Why does osteochondrosis occur and how is it treated?

Osteochondrosis is a disease in which degenerative-dystrophic changes in the cartilaginous tissues of the spine are diagnosed, which are also accompanied by disorders 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.Under unfavorable conditions, signs of osteochondrosis may appear in an earlier period, especially with prolonged uneven loads on the back, legs and the 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 disease is 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 disorders and dysfunction of internal organs begin, caused by their compression and displacement.In the absence of 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.A common cause of incorrect load distribution is the habit of carrying a bag on one shoulder or in one hand, an incorrect sitting position, sleeping on a mattress that is too soft, a high pillow, and wearing anatomically incorrect shoes.

Additional risk factors include physical inactivity, a sedentary lifestyle, excess weight, injuries to the back, lower extremities, 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 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 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 (narrow, heels);
• prolonged and/or regular dehydration;
• poor nutrition, hypovitaminosis;
• smoking;
• pregnancy, especially multiple pregnancy, in combination with an undeveloped musculo-ligamentous system (due to the shift in the center of gravity of the body).

Stages of development of osteochondrosis

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

• Stage 1 (grade) osteochondrosis 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 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 absent;mild discomfort may occur during prolonged stay in an uncomfortable static position or active movement;
• in phase 2, a decrease in the height of the discs leads to a decrease in the distance between the vertebrae and failure 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 slipping.During the second phase of the disease, discomfort and pain appear, especially with certain types of load, movements, positions;
• Stage 3 (grade) osteochondrosis is characterized by the formation of prolapses and protrusions of the intervertebral discs and may be accompanied by subluxations and/or development of arthrosis of the intervertebral joints.With some types of movement, patients experience stiffness, lack of mobility, and a tingling sensation and numbness in the limbs may occur.At this stage of osteochondrosis, pain is clearly felt in the back, neck, lumbosacral region or coccyx area, depending on the location of the affected discs;
• at stage 4 of osteochondrosis, the body tries to correct the consequences of spinal hypermobility and adapt to the impaired functionality of the spine.Osteophytes, new bone formations, improve the fixation of the vertebrae, they form at the contact points between the vertebrae.However, in some cases, osteophytes can cause compression of the nerves and injury to the vertebrae.Fibrous ankylosis begins in the intervertebral discs and joints.In the absence of microtraumas and crushed nerve roots, the symptoms of the disease regress.

Symptoms of osteochondrosis

The main symptoms of osteochondrosis are a feeling of discomfort and/or pain in the neck and back.The severity of sensations and the presence of additional symptoms depend on the stage of the disease.During the examination of the patient and taking the medical history, the specialist makes a primary diagnosis, suggesting the presence of osteochondrosis by a visually detectable curvature of the spine observed in the transverse or longitudinal plane of the spine.Pathologies of the intervertebral discs of the cervical and lumbar spine are much more common than degenerative and dystrophic changes in the sternum.

The signs of osteochondrosis felt by the patient include a periodic or permanent sensation 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 movement of the upper limbs difficult and limiting.

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 patients.The pathology of the intervertebral discs, displacements, protrusions, hernias and the growth of osteophytes lead to various consequences.Among the most common are disorders of normal blood circulation in the tissues, crushing of nerve endings, dysfunction of the spinal canal, edema, fibrosis of tissues and structures.Such consequences can be accompanied by many different symptoms, leading to misdiagnosis of diseases.

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, rotation, increased muscle tension;
• feeling of numbness in the upper and lower limbs;
• muscle and joint discomfort, muscle spasms;
• headache, dizziness, increased fatigue;
• pain in the heart area;
• reduced 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;you notice headaches, dizziness, flashing "spots" or spots before the eyes, and tinnitus;
• if the thoracic spine is affected, the pain is localized in the chest, heart, inner surface of the shoulder, in the armpit area, respiratory discomfort is also noted, shortness of breath is possible;
• Osteochondrosis of the lumbosacral spine manifests as 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 not related to the degeneration of intervertebral discs.The diagnosis of "osteochondrosis" can be made only by a specialist, and self-medication for such symptoms is unacceptable.

Classification of osteochondrosis

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

For the pathology of the thoracic level there are:

• for reflex syndromes - thoracalgia with vegetovisceral, neurodystrophic or muscular-tonal manifestations;
• from radicular – discogenic lesion of the roots of the thoracic region.

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

• depending on the type of reflex syndrome - lumbago (low back pain), lumbago, lumboischialgia with vegetative-vascular, neurodystrophic or muscular-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:

• Radiographic examination of the spine;
• myelography;
• neurological examination of sensitivity, reflexes.

Additional methods prescribed to differentiate and clarify the diagnosis and stage of the pathology include:

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

Therapeutic indications for osteochondrosis

The 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 result and prevent relapses.

Therapy for osteochondrosis disease is carried out in two directions, depending on the degree of osteochondrosis and the patient's health condition.Conservative treatment of the disease consists of taking medications and performing a set of exercises.Surgical treatment in almost all situations cannot be the first choice method and is prescribed in the absence of positive dynamics or progression of the disease against the background of long-term conservative therapy.

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

Conservative treatment of osteochondrosis

Conservative therapy is aimed at relieving pain, normalizing the functionality of the spine 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 the tissues and normalize the body's metabolic processes.In case of severe pain syndrome, it is recommended to use pharmacological blocks of nerve endings, which also help to reduce the severity of tonic-muscular syndrome.The following types of blocks are distinguished: trigger point block, intraosseous, faceted, paravertebral, epidural;
• physiotherapeutic methods.Physiotherapeutic procedures help reduce pain, increase the effect of drugs, and are also used during the rehabilitation period.The most common use is 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, help to correct posture, strengthen the muscular corset, ligament apparatus, normalize muscle function, reduce compression of nerve fibers and help prevent complications of osteochondrosis.Physical therapy methods and kinesitherapy procedures are aimed at normalizing metabolic processes, restoring adequate nutrition of the intervertebral discs, restoring the position of the vertebrae and discs among themselves and evenly distributing the load in the musculoskeletal system;
• massage.Manual massage techniques are used to improve blood flow to tissues, relieve spasms and muscle 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 on an individual basis.A targeted effect on the musculoskeletal system of the body helps to improve blood circulation, lymphatic circulation, improves metabolism, helps to 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 using special equipment.The purpose of the manipulations is to bring the intervertebral space back to normal parameters and correct structural disorders of the spine.

Osteochondrosis: drug therapy

In the treatment of osteochondrosis, drugs are aimed at reducing the severity of symptoms, improving the processes of blood supply to tissues and their regeneration.Osteochondrosis cannot be cured by taking medications alone;therapy should be combined, including series of exercises, 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 to relieve pain and treat osteochondrosis:

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

Drugs can be prescribed both in the form of ointments, creams for local use against pain, and for oral administration and injections.

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

Osteochondrosis: dietary nutrition 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 recommended drinking regime 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 meats, poultry, fish, fresh vegetables, fruits, nuts and seeds, cereals and mushrooms.It is especially recommended to include meat and fish jellies, jellied meats, jellied dishes in the diet, and use extra virgin olive oil without heat treatment (for dressing salads).

Preferred food processing methods: steaming, baking, boiling.Limit the intake of flour and confectionery products, fatty foods, spicy and salty dishes and seasonings, canned and smoked foods, strong meat broths, legumes, sugar and fruits with high sugar content (grapes).During the day it is necessary to drink at least 1.5 liters of liquids, favoring clean and mineral water, dried fruit compotes, unsweetened fruit drinks and herbal teas.You should limit the amount of strong black tea, coffee, sweet carbonated drinks and alcohol.

Complications of osteochondrosis

Failure to comply with the prescribed treatment, prolonged absence of the doctor and lack of treatment for osteochondrosis contribute to the progression of the disease and provoke the development of complications, pathologies and new diseases, such as:

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

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

Prevention of osteochondrosis

The causes of osteochondrosis are mainly related to 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: physical exercise, running, swimming, cycling, skiing, gymnastics, non-contact wrestling, etc.;
• When working or performing other activities that require prolonged standing in a static position, you should 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 provide support for the spine, ensure compliance with the standards for the position of the hands on the table, feet on the floor or a special support, learn to maintain posture (straight back, relaxed shoulders);
• for night sleep it is necessary 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 jerks when lifting weights from a semi-squat position, use special belts that support the lower back;
• choose 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, this is especially important for women during the pregnancy period.In summer the possibility of walking barefoot on uneven surfaces should not be overlooked;this strengthens the foot muscles and relieves tension from the musculoskeletal system;
• An adequate diet and nutritional regime contribute to general health and help maintain normal metabolism;
• If you are prone to increased emotionality, anxiety with a muscle spasmodic reaction to stress, it is worth learning relaxation methods and regularly taking restorative massage courses.