Why does osteochondrosis occur and how is it treated?

Osteochondrosis is a disease in which degenerative-dystrophic changes in the cartilage tissue of the spine are diagnosed, accompanied by disturbances 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, symptoms of osteochondrosis are observed in 50-90% of the population.The average age of onset of osteochondrosis is 30-35 years.In unfavorable conditions, signs of osteochondrosis may appear earlier, especially in case of long-term uneven loads on the back, legs and 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 is pain in the neck, back and lumbar region;as it progresses, the pain "spreads" into the arms, chest, shoulders, and upper thighs.With the negative dynamics of osteochondrosis, muscle tissue atrophy, sensory disturbances and dysfunction of internal organs, caused by their compression and displacement, begin.In the absence of timely treatment, osteochondrosis develops into an incurable condition.

Causes of osteochondrosis

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

Additional 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 degenerative processes related to aging due to age-related changes in blood supply to the spinal column.

The following factors may also play a role in the etiology of osteochondrosis:

• physical overload of the body;
• neuro-emotional exhaustion;
• metabolic disorders, poisoning, diseases of the gastrointestinal tract that prevent the complete absorption of nutrients;
• occupational risks, especially working on vibrating platforms;
• genetic predisposition;
• poor posture during the period of active growth, scoliosis;
• wearing uncomfortable shoes (tight, heels);
• prolonged and/or regular dehydration;
• poor nutrition, 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 the disease goes through four stages:

• Osteochondrosis of the 1st degree 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 leads to a decrease in the height of the disc and the appearance of cracks in the fibrous ring.Symptoms in this phase, as a rule, are absent;minor discomfort may appear during a long stay in an uncomfortable static position or active movement;
• in phase 2, the reduction in the height of the discs leads to a reduction in the distance between the vertebrae and a lowering of the spinal muscles and ligaments.This causes increased mobility of the vertebrae with the affected discs, which is dangerous due to their displacement or slippage.In the second stage of the disease, discomfort and pain appear, especially with certain types of load, movement, position;
• Osteochondrosis of the 3rd degree (degree) is characterized by the formation of prolapse and protrusions of the intervertebral discs, and may be accompanied by subluxations and/or the development of arthrosis of the intervertebral joints.With some types of movements, patients feel stiffness, lack of mobility, and may also experience tingling and numbness in the limbs.At this stage of osteochondrosis, the pain is clearly felt in the back, neck, lumbosacral region or coccyx, depending on the location of the affected discs;
• in the 4th stage of osteochondrosis, the body tries to correct the consequences of hypermobility of the vertebrae and adapt to the impaired functionality of the spinal column.Osteophytes, new bone formations, improve the fixation of the vertebrae, are formed at the points of contact between the vertebrae.However, in some cases, osteophytes can cause nerve entrapment and vertebral injuries.Fibrous ankylosis begins in the intervertebral discs and joints.In the absence of microtrauma 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.During the examination of the patient and the collection of anamnesis, the specialist carries out a primary diagnosis, suggesting the presence of osteochondrosis by a visually noticeable curvature of the spine observed in the transverse or longitudinal plane of the spinal column.Pathologies of the intervertebral discs of the cervical and lumbar spine are much more common than degenerative and dystrophic changes in the sternum.

Signs of osteochondrosis in patients are a periodic or permanent feeling of fatigue in the back, 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 restricting the movements of the upper limbs.

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.Intervertebral disc pathology, displacements, protrusions, hernias and growth of osteophytes lead to various consequences.Among the most common are disorders of normal blood circulation in tissues, pinching of nerve endings, dysfunction of the spinal canal, edema, fibrosis of tissues and structures.Such consequences can be accompanied by various symptoms, which leads to a wrong diagnosis 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 occurs in certain body positions, bending, turning, increased muscle tension;
• feeling of numbness in the upper and lower extremities;
• muscle and joint discomfort, muscle cramps;
• headaches, dizziness, increased fatigue;
• pain in the region of the heart;
• reduced hand sensitivity;
• muscle hypotonia.

Symptoms of osteochondrosis vary depending on the location of the pathology:

• with osteochondrosis of the cervical spine, pain prevails in the neck, arms and shoulder girdle, radiating to the scapula and shoulder area;headache, dizziness, flickering "spots" or spots before the eyes and tinnitus are observed;
• 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, difficulty breathing is possible;
• Osteochondrosis of the lumbosacral spine is manifested by pain in the lower back that spreads to the legs, upper legs or pelvic organs, often accompanied by sexual disorders.

Superficial symptoms - fatigue in the back, 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 the degeneration of the intervertebral discs.The diagnosis of "osteochondrosis" can only be made by a specialist, and self-treatment of such symptoms is unacceptable.

Classification of osteochondrosis

Types of osteochondrosis differ according to several principles.Depending on the localization of the pathology, cervical, thoracic, lumbar, sacral or mixed, combined types of osteochondrosis are distinguished.According to clinical manifestations, osteochondrosis of different 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 different manifestations (vegetative-vascular, neurodystrophic, muscle-tonal) are identified;
• if the result of the test for radicular syndrome is positive, discogenic damage to the root of the cervical spine is diagnosed.

For the pathology of the thoracic level there are:

• for reflex syndromes - thoracalgia with vegetovisceral, neurodystrophic or muscle-tonal manifestations;
• radicular - discogenic lesion of the root of the thoracic region.

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

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

Diagnosis of osteochondrosis

Instrumental examination methods are used to establish the diagnosis:

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

Additional methods prescribed for distinguishing and clarifying the diagnosis and stage of pathology include:

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

Instructions for the treatment of 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 results and prevent recurrence.

Osteochondrosis therapy is carried out in two directions, depending on the degree of osteochondrosis and the patient's state of health.Conservative treatment of the disease consists of taking medication and performing a set of exercises.Surgical treatment in almost every situation cannot be the method of first choice and is prescribed in the absence of positive dynamics or progression of the disease on the background of long-term conservative therapy.

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

Conservative treatment of osteochondrosis

Conservative therapy is aimed at alleviating pain, normalizing the functionality of the spinal column 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 the case of a severe pain syndrome, it is recommended to use drugs that block nerve endings, which also help reduce the severity of the muscle-tonic syndrome.The following types of blockades are distinguished: blockade of the trigger point, intraosseous, facet, paravertebral, epidural;
• physiotherapy methods.Physiotherapy procedures help reduce pain, increase the effect of drugs, 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 physical therapy (physical therapy) and kinesitherapy.A set of special exercises, when performed regularly and correctly, helps to correct posture, strengthen the muscle corset, ligamentous apparatus, normalize muscle function, reduce compression of nerve fibers and prevent complications of osteochondrosis.The methods of exercise therapy and kinesitherapy procedures are aimed at normalizing metabolic processes, restoring adequate nutrition of the intervertebral discs, restoring the position of the vertebrae and the discs between them, and evenly distributing the load on the musculoskeletal system;
• massage.Manual massage techniques are used to improve tissue blood supply, relieve muscle spasms and tension, and generally improve blood circulation.Hydromassage as a therapeutic activity, in addition to the mentioned effects, helps to normalize the functioning of the body's nervous system;
• manual therapy.Manual therapy methods are selected on an individual basis.Targeted action on the musculoskeletal system of the body 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 complications of osteochondrosis;
• traction therapy(traction) of the spine with the help of special equipment.The purpose of the manipulations is to increase the intervertebral space to normal parameters and correct structural disorders of the spinal column.

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 medication alone;therapy must be combined, including exercise sets, diet and preventive measures.

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

Medicines used for pain relief and treatment of osteochondrosis:

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

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

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

Osteochondrosis: diet 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 drinking regime recommended for osteochondrosis is aimed at preventing dehydration of the body, which can adversely affect the affected tissues.You must eat in small portions, 5-6 times a day.

The basis of the diet consists of milk and fermented milk products, lean meat, poultry, fish, fresh vegetables, fruit, nuts and seeds, cereals and mushrooms.It is especially recommended to include meat and fish jellies, jellies, jellies and use extra virgin olive oil without heat treatment (for dressing salads) in your diet.

Preferred food processing methods: steaming, baking, cooking.Limit the intake of flour and confectionery products, fatty foods, hot, salty dishes and spices, canned and smoked foods, strong meat broths, 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 pure and mineral water, dried fruit compotes, unsweetened fruit drinks and herbal teas.You should limit the amount of strong black tea, coffee, sugary sodas and alcohol.

Complications of osteochondrosis

Non-compliance with the prescribed treatment, long-term avoidance of doctors and non-treatment of osteochondrosis contributes to the progression of the disease and provokes the development of complications, pathologies and new diseases, such as:

• hernia of intervertebral discs (spinal hernia);
• protrusion;
• kyphosis;
• radiculitis;
• salt deposits in the intervertebral space;
• spinal cord strokes;
• decrease in limb muscle mass, muscle atrophy due to blood supply disorders;
• paralysis of the lower limbs.

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

Prevention of osteochondrosis

The causes of osteochondrosis are mainly related to the lack of attention to the body's needs, poor nutrition and excessive stress on the body.In order 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:

• eliminating the possibility of physical inactivity: moderate sports: exercise, running, swimming, cycling, skiing, gymnastics, wrestling without contact, etc.;
• During work or other activities that involve a long stay in a static position, you must take warm-up breaks every 45 minutes to restore blood circulation.If you need to sit for a long time, you should choose the right chairs, chairs that support the spine, ensure compliance with the standards for the position of hands on the table, feet on the floor or a special stand, learn to maintain your posture (straight back, relaxed shoulders);
• for a night's sleep, you must choose an elastic, preferably orthopedic, mattress with a flat surface, avoid high or too flat pillows;
• if necessary, lift and/or carry heavy objects, avoid jerks when lifting weights from half-squats, use special belts that support the lower back;
• choosing the correct orthopedic shoes: with the appropriate width for the foot, without high heels and their timely replacement will help reduce the load on the spine, which is especially important for women in the period of childbearing.In summer, you should not ignore the possibility of walking barefoot on uneven surfaces;this strengthens the foot muscles and relieves tension from the musculoskeletal system;
• Proper nutrition and drinking regimen contribute to general health and help maintain normal metabolism;
• If you are prone to increased emotionality, anxiety with spasmodic muscle reaction to stress, it is worth learning relaxation methods, as well as regularly attending restorative massage courses.