Why does osteochondrosis develop and how is it treated?

Osteochondrosis is a disease in which degenerative-dystrophic changes in the cartilage tissue of the spine are diagnosed, which are also accompanied by disorders in the structure and functionality of the intervertebral discs.Depending on the location of the damaged tissue, a distinction is made between osteochondrosis of the cervical, thoracic and lumbar regions.

According to medical statistics, symptoms of osteochondrosis are observed in 50-90% of the population.The average age of onset of osteochondrosis is 30-35 years.Under unfavorable conditions, signs of osteochondrosis may appear earlier, especially with prolonged uneven loads on the back, legs and the consequences of injuries.

What is Osteochondrosis?

Osteochondrosis is a disease of the spine that causes degenerative and dystrophic damage to the intervertebral discs.With the development of osteochondrosis, degenerative-dystrophic lesions spread to the tissues of the vertebrae.

The main sign of the development of the disease osteochondrosis is pain in the neck, back and lumbar regions;As it progresses, the pain “radiates” to the arms, chest, shoulders and thighs.With the negative dynamics of osteochondrosis, muscle tissue atrophy, sensitivity disorders and dysfunction of internal organs, caused by their compression and displacement, begin.Without timely treatment, osteochondrosis develops into an incurable condition.

Causes of osteochondrosis

The main factor in the development of osteochondrosis is uneven load on the spine.A common cause of incorrect load distribution is carrying a bag on the shoulder or in the hand, incorrect sitting position, sleeping on a mattress that is too soft, a high pillow and wearing shoes that are anatomically incorrect.

Other risk factors include physical inactivity, lack of exercise, obesity, injuries to the back, lower extremities, flat feet and other diseases of the musculoskeletal system, as well as age-related degenerative processes due to age-related changes in the blood supply to the spine.

The following factors may also play a role in the etiology of osteochondrosis:

• physical overload on the body;
• neuro-emotional exhaustion;
• Metabolic disorders, poisoning, diseases of the gastrointestinal tract that prevent the full absorption of nutrients;
• Occupational risks, particularly working on vibration platforms;
• genetic predisposition;
• poor posture during the active growth period, scoliosis;
• Wearing uncomfortable shoes (tight heels);
• prolonged and/or regular dehydration;
• poor nutrition, hypovitaminosis;
• Smoke;
• Pregnancy, especially multiple pregnancy, in combination with an undeveloped muscular-ligamentous system (due to a shift in the body's center of gravity).

Stages of development of osteochondrosis

Osteochondrosis in the dynamics of the disease goes through four stages:

• Stage 1 (degree) osteochondrosis is characterized by the initial stage of pathology in the nucleus pulposus of the intervertebral disc.Due to excessive stress, the process of desiccation (desiccation) of the core begins, which leads to a decrease in the height of the intervertebral disc and the appearance of cracks in the fibrous ring.Symptoms are usually absent at this stage;Mild discomfort may occur when staying in an uncomfortable static position for a long time or during active movement;
• In stage 2, a decrease in disc height leads to a decrease in the distance between the vertebrae and relaxation of the spinal muscles and ligaments.This leads to increased mobility of the vertebrae with affected intervertebral discs, which is dangerous due to their displacement or slipping.In the second stage of the disease, discomfort and pain occur, especially with certain types of stress, movements, positions;
• Stage 3 (degree) osteochondrosis is characterized by the formation of prolapses and protrusions of the intervertebral discs and may be accompanied by subluxations and/or the development of arthrosis of the intervertebral joints.With some types of movement, patients experience stiffness, restricted movement and may experience tingling and numbness in the limbs.At this stage of osteochondrosis, depending on the location of the affected intervertebral discs, pain is clearly felt in the back, neck, lumbosacral area or coccyx area;
• In stage 4 of osteochondrosis, the body tries to correct the consequences of hypermobility of the vertebrae and adapt to the limited functionality of the spine.Osteophytes, new bone formations, form at the contact points of the vertebrae, which improve the fixation of the vertebrae.However, in some cases, osteophytes can lead to pinched nerves and injuries to the vertebrae.Fibrous ankylosis begins in the intervertebral discs and joints.Without microtrauma and pinched nerve roots, the symptoms of the disease subside.

Symptoms of osteochondrosis

The main symptoms of osteochondrosis are discomfort and/or pain in the neck and back.The severity of sensations and the presence of additional symptoms depend on the stage of the disease.When examining the patient and collecting an anamnesis, the specialist carries out a primary diagnosis, which indicates the presence of osteochondrosis by a visually noticeable curvature of the spine in the transverse or longitudinal plane of the spine.Pathologies of the intervertebral discs of the cervical and lumbar spine are much more common than degenerative and dystrophic changes in the sternum.

Signs of osteochondrosis that the patient feels, depending on the stage of the disease, are a periodic or constant feeling of back fatigue, as well as mild or severe pain.The pain can be localized in the neck, back, chest and shoulder girdle and can make movements of the upper extremities difficult and restricted.

The clinical picture of osteochondrosis largely depends on the localization of the pathology, the degree of development of the process and the individual characteristics of the patient.Pathologies of the intervertebral discs, displacements, bulges, hernias and the growth of osteophytes lead to various consequences.The most common include disorders of normal blood circulation in tissues, pinched nerve endings, dysfunction of the spinal canal, edema, fibrosis of tissues and structures.Such consequences can be accompanied by a wide range of symptoms and lead to misdiagnosis of diseases.

The most common and characteristic symptoms of osteochondrosis include:

• Pain in the back, neck, lower back, shoulder girdle, rib area;
• Malaise, stiffness during body movements that occur in certain body positions, bending, twisting, increased muscle tension;
• numbness in the upper and lower extremities;
• Muscle and joint pain, muscle cramps;
• headache, dizziness, increased fatigue;
• pain in the heart area;
• impaired hand sensitivity;
• Hypotonia.

Symptoms of osteochondrosis vary depending on the localization of the pathology:

• With osteochondrosis of the cervical spine, pain in the neck, arms and shoulder girdle predominates, radiating to the area of the scapula and shoulder;Headaches, dizziness, flashing “spots” or spots in front of the eyes, and tinnitus are noted;
• if the thoracic spine is affected, the pain is localized in the chest, heart, on the inside of the shoulder and in the armpit area, difficulty breathing is also noted, shortness of breath is possible;
• Osteochondrosis of the lumbosacral spine is manifested by pain in the lower back radiating to the legs, thighs or pelvic organs, often accompanied by sexual dysfunction.

Superficial symptoms - back fatigue, pain - can indicate not only the presence of osteochondrosis, but also the addition of other diseases or the development of other pathological processes and disorders that are not related to degeneration of the intervertebral discs.The diagnosis of “osteochondrosis” can only be made by a specialist; self-medication for such symptoms is unacceptable.

Classification of osteochondrosis

Types of osteochondrosis are distinguished according to several principles.Depending on the location of the pathology, osteochondrosis of the cervical, thoracic, lumbar, sacral or mixed, combined forms of the disease are distinguished.According to the clinical manifestations, osteochondrosis of various localizations is divided into subtypes depending on the identified symptoms and the overall clinical picture.

Osteochondrosis of the cervical spine:

• depending on the type of reflex syndrome, cervicalgia, cervicocranialgia, cervicobrachialgia with different manifestations (vegetative-vascular, neurodystrophic, muscle-tonal) are identified;
• If the test result is positive for radicular syndrome, discogenic damage to the roots of the cervical spine is diagnosed.

For the pathology of the thoracic plane there are:

• in reflex syndromes – thoracic pain with vegetative-visceral, neurodystrophic or muscle tone manifestations;
• due to radicular-discogenic lesion of the roots of the thoracic region.

Osteochondrosis of the lumbosacral level is diagnosed as:

• depending on the type of reflex syndrome - lumbago (lumbago), lumbodynia, lumboischialgia with vegetative-vascular, neurodystrophic or muscle tone manifestations;
• Radicular syndrome indicates discogenic damage to the roots of the lumbosacral region.
• Radicular vascular syndrome indicates radiculoischemia.

Diagnosis of osteochondrosis

Instrumental examination methods are used to make the diagnosis:

• X-ray examination of the spine;
• myelography;
• neurological examination of sensitivity, reflexes.

Other prescribed methods for differentiating and clarifying the diagnosis and stage of pathology include:

• computed tomography of the spine (CT);
• nuclear magnetic resonance (NMR);
• Magnetic resonance imaging (MRI).

Therapy instructions for osteochondrosis

The treatment is based on an integrated approach and, depending on the stage, lasts 1 to 3 months of intensive therapy and 1 year of supportive measures to consolidate the result and prevent relapses.

Therapy for the disease osteochondrosis is carried out in two directions, depending on the degree of osteochondrosis and the patient's health status.Conservative treatment of the disease consists in taking medications and performing a set of exercises.Surgical treatment cannot be the method of first choice in almost every situation and is prescribed in the absence of positive dynamics or progression of the disease against the background of long-term conservative therapy.

In addition to medical therapy methods, general recommendations for osteochondrosis must be followed: follow a diet, take rehabilitation measures.

Conservative treatment of osteochondrosis

Conservative therapy is aimed at relieving pain, normalizing the functionality of the spine and preventing negative changes

Conservative treatment of osteochondrosis includes the following types of therapy:

• drug therapy.Drugs for osteochondrosis are used to relieve pain syndromes, inflammatory processes in tissues and to normalize the body's metabolic processes.In case of severe pain syndrome, the use of drug blocks of nerve endings is recommended, which also helps to reduce the severity of muscle tone syndrome.The following types of blockades are distinguished: trigger point blockade, intraosseous, faceted, paravertebral, epidural;
• physiotherapeutic methods.Physiotherapeutic procedures help to relieve pain, enhance the effect of medications and are also used during the rehabilitation period.Ultrasonic waves, magnetic fields, low-frequency currents and laser beams are most commonly used.
• Methods of physiotherapy (physiotherapy) and exercise therapy.A set of special exercises, when performed regularly and correctly, helps to correct posture, strengthen the muscular corset and ligamentous apparatus, normalize muscle function, reduce compression of nerve fibers and prevent complications of osteochondrosis.Methods of exercise therapy and exercise therapy procedures are aimed at normalizing metabolic processes, restoring sufficient nutrition to the intervertebral discs, restoring the position of the vertebrae and intervertebral discs between them and evenly distributing the load in the musculoskeletal system;
• Massage.Manual massage techniques are used to improve blood supply to tissues, relieve muscle spasms and tension, and generally improve blood circulation.Hydromassage as a direction of therapeutic action, in addition to the listed effects, helps to normalize the functioning of the body's nervous system;
• manual therapy.Manual therapy methods are selected individually.A targeted effect on the musculoskeletal system of the body contributes to improving blood circulation, lymphatic circulation, improving metabolism, correcting the mobility of the musculoskeletal system, strengthening the immune system and preventing complications of osteochondrosis;
• Traction therapy(traction) of the spine using special devices.The purpose of the manipulations is to increase the intervertebral space to normal parameters and correct structural disorders of the spine.

Osteochondrosis: drug therapy

In the treatment of osteochondrosis, drugs are aimed at reducing the severity of symptoms and improving the processes of blood supply to tissue and its regeneration.Osteochondrosis cannot be cured by taking medications alone;Therapy must be combined, including exercises, diet and preventive measures.

If there are no pronounced dystrophic changes and pain, taking medications without a specialist prescription may be considered unjustified.

Medicines for pain relief and treatment of osteochondrosis:

• anti-inflammatory group;
• Antioxidant preparations: vitamins C (in the form of ascorbic acid), E (tocopherol acetate), N (thioctic acid);
• Means for improving blood supply to tissues, B vitamins (mainly B3);
• Preparations for the regeneration and/or prevention of degeneration of cartilage tissue, hyaluronic acid.

Medicines can be prescribed both in the form of ointments, creams for local use for pain, as well as for oral administration and injections.

In acute complications, medications are used to block the nerve endings.

Osteochondrosis: dietary nutrition of the patient

The principles of nutrition are based on the need to improve metabolic processes, saturate the body with essential nutrients, vitamins and minerals, and include foods with a high content of antioxidants, polyunsaturated fatty acids and compounds that promote the regeneration of cartilage tissue.The drinking regimen recommended for osteochondrosis is aimed at preventing dehydration of the body, which can have a negative effect on the affected tissues.You need to eat 5-6 times a day in small portions.

The basis of the diet is dairy and fermented milk products, lean meat, poultry, fish, fresh vegetables, fruits, nuts and seeds, grains and mushrooms.It is especially recommended to include meat and fish jellies, jellied meats and jellied dishes in the diet, and to use extra virgin olive oil without heat treatment (for dressing salads).

Preferred food processing methods: steaming, baking, boiling.Limit the intake of flour and confectionery, fatty foods, hot, salty dishes and spices, canned and smoked foods, strong meat broths, legumes, sugar and fruits with a high sugar content (grapes).During the day you need to drink at least 1.5 liters of liquid, giving preference to clean mineral water, dried fruit compote, unsweetened fruit drinks and herbal teas.You should limit the amount of strong black tea, coffee, sweet carbonated drinks and alcohol.

Complications of osteochondrosis

Non-compliance with the prescribed treatment, prolonged avoidance of visiting the doctor and lack of treatment for osteochondrosis contribute to the progression of the disease and provoke the development of complications, pathologies and new diseases, such as:

• Herniated disc (spine herniation);
• Projection;
• kyphosis;
• radiculitis;
• salt deposits in the intervertebral space;
• spinal cord strokes;
• Decrease in muscle mass of the limbs, muscle atrophy due to impaired blood supply;
• Paralysis of the lower limbs.

Although grade 4 osteochondrosis can occur without severe symptoms and pain, advanced osteochondrosis is the most dangerous for the development of serious complications and can lead to disability of the patient.

Prevention of osteochondrosis

The causes of osteochondrosis are mainly associated with lack of attention to the body's needs, poor nutrition and excessive stress on the body.To prevent the occurrence of pathological changes in the spine and contain the dynamics of existing osteochondrosis, it is recommended to adhere to the general principles of a healthy lifestyle:

• Elimination of the possibility of physical inactivity: moderate sports: exercise, running, swimming, cycling, skiing, gymnastics, non-contact wrestling, etc.;
• When working or doing other activities that require you to remain in a static position for a long time, you need to take warm-up breaks every 45 minutes to restore blood circulation.If you have to sit for a long time, you should choose the right chairs, chairs that support the spine, ensure compliance with the standards for the position of your hands on the table, feet on the floor or a special stand, learn to maintain your posture (straight back, relaxed shoulders);
• for night sleep, you need to choose an elastic, preferably orthopedic, mattress with a flat surface, avoid high or too flat pillows;
• Lift and/or carry heavy objects as necessary.Avoid jerky movements when lifting weights from the semi-squat position.Use special straps that support the lower back.
• Choosing orthopedically correct shoes: With the appropriate width for the foot, without high heels and their timely replacement, they help reduce the load on the spine, this is especially important for women during pregnancy.In summer you shouldn't miss walking barefoot on uneven surfaces;This strengthens the foot muscles and relieves tension in the musculoskeletal system;
• Proper diet and drinking habits contribute to overall health and help maintain normal metabolism.
• If you are prone to increased emotionality and anxiety with spasmodic muscle reactions to stress, it is worth learning relaxation methods and regularly taking courses in restorative massage.