Osteochondrosis -degenerative-dystrophic damage to the tissues of the spine, characterized by damage to the intervertebral discs, adjacent articular surfaces and vertebral bodies, the ligamentous apparatus of the spine.
Most often, pathological processes in osteochondrosis first affect the bones and ligaments. We usually find out that the disease has already begun when complications appear - pain, sensory disturbances, muscle atrophy, and disruption of the internal organs.
Who suffers from osteochondrosis?
Nowadays, from 40 to 90% of the world's population suffer from osteochondrosis. Most often, the disease affects people over the age of 30. 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 annulus fibrosus, but the pathological process does not go beyond the intervertebral disc.
- The second stage in the development of osteochondrosis.
As a result of a decrease in the height of the disc, the attachment points of muscles and ligaments belonging to two adjacent vertebrae come closer. Therefore, the muscles and ligaments sag. This can lead to excessive mobility of the two vertebrae relative to each other, i. e. instability of the vertebral-motor segment is formed. This stage is characterized by slipping 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 primarily concern the intervertebral discs themselves: prolapses and protrusions of discs are formed. The articular apparatus of the vertebral-motor segment also suffers. In the intervertebral joints and unco-vertebral joints, subluxations occur, arthrosis is formed.
- The fourth stage in the development of osteochondrosis.
At this stage, adaptive changes occur in the affected segments of the spine. The body tries to overcome the excessive mobility of the vertebrae, to immobilize the spine to maintain its supporting and protective functions. In this regard, marginal bone growths appear on the adjacent surfaces of the vertebral bodies, in other words, osteophytes. An osteophyte grown up "in the wrong place" causes microtraumatization of the nerve root. At the fourth stage, the processes of fibrous ankylosis usually begin in the intervertebral discs and joints. Ultimately, the vertebral-motor segment turns out to be, as it were, walled up in a shell - the clinical manifestations subside.
Causes of osteochondrosis
In each of the many existing theories of the development of osteochondrosis, various causes are accepted that are responsible for the onset of the disease, for example, mechanical trauma, 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 both the elderly and young people, both physically fit 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 crunching and creaking in the joints, as if sand were poured between them, for many patients the only reason for this condition is the notorious "salt deposition". Such misconceptions are not at all harmless: the correct idea of \ u200b \ u200bthe ways of treating an ailment can be determined based on an analysis of the causes that caused it.
The term "osteochondrosis" comes from the Greek roots osteon - "bone" and chondr - "cartilage". The ending "-oz" means that the disease of the bone and cartilage is not associated with inflammatory processes, is degenerative-dystrophic in nature, that is, the basis of the disease is tissue malnutrition and, as a consequence, the degeneration of its structure. Like all living tissues, the bone tissue of the vertebrae and the cartilaginous tissue of the intervertebral discs are constantly rearranging and self-renewing. Under the influence of regular physical exertion, they acquire strength and elasticity, and in the absence of loads, the strength of the tissues decreases.
This is due to the peculiarities of nutrition and blood supply to bone and cartilaginous tissues. The discs of adults do not have their own vessels; they receive nutrients and oxygen from neighboring 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.
According to 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 surrounding it. Due to the deterioration of the nutrition of the intervertebral discs, the complex structure of biopolymer compounds that make up the nucleus pulposus is destroyed. The moisture content in the gelatinous core 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 these factors create the basis and form the cause for the development of osteochondrosis.
To restore the function of the spine, scarring of the damage to the intervertebral disc, mobilization of the compensatory capabilities of the spine, as well as of the musculoskeletal system as a whole, is necessary, and not the resorption of "salt deposits" or the elimination of "thorns" on the vertebrae. When conducting an X-ray examination after the end of treatment, it can be seen that the vertebrae have not changed their shape. And the notorious "thorns" are not the cause of osteochondrosis, but a consequence of adaptive processes. Marginal growths increase the area of the supporting surface of the vertebral body. Due to the increased area, the specific pressure decreases, which makes it possible to compensate for the decrease in the strength and elasticity of the intervertebral disc.
The degenerative-dystrophic changes occurring in the spine are accompanied by calcification (calcification) of damaged discs, individual sections of articular ligaments, cartilage, capsules. This process can only be called salt deposition. Thus, this is not the cause of osteochondrosis, but only a consequence and the final stage of the above process.
The reverse development of structural changes in the spine is almost impossible. But keeping them to a minimum is a very real challenge. If no effort is made to maintain the spine in the same condition as achieved with treatment, pain may recur.
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 annulus fibrosus and the posterior longitudinal ligament. Depending on the stage of degeneration of the intervertebral discs, irritation, compression or impaired conduction of the spinal cord roots, compression of the vessels or the spinal cord occur. Various neurological syndromes develop - reflex and compression.
The main cause of pain in osteochondrosis is the so-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 in the affected segment of the spine, etc. ).
Vascular disorders in osteochondrosis are often associated with impaired vasomotor innervation. Mechanical compression of blood vessels by osteophytes is also possible, for example, in the cervical spine.
Symptoms of osteochondrosis
One of the features of spinal osteochondrosis, aggravating the process, is its too 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 does not in any way associate pain in the region of the heart, abnormalities in the functioning of the genital organs, headaches, pain and numbness in the legs with osteochondrosis and in general with the spine, dealing with the "treatment" directly of the symptoms of osteochondrosis with the help of various kinds of painkillers, all kinds ofadvertised drugs, dietary supplements and other methods. But this path only exacerbates the situation. Osteochondrosis continues to develop, and the methods of treatment used, at best, simply do not lead to significant improvement, except for temporarily relieving pain, and in the worst case, they can further harm the body.
Thus, it is important to carefully analyze your condition and the changes taking place in it. It is necessary to start moving in the right direction: consult a doctor in a timely manner, undergo the necessary diagnostics and only after determining the correct diagnosis, start 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, pain can be of a periodic, unstable nature, then appearing, then disappearing. But already the first feeling of discomfort or pain in the spine should make you think. The appearance of the first pains is a signal to at least pay attention to it, try to remember the reason why they appeared. This can be caused by lifting a heavy object, sudden movement, falling, etc.
Another symptom of osteochondrosis is the accompaniment of discomfort or back pain with pain and numbness of the extremities (arms or legs). The pain most often radiates to the left limb, that is, to the left arm or leg. In addition, 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. In this case, it is especially important to pay attention to the nature of the change in pain depending on the patient's actions, comparing the sensations of pain in the back with pain, for example, in the leg. If the patient has been sitting for a long time and he has pain or numbness in the foot, discomfort in the lower back, and after a little warm-up or walk, the pain has disappeared, then this will be an indirect sign that determines lumbar osteochondrosis of the spine. The same picture can be with the neck and arm. Summing up, we can say that the main symptoms of osteochondrosis include pain and discomfort in the back. In the case when these symptoms coincide with pain in other parts of the body, osteochondrosis can be complicated by protrusion, disc herniation, with a pinched nerve.
Additionally, 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 malaise. After all, osteochondrosis can manifest itself weakly or not manifest at all for a long time. At the same time, it will continue to successfully develop in the spine, leading to the degradation of an increasing number of discs. Therefore, a timely visit to a doctor will allow diagnosing osteochondrosis at an earlier stage, which will facilitate its treatment.
Osteochondrosis and salt deposition
Osteophytes, or hooklike growths of the vertebrae, appear in order to reduce the load on the intervertebral discs. In this case, the appearance of osteophytes harms the mobility of the intervertebral joints.
The common opinion in everyday life that salt deposition is the main cause of osteochondrosis is erroneous. Therefore, the treatment of osteochondrosis using a salt-free diet is meaningless.
The most common complaints of osteochondrosis of the spine
The most common complaints in osteochondrosis are as follows:
- Discomfort in various parts of the spine. 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 in the limbs and various parts of the body, chilliness of the arms or legs.
- Pain radiating to the legs, along the nerve trunks.
- Pain radiating to the scapula, shoulder, as well as pain in the neck and back of the head.
- A frequent companion of cervical osteochondrosis are headaches, dizziness. 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 treatment, there is an increase in sexual power. In women, the normal functioning of the lumbosacral area increases the likelihood of conception and contributes to a comfortable pregnancy.
Diagnosis of osteochondrosis
To diagnose osteochondrosis, it is necessary to collect anamnesis. In this case, the establishment of the patient's complaints is of decisive importance. Certain symptoms of osteochondrosis are quite typical. Others, on the other hand, must be differentiated from the signs of other diseases. It is important that the nervous, vascular, trophic disorders that occur in osteochondrosis can simulate various diseases, such as angina pectoris, gastritis, gastric ulcer, acute surgical diseases of the abdominal organs. Therefore, in order to avoid misdiagnosis and subsequent prescription of the wrong treatment, each symptom must be subjected to a detailed analysis.
When collecting anamnesis, including the patient's complaints, the history of the current disease and the patient's life, the doctor pays attention to his age, since osteochondrosis develops more often in older people and on the evolution of symptoms from the moment of their occurrence until the moment the patient goes to 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 examinations 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:
Plain X-ray of the spine is the simplest X-ray method for diagnosing osteochondrosis. Its essence lies in obtaining an X-ray of the spinal column as a whole or its individual segments. Most often, sighting radiography is performed - based on the symptoms of the disease and the patient's complaints, the location of the spinal lesion is determined. On the X-ray image of the segment of the spine affected by osteochondrosis, one can see a decrease in the thickness (atrophy) of the intervertebral discs, manifested in the form of a decrease in the space between the vertebrae, the appearance of bone outgrowths of the vertebral bodies - osteophytes, partial dissolution - resorption of the bone tissue of the vertebral body, a change in the shape of the segment of the spine, for example, smoothing of the 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 damage to the spinal cord during the puncture of the spinal canal. Thanks to myelography, the internal structure of the spinal canal can be determined. This method is especially informative for the determination of spinal hernias.
Computed tomography and magnetic resonance imaging are the most modern, but also the most expensive and difficult to access methods for diagnosing osteochondrosis. These diagnostic methods are usually used when it is necessary to differentiate between osteochondrosis and 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 localization and degree of motor and sensory disorders.
Treatment of osteochondrosis
The clinic provides effective treatment for all forms of osteochondrosis. Treatment is carried out on an outpatient basis. The treatment is based on a comprehensive program aimed at quickly eliminating the underlying syndrome and the cause that causes 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 course of treatment is 10-15 sessions, and the elimination of acute pain syndrome is from 1 to 3 sessions.
The earlier the treatment is started, the better the result will be!
Is complete elimination of osteochondrosis real?
It depends on the form of the disease, the severity, correctness and timeliness of treatment. A complete cure is possible only in the initial stages.
But it is possible to prevent exacerbations of osteochondrosis, not to feel pain for years. If a person had osteochondrosis, but now he does not feel discomfort, this does not mean that he has passed without a trace. There may be changes in the spine.
The main task is to suspend the development of the disease and 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 of the arms, legs, headaches, etc. ).