Spinal osteochondrosis: symptoms and treatment

Osteochondrosis is a common disease that occurs to varying degrees in most people by the age of 35-40. The most likely localization of osteochondrosis is the lower cervical, upper thoracic and lower lumbar spine. The etiology of osteochondrosis, i. H. the specific causes and conditions of occurrence is completely unknown. However, hereditary predisposition, age-related changes, injuries and circulatory disorders of the tissue have a direct influence.

In the development of the disease, changes in the central part of the intervertebral disc, namely dehydration, play the main role. Remember that the disc consists of the nucleus pulposus and the surrounding annulus fibrosus. With dehydration, the disc loses its shock-absorbing functions, which leads to its gradual destruction. In the development of the disease, four stages are distinguished, which differ in certain changes in the intervertebral disc and adjacent tissues. The severity of spinal osteochondrosis, symptoms and treatment directly depend on the stage of development of the pathology.

Symptoms and causes of osteochondrosis of the spine

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

• First stage. Cracking of the inner layers of the fibrous ring and nucleus pulposus. The nucleus penetrates the cracks and 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 section. Gradual damage to the annulus fibrosus. There is a protrusion of the nucleus (protrusion) beyond the anatomical limits of the fibrous ring, and then there is rupture of the ring and 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 becomes scarred, which leads to the development of fibrosis.

Depending on the localization 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 the symptoms depend on this
about the degree of damage to the intervertebral disc and surrounding tissues.

Cervical osteochondrosis	Thoracic osteochondrosis	Lumbar osteochondrosis
Aching or stabbing pain in a neck muscle, part of the neck, or the whole neck. Strong headache. Nerve root syndrome: pain spread to the collarbone, shoulder, one arm, etc. Cardiac syndrome that is not stopped by taking glycerol trinitrate. "Severity, " weakness, or difficulty moving in one of the arms. Symptoms of basilar artery insufficiency: dizziness, ringing in the ears, double vision, speech disorders, difficulty swallowing, hearing loss, unconsciousness. Paresthesias of the upper limbs: numbness of the hands (one or both), goose bumps, tingling, false sensation of swelling of the limbs. Selective muscular atrophy and reduced limb reflexes.	The main types of osteochondrosis are considered cervical and lumbar. However, the thoracic spine is under constant stress and 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 are manifested at a late stage of the disease. In most cases, the disease occurs with an injury (for example, as a result of being overweight). Short-term or long-term, aching or stabbing pain in the back. Belt pain in chest. Pain in the chest wall and pain in the heart area. Pain in the muscles of the back radiating to the buttocks, groin or thigh. Radiation for pain in the kidneys or gallbladder. stiffness of the spine. Pain when moving and stooping. Pain and impaired pressure sensitivity in the affected spinal region. Movement disorders, depending on the degree of damage to one or both legs. Internal organ failure: constipation and urinary problems. Sloppy.	Anomalies are most often observed in the lumbar spine. Lower back pain can be given to the groin, thigh, buttocks and lower leg. The pain often radiates down one of the legs. Heaviness and stiffness of movements. Increase in body temperature in the acute phase. Pain on probing IV-V lumbar vertebrae. spasms of the back muscles. weakness of the leg muscles. Changes in vertebrae numbered III and IV cause pain when bending the knee joint in a supine position. Damage to the V vertebra causes pain from the outside of the leg to the foot and loss of feeling. Violation of defecation and urination. Neuralgia of the sciatic nerve, unilateral or bilateral. Further development of radicular syndrome can be atrophy of the leg muscles and impaired reflexes.

It has already been mentioned 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:

• Regular dynamic and static loads on the spine of varying intensity. For example, the work of a loader (carrying weights) or a miner (working for hours in unnatural positions and a huge amount of physical strain), 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 correct posture and stoop;
• Flat feet and a consequent muscle imbalance lead to an uneven distribution of the load on different parts of the spine;
• genetic traits;
• 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) is made 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 based on the topography of the spread of pain, which can 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 x-ray of the spine, degenerative changes in the intervertebral joints, intervertebral discs, narrowing of the intervertebral canal, sclerotic changes in the tissues of the spine can be seen. At the same time, the detection of spinal lesions (especially in the early stages) is always difficult, since the processes occurring with them are characteristic of a number of other diseases (tumors, metastases, Bechterew's disease, tuberculosis lesions).

On the frontal x-rays, the unevenness of the plates, an increase or aggravation of the uncinate processes are noted. Profile images show a decrease in height, a change in shape, a herniated disc, osteophytes, and other changes in the vertebral body. Small degenerative changes are not visible on a plain x-ray, and an x-ray with contrast medium is done 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 examination of the spine is a functional X-ray method. Thanks to the X-ray taken at 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 70's and 80's, technologies are still actively being developed and improved while being quite inaccessible to the general population due to high examination costs or lack of equipment in local hospitalsstay.

Methods of treating osteochondrosis of the spine

Treatment of osteochondrosis is a long periodic complex process. It aims to reduce and eliminate the consequences of disc changes. Namely inflammation, bruising, poor circulation, muscle spasms. Many forms of therapy can help, including the methods of oriental healers. When treating osteochondrosis, the patient needs complete rest.

Treatment is mostly non-invasive, such asB. drug therapy, antiparasitic therapy, exercise therapy and others. Invasive therapy, i. e. surgical intervention, is rarely resorted to. For example, in those cases where the intervertebral hernia lasts longer 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, as a rule, is 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. reducing pain syndrome;
2. removal of spasms;
3. elimination of inflammation;
4. reduction of crushing;
5. Improved blood circulation;
6. prevent further deterioration.

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

Physiotherapeutic treatment

Physiotherapeutic procedures are aimed at improving blood microcirculation in the area of \u200b\u200bthe affected spine, eliminating pain and reducing edema. Physiotherapy also helps to reduce the dose of drugs used. There are dozens of types of physical therapy. Here are some of them:

• Reflexology is the action on acupuncture points using needles, electricity, lasers. Helps relieve spasms and improve blood circulation;
• Kinesitherapy is a treatment through movement and special physical exercises. This is actually remedial gymnastics, but in a broader sense. These include 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 have difficulty performing them. For example, older people, people who are overweight or have motor disabilities. It is important to note that due to the buoyancy of the water, there is an even load distribution on the spine;
• Therapy with impulse currents, UHF therapy, neurostimulation, magnetic therapy, massage and others.

acupuncture

A unique method that comes from oriental medicine. Its essence lies in the use of special very thin needles that penetrate special points of the body literally under the influence of gravity. These points were discovered through thousands of years of experience of Eastern healers, later proven by official medicine. Acupuncture helps to get rid of even excruciating pain, has a beneficial effect on the entire nervous system and nervous disorders.

Surgical intervention

Surgery is only indicated if non-invasive treatment does not show any positive effect or if serious complications occur. The main method of surgical treatment is discectomy - removal of a damaged intervertebral disc. But even after the operation using minimally invasive methods, rehabilitation takes at least 6 months.

At the same time, the operation will not eliminate the need for regular treatment of osteochondrosis. After all, 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 relieve pain, eliminate inflammation, relieve spasms, etc. However, as soon as they are canceled, their effect will quickly disappear in the absence of other procedures necessary for the treatment of osteochondrosis. At the same time, you cannot 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 treatments. They are often necessary to improve the patient's life. They are used to relieve pain (therapeutic blockade), eliminate inflammation, relieve muscle spasms and improve blood circulation. In recent years, another type of medicine is increasingly used - chondroprotectors. However, drugs alone cannot produce a long-term lasting effect.

treatment at home

Home treatment of osteochondrosis consists of manual therapy (exercise therapy, shants collar), acupuncture and vacuum therapy. These methods help improve circulation and reduce congestion in the muscles and spine. This significantly improves tissue regeneration.

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

physical therapy

Thanks to gymnastics, the mobility of the vertebrae is restored, the muscles and their circulation are strengthened. The latter is of great importance, since the spine is deprived of its blood supply and the intervertebral disc can only be supplied with nutrients via the adjacent tissue. In this case, a distinction must be made between therapeutic exercise and any other training.

Manual therapy

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

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