Osteochondrosis -degenerative-dystrophic lesions of the tissues of the spine, characterized by lesions of the intervertebral discs, adjacent joint surfaces and vertebral bodies, ligamentous apparatus of the spine.
Most often, the pathological processes of osteochondrosis first affect the bones and ligaments. The fact that the disease has already started, 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's population suffers from osteochondrosis. Most often, the disease affects people over 30 years old. 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.
Due to a decrease in the height of the disc, the attachment points of muscles and ligaments belonging to two adjacent vertebrae come closer together. As a result, muscles and ligaments sag. This can lead to excessive mobility of the two vertebrae relative to each other, that is, instability of the vertebral-motor segment is formed. This stage is characterized by a 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, which mainly affect the intervertebral discs themselves: prolapse and protrusions of the discs are formed. The articular apparatus of the vertebral-motor segment also suffers. In intervertebral joints and non-co-vertebral joints, subluxations occur, osteoarthritis is formed.
- The fourth stage in the development of osteochondrosis.
At this point, adaptive changes occur in the affected segments of the spine. The body tries to overcome the excessive mobility of the vertebrae, immobilize the spine to maintain its supporting and protective functions. In this regard, marginal bony growths appear on the adjacent surfaces of the vertebral bodies, that is, osteophytes. An osteophyte that has grown "in the wrong place" causes microtrauma of the nerve root. In the fourth stage, the processes of fibrous ankylosis usually begin in the intervertebral discs and joints. In the end, the vertebral-motor segment turns out to be, so to speak, enclosed in a shell - the clinical manifestations subside.
Causes of osteochondrosis
In each of the many existing theories about the development of osteochondrosis, various causes are accepted that are responsible for the onset of the disease, for example, mechanical injury, 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 old people as well as in young people, both in good physical condition and less trained. There is a widespread belief that the cause of osteochondrosis is the deposition of salts in the spine: allegedly on x-rays, salt can be seen in the form of "growths" or "hooks" on the vertebrae. If, during movement, there is a crunch and crackle in the joints, as if sand is poured between them, for many patients the only reason for this condition is the notorious "salt deposit". Such misconceptions are not at all harmless: the correct idea of the means to treat a disease can be determined on the basis of an analysis of the causes that provoked it.
The term "osteochondrosis" comes from the Greek roots osteon - "bone" and chondr - "cartilage". The ending "-oz" means that the disease of bones and cartilage is not associated with inflammatory processes, is degenerative-dystrophic in nature, that is, the basis of the disease is malnutrition of the tissuesand, consequently, the degeneration of its structure. Like all living tissue, the bone tissue of the vertebrae and the cartilage tissue of the intervertebral discs are constantly rearranging and renewing themselves. Under the influence of regular physical exertion, they acquire strength and elasticity, and in the absence of loads, the resistance of the tissues decreases.
This is due to the peculiarities of nutrition and blood supply to bone and cartilage tissue. Adult discs 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 muscular work.
Depending on its composition, the intervertebral disc can be divided into two parts: it is the gelatinous nucleus that gives elasticity to the disc, located in the center, and the strong fibrous ring that surrounds it. Due to the deterioration of the nutrition of the intervertebral discs, the complex structure of the biopolymeric compounds that make up the nucleus pulposus is destroyed. The moisture content of the gelatinous nucleus decreases and it becomes more fragile. When exposed to even minor overloads, the gelatinous nucleus 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 of these factors create the basis and are the root cause of the development of osteochondrosis.
To restore the function of the spine, the healing of lesions of the intervertebral disc, the mobilization of the compensatory capacities of the spine, as well as the musculoskeletal system as a whole, is necessary, and not the resorption of "salt deposits"or the elimination of" thorns "on the vertebrae. On an x-ray examination after the end of 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 the adaptation processes. Marginal growths increase the area of the supporting surface of the vertebral body. By increasing the surface area, the specific pressure decreases, which makes it possible to compensate for the decrease in resistance 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. So, this is not the cause of osteochondrosis, but only a consequence and the final step in the above process.
The 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 as that obtained with the treatment, the pain may return.
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 annulus 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 occurs. Various neurological syndromes develop - reflex and compression.
The main cause of pain in osteochondrosis is what is 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 inthe affected segment of the spine, etc. ).
Vascular disorders of osteochondrosis are often associated with impaired vasomotor innervation. Mechanical compression of blood vessels by osteophytes, for example in the cervical spine, is also possible.
Symptoms of osteochondrosis
One of the hallmarks of spinal osteochondrosis that worsens the process is its overly extensive symptomatology. The disease can manifest itself in completely different parts of the body. It can be pain or numbness in the extremities or disorders and pain in the internal organs. At the same time, often a person in no way associates pain in the region of the heart, abnormalities in the functioning of the genitals, headaches, pain and numbness in the legs with osteochondrosis and in general withthe spine, by directly "treating" the symptoms of osteochondrosis using various types of pain relievers, all kinds of advertised drugs, dietary supplements and other methods. But this path only makes the situation worse. Osteochondrosis continues to develop, and the treatment methods used, at best, simply do not lead to significant improvement except for temporary pain relief, and in the worst case, they can cause further harm to the body.
Thus, it is important to carefully analyze your condition and the changes occurring in it. It is necessary to start moving in the right direction: timely consult a doctor, make 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, pain and discomfort in the back. At the same time, pains can be periodic and unstable in nature, appearing and then disappearing. But already the first feeling of discomfort or pain in the spine should give you pause. The appearance of the first pains is a signal to at least pay attention to them, try to remember the reason for which they appeared. It can be caused by heavy object lifting, 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, the 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 course of pain depending on the actions of the patient, comparing pain sensations 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 a little warm-up or walking the pain has subsided, then this will be an indirect sign thatwill determine lumbar osteochondrosis of the spine. The same image can be with the neck and the arm. In summary, we can say that the main symptoms of osteochondrosis include pain and discomfort in the back. In the event that these symptoms coincide with pain in other parts of the body, osteochondrosis may be complicated by a protrusion, a 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 discomfort. After all, osteochondrosis can manifest itself weakly or not manifest at all for a long time. At the same time, it will continue to grow successfully in the spine, leading to the degradation of an increasing number of discs. Therefore, a timely visit to a doctor will diagnose osteochondrosis at an earlier stage, which will facilitate its treatment.
Osteochondrosis and salt 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 popular opinion in everyday life that salt deposits are the main cause of osteochondrosis is wrong. Therefore, treating osteochondrosis with the help of a salt-free diet does not make sense.
The most common complaints of osteochondrosis of the spine
The most common complaints in osteochondrosis are:
- Discomfort in various parts of the spine. The pain can vary from minor, dull, pulling to strong, sometimes very intense and unbearable - with lumbago.
- Increased fatigue at work, both physical and mental.
- Sensory impairment of limbs and various parts of the body, chills in the arms or legs.
- Pain radiating to the legs, along the nerve trunks.
- Pain radiating to the scapula, shoulder, neck and back of the head.
- Headaches and dizziness are frequent companions of cervical osteochondrosis. Increased visual fatigue or decreased visual acuity is often observed.
- With the defeat of the lumbar-sacral region, disorders of the reproductive system are common - various sexual dysfunctions. Therefore, in most men, after the treatment, there is an increase in sexual potency. In women, normal functioning of the lumbosacral area increases the chances of conception and contributes to a comfortable pregnancy.
Diagnosis of osteochondrosis
To diagnose osteochondrosis, it is necessary to take a history. In this case, it is crucial to establish the patient's complaints. Some symptoms of osteochondrosis are quite typical. Others, on the other hand, must be differentiated from signs of other diseases. It is important that the nervous, vascular and trophic disorders that occur in osteochondrosis can simulate various diseases, such as angina, gastritis, gastric ulcer, acute surgical diseases of the abdominal organs. Therefore, in order to avoid misdiagnosis and subsequent prescription of improper treatment, each symptom should be analyzed in detail.
When collecting the anamnesis, 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 develops more often in the elderly andthe evolution of symptoms from the moment they appear until the patient leaves for the doctor. For osteochondrosis, slow development is characteristic, in which periods of exacerbation are periodically replaced by periods of remission. Additional research methods are prescribed to clarify the diagnosis.
X-ray exams for osteochondrosis
The most accessible method for diagnosing osteochondrosis and at the same time quite informative is X-ray examination. There are several types of X-ray method for diagnosing this disease:
The standard 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, an observational x-ray is performed - depending on the symptoms of the disease and the patient's complaints, the location of the spinal injury is determined. On the x-ray of the spinal segment with osteochondrosis, a decrease in the thickness (atrophy) of the intervertebral discs can be seen, which is manifested by a decrease in the space between the vertebrae, the appearance of bone growths of the bodiesvertebral - osteophytes, partial dissolution - resorption of bone tissue of the vertebral body, change in the shape of the spinal segment, for example, smoothing of lumbar lordosis.
Myelography is a more complex and dangerous diagnostic method. During such an 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 injury to the spinal cord during puncture of the spinal canal. Through myelography, the internal structure of the spinal canal can be determined. This method is particularly informative for the determination of vertebral hernias.
Computed tomography and magnetic resonance imaging are the most modern, but also the most expensive and difficult to access methods of diagnosing osteochondrosis. These diagnostic methods are usually used when it is necessary to differentiate osteochondrosis from 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 location and degree of motor and sensory disturbances.
Treatment of osteochondrosis
The clinic offers 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 the 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 duration of treatment is 10-15 sessions, and the elimination of acute pain syndrome is 1-3 sessions.
The earlier the treatment is started, the better the result!
Is Complete Osteochondrosis Elimination Real?
It depends on the form of the disease, the severity, correctness and speed of treatment. Complete recovery is only possible in the early stages.
But it is possible to prevent exacerbations of osteochondrosis, not to feel pain for years. If a person had osteochondrosis, but no longer feels discomfort now, it does not mean that they passed away without a trace. There may be changes in the spine.
The main task is to suspend the development of the disease and to do everything possible so that some of the pathological changes in the spine disappear, the symptoms disappear or decrease (back pain, cold snap and numbness in the arms, legs, headaches, etc. ).