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, 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.Under unfavorable conditions, signs of osteochondrosis may appear earlier, especially with long-term 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 in the tissues of the vertebrae.

The main sign indicating the development of the disease osteochondrosis 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, muscle tissue atrophy, sensory disturbances and dysfunction of internal organs, provoked 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 the uneven load on the spine.A common cause of improper load distribution is the habit of carrying a bag on one shoulder or in one hand, incorrect sitting position, sleeping on a too soft mattress, a high pillow and wearing anatomically incorrect types of shoes.

Additional risk factors include lack of physical activity, sedentary lifestyle, overweight, injuries to the back, lower extremities, flat feet and other diseases of the musculoskeletal system, as well as age-related degenerative processes due to age-related changes in blood supply to the spine.

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

• physical overexertion of the body;
• neuro-emotional exhaustion;
• metabolic disorders, poisoning, diseases of the gastrointestinal tract that prevent the complete absorption of nutrients;
• occupational risks, in particular work 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 diet, hypovitaminosis;
• smoking;
• pregnancy, especially multiple pregnancy, in combination with an underdeveloped musculo-ligamentous apparatus (due to displacement of the body's center of gravity).

Stages of development of osteochondrosis

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

• Stage 1 (grade) osteochondrosis is characterized by an 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 at this stage, as a rule, are absent;slight discomfort may occur during prolonged stay in an uncomfortable static position or active movement;
• in stage 2, the reduction in the height of the discs leads to a reduction in the distance between the vertebrae and a sagging of the spinal muscles and ligaments.This leads to increased mobility of the vertebrae with affected discs, which is dangerous due to their displacement or slippage.During the second stage of the disease, discomfort and pain appear, especially with certain types of loading, movements, positions;
• Osteochondrosis 3 degree (grade) is characterized by the formation of prolapses 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, a feeling of numbness and tingling in the limbs may appear.At this stage of osteochondrosis, the pain is clearly felt in the back, neck, lumbosacral region or coccyx region, depending on the location of the affected discs;
• in stage 4 of osteochondrosis, the body tries to correct the consequences of hypermobility of the vertebrae and adapt to the impaired functionality of the spine.At the points of contact between the vertebrae, osteophytes, new bone formations, improve the fixation of the vertebrae.However, in some cases, osteophytes can cause nerve pinching and vertebral injury.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 a feeling of discomfort and/or pain in the neck and back.The severity of the sensations and the presence of additional symptoms depend on the stage of the disease.When examining the patient and taking an anamnesis, the specialist conducts a primary diagnosis, assuming the presence of osteochondrosis through 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.

Signs of osteochondrosis felt by the patient include a periodic or constant 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, which makes it difficult and limits 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.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 tissues, pinched nerve endings, dysfunction of the spinal canal, edema, fibrosis of tissues and structures.Such consequences can be accompanied by many different symptoms, which leads to the wrong diagnosis 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 occurring in certain body positions, bending, turning, increased muscle tension;
• tingling sensation in the upper and lower extremities;
• muscle and joint discomfort, muscle spasms;
• headache, dizziness, increased fatigue;
• pain in the region of the heart;
• impaired sensitivity of the hands;
• muscle hypotension.

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

• with osteochondrosis of the cervical spine, the pain in the neck, arms and shoulder girdle prevails, radiating to the scapula and shoulder area;headache, dizziness, flashing "spots" or spots before the eyes, and tinnitus are noted;
• 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 noted, shortness of breath is possible;
• Osteochondrosis of the lumbosacral spine is manifested by pain in the lower back, radiating to the legs, upper thighs or pelvic organs, often accompanied by sexual dysfunction.

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

Classification of osteochondrosis

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

Osteochondrosis of the cervical vertebrae:

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

For pathology at the chest level there are:

• in reflex syndromes - thoracalgia with vegetovisceral, neurodystrophic or muscle-tonal manifestations;
• through radicular - discogenic damage to the roots of the thoracic region.

With osteochondrosis at 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 radiculoischaemia.

Diagnosis of osteochondrosis

Instrumental research methods are used to establish the diagnosis:

• x-ray 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).

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 the result and prevent relapses.

The therapy of the disease osteochondrosis 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 drugs 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 against the background of long-term conservative therapy.

In addition to medical methods of treatment, 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 alleviating 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 tissues and normalize metabolic processes in the body.In the case of severe pain syndrome, the use of drug blockades of the nerve endings is recommended, which also help to reduce the severity of the muscle-tonic syndrome.The following types of blockades are distinguished: blockade of a trigger point, intraosseous, facet, paravertebral, epidural;
• physiotherapy methods.Physiotherapy procedures help reduce pain, enhance 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 (PFC) 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 training therapy and kinesitherapeutic procedures are aimed at normalizing metabolic processes, restoring the full nutrition of the intervertebral discs, restoring the location of the vertebrae and the discs between them, and evenly distributing the load in the musculoskeletal system;
• massage.Manual massage techniques are used to improve tissue blood supply, relieve muscle spasms and tension, and generally improve 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 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 the complications of osteochondrosis;
• traction therapy(traction) of the spine using special equipment.The purpose of the manipulations is to increase the intervertebral space to normal parameters and to 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 processes of tissue blood supply and their regeneration.Osteochondrosis cannot be cured with drugs alone;therapy should be combined, including complexes 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 tissue blood supply, vitamins of group B (mainly B3);
• preparations for the regeneration and/or prevention of cartilage tissue degeneration, hyaluronic acid.

Medicines can be prescribed both in the form of ointments, creams for local application for pain, as well as 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 with a high content of 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 negatively affect the affected tissues.You should eat in small portions, 5-6 times a day.

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

Preferred food processing methods: stewing, baking, boiling.Limit the intake of flour and confectionery, fatty foods, spicy, 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 should drink at least 1.5 liters of liquid, preferring pure and mineral water, dried fruit compotes, unsweetened fruit drinks and herbal teas.You should limit the amount of strong black tea, coffee, sugary carbonated drinks and alcohol.

Complications of osteochondrosis

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

• herniation of intervertebral discs (spinal hernia);
• protrusion;
• kyphosis;
• sciatica;
• salt deposits in the intervertebral space;
• spinal cord strokes;
• decrease in muscle mass of the limbs, 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 damage to the patient.

Prevention of osteochondrosis

The causes of osteochondrosis are mainly related to the lack of attention to the needs of the body, poor nutrition and excessive stress on the body.In order to prevent the appearance of pathological changes in the spine and limit the dynamics of existing osteochondrosis, it is recommended to observe the general principles of a healthy lifestyle:

• eliminating the possibility of lack of physical activity: moderate sports: exercise, running, swimming, cycling, skiing, gymnastics, non-contact wrestling, etc.;
• When working or performing other activities that involve a prolonged static position, you should take warm-up breaks every 45 minutes to restore circulation.If you have to sit for a long time, you need to choose the right chairs, chairs that provide 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 a night's sleep, you should 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 pull-ups when lifting weights from a semi-squatting position, use special belts that support the lower back;
• choosing the right orthopedic shoes: with the right width of 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 period of childbirth.In the summer, you should not neglect the possibility of walking barefoot on uneven surfaces;this strengthens the muscles of the foot and relieves tension from the musculoskeletal system;
• A proper diet and drinking regimen contribute to overall health and maintain normal metabolism;
• If you are prone to increased emotionality, anxiety with muscle spasm reaction to stress, it is worth learning relaxation methods, as well as regularly conducting restorative massage courses.