Spinal osteochondrosis: symptoms and treatment

Osteochondrosis is a disease with extensive distribution, by the age of 35-40 it is found in varying degrees in most people. The most likely localization of osteochondrosis is the lower cervical, upper thoracic and lower lumbar spine. The etiology of osteochondrosis, that is, the specific causes and conditions of occurrence, is thoroughly unknown. However, there is a direct influence of hereditary predisposition, age-related changes, injuries and impaired blood supply to tissues.

In the development of the disease, the main role is played by changes in the central part of the intervertebral disc, namely, dehydration. Recall that the disc consists of the nucleus pulposus and the annulus fibrosus around it. Due to desiccation, the disk loses its shock-absorbing functions, which leads to gradual destruction. In the development of the disease, four stages are distinguished, differing in certain changes in the disc and in adjacent tissues. The severity of osteochondrosis of the spine, the symptoms and treatment directly depend on the stage of development of the pathology.

Symptoms and causes of osteochondrosis of the spine

Let us briefly consider the stages of progression of osteochondrosis in terms of anatomical changes.

• First stage. The formation of cracks in the inner layers of the fibrous ring and in the nucleus pulposus. Penetrating into the cracks, the nucleus irritates the nerve endings of the fibrous ring;
• Second phase. While further irritation of the annulus fibrosus occurs due to the pathology of the nucleus pulposus, the fixation of the vertebrae deteriorates. There is an unusual mobility of 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 a rupture of the ring occurs and the formation of an intervertebral hernia (extrusion);
• Fourth stage. There is a spread of degenerative changes to 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 is worth noting that some sources distinguish the fourth type - sacral osteochondrosis.

Symptoms

The severity and intensity of symptoms depends on
on the degree of damage to the intervertebral disc and surrounding tissues.

Cervical osteochondrosis	Thoracic osteochondrosis	Lumbar osteochondrosis
Aching or sharp pain in one muscle of the neck, or part of the neck, or the whole neck. Severe headaches. Nerve root syndrome: spread of pain to the collarbone, shoulder, one arm, etc. Cardiac syndrome, which is not stopped by taking glycerol trinitrate. "Heaviness", weakness or movement disorder in one of the arms. Symptoms of basilar artery insufficiency: dizziness, tinnitus, double vision, speech disorder, swallowing problems, hearing loss, loss of consciousness. Paresthesia of the upper limbs: sensation of numbness of the hands (one or both), goosebumps, tingling, false sensation of swelling of the limbs. Selective muscle atrophy and reduced limb reflexes.	The main types of osteochondrosis are considered to be cervical and lumbar. However, the thoracic spine is under constant stress and is prone to 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 manifest themselves at a late stage of the disease. In most cases, the disease occurs with an injury (for example, as a result of lifting too much weight). Short-term or long-term, aching or shooting pains in the back. Girdle pains in the chest. Pain in the chest wall, and pain in the region of the heart. Pain in the muscles in the back, radiating to the buttocks, groin, or thigh. Irradiation of pain in the region of the kidneys or gallbladder. Stiffness of the spine. Pain on movement and stooping. Pain and impaired sensitivity to pressure in the area of the affected area of the spine. Movement disorders, depending on the degree of damage to one or both legs. Failure of the internal organs: constipation and problems with urination. Slouch.	Anomalies are most often observed in the lumbar spine. Pain in the lower back, can be given to the groin, thigh, buttocks, lower leg. Often the pain radiates to one of the legs. Heaviness and stiffness of movements. Increase in body temperature in the acute period. Pain when probing IV-V lumbar vertebrae. Spasms of the muscles of the back. Weakness of the leg muscles. Changes in the vertebrae numbered III and IV cause pain when bending the knee joint in the supine position. Damage to the V vertebra leads to pain on the outer part of the leg up to the foot and loss of sensation. Violation of defecation and urination. Neuralgia of the sciatic nerve, unilateral or bilateral. Further development of the radicular syndrome may be atrophy of the muscles of the legs and impaired reflexes.

It was previously mentioned that the etiology of osteochondrosis is not completely known. However, we can name the main causes of osteochondrosis of the spine, with a proven effect on the development of the disease:

• Regular dynamic and static loads on the spine of varying intensity. For example, the work of a loader (carrying weights) or a miner (being in unnatural positions for hours and a huge physical load), a driver (vibration and a sedentary lifestyle) or an office worker (a sedentary sedentary lifestyle;
• back injury;
• Weak physical development or excess weight;
• Failure to maintain correct posture and stoop;
• Flat feet and muscle imbalance as a result, leads to an uneven distribution of the load on different parts of the spine;
• genetic features;
• Hypothermia leads to more intense symptoms of osteochondrosis;
• And finally, the process of human aging.

Diagnosis of osteochondrosis of the spine

Preliminary diagnosis of the disease (osteochondrosis) occurs on the basis of the patient's complaints, his examination and palpation of the spine. Also, the affected part of the spine can be identified due to the topography of the spread of pain, which is able to tell exactly where (in the vertebrae of the neck, chest, lower back) the compression of the nerves occurred.

The main diagnostic method for diagnosing osteochondrosis is an X-ray examination. On the radiograph of the spine, degenerative changes in the intervertebral joints, discs, narrowing of the intervertebral canal, sclerotic changes in the tissues of the spine are noticeable. At the same time, the recognition of spinal lesions (especially at an early stage) is always difficult, since the processes occurring in this case are characteristic of a number of other diseases (tumors, metastases, ankylosing spondylitis, tuberculosis lesions).

On the frontal x-ray images, the unevenness of the plates, an increase or sharpening of the uncinate processes are detected. In profile images, a decrease in height, a change in shape, a herniated disc, osteophytes and other changes in the vertebral body are noticeable. Small degenerative changes are not visible on a plain X-ray, and an X-ray examination using contrast is performed to detect them. The most complete information can be given by discography - an X-ray examination with the introduction of a contrast agent through a puncture directly into the intervertebral disc.

Another study of the spine is a functional X-ray method. Thanks to the radiograph 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, technologies are still being actively developed and improved, while remaining quite 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 is aimed at reducing and eliminating the consequences of changes in the intervertebral disc. Namely, inflammation, squeezing, poor blood flow, muscle spasms. Many types of therapy can help in this process, including the methods of oriental healers. 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, and others. Invasive therapy, that is, surgical operations, is rarely resorted to. 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: a neurologist, an orthopedist, a vertebrologist, a chiropractor and others. However, the diagnosis, the appointment of tests and studies, is usually carried out by a neurologist, as well as a vertebrologist, if a doctor of such a specialty is available in the clinic, due to his specialization in diseases of the spine.

Summing up, 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 squeezing;
5. Improved blood flow;
6. Prevention of further deterioration.

Let's take a 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 area of the affected spine, eliminating pain and relieving edema. Also, physiotherapy helps to reduce the doses of drugs used. There are dozens of types of physiotherapy. Here is some of them:

• Reflexology is the impact on acupuncture points with needles, electricity, laser. Helps relieve spasm and improve blood flow;
• Kinesitherapy is a treatment through movement and special physical exercises. In fact, this is therapeutic gymnastics, but in an expanded sense. This includes training on simulators, exercises in groups under the guidance of a doctor, stretching the spine;
• Therapeutic swimming. Allows you to perform exercises with damage to the spine for those 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 lifting force of water, there is a uniform distribution of loads on the spine;
• Therapy with impulse currents, UHF therapy, neurostimulation, magnetotherapy, massage, and others.

Acupuncture

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

Surgical intervention

Surgery is indicated only 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 a damaged disc. However, even after the operation using minimally invasive methods, rehabilitation 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 a specific defect: hernia, deformity, subluxation, etc. The operation does not affect the general process of degeneration of the cartilaginous tissue of the spine.

Medical treatment

This type of treatment is most effective in the short term. Medicines immediately reduce pain, eliminate inflammation, relieve spasms, etc. However, as soon as they are canceled, in the absence of other procedures necessary for the treatment of osteochondrosis, their effect will quickly disappear. At the same time, you can’t spend your whole life on drugs, sooner or later they will have a side effect on the body.

Medications can be classified as both primary and secondary treatment. They are often necessary to improve the patient's life. They are used to relieve pain (therapeutic blockade), eliminate inflammation, relieve muscle spasms, improve blood flow. In recent years, another type of medicine is increasingly being used - chondroprotectors. However, drugs alone cannot achieve a long-term permanent effect.

Treatment at home

Home treatment of osteochondrosis consists of manual therapy (exercise therapy, Shants collar), acupuncture and vacuum therapy. These methods help improve blood circulation and reduce congestion in the muscles and spine. As a result, tissue regeneration is significantly improved.

The listed procedures in combination with drugs provide an 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, the muscles and their circulatory system are strengthened. The latter is of great importance, becausethe spine is deprived of its blood supply system and the intervertebral disc can receive nutrients only through adjacent tissues. In this case, it is necessary to distinguish between therapeutic exercises and any other training.

Manual therapy

One of the most effective methods. Since the manual therapist affects the muscles, ligaments, and bones. It improves posture, restores the "normal" structure of the skeleton, relieves excess 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.