Osteochondrosis: symptoms, causes, methods of treatment

Excessive tension in the back muscles causes a lot of discomfort and pain.Osteochondrosis, which causes disruption of the structure of the vertebrae and intervertebral discs, leads to severe pinching of nerve endings.Often, the pathology is accompanied by a deterioration of blood circulation, which provokes disturbances in the nutrition of the brain and internal organs.

Osteochondrosis - what is it?

Osteochondrosis is a recurrent disease that occurs in a chronic form and is accompanied by destruction of the vertebrae and intervertebral discs.Their tissues are disrupted, which leads to a decrease in their elasticity with a subsequent change in shape.There is a gradual reduction of the intervertebral space.This leads to a loss of stability of the spine in the areas where the pathology develops.

The processes of pathological tissue destruction occur against the background of pinched nerve endings, which are directed from the area where the spinal cord is located.As a result, the back muscles are in constant tension.In such a situation, patients complain of back pain and other symptoms.

Based on the peculiarities of the localization of the spinal structures affected by degenerative changes, cervical, thoracic and lumbosacral varieties of the pathological process are distinguished.The main sign of the development of osteochondrosis is pain, the intensity and severity of which usually increases during physical activity.

There is also stiffness in movements.In addition, the clinical picture is characterized by the presence of signs of the vertebral type - headache, changes in blood pressure, deterioration of visual function, hearing, etc.

Mechanism of development

The development of osteochondrosis is due to the fact that the nucleus pulposus begins to lose its hydrophilic properties.This semi-fluid structure contains connective tissue fibers and chondroitin, a gelatinous substance.During the development of the human body and its growth, processes of reduction of the vascular bed in the intervertebral discs are actively taking place.Nutrients are supplied in a diffuse manner, which is expressed in a spontaneous stabilization of the concentration.This characteristic creates difficulties in the complete restoration of cartilage that has suffered damage or excessive pressure on the spine.

Pathological deviations become more pronounced due to disturbances in hormonal levels and human nutrition.Cartilage tissue begins to experience a shortage of nutrients necessary for its normal development.Therefore, violations are manifested in the form of:

• reduced strength and elasticity;
• changes to consistency parameters and configuration properties.

Against the background of flattening of the intervertebral discs, radial cracks are formed in the fibrous rings.As a result, the intervertebral distance decreases and the facet joints begin to shift.Over time, pathological changes involve connective tissues associated with fibrous rings and ligaments.

As the tissue breaks down, the immune system produces immunoglobulins in increased amounts.This provokes the development of the process of aseptic inflammation and swelling is formed in the area where the facet joints are located.They also spread into nearby soft tissues.

Due to stretching of the joint capsules, the intervertebral discs lose their ability to fix the vertebrae.Such instability in the position of the spinal structure increases the risk of pinching nerve roots or squeezing blood vessels.This feature is characteristic, for example, of cervical osteochondrosis, which is accompanied by intense verbal symptoms.

Reasons for the development of the disease

The condition of the intervertebral discs can worsen with reduced tone of the skeletal muscles of the spine.Due to irrational and asymmetric muscle work, when the non-physiological position of the body is maintained for a long time, destruction of cartilage tissue may occur.This disorder occurs as a result of carrying heavy bags on one shoulder, using soft mattresses and high pillows.

The process of destruction of the intervertebral discs is accelerated due to the action of a number of negative factors of an external and internal nature.These include:

• disorders in the functioning of the endocrine mechanism and metabolic disorders;
• pathologies of an infectious nature, including chronic ones;
• damage to the spine in the form of compression fractures, bruises;
• regular and prolonged hypothermia of the body;
• diseases of systemic and degenerative-dystrophic type - gouty, psoriatic, rheumatoid arthritis, osteoporosis, osteoarthritis;
• smoking and alcohol abuse, which disrupts the state of the vascular system, disrupts blood circulation and provokes a lack of nutrients in the cartilage;
• insufficient physical development, problems with posture, flat feet - these defects increase the load on the spine, since shock absorption will be insufficient;
• obesity;
• genetic predisposition;
• exposure to regular stress.

Symptoms

The main clinical sign of osteochondrosis of any localization (cervical, thoracic or lumbosacral) is pain.In case of recurrence, the pain is piercing, radiating to nearby parts of the body.Even with slight movement it is amplified.This forces the patient to assume a forced body position to minimize discomfort and pain:

• with cervical osteochondrosis, it is preferable to turn not only one head, but the whole body;
• when the thoracic form of the disease is present, it is difficult for the patient to take a deep breath, and therefore, to avoid acute pain in the chest, he tries to minimize the depth and frequency of breathing;
• Patients with lumbar type disease have difficulty sitting, standing upright, and moving because the spinal nerve is compressed.

Usually, patients complain of the presence of dull, constant pain and a feeling of stiffness of movements in the morning after waking up.In this case, a differential diagnosis will be necessary to eliminate the risks of developing myositis caused by inflammation of the skeletal spinal muscles or osteoarthritis.

Aching and pressing pains occur due to compensatory tension in the muscle tissue.This condition is necessary to stabilize the range of motion of the spine.Persistent mild to moderate pain may also occur with significant stretching of the intervertebral disc as a result of aseptic inflammatory changes.

Osteochondrosis of a certain localization is characterized by special symptoms:

1. With cervical osteochondrosis, pain is felt in the area of the cervix, in the upper limbs.There is pain in the head and numbness in the fingers.If the disease manifests itself in a serious form, pinching of the vertebral artery may occur.In this case, the patient begins to complain of a significant deterioration in health.
2. Thoracic localization is manifested by sharp and painful pain in the back;there is a syndrome of visceral pain in the heart region, right hypochondrium and abdomen.Patients complain of numbness, paresthesia of the skin, difficulty breathing and crunching in the vertebrae.
3. Patients with lumbar osteochondrosis complain of pain in the back and lower limbs with increasing intensity during movement.Disorders in the work of the genitourinary system, problems with male potency, ovarian dysfunction are often diagnosed.During remission, the pain may decrease.Exposure to a provoking factor, however, leads to its resumption.

4. When mixed osteochondrosis occurs, symptoms can appear in several areas at the same time.This condition is characterized by a more severe course of the disease.

It should be remembered that the displacement of the vertebrae and the formation of osteophytes cause compression of the vertebral artery.Nourishes the brain, supplying its cells with oxygen.When squeezing, nutrition is limited, and therefore the patient has problems with coordination, headaches, tinnitus and arterial hypertension.

Consequences if not treated

The reason for the complex course of osteochondrosis is the relatively rapid formation of hernias in the intervertebral discs.Their appearance is associated with a posterior displacement of the spinal structure.This provokes a rupture of the posterior longitudinal ligament, which leads to instability of the position of the disc and protrusion of its individual sections in the region of the spinal canal.The hernia ruptures when the disc with the nucleus pulposus penetrates the area of the canal.

When pathological abnormalities occur in the spinal structures, the spinal cord begins to compress and the patient develops discogenic myelopathy.Symptoms of this condition are associated with numbness and weakness in certain muscle groups of the upper and lower limbs.Paresis, muscle atrophy and impaired tendon reflexes appear.In some cases, problems with emptying the bladder and bowels occur.

The formation of intervertebral hernias is dangerous due to the compression of the arteries that supply the spinal cord.The result of this pathology is the formation of ischemic zones where nerve cells are damaged and killed.The manifestation of the neurological effect is expressed in motor function disorders, a decrease in the degree of tactility and trophic disorders.

Diagnosis of the disease

The initial diagnosis is made based on the patient's complaints and existing symptoms.The specialist examines the condition of the spine in different positions, making the patient at rest or in motion.At the next stage, the patient is sent for laboratory diagnostics, which will help clarify the diagnosis or refute it.

Research methods used include:

1. Radiography- provides a comprehensive examination of the spine with an assessment of the condition of the vertebrae, existing disorders in the form of growths, distortions.The specialist will be able to determine the intervertebral spaces and the condition of the holes.To accurately identify osteochondrosis localized in the thoracic or cervical region, a two-stage X-ray examination is performed.In the first stage, the patient lies on his side, and in the second - directly on his back.
2. Tomographic method using MRI or CTprovide highly informative data that help the detailed examination of the vertebrae without interference from the organs covering them.The image shows the nerves and vascular system.MRI helps to identify signs of many diseases of the spine and the location of the damage.CT visualizes the hernia and determines possible deviations in the structure of the spine.
3. Laboratory researchto assess the condition of the blood and its basic parameters.It allows you to clarify the diagnosis and determine the possibility of developing concomitant diseases.

In many cases, as a result of examinations, doctors diagnose the presence of some underlying diseases that are potentially dangerous due to their complications.We are talking, for example, about hernia, protrusion, sciatica.Correct diagnosis of problems helps to treat osteochondrosis more effectively.At the same time, the disease itself in the first stages of development is disguised as the symptoms of other diseases.

Therapeutic process

Osteochondrosis is treated conservatively or surgically.The choice depends on the severity of the condition, its neglect, the level of tissue deterioration and the reasons for its occurrence.

It is important to remember that it is not possible to completely cure osteochondrosis, since there are no drugs that will help to completely restore the discs and vertebrae.The therapeutic effect is aimed at inhibiting the destruction process and increasing the duration and stability of remission.

Chondroprotectors based on chondroitin or glucosamine sulfate are used for symptomatic therapy.

The effectiveness of the therapeutic process with chondroprotectors has been clinically confirmed based on long-term tests.If you take these drugs for a long time (from 3 months), then there is a partial recovery of cartilage and other elements of the connective type - the tendon-tendon apparatus, bursa.

The accumulation of glucosamine and chondroitin in the area of the intervertebral discs leads to an analgesic, anti-edematous and anti-inflammatory effect.Therefore, there is a real opportunity to optimize the dosage of NSAIDs, glucocorticosteroids and muscle relaxants.You can count on reducing the patient's medication burden.

The effectiveness of chondroprotectors is determined by the regularity of their use.Otherwise, there will be no result.Inefficiency is also registered in the treatment of osteochondrosis of the 3rd degree, accompanied by significant destruction of cartilage.

The following groups of drugs can be used to relieve pain:

1. Nonsteroidal anti-inflammatory drugshelp eliminate inflammatory disorders in the soft tissues caused by displacement of the vertebrae.NSAIDs are effective in reducing pain, swelling, and stiffness.
2. Medicines from the group of glucocorticosteroids– blocks are usually used in conjunction with anesthesia.They are able to relieve pain, restore the functioning of the immune mechanism and provide an anti-exudative effect.
3. Muscle relaxants.They are effective in combating muscle spasms due to nerve impulses.They help to relax the skeletal muscles and block polysynaptic spinal reflexes with an antispasmodic effect.
4. External products with a warming effect.The irritation of the receptors of the subcutaneous tissue with the activation of blood flow is provided by special gels and ointments.These drugs have an analgesic and anti-edematous effect.

Symptoms of the vertebrogenic type, which appear due to the localization of the pathology in the cervical or thoracic region, can be eliminated with the help of medical means to activate the blood flow.Nootropics and drugs to improve microcirculation are also prescribed.In some cases, it may be necessary to take antidepressants, as well as pharmaceutical drugs with an anticonvulsant effect.

During the treatment of osteochondrosis, they also resort to physiotherapy.UHF therapy, magnetic therapy, laser therapy, reflexology, massage, exercise therapy, hirudotherapy, as well as swimming and yoga can be prescribed.If conservative treatment is ineffective, surgery is performed through microdiscectomy, puncture disc valorization, laser reconstruction, or implant replacement.