed in the form of ointments, creams for local use for pain, and for oral administration and injections.

In cases of acute complications, drugs are used to block nerve endings.

Osteochondrosis: nutrition of the patient

The principle of the diet is based on the need to improve metabolic processes, saturate the body with essential nutrients, vitamins, minerals, and include foods high in antioxidants, unsaturated 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.You need to eat in small portions, 5-6 times a day.

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

Preferred food processing methods: steaming, baking, boiling.Limit the intake of flour and confectionery products, fatty foods, spicy, salty dishes and seasonings, canned and smoked foods, strong meat soups, legumes, sugar and fruits with a high sugar content (grapes).During the day, you must drink at least 1.5 liters of liquid, giving preference to clean and mineral water, dried fruit compote, unsweetened fruit drinks, and herbal tea.You should limit the amount of strong black tea, coffee, sugary carbonated drinks and alcohol.

Complications of osteochondrosis

Failure to comply with prescribed treatment, prolonged avoidance of doctors and lack of treatment for osteochondrosis contribute to the development of the disease and trigger the development of complications, pathologies and new diseases, such as:

• herniated intervertebral disc (spinal hernia);
• protrusion;
• kyphosis;
• radiculitis;
• salt deposits in the intervertebral space;
• spinal cord stroke;
• decrease in limb muscle mass, muscle atrophy due to blood supply disruption;
• lower limb paralysis.

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

Prevention of osteochondrosis

The causes of osteochondrosis are mainly related to a lack of attention to the body's needs, poor nutrition, and excessive stress on the body.To prevent the occurrence of pathological changes in the spine and curb the dynamics of existing osteochondrosis, it is recommended to adhere to 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 other activities that involve staying in a static position for a long time, you must take a warm-up break every 45 minutes to restore blood circulation.If you have to sit for a long time, you should choose the right chair, a chair that provides support for the spine, ensure compliance with the standards for the position of your hands on the table, feet on the floor or a special stand, learn to maintain your posture (straight back, relaxed shoulders);
• for night sleep, you need to choose an elastic mattress, preferably orthopedic, with a flat surface, avoid high or too flat pillows;
• if necessary, lift and/or carry heavy objects, avoid jerking when lifting weights from a half-squat position, use a special belt that supports the lower back;
• choosing the right orthopedic shoes: with the right width for the feet, without high heels and timely replacement will help reduce the load on the spine, this is especially important for women during the period of childbirth.In the summer, you can't ignore the opportunity to walk barefoot on uneven surfaces;this strengthens the leg muscles and relieves tension from the musculoskeletal system;
• A proper diet and drinking regimen contributes to overall health and helps maintain a normal metabolism;
• If you are prone to increased emotions, anxiety with muscle spasm response to stress, it is worth learning relaxation methods, as well as regularly taking courses in restorative massage.