Osteochondrosis -degenerative-dystrophic damage of spinal tissues, characterized by damage to the intervertebral discs, adjacent articular surfaces and vertebral bodies, the ligament apparatus of the spine.
Most often, pathological processes in osteochondrosis first affect the bones and ligaments. The fact that the disease has already begun, we usually learn when complications appear - pain, sensory disturbances, muscle atrophy, breakdown of internal organs.
Who suffers from osteochondrosis?
Nowadays, 40 to 90% of the world's population suffers from osteochondrosis. Most often, the disease affects people over the age of 30 years. However, the first symptoms of osteochondrosis may appear in adolescence.
Stages of development of osteochondrosis of the spine
- The first stage in the development of osteochondrosis.
Dehydration of the pulposus nucleus begins. This leads to a reduction in disk height. Cracks appear in the ring fibrosis, 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 points of connection of the muscles and ligaments belonging to the two adjacent vertebrae come closer. Therefore, muscles and ligaments contract. This can lead to excessive movement of the two vertebrae in relation to each other, d. m. th. the instability of the vertebral-motor segment is formed. This stage is characterized by sliding 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 are mainly related to the intervertebral discs themselves: prolapses and discs are formed. The articular apparatus of the vertebral-motor segment also suffers. In the intervertebral joints and non-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 movement of the vertebrae, to immobilize the spine to maintain its supporting and protective functions. In this regard, marginal bone growths appear on adjacent surfaces of vertebral bodies, in other words, osteophytes. An adult osteophyte "in the wrong place" causes microtrauma to the nerve root. In stage four, fibrous ankylosis processes usually begin in the intervertebral discs and joints. After all, the vertebral-motor segment turns out to be, so to speak, walled in a shell - clinical manifestations subside.
Causes of osteochondrosis
In each of the many existing theories of the development of osteochondrosis, different causes are accepted that are responsible for the onset of the disease, for example, mechanical damage, hereditary predispositions 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 the young, both physically fit and less trained. There is a widespread belief that the cause of osteochondrosis is the deposition of salts in the spine: supposedly in X-rays, the salt can be seen in the form of "growths" or "hooks" in the vertebrae. If during movement there is a tearing and cracking in the joints, as if sand has been poured between them, for many patients the only reason for this condition is the infamous "salt deposition". Such misconceptions are by no means harmless: the exact idea of how to treat a disease 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 term "-oz" means that bone and cartilage disease is not associated with inflammatory processes, it is degenerative-dystrophic in nature, ie the basis of the disease is tissue malnutrition and, consequently, degeneration of its structure. Like all living tissues, vertebral bone tissue and intervertebral disc cartilage tissue are constantly being rearranged and renewed themselves. Under the influence of regular physical exertion, they gain strength and elasticity, and in the absence of loads, the strength of the tissue decreases.
This is due to the nutritional and blood supply properties of bone and cartilage tissue. Adult discs do not have their own vessels; they receive nutrients and oxygen from neighboring tissues. Therefore, for proper disc nutrition, it is necessary to activate blood circulation to the tissues around 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: this is the gelatinous nucleus that gives the disc elasticity, placed in the center and the strong fibrous ring that surrounds it. Due to the deterioration of the nutrition of the intervertebral discs, the complex structure of the biopolymer compounds that make up the pulposus nucleus is destroyed. The moisture content in the gelatinous nucleus decreases and becomes more brittle. When exposed to even small 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 form the basis and form the cause for the development of osteochondrosis.
To restore spinal function, indentation of intervertebral disc damage, mobilization of the compensatory abilities of the spine, as well as the musculoskeletal system as a whole, is necessary, and not resorption of "salt deposits" or elimination of "thorns"in beads. When you perform an X-ray examination after the end of treatment, it can be seen that the vertebrae have not changed their shape. And the infamous "thorns" are not the cause of osteochondrosis, but a consequence of adaptive processes. Marginal growths increase the supporting surface area of the vertebral body. By increasing the area, the specific pressure decreases, which makes it possible to compensate for the decrease in the strength and elasticity of the intervertebral disc.
Degenerative-dystrophic changes that occur in the spine are associated with 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 attempt is made to keep the spine in the same condition as achieved with the treatment, the pain may recur.
Clinical manifestations of osteochondrosis
The clinical manifestations of osteochondrosis are very different. 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 fibrosus ring 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 spinal cord occurs. Various neurological syndromes develop - reflex and compression.
The main cause of pain in osteochondrosis is the so-called irritation of the nerve root. In this case, circulatory disorders occur, edema appears 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 nervousness. Mechanical compression of blood vessels by osteophytes, for example, in the cervical spine, is also possible.
Symptoms of osteochondrosis
One of the features of spinal osteochondrosis that aggravates the process is its very broad symptomatology. The disease can appear in completely different parts of the body. It may be pain or numbness in the extremities or disorders and pain in the internal organs. At the same time, often a person does not associate in any way pain in the region of the heart, abnormalities in the functioning of the genitals, headaches, pain and numbness in the legs with osteochondrosis and generally with the back, dealing with "treatment" directlyof symptoms of osteochondrosis with the help of various types of pain relievers, all kinds of advertised drugs, dietary supplements and other methods. But this road only worsens the situation. Osteochondrosis continues to develop, and the treatment methods used, at best, simply do not lead to significant improvement, other than temporary pain relief, and at worst, they can further damage the body.
Thus, it is important to carefully analyze your condition and the changes that occur in it. It is necessary to start moving in the right direction: consult a doctor at the right time, go through the necessary diagnosis 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, back pain and discomfort. At the same time, the pain may be of a periodic, unstable nature, now appear, then disappear. But already the first feeling of discomfort or back pain should make you think. The appearance of the first pains is a signal to at least pay attention, 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 association of discomfort or back pain with pain and numbness of the extremities (arms or legs). The pain most often radiates to the left limb, i. e. to the left arm or leg. In addition, pain can appear in the region of the heart, in the back and not only in the region of the back, but for example, in the ribs, etc. It is especially important in this case to pay attention to the nature of the pain change depending on the actions of the patient, comparing the sensations of back pain with pain, for example, in the legs. If the patient has been sitting for a long time and he has pain or numbness in the legs, discomfort in the lower back and after a little warming up or walking, the pain is gone, then this will be an indirect sign defining lumbar osteochondrosis ofspine. The same picture can be with the neck and arm. In summary, the main symptoms of osteochondrosis include back pain and discomfort. In case these symptoms coincide with pain in other parts of the body, osteochondrosis can be complicated by elongation, disc herniation, with an embedded nerve.
In addition, I would like to draw attention to the fact that even with the appearance of the first back pain, it is necessary to pay special attention to this disease. Above all, osteochondrosis may present poorly or not at all for a long time. At the same time, it will continue to develop successfully in the spine, leading to the degradation of an increasing number of discs. Therefore, a timely visit to a doctor will allow the diagnosis of osteochondrosis at an early stage, which will facilitate its treatment.
Osteochondrosis and salt deposition
Osteophytes, or growths like vertebral circles, appear in order to reduce the load on the intervertebral discs. In this case, the appearance of osteophytes impairs the movement of the intervertebral joints.
The common thought in everyday life that salt deposition is the leading cause of osteochondrosis is wrong. Therefore, treating osteochondrosis using a salt-free diet is pointless.
The most common complaints of osteochondrosis of the spine
The most common complaints in osteochondrosis are as follows:
- Discomfort in different parts of the back. The pain can vary from small, dull, attractive to strong, sometimes very strong and unbearable - with lumbago.
- Increased fatigue at work, physical and mental.
- Sensory damage to limbs and various parts of the body, coldness of hands or feet.
- Pain radiating to the legs, along the nerve trunks.
- Radiating pain in the shoulder, shoulder, as well as pain in the neck and back of the head.
- A frequent accompaniment of cervical osteochondrosis are headaches, dizziness. Increased visual fatigue or decreased visual sensitivity 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 potency. 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 a medical history. In this case, it is essential to determine the patient's complaints. Certain symptoms of osteochondrosis are quite typical. On the other hand, others need to be differentiated from the signs of other diseases. Importantly 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 description of mistreatment, each symptom must undergo a detailed analysis.
When collecting anamnesis, including patient complaints, current disease history, and patient life, the physician pays attention to his or her age, as osteochondrosis develops more frequently in older people and the evolution of symptoms from the time of onset until the patientgo to the doctor. For osteochondrosis, slow development is characteristic, in which periods of deterioration 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 the X-ray examination. There are several types of X-ray method for the diagnosis of this disease:
Plain spine radiography is the simplest X-ray method for diagnosing osteochondrosis. Its essence lies in obtaining a radiograph of the spine as a whole or its individual segments. Most often, radiography of the eye is performed - based on the symptoms of the disease and the patient's complaints, the location of the spinal cord injury is determined. In the X-ray image of the spinal segment affected by osteochondrosis, a decrease in the thickness (atrophy) of the intervertebral discs can be seen, which is manifested in the form of a decrease in the space between the vertebrae, the appearance of bones, increases in vertebral bodies - osteophytes, partial disintegration - resorption of bone tissue of the vertebral body, a change in the shape of the spinal segment, for example, softening 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 spinal cord injury during spinal canal drilling. Thanks to myelography, the internal structure of the spinal canal can be determined. This method is especially informative for determining spinal hernias.
Computed tomography and magnetic resonance imaging are the most modern methods, but also the most expensive and difficult to achieve for the diagnosis of osteochondrosis. These diagnostic methods are usually used when it is necessary to distinguish between osteochondrosis and other diseases of the spine, which have similar symptoms, for example, spinal canal tumors.
For a comprehensive assessment of the patient's condition, it is mandatory to perform a neurological examination of the patient with osteochondrosis. Thanks to a neurological consultation, it is possible to clarify the localization and extent of motor and sensory disorders.
Treatment of osteochondrosis
The clinic offers effective treatment for all forms of osteochondrosis. Treatment is performed on an outpatient basis. Treatment is based on a comprehensive program aimed at the rapid elimination of the underlying syndrome and the cause that causes the suffering. The following methods can be used as part of complex therapy:
- acupuncture;
- vacuum therapy;
- gentle manual therapy techniques (post-isometric relaxation);
- laser therapy;
- pharmacopuncture;
- dry traction;
- magnetopuncture;
- electrical stimulation and other treatment methods.
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 starts, the better the result will be!
Is complete elimination of osteochondrosis true?
It depends on the form of the disease, the severity, the correctness and the timing of treatment. A complete cure is possible only in the initial stages.
But it is possible to prevent the exacerbations of osteochondrosis, not to feel pain for years. If a person had osteochondrosis but now he does not feel discomfort, it does not mean that he has passed without leaving 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 subside (back pain, cold sores and numbness of the hands, feet, headache, etc. ))