Spinal osteochondrosis: symptoms and treatment

Osteochondrosis is a widespread disease, it occurs in varying degrees in most people by the age of 35-40. The most likely localization of osteochondrosis is lower cervical, upper thoracic and lower back. The etiology of osteochondrosis, that is, the specific causes and conditions of its occurrence, is not completely known. However, hereditary predisposition, age-related changes, injuries and impaired blood supply to tissues have a direct effect.

The main role in the development of the disease is played by changes in the central part of the intervertebral disc, that is, dehydration. Recall that the disc consists of the nucleus pulposus and the annulus fibrosus around it. Due to drying, the disk loses its shock absorption functions, which leads to its gradual destruction. Four stages are distinguished in the development of the disease, which are distinguished by certain changes in the disc and adjacent tissues. The severity, symptoms and treatment of osteochondrosis of the spine 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 development of osteochondrosis in terms of anatomical changes.

• The first stage. The formation of cracks in the inner layers of the annulus fibrosus and nucleus pulposus. Penetrating into the cracks, the nucleus irritates the nerve endings of the fibrous ring;
• The second stage. Further irritation of the annulus fibrosus occurs due to the pathology of the nucleus pulposus, and the fixation of the vertebrae deteriorates. The spine has unusual mobility;
• The third stage. Gradual damage to the annulus fibrosus. There is a protrusion of the nucleus beyond the anatomical limits of the fibrous annulus (protrusion), then the rupture of the annulus occurs and an intervertebral hernia is formed (extrusion);
• The fourth stage. There is a spread of degenerative changes to the surrounding tissues - vertebrae, ligaments, nerves, blood vessels. As a result of chronic inflammation, a scar forms in the intervertebral disc, which leads to the development of fibrosis.

Depending on the location of 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 it
according to the degree of damage to the intervertebral disc and surrounding tissues.

Cervical osteochondrosis	Thoracic osteochondrosis	Lumbar osteochondrosis
Aching or sharp pain in a muscle of the neck or part of the neck or the whole neck. Severe headaches. Nerve root syndrome: radiating pain to the collarbone, shoulder, arm, etc. Cardiac syndrome not stopped by taking glycerol trinitrate. "Heaviness", weakness or impaired movement in one of the arms. Symptoms of basilar artery insufficiency: dizziness, tinnitus, double vision, speech disorder, swallowing problems, hearing loss, fainting. Paresthesia of the upper limbs: a feeling of numbness in the hands (one or both), flatulence, tingling, false sensation of swelling of the limbs. Selective muscle atrophy and decreased limb reflexes.	The main types of osteochondrosis are neck and back. However, the thoracic spine is under constant stress and is prone to the early development of gross degenerative changes, especially in young people. Due to the characteristics of the development of changes in the thoracic spine, neurological symptoms appear in the 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 burning pains in the back. Belt pain in the chest area. Pain in the chest wall and pain in the heart region. Pain in the muscles of the back, buttock, groin, or thigh. Radiating pain in the region of the kidneys or gall bladder. Rigidity of the spine. Pain during movement and bending. Violation of sensitivity to pain and pressure in the affected area of the spine. Movement disorders depending on the degree of damage to one or both legs. Internal organ failure: constipation and urinary problems. Slouch.	Abnormalities are most often observed in the lumbar region. Pain in the lower back, groin, thigh, hip, lower leg can be transmitted. Often the pain spreads to one of the legs. Heaviness and stiffness of movements. An increase in body temperature during the acute period. Pain during probing IV-V lumbar vertebrae. Back muscle spasms. Weakness of leg muscles. Displacement of vertebrae III and IV causes pain when bending the knee joint in a supine position. Damage to the V vertebra causes pain and loss of sensation on the outside of the leg down to the foot. Defecation and urination disorders. Neuralgia of the sciatic nerve, unilateral or bilateral. Further development of radicular syndrome can be atrophy of the muscles of the legs and impaired reflexes.

It was mentioned earlier 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 at different intensities. For example, the work of a loader (weight bearing) or miner (long hours in unnatural positions and great physical load), driver (vibration and sedentary lifestyle) or office worker (sedentary lifestyle);
• back injury;
• Poor physical development or overweight;
• Violation of correct posture and bending;
• Straight legs and the resulting muscle imbalance cause uneven distribution of the 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

The initial diagnosis of the disease (osteochondrosis) is based on the patient's complaints, his examination and palpation of the spine. Also, the affected part of the spine can be determined by the topography of the distribution of pain, which is able to tell exactly where the compression of the nerves occurs (in the neck, chest, lower back vertebrae).

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

Frontal X-ray images show unevenness of plates, increase or sharpening of uncinate processes. Profile images show height reduction, shape changes, disc herniation, osteophytes, and other changes in the vertebral body. 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 application of a contrast agent through a puncture directly into the intervertebral disc.

Another examination of the spine is the functional X-ray method. It is possible to determine the mobility or immobility of the intervertebral space thanks to the X-ray taken with the maximum flexion and extension of the spine.

Computer tomography (hereinafter CT) and magnetic resonance imaging (hereinafter MRI) are considered the most modern and high-tech research methods. Although the first CT and MRI machines appeared in the 70s and 80s, the technologies are still being actively developed and improved, although they remain 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 complex process that lasts for a long time. It aims to reduce and eliminate the consequences of changes in the intervertebral disc. That is, inflammation, tightness, 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.

In most cases, treatment is carried out by non-invasive methods, such as drug therapy, antiparasitic therapy, exercise therapy, etc. Invasive therapy, that is, surgical operations, is rarely used. For example, in such cases, the intervertebral hernia lasts more than six months, and conservative treatment does not give positive results.

Osteochondrosis of the spine and its treatment are carried out by doctors of various specialties: neurologist, orthopedist, vertebrologist, 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 there is a doctor of such a specialty in the clinic due to his specialty in spinal diseases.

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

1. reduction of pain syndrome;
2. elimination of spasms;
3. elimination of inflammation;
4. Reduction of compression;
5. Improved blood flow;
6. Prevention of further deterioration.

Let's take a look at some commonly used treatments, each of which includes 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, relieving pain and eliminating edema. Also, physiotherapy helps to reduce the dose of drugs used. There are dozens of types of physiotherapy. Here are some of them:

• Reflexology is an effect on acupuncture points with needles, electricity, laser. helps to eliminate spasm and improve blood flow;
• Kinesitherapy is treatment through movement and specific physical exercises. In fact, this is therapeutic gymnastics, but in a broad sense. This includes training on simulators, exercises in groups under the guidance of a doctor, stretching of the spine;
• Therapeutic swimming. It allows you to perform exercises for patients who have difficulty performing exercises that damage the spine. For example, the elderly, people who are overweight or have motor disabilities. It should be noted that thanks 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, etc.

Acupuncture

A unique method from Eastern medicine. Its essence lies in the use of special very thin needles that enter special points of the body under the influence of gravity. These points were discovered by thousands of years of experience of Eastern healers and later proved by official medicine. Acupuncture helps to relieve even unbearable 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 of non-invasive treatment or if there are severe complications. The main method of surgical treatment is discectomy - removal of the damaged disc. However, even after surgery using minimally invasive methods, rehabilitation will take at least 6 months.

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

Treatment

This type of treatment is most effective in the short term. Medicines immediately relieve pain, relieve inflammation, relieve spasms, etc. However, after they are canceled, their effect will quickly disappear if there are no 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 side effects on the body.

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

Treatment at home

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

The listed procedures together with drugs provide effective treatment that eliminates unpleasant symptoms and improves the general condition. At this time, 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 blood circulation system are strengthened. The latter is of great importance, because the spine lacks a blood supply system, and the intervertebral disc can receive nutrients only through neighboring tissues. In this case, it is necessary to distinguish between therapeutic exercises and any other exercise.

Manual therapy

One of the most effective methods. Since the chiropractor affects the muscles, ligaments and bones. It improves posture, restores the "normal" structure of the skeleton, removes excess muscle tension. Including, it directly affects the vertebra.

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