Osteochondrosis

Most cases of unpleasant pain in the lumbar region and spine are associated with a disease such as osteochondrosis.It affects about 40% of men and women aged 30-40 years and about 90% of older people.Therefore, the earlier the disease is diagnosed, the more thoroughly the patient is examined, the higher the likelihood of stopping the progression of osteochondrosis and maintaining activity at an older age. 

Definition of disease, cause of disease

So, what is osteochondrosis, where does it develop, what structures are affected, what is the treatment method?The disease affects the spine and tissues between the vertebrae and is expressed in a violation of their shape, density, elasticity, and sometimes even integrity.As a result, the distance between the vertebrae is reduced, the spinal column gradually loses stability, pinched nerves and the formation of hernias can develop, which is accompanied by back pain and discomfort during movement.

To briefly describe the essence of osteochondrosis, it is the gradual abrasion of the tissues of the intervertebral discs (cartilage), leading to instability of the spine.In the absence of treatment, degradation of ligaments and joints develops, osteophytes appear, posture is disturbed, and movements are accompanied by pain. 

Causes of spinal osteochondrosis:

• inactive lifestyle with a lack of muscle load;
• spinal injuries;
• systematic intense loads on the spine;
• heredity;
• overweight;
• hypothermia;
• hormonal and autoimmune diseases;
• toxic poisoning;
• congenital connective tissue deficiency;
• psychosomatic reasons (stress, depression, etc.).

Symptoms of osteochondrosis

The disease is characterized by periods of remission and exacerbation with varying degrees of severity of symptoms.The main symptoms of spinal osteochondrosis, characteristic of the main types of disease, lumbar, cervical and thoracic:

• pain localized in a certain area of the spine;
• referred pain syndrome associated with damage to nearby musculoskeletal tissues;
• myelopathy and radiculopathy, arising as a result of compression of the nerve endings of the spinal cord and blood vessels. 

Depending on which part of the spine is affected by the disease, the list of symptoms of osteochondrosis may vary.Namely: patients note tingling in the muscles, numbness in the limbs, other sensory disorders, decreased strength in the arms and legs, attacks of headaches and heart pain, aching lumbar pain.

Pathogenesis of osteochondrosis

Before the elastic fibrous core of the intervertebral disc begins to lose elasticity and deform, a number of processes suggestive of osteochondrosis occur in the human body:

• spasms, dystonia, inflammation;
• decreased blood circulation;
• damage to nerve cell processes.

Next, cracks appear on the deformed fibrous ring, disc protrusion develops, and a hernia forms.Typically, such predisposing factors for spinal disease develop in childhood or adolescence and are often the result of poor posture, scoliosis, sports injuries, infectious diseases or congenital vascular pathologies.

Stages of osteochondrosis

There are three stages of development of spinal osteochondrosis:

• the first, in which the intervertebral disc begins to decrease in height, acquiring a flattened shape, loses moisture, elasticity, and can bulge;
• the second develops in the absence of treatment and is manifested by a violation of the structure of the fibrous ring of the vertebral disc, the appearance of cracks and the development of instability of a certain area of the spine;
• characterized by ruptures of intervertebral cartilage, the development of a hernia, and the formation of bone processes of osteophytes. 

Symptoms of the development of spinal osteochondrosis become more intense from the first to the third stage. 

Classification of osteochondrosis

The classification of osteochondrosis is based on several signs, the main one of which is the localization zone.There are:

• lumbar osteochondrosis;
• osteochondrosis of the cervical spine;
• osteochondrosis of the thoracic spine.

Osteochondrosis in the lumbar spine is manifested by pain in the lumbar region, which intensifies when turning the body or lifting heavy objects.The pain can radiate to the leg or both legs and is characterized as aching.In case of severe syndrome, a hernia is suspected.With lumbar osteochondrosis, spasms in the leg muscles and peeling of the skin often occur.

With the development of spinal osteochondrosis in the cervical region, vertebrae 1-7 are affected.The disease is accompanied by a headache in the back of the head, pain in the neck, collarbones, and shoulders.There may be a crunching sound when turning the head, numbness of the upper extremities, and a feeling of a lump in the throat.

With osteochondrosis of the spine in the thoracic region, the patient is bothered by pain in the chest, shoulders, armpits, and heart.There may be a feeling of difficulty breathing and the development of attacks of intercostal neuralgia. 

Osteochondrosis in the lumbar spine is the most common, in the thoracic spine it is the rarest.

Complications of osteochondrosis

If the patient thinks about treating osteochondrosis too late, when the symptoms of the disease are pronounced, the following complications may develop:

• intervertebral hernia;
• spinal cord stroke;
• spinal kyphosis;
• protrusion;
• radiculitis;
• paralysis of the lower limbs.

In the absence of treatment, the patient begins to suffer from regular exacerbations of the condition, which are characterized by increased pain that hinders movement and sharply worsens general well-being.The most terrible complication of spinal osteochondrosis is disability.Therefore, in order to prevent such serious changes in the functioning of the musculoskeletal system, high-quality and timely treatment of osteochondrosis is needed.

Diagnosis of osteochondrosis

A disease such as osteochondrosis is primarily pain in the spine.But it is important to distinguish it from pain caused by problems not related to intervertebral disc degeneration.To do this, doctors carry out a step-by-step diagnosis, which includes:

• History taking, which involves a conversation between a specialist and the patient to identify the exact area of pain localization and factors that provoke deterioration of the condition.It is important to know the patient’s occupation, the period when problems with the spine began, when there was an exacerbation, what kind of pain in the lumbar and other parts occurs, what treatment methods the patient used.
• Physiological examinationallows you to determine the proportions of the body, the quality of movements and actions performed, the condition of the skin, and the degree of pain sensitivity.The doctor uses palpation to determine the condition of the muscle tissue, the presence of compactions, swelling, etc.
• X-ray of the spine in two planesfor a visual assessment of the condition.Allows you to determine the displacement of the vertebrae, the presence of osteophytes, and salt deposition. 

If the collected data for prescribing treatment is not enough, or there is a suspicion of a serious pathology of the spine, the patient is prescribed CT and magnetic resonance imaging, thanks to which it is possible to examine in detail the vertebrae, blood vessels, soft tissues, nerve processes and create a complete picture of the condition of the spine affected by osteochondrosis to determine treatment tactics. 

Treatment of osteochondrosis

Like any disease, osteochondrosis requires identifying the cause that triggered its development.Reducing the severity of symptoms is not the main, but important stage of treatment, the outcome of which depends on a number of factors.In some cases this is a complete cure, in others it is the prevention of complications and disability. 

In the treatment of spinal osteochondrosis, a group of measures is used:

• changing the patient's daily routine;
• prescribing medications to reduce symptoms;
• physiotherapeutic procedures (massage, acupuncture, electrophoresis, exercise therapy, etc.).

Changing the daily routine in the treatment of spinal osteochondrosis involves reducing the intensity of physical activity, bed rest for severe pain, and avoiding sudden turns and bends. 

Drugs for the treatment of spinal osteochondrosis

They can be divided into several groups: 

• muscle relaxants for pain relief, including tablets, injection anesthetics and anti-inflammatory injections for osteochondrosis.The homeopathic medicine normalizes the functionality of the thyroid gland, improves lymphatic drainage, and has an anti-inflammatory, detoxification and immunomodulatory effect.
• non-steroidal anti-inflammatory drugs.When used in patients with osteoarthritis, there is a decrease in the progression of inflammatory and destructive changes in the joints, an improvement in the integrity, thickness and other characteristics of cartilage, and stimulation of bone tissue repair.
• anti-inflammatory ointments for topical applications and alternative transdermal patches.Such drugs have an analgesic, antirheumatic, antipyretic and anti-inflammatory effect.The mechanism of action is to reduce the production of inflammatory mediators, lower body temperature and pain.
• chondroprotectors;
• means for therapeutic analgesic blockades;
• B vitamins.

Supportive treatments

Of the additional means that can be used for treatment, alleviation of the general condition and improvement of the function of the spine and intervertebral discs, the most effective are: 

• acupuncture;
• magnetic therapy;
• professional massage and self-massage;
• physical education courses;
• manual therapy. 

Forecast, prevention

If the spinal disease is not advanced and proceeds without serious complications, 1.5-2 months of competent treatment can significantly improve the condition and prevent the disease from becoming chronic.In difficult cases, doctors recommend surgical treatment.

Prevention of spinal osteochondrosis includes:

• maintaining the correct daily routine, with changes in body position and moderate physical activity;
• regular visits to the pool;
• body weight control;
• wearing comfortable shoes;
• balanced diet;
• sleeping on an orthopedic pillow and mattress;
• taking missing nutrients or preventive homeopathic medications to increase immunity, improve overall health, and eliminate dystonia.

It is necessary to undergo annual medical examinations and consult a doctor for treatment immediately after the appearance of any pain in the spine. 

It doesn’t matter what kind of osteochondrosis we are talking about - lumbar, cervical or thoracic, attention to one’s own health should become a good habit, especially when it comes to the basis of the entire musculoskeletal system - the spine.