Osteochondrosis of the spine: symptoms and treatment

Osteochondrosis is a disease with a wide distribution, at the age of 35-40 it is found in various stages in most people. The most likely localization of osteochondrosis is the lower cervical spine, upper thoracic and lower lumbar spine. The etiology of osteochondrosis, that is, the cause and specific circumstances of the occurrence, is not fully known. However, there is a direct influence of hereditary predisposition, age-related changes, injuries and disruption of blood supply to tissues.

In the development of the disease, the main role is played by changes in the middle part of the intervertebral disc, that is, dehydration. Remember that the disc consists of the nucleus pulposus and the annulus fibrosus around it. Due to drying, the disc loses its shock-absorbing function, which leads to gradual destruction. In the development of the disease, four stages are distinguished, differing in certain changes in the disc and in the adjacent tissue. The severity of osteochondrosis of the spine, symptoms and treatment directly depend on the level of development of the pathology.

Symptoms and causes of osteochondrosis of the spine

Let's briefly consider the stages of development of osteochondrosis in terms of anatomical changes.

• First stage. Formation of fissures in the inner layer of the fibrous ring and in the nucleus pulposus. Penetrating into the fissure, the nucleus irritates the nerve endings of the fibrous ring;
• The second phase. Although further irritation of the annulus fibrosus occurs due to the pathology of the nucleus pulposus, the fixation of the vertebrae deteriorates. There is unusual mobility in the spine;
• Third stage. Gradual damage to the annulus fibrosus. There is a protrusion of the nucleus (protrusion) beyond the anatomical boundaries of the fibrous ring, and then the rupture of the ring occurs and the formation of an intervertebral hernia (extrusion);
• Fourth stage. There is a spread of degenerative changes in the surrounding tissues - vertebrae, ligaments, nerves, blood vessels. As a result of chronic inflammation, the intervertebral disc is scarred, which leads to the development of fibrosis.

Depending on the location in the spine, there are 3 types of osteochondrosis:

1. cervical osteochondrosis;
2. Thoracic osteochondrosis;
3. Lumbar osteochondrosis.

It should be noted that some sources distinguish a fourth type - sacral osteochondrosis.

symptoms

The severity and intensity of symptoms depends on
at the level of damage to the intervertebral disc and surrounding tissue.

Cervical osteochondrosis	Thoracic osteochondrosis	Lumbar osteochondrosis
Pain or sharp pain in one neck muscle, or part of the neck, or the entire neck. Severe headache. Nerve root syndrome: the spread of pain to the collarbone, shoulder, one arm, etc. Cardiac syndrome, which is not stopped by taking glycerol trinitrate. "Heaviness", weakness or impaired movement in one of the arms. Symptoms of basilar artery deficiency: dizziness, tinnitus, double vision, speech disorders, swallowing problems, hearing loss, loss of consciousness. Paresthesia of the upper limbs: sensation of numbness of the hand (one or both), tingling, tingling, false sensation of limb swelling. Selective muscle atrophy and reduced limb reflexes.	The main types of osteochondrosis are cervical and lumbar. However, the thoracic spine is under constant pressure and prone to the early development of gross degenerative changes, especially in young people. Due to the peculiarities of the development of changes in the thoracic spine, neurological symptoms appear in the late stages of the disease. In most cases, this disease occurs with an injury (for example, as a result of lifting too much weight). Short-term or long-term, pain or shooting pain in the back. Lumbar pain in the chest. Pain in the chest wall, and pain in the heart area. Pain in the muscles in the back, radiating to the buttocks, groin, or thighs. Radiating pain in the kidney or gall bladder area. Spinal stiffness. Pain on movement and bending. Pain and sensitivity to pressure in the affected spinal area. Impairment of movement, depending on the degree of damage to one or both legs. Internal organ failure: constipation and urinary problems. Slouch.	Anomalies are most often observed in the lumbar spine. Pain in the lower back, can be given in the thigh gap, thighs, buttocks, lower legs. Often the pain radiates to one of the legs. Weight and stiffness of movement. Increased body temperature in the acute period. Pain when examining IV-V lumbar vertebrae. Back muscle spasms. Leg muscle weakness. Changes in vertebrae number III and IV cause pain when bending the knee joint in a supine position. Damage to the V vertebra leads to pain on the outside of the leg down to the foot and loss of sensation. Violation of defecation and urination. Sciatic neuralgia, unilateral or bilateral. Further development of radicular syndrome may atrophy leg muscles and impaired reflexes.

It has been mentioned before that the etiology of osteochondrosis is not fully known. However, we can name the main causes of osteochondrosis of the spine, with a proven effect on the development of the disease:

• Constant dynamic and static loads on the spine with varying intensities. For example, the work of a loader (carrying heavy loads) or a miner (being in an unusual position for many hours and a large physical load), a driver (vibration and a sedentary lifestyle) or an office worker (a sedentary sedentary lifestyle;
• back injury;
• Poor physical development or overweight;
• Failure to maintain proper posture and bending;
• Flat feet and muscle imbalances as a result, lead to an uneven distribution of load on different parts of the spine;
• genetic characteristics;
• Hypothermia leads to more intense symptoms of osteochondrosis;
• And finally, the human aging process.

Diagnosis of osteochondrosis of the spine

Early diagnosis of the disease (osteochondrosis) is based on the patient's complaints, examination and palpation of the spine. Also, the affected part of the spine can be identified due to the topography of the distribution of pain, which can tell exactly where (in the vertebrae of the neck, chest, lower back) nerve compression occurs.

The main diagnostic method for diagnosing osteochondrosis is X-ray examination. On radiography of the spine, degenerative changes in the intervertebral joints, discs, narrowing of the intervertebral canal, sclerotic changes in the spinal tissue are noticeable. At the same time, the recognition of spinal lesions (especially in the early stages) is always difficult, because the process that occurs in this case is characteristic of several other diseases (tumors, metastases, ankylosing spondylitis, tuberculosis lesions).

On the front x-ray image, the unevenness of the plate, the increase or sharpening of the uncinate process is detected. In the profile image, a decrease in height, changes in shape, herniated discs, osteophytes and other changes in the vertebral body are noticeable. Small degenerative changes are not visible on plain X-rays, and X-ray examinations using contrast are performed to detect them. The most complete information can be provided by discography - an X-ray examination with the introduction of a contrast agent through a direct puncture into the intervertebral disc.

Another study of the spine is the functional X-ray method. Thanks to radiographs taken with maximum flexion and extension of the spine, it is possible to determine the mobility or immobility of the intervertebral space.

The most modern and high-tech research methods are computed tomography (hereinafter referred to as CT) and magnetic resonance imaging (hereinafter referred to as MRI). Although the first CT and MRI machines appeared in the 70s and 80s, the technology is still being actively developed and improved, while still being relatively inaccessible to the general population due to the high cost of examinations or the lack of machines in local hospitals.

Methods of treatment of osteochondrosis of the spine

Treatment of osteochondrosis is a long periodic complex process. It aims to reduce and eliminate the consequences of changes in the intervertebral disc. That is, inflammation, squeezing, poor blood flow, muscle spasms. Many types of therapy can help in this process, including oriental healing methods. In the treatment of osteochondrosis, the patient needs complete rest.

For the most part, treatment occurs with non-invasive methods, such as drug therapy, antiparasitic therapy, exercise therapy, etc. Invasive therapy, that is, surgery, is rarely used. For example, in such cases when the intervertebral hernia persists for more than six months and conservative treatment does not give a positive effect.

Osteochondrosis of the spine and its treatment are carried out by doctors of various specialties: neurologists, orthopedists, vertebrologists, chiropractors and others. However, the diagnosis, appointment of tests and studies, are usually carried out by neurologists, as well as vertebrologists, if such specialist doctors are available in the clinic, because of their specialization in spinal diseases.

In conclusion, we can say that the treatment of osteochondrosis is divided into the following main categories:

1. Reduction of pain syndrome;
2. Removal of spasms;
3. Elimination of inflammation;
4. Reduction of flushing;
5. Better blood flow;
6. Prevention of further deterioration.

Let's look at commonly used treatments, each covering one or more of the items on this list.

Physiotherapy treatment

Physiotherapy procedures are aimed at improving blood microcirculation in the affected spinal area, eliminating pain and relieving edema. Also, physiotherapy helps reduce the dose of medication used. There are dozens of types of physiotherapy. Here are some of them:

• Reflexology is the effect on acupuncture points with needles, electricity, lasers. Helps relieve spasms and increase blood flow;
• Kinesitherapy is treatment through movement and special physical exercises. Actually, this is therapeutic gymnastics, but in an expanded sense. This includes training on simulators, training in groups under the guidance of a doctor, stretching the spine;
• Therapeutic swimming. Allows you to perform exercises with damage to the spine for patients who find it difficult to do them. For example, the elderly, people who are overweight or have motor disabilities. It is important to note that due to the buoyancy of the water, there is a uniform distribution of the load on the spine;
• Therapy with impulse current, UHF therapy, neurostimulation, magnetotherapy, massage, etc.

Acupuncture

A unique method that comes from oriental medicine. Its essence lies in the use of very thin special needles that enter special points of the body, literally, under the influence of gravity. These things were discovered by thousands of years of experience of Eastern healers, then proved by official medicine. Acupuncture helps to eliminate even painful pain, has a positive effect on the nervous system as a whole and neurological diseases.

Surgical intervention

Surgery is only indicated if there is no positive effect from non-invasive treatment or in case of severe complications. The main method of surgical treatment is discectomy - removal of the damaged disc. However, even after an operation using minimally invasive methods, recovery will take at least 6 months.

At the same time, surgery will not eliminate the need for regular treatment of osteochondrosis. Since before the operation there is always a clear task to eliminate certain defects: hernia, defect, subluxation, etc. The operation does not affect the general process of degeneration of the cartilage tissue of the spine.

Medical treatment

This type of treatment is most effective in the short term. Medicines immediately reduce pain, relieve inflammation, relieve spasms, etc. However, as soon as it is canceled, if no other procedures are needed for the treatment of osteochondrosis, the effect will disappear quickly. At the same time, you can't spend your whole life on drugs, sooner or later they will have side effects on the body.

Medicines can be classified as primary and secondary treatment. They are often needed to improve the patient's life. They are used to relieve pain (therapeutic restrictions), eliminate inflammation, relieve muscle spasms, increase blood flow. In recent years, another type of drug is increasingly used - chondroprotectors. However, drugs alone cannot achieve long-term permanent effects.

Treatment at home

Treatment of osteochondrosis at home consists of manual therapy (exercise therapy, Shants collar), acupuncture and vacuum therapy. This method helps improve blood circulation and reduce congestion in the muscles and spine. As a result, tissue regeneration is significantly improved.

The procedures listed in combination with medications provide effective treatment that relieves unpleasant symptoms and improves the general condition. In this case, special attention should be paid to proper nutrition and regulation of excess weight.

Physiotherapy

Thanks to gymnastics, the mobility of the vertebrae is restored, their muscles and circulatory system are strengthened. The latter is very important, because the spine loses its blood supply system and the intervertebral disc can receive nutrients only through the adjacent tissue. In this case, it is necessary to distinguish between therapeutic exercises and other exercises.

Manual therapy

One of the most effective methods. Because manual therapists affect muscles, ligaments, and bones. It improves posture, restores the "normal" structure of the skeleton, relieves excessive muscle tension. Including, it directly affects the vertebrae.

Manual therapy of osteochondrosis should be carried out regularly, from once a year to several, depending on the need. It should be noted that this is not a one-time procedure, multidimensional, lasting 10-20 sessions. Only then will it have a positive long-term effect.