Why does osteochondrosis occur and how is it treated?

Osteochondrosis is a disease characterized by degenerative-dystrophic changes in the cartilage tissues of the spine, as well as 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 can appear earlier, especially in the back, legs, as a result of long-term uneven loads and 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 vertebral tissues.

The main symptom that indicates the development of osteochondrosis of the disease is pain in the neck, back and lower back;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 disturbances, dysfunctions of internal organs provoked by compression and displacement begin.In the absence of timely treatment, osteochondrosis becomes 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 one hand, incorrect sitting position, sleeping on an overly soft mattress, high pillow, and wearing anatomically incorrect shoes.

Additional risk factors include physical inactivity, sedentary lifestyle, overweight, back injuries, lower limbs, flat feet, and other musculoskeletal disorders, as well as age-related degenerative processes due to age-related changes in blood supply to the spine.

The following factors can 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 active growth, scoliosis;
• wearing uncomfortable shoes (narrow, heels);
• prolonged and/or regular dehydration;
• poor diet, hypovitaminosis;
• smoking;
• pregnancy, especially multiple pregnancy, together with an underdeveloped musculo-ligamentous apparatus (due to a shift in the body's center of gravity).

Stages of development of osteochondrosis

In the dynamics of the disease, osteochondrosis goes through four stages:

• Stage 1 (degree) osteochondrosis is characterized by the initial stage of pathology in the nuclear pulp of the intervertebral disc.Due to the excessive load, the process of dehydration of the nucleus begins, which causes a decrease in the height of the disk and the appearance of cracks in the fibrous ring.At this stage, there are usually no symptoms;slight discomfort may occur during a long stay in an uncomfortable static position or active movement;
• In stage 2, the decrease in the height of the discs causes the distance between the vertebrae to decrease and the spinal muscles and ligaments to sag.This leads to 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 occur, especially with certain types of load, movements, positions;
• The 3rd stage (degree) of osteochondrosis is characterized by the formation of prolapses and protrusions of the intervertebral discs and may be accompanied by the development of subluxation and/or arthrosis of the intervertebral joints.With some types of movement, patients may experience stiffness, lack of mobility, 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 vertebral hypermobility and adapt to the impaired functionality of the spine.Osteophytes, new bone formations, improve the fixation of the vertebrae, are formed at the contact points of the vertebrae.However, in some cases, osteophytes can cause nerve compression and damage to the vertebrae.Fibrous ankylosis begins in the intervertebral discs and joints.In the absence of microtraumas and pinched nerve roots, the symptoms of the disease decrease.

Symptoms of osteochondrosis

The main symptoms of osteochondrosis are discomfort and/or pain in the neck and back.The severity of feelings and the presence of additional symptoms depend on the stage of the disease.When examining the patient and taking an anamnesis, the specialist makes a preliminary diagnosis suggesting the presence of osteochondrosis with the curvature observed in the transverse or longitudinal plane of the spine.Pathologies of the intervertebral discs of the cervical and lumbar vertebrae are more common than degenerative and dystrophic changes in the sternum.

Symptoms of osteochondrosis experienced by the patient include periodic or constant fatigue, mild or severe pain, depending on the stage of the disease.Pain can be localized in the neck, back, chest, shoulder girdle, which makes it difficult and restricts the movements of the upper limbs.

The clinical picture of osteochondrosis mainly depends on the localization of the pathology, the degree of development of the process and the individual characteristics of the patients.Pathology of intervertebral discs, displacements, protrusions, tears and growth of osteophytes lead to various consequences.Among the most common, there is a violation of normal blood circulation in tissues, compression of nerve endings, dysfunction of the spinal canal, edema, fibrosis of tissues and structures.Such results can be accompanied by many different symptoms, which leads to wrong diagnosis of diseases.

The most common and characteristic symptoms of osteochondrosis include:

• pain in the back, neck, back, shoulder girdle, ribs;
• anxiety, stiffness in body movements occurring in certain body positions, bending, turning, increased muscle tension;
• numbness in the upper and lower limbs;
• discomfort in muscles and joints, muscle spasms;
• headache, dizziness, increased fatigue;
• pain in the heart region;
• violation of the sensitivity of the hands;
• muscle hypotonia.

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

• with osteochondrosis of the cervical spine, pain prevails in the neck, arm and shoulder girdle, spreading to the scapula and shoulder area;headache, dizziness, flashing "spots" or spots before the eyes and tinnitus are noted;
• if the thoracic spine is damaged, the pain is localized in the chest, heart, inner surface of the shoulder, in the axilla, respiratory discomfort is also noted, shortness of breath is possible;
• Osteochondrosis of the lumbar-sacral spine is manifested by lower back pain that spreads to the legs, upper thighs or pelvic organs, often accompanied by sexual dysfunction.

Superficial symptoms - back fatigue, 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 not related to the degeneration of intervertebral discs.The diagnosis of "osteochondrosis" can only be made by a specialist, and self-treatment for such symptoms is unacceptable.

Classification of osteochondrosis

Types of osteochondrosis differ according to several principles.Depending on the location of the pathology, osteochondrosis of cervical, thoracic, lumbar, sacral or mixed, combined diseases is distinguished.According to clinical manifestations, osteochondrosis of different localizations is divided into subtypes according to 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 defined with different manifestations (vegetative-vascular, neurodystrophic, muscle-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 muscle-tonal manifestations;
• with radicular-discogenic damage to the roots of the breast.

The following diagnosis is made for osteochondrosis of the lumbar-sacral level:

• 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 radiculoischemia.

Diagnosis of osteochondrosis

Instrumental examination methods are used to make a 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 pathology include:

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

Treatment directions for osteochondrosis

Treatment is based on an integrated approach and, depending on the stage, 1 to 3 months of intensive therapy and 1 year of supportive measures to consolidate the result and prevent relapses.

Treatment of osteochondrosis is carried out in two ways, depending on the degree of osteochondrosis and the patient's health.Conservative treatment of the disease consists of taking medicine and performing a number of exercises.In almost any case, surgical treatment cannot be the method of first choice and is prescribed when there is no 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 necessary measures for rehabilitation.

Conservative treatment of osteochondrosis

Conservative therapy aims to relieve pain, normalize the functionality of the spine and prevent negative changes.

Conservative treatment of osteochondrosis includes the following types of therapy:

• drug treatment.Medicines for osteochondrosis are used to eliminate pain syndromes, inflammatory processes in tissues and normalize metabolic processes of the body.In case of severe pain syndrome, it is recommended to use drug blockades of nerve endings, which helps to reduce the severity of muscle-tonic syndrome.The following types of blockade are distinguished: trigger point blockade, intraosseous, facet, paravertebral, epidural;
• physiotherapy methods.Physiotherapy procedures help to reduce pain, increase the effect of drugs and are also used during the rehabilitation period.The most common uses are ultrasound waves, magnetic fields, low-frequency currents, and laser beams;
• physical therapy (physical therapy) and kinesitherapy methods.A set of special exercises, if performed regularly and correctly, helps to correct posture, strengthen the muscle corset, ligament 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 location of the vertebrae and the discs between them, and equal distribution of the load in the musculoskeletal system;
• massage.Hand massage techniques are used to improve tissue blood supply, relieve muscle spasms and tension, and generally improve blood circulation.Hydromassage as a direction of therapeutic activity, in addition to the listed effects, helps to normalize the work of the body's nervous system;
• manual therapy.Manual therapy methods are selected individually.Targeted effect on the body's musculoskeletal system helps to improve blood circulation, lymph circulation, improves metabolism, helps to improve the mobility of the musculoskeletal system, strengthens the immune system and serves as a means of preventing complications of osteochondrosis;
• traction therapy(stretching) of the spine using special equipment.The purpose of the manipulations is to increase the intervertebral space to normal parameters and correct the structural disorders of the spine.

Osteochondrosis: drug treatment

Medicines in the treatment of osteochondrosis are aimed at reducing the severity of symptoms, improving blood supply to tissues and their regeneration processes.Osteochondrosis cannot be treated by medication alone;The therapy complex should be combined, including exercises, diet and preventive measures.

In the absence of obvious dystrophic changes and pain, taking drugs without a specialist's prescription may be considered unreasonable.

Medicines used to relieve pain and treat osteochondrosis:

• anti-inflammatory group;
• antioxidant preparations: vitamins C (as 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 cartilage tissue degeneration, hyaluronic acid.

Medicines can be prescribed as ointments and creams for local use for pain, as well as for oral administration and injection.

In case of acute complications, drugs are used to close 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 high 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 have a negative effect on the affected tissues.You need to 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.In particular, it is recommended to include meat and fish jelly, jellied meat, jellied dishes in the diet, 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, salty foods and spices, canned and smoked foods, strong meat broths, legumes, sugar and fruits with high sugar content (grapes).During the day, you should drink at least 1.5 liters of liquid, giving preference to pure and mineral water, dried fruit compotes, sugar-free fruit drinks and herbal teas.You should limit the amount of strong black tea, coffee, sweet carbonated drinks and alcohol.

Complications of osteochondrosis

Non-compliance with the prescribed treatment, long-term avoidance of the doctor and lack of treatment for osteochondrosis contribute to the progression of the disease and lead to the development of complications, pathologies and new diseases, for example:

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

Although 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 disability of the patient.

Prevention of osteochondrosis

The causes of osteochondrosis are mainly related to not paying attention to the body's requirements, improper 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 follow the general principles of a healthy lifestyle:

• eliminating the possibility of physical inactivity: moderate sports: sports, running, swimming, cycling, skiing, gymnastics, non-contact wrestling, etc.;
• During work or other activities that involve staying in a static position for a long time, 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 support the spine, ensure compliance with the standards regarding 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 night sleep, it is necessary to choose a flexible, preferably orthopedic, mattress with a flat surface, avoid high or very flat pillows;
• if necessary, lift and/or carry heavy objects, avoid jumping when lifting weights in a semi-squatting position, use special belts that support the lower back;
• correct selection of orthopedic shoes: with a suitable width for the foot, without high heels and changing them on time will help reduce the load on the spine, which is especially important for women during childbirth.In summer, you should not neglect the opportunity to walk barefoot on uneven surfaces;it strengthens the leg muscles and relieves tension from the musculoskeletal system;
• A proper diet and drinking regimen contributes to overall health and helps maintain a normal metabolism;
• If you are prone to increased emotionality, anxiety with muscle spasmodic response to stress, it is worth learning relaxation techniques, as well as regularly taking restorative massage courses.