Why does osteochondrosis appear and how is it treated?

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

According to medical statistics, symptoms of osteochondrosis are observed in 50-90% of the population.The average age of onset of osteochondrosis is 30 to 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 spinal disease characterized by degenerative and dystrophic lesions of the intervertebral discs.With the development of osteochondrosis, degenerative-dystrophic lesions spread to the tissues of the vertebrae.

The main sign indicating the development of osteochondrosis disease is pain in the neck, back and lumbar region;as it progresses, the pain “radiates” to the arms, chest, shoulders and upper thighs.With the negative dynamics of osteochondrosis, atrophy of muscle tissues, sensory disturbances and dysfunction of internal organs, caused by their compression and displacement, begin.In the absence of timely treatment, osteochondrosis develops into an incurable disease.

Causes of osteochondrosis

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

Other risk factors include physical inactivity, a sedentary lifestyle, excess weight, injuries to the back, lower extremities, flat feet and other disorders 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 overstrain of the body;
• neuro-emotional exhaustion;
• metabolic disorders, poisoning, diseases of the gastrointestinal tract that prevent the full absorption of nutrients;
• occupational risks, in particular working on vibrating platforms;
• genetic predisposition;
• poor posture during the period of active growth, scoliosis;
• wear uncomfortable shoes (tight, heels);
• prolonged and/or regular dehydration;
• poor diet, hypovitaminosis;
• smoking;
• pregnancy, especially multiple, in combination with an underdeveloped musculo-ligamentous apparatus (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:

• Osteochondrosis stage 1 (degree) is characterized by the initial stage of pathology of the nucleus pulposus of the intervertebral disc.Due to excessive load, the process of dehydration (dehydration) of the core begins, which leads to a decrease in the height of the disc and the appearance of cracks in the annulus fibrosus.At this stage, symptoms are usually absent;minor discomfort may occur during prolonged stay in an uncomfortable static position or in active movement;
• in stage 2, a decrease in the height of the discs leads to a decrease in the distance between the vertebrae and a sagging of the spinal muscles and ligaments.This causes increased mobility of the vertebrae with the affected discs, which is dangerous due to them shifting or slipping.During the second stage of the disease, discomfort and pain occur, especially with certain types of loads, movements, positions;
• Osteochondrosis stage 3 (degree) 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 certain types of movements, patients experience stiffness, lack of mobility, and a feeling of tingling and numbness may occur in the limbs.At this stage of osteochondrosis, pain is clearly felt in the back, neck, lumbosacral region or coccyx, depending on the location of the affected discs;
• in stage 4 of osteochondrosis, the body tries to correct the consequences of spinal hypermobility and adapt to alterations in the functionality of the spine.Osteophytes, new bone formations, improve the fixation of the vertebrae, forming at the points of contact between the vertebrae.However, in some cases, osteophytes can cause pinched nerves and injure the vertebrae.Fibrous ankylosis begins in the intervertebral discs and joints.In the absence of microtrauma and pinched nerve roots, the symptoms of the disease subside.

Symptoms of osteochondrosis

The main symptoms of osteochondrosis are a feeling of 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 anamnesis, the specialist makes a primary diagnosis, suggesting the presence of osteochondrosis by a visually detectable curvature of the spine observed 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 experienced by the patient include a periodic or permanent feeling of back fatigue, mild or severe pain, depending on the stage of the disease.The pain can be localized in the neck, back, chest, shoulder girdle, making movements of the upper limbs difficult and restrictive.

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 patients.Pathology of intervertebral discs, displacements, protrusions, hernias and growth of osteophytes lead to various consequences.Among the most common are 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 many different symptoms, leading to incorrect diagnosis of diseases.

The most common and characteristic symptoms of osteochondrosis are:

• pain in the back, neck, lower back, shoulder girdle, rib area;
• discomfort, stiffness in body movements that occur in certain body positions, bending, rotation, increased muscle tension;
• feeling of numbness in the upper and lower limbs;
• muscle and joint discomfort, muscle spasms;
• headaches, dizziness, increased fatigue;
• pain in the heart region;
• impaired hand sensitivity;
• muscular hypotonia.

The symptoms of osteochondrosis vary depending on the location of the pathology:

• with osteochondrosis of the cervical spine, pain in the neck, arms and shoulder girdle predominates, radiating to the region of the scapula and shoulder;headaches, dizziness, flashing “spots” or spots before the eyes, and tinnitus are noted;
• if the thoracic spine is affected, the pain is localized in the chest, heart, inner surface of the shoulder, armpits, difficulty breathing is also noted, shortness of breath is possible;
• Osteochondrosis of the lumbosacral spine manifests as lower back pain radiating to the legs, upper thighs or pelvic organs, often accompanied by sexual dysfunction.

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

Classification of osteochondrosis

Types of osteochondrosis are distinguished according to several principles.Depending on the localization of the pathology, osteochondrosis is distinguished from cervical, thoracic, lumbar, sacral or mixed and combined types of diseases.According to clinical manifestations, osteochondrosis of various localizations is divided into subtypes depending on the identified symptoms and the clinical picture as a whole.

Osteochondrosis of the cervical spine:

• depending on the type of reflex syndrome, we identify neck pain, cervicocranialgia, cervicobrachialgia with various manifestations (vegetative-vascular, neurodystrophic, musculo-tonal);
• if the radicular syndrome test result is positive, discogenic lesions of the roots of the cervical spine are diagnosed.

For pathologies of the thoracic level there are:

• for reflex syndromes - thoracalgia with vegeto-visceral, neurodystrophic or musculo-tonal manifestations;
• by radicular – discogenic lesion of the roots of the thoracic region.

For osteochondrosis of the lumbosacral level, the following are diagnosed:

• depending on the type of reflex syndrome - lumbago (lumbago), lumbodynia, lumboischialgia with vegetative-vascular, neurodystrophic or musculo-tonal manifestations;
• radicular syndrome indicates discogenic lesions of the roots of the lumbosacral region;
• radicular vascular syndrome indicates radiculoischemia.

Diagnosis of osteochondrosis

To make a diagnosis, instrumental examination methods are used:

• Radiological examination of the spine;
• myelography;
• neurological examination of sensitivity, reflexes.

Additional methods prescribed to differentiate and clarify the diagnosis and stage of pathology include:

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

Therapeutic directions for osteochondrosis

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

Treatment of 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 of taking medications and performing a set of exercises.Surgical treatment in almost all situations cannot be the method of first choice and is prescribed in the absence of positive dynamics or progression of the disease against the background of long-term conservative treatment.

In addition to medical therapeutic methods, it is necessary to follow general recommendations for osteochondrosis: follow a diet, take the necessary measures for rehabilitation.

Conservative treatment of osteochondrosis

Conservative therapy aims to relieve pain, normalize the functionality of the spine and prevent negative changes.

Conservative treatment of osteochondrosis includes the following types of therapy:

• drug therapy.Medicines for osteochondrosis are used to relieve pain syndromes, inflammatory processes in tissues and normalize metabolic processes in the body.In case of severe pain syndrome, it is recommended to use drug blockades of nerve endings, which also help to reduce the severity of musculo-tonic syndrome.There are the following types of blockages: trigger point blockade, intraosseous, facet, paravertebral, epidural;
• physiotherapy methods.Physiotherapeutic procedures help reduce pain, increase the effect of medications, and are also used during the rehabilitation period.The most common use is with ultrasonic waves, magnetic fields, low-frequency currents, and laser beams;
• methods of physiotherapy (physiotherapy) and physiotherapy.A set of special exercises, when performed regularly and correctly, help to correct posture, strengthen the muscular corset, ligamentous apparatus, normalize muscle function, reduce compression of nerve fibers and prevent complications of osteochondrosis.Methods of exercise therapy and physiotherapy procedures are aimed at normalizing metabolic processes, restoring adequate nutrition of the intervertebral discs, restoring the location of the vertebrae and 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 activity, in addition to the listed effects, helps to normalize the functioning of the nervous system of the body;
• manual therapy.Manual therapy methods are selected on an individual basis.A targeted effect on the musculoskeletal system of the body helps to improve blood circulation, lymphatic circulation, improves metabolism, helps correct the mobility of the musculoskeletal system, strengthens the immune system and serves as a means of preventing complications of osteochondrosis;
• traction therapy(traction) of the spine using special equipment.The goal 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, medications are aimed at reducing the severity of symptoms, improving the processes of blood supply to tissues and their regeneration.Osteochondrosis cannot be cured by taking medication alone;therapy should be combined, including sets of exercises, diet and preventive measures.

In the absence of pronounced dystrophic changes and pain, taking medications without a specialist's prescription can be considered unjustified.

Medicines used to relieve pain and treat 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 case of acute complications, drugs are used to block nerve endings.

Osteochondrosis: dietary nutrition of the patient

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

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

Preferred food processing methods: steaming, baking, boiling.Limit the consumption of flour and confectionery products, fatty foods, spicy and salty dishes and seasonings, canned and smoked foods, strong meat broths, legumes, sugar and fruits with a high sugar content (grapes).During the day, you should drink at least 1.5 liters of liquid, favoring clean and mineral water, dried fruit compotes, 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 prescribed treatment, prolonged avoidance of the doctor and lack of treatment of osteochondrosis contribute to the progression of the disease and provoke the development of complications, pathologies and new diseases, such as:

• intervertebral disc herniation (vertebral herniation);
• protrusion;
• kyphosis;
• radiculitis;
• salt deposits in the intervertebral space;
• spinal cord strokes;
• decrease in muscle mass of the limbs, muscle atrophy due to blood supply disorders;
• paralysis of the lower limbs.

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

Prevention of osteochondrosis

The causes of osteochondrosis are mainly related to lack of attention to the needs of the body, poor diet and excessive stress on the body.To prevent the occurrence of pathological changes in the spine and slow down the dynamics of existing osteochondrosis, it is recommended to adhere to the general principles of a healthy lifestyle:

• eliminate the possibility of physical inactivity: moderate sports: physical exercise, running, swimming, cycling, skiing, gymnastics, non-contact wrestling, etc.;
• When working or performing other activities that require staying in a static position for a long time, you should take warm-up breaks every 45 minutes to restore blood circulation.If you need to sit for a long time, you need to choose the right chairs, chairs that support the spine, ensure compliance with the norms of position of hands on the table, feet on the floor or special support, learn to maintain your posture (back straight, shoulders relaxed);
• to sleep at night, you must choose an elastic mattress, preferably orthopedic, with a flat surface, avoid high or too flat pillows;
• if necessary, lift and/or carry heavy objects, avoid jerking when lifting weights in a semi-squat position, use special belts that support the lower back;
• choosing correct orthopedic shoes: with the appropriate width for the foot, without high heels and their timely replacement will help reduce the load on the spine, this is especially important for women during the childbearing period.In summer, you should not neglect the possibility of walking barefoot on uneven surfaces;this strengthens the foot muscles and relieves tension in the musculoskeletal system;
• A proper diet and drinking regime contributes to overall health and helps maintain normal metabolism;
• If you are prone to increased emotionality, anxiety accompanied by a spasmodic muscle reaction to stress, it is worth learning relaxation methods, as well as regularly attending restorative massage courses.