Spinal osteochondrosis: symptoms and treatment

Osteochondrosis is a disease with a wide distribution, around the age of 35-40 it is found in varying degrees in most people. The most likely location of osteochondrosis is the lower cervical, upper thoracic, and lower lumbar spine. The etiology of osteochondrosis, that is, the specific causes and conditions of occurrence, is completely unknown. However, there is a direct influence of hereditary predisposition, age-related changes, injuries and impaired blood supply to tissues.

In the development of the disease, the main role is played by changes in the central part of the intervertebral disc, that is, dehydration. Remember that the disc consists of the nucleus pulposus and the annulus fibrosus around it. Due to desiccation, the disc loses its shock-absorbing functions, which leads to gradual destruction. In the development of the disease, four stages are distinguished, differing in certain changes in the disc and adjacent tissues. The severity of osteochondrosis of the spine, symptoms and treatment directly depend on the stage of development of the pathology.

Symptoms and causes of osteochondrosis of the spine

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

• First step. The formation of fissures in the inner layers of the annulus fibrosus and in the nucleus pulposus. Penetrating the slits, the nucleus irritates the nerve endings of the annulus fibrosus;
• Second level. As further irritation of the annulus fibrosus occurs due to the pathology of the nucleus pulposus, the attachment of the vertebrae deteriorates. There is unusual mobility of the spine;
• Third stage. Gradual damage to the annulus fibrosus. There is a protrusion of the nucleus (protrusion) beyond the anatomical limits of the annulus fibrosus, and then there is a rupture of the annulus and the formation of an intervertebral hernia (extrusion);
• Fourth step. There is a spread of degenerative changes to 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 location 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 symptoms depend on
on the degree of damage to the intervertebral disc and surrounding tissues.

cervical osteochondrosis	Thoracic osteochondrosis	lumbar osteochondrosis
Painful or sharp pain in a muscle in the neck, or part of the neck, or in the entire neck. Severe headaches. Nerve root syndrome: spread of pain to collarbone, shoulder, an arm, etc. Cardiac syndrome, which is not stopped by taking glycerol trinitrate. "Heaviness", weakness or movement disorder in one of the arms. Symptoms of Basilar Artery Insufficiency: dizziness, tinnitus, double vision, speech disorder, swallowing problems, hearing loss, loss of consciousness. Upper limb paresthesia: sensation of numbness of the hands (one or both), chills, tingling, false sensation of swelling of the limbs. Selective muscle atrophy and reduced limb reflexes.	The main types of osteochondrosis are considered cervical and lumbar. However, the thoracic spine is under constant stress and is prone to early development of gross degenerative changes, especially in young people. Due to the peculiarities of the development of alterations in the thoracic spine, the 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 lifting too much weight). Short term or long term, back pain or shooting. Waist chest pains. Pain in the chest wall and pain in the heart region. Pain in the muscles of the back, radiating to the buttocks, groin or thigh. Radiating pain in the region of the kidneys or gallbladder. Column stiffness. Pain on movement and on bending over. Pain and impaired sensitivity to 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 problems with urination. sloppy	Anomalies are most often seen in the lumbar spine. Pain in the lower back, it can be given in the groin, thigh, buttocks, leg. Often the pain radiates to one of the legs. Weight and stiffness of movements. Increase in body temperature in the acute period. Pain when probing IV-V lumbar vertebrae. Spasms of the back muscles. Weakness of leg muscles. Changes in the number III and IV vertebrae cause pain when bending the knee joint in the supine position. Damage to the V vertebra leads to pain from the outside of the leg to the foot and loss of sensation. Violation of defecation and urination. Sciatic nerve neuralgia, unilateral or bilateral. Further development of radicular syndrome can be atrophy of the leg muscles and impaired reflexes.

It was mentioned earlier that the etiology of osteochondrosis is not completely known. However, we can cite 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 variable intensity column. For example, the work of a porter (carrying weights) or a miner (being in unnatural positions for hours and a large physical load), a driver (vibration and sedentary) or an office worker (a sedentary sedentary lifestyle ;
• back injury;
• Poor physical development or overweight;
• Failure to maintain correct posture and stoop;
• As a result, flat feet and muscle imbalance lead to an uneven distribution of 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 preliminary 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 identified due to the topography of the spread of pain, which is able to tell exactly where (in the vertebrae of the neck, chest, lumbar region) the compression of the nerves took place.

The main diagnostic method for diagnosing osteochondrosis is an X-ray examination. On spinal radiography, degenerative changes are noticeable in the intervertebral joints, discs, narrowing of the intervertebral canal, sclerotic changes in the tissues of the spine. At the same time, the recognition of spinal injuries (especially at an early stage) is always difficult, since the processes that occur in this case are characteristic of various other diseases (tumors, metastases, ankylosing spondylitis, tuberculosis lesions).

In frontal x-ray images, the unevenness of the plates, increase or sharpness of the uncinate processes are detected. In profile images, a decrease in height, a change in shape, a herniated disc, osteophytes and other changes in the vertebral body are noticeable. 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 - a radiographic examination with the introduction of a contrast agent through a puncture directly into the intervertebral disc.

Another spinal study is a functional X-ray method. Thanks to the radiograph taken with 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 called CT) and magnetic resonance imaging (hereinafter called MRI). Although the first CT and MRI machines appeared in the 1970s and 1980s, the technologies are still being actively developed and improved, remaining largely inaccessible to the general population due to the high cost of exams or the lack of machines in local hospitals.

Methods of treating osteochondrosis of the spine

The treatment of osteochondrosis is a long and periodic complex process. It is intended to reduce and eliminate the consequences of changes in the intervertebral disc. Namely, inflammation, tightness, poor blood flow, muscle spasms. Many types of therapy can help with this process, including the methods of Eastern healers. In the treatment of osteochondrosis, the patient needs complete rest.

Most often, treatment takes place with non-invasive methods such as drug therapy, antiparasitic therapy, exercise therapy, and others. Invasive therapy, that is, surgical operations, is rarely used. For example, in such cases, when the intervertebral hernia persists for more than six months and conservative treatment does not produce a positive effect.

Osteochondrosis of the spine and its treatment are performed by doctors of various specialties: neurologist, orthopedist, vertebrologist, chiropractor and others. However, the diagnosis, appointment of exams and studies, is usually performed by a neurologist, as well as a vertebrologist, if there is a doctor of this specialty available in the clinic, due to their specialization in diseases of the spine.

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

1. Reduction of pain syndrome;
2. Removal of spasms;
3. Elimination of inflammation;
4. Squeezing reduction;
5. Improved blood flow;
6. Further spoilage prevention.

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

physiotherapy treatment

Physiotherapy procedures aim to improve blood microcirculation in the affected spine area, eliminating pain and relieving edema. In addition, physical therapy helps to reduce the doses of medications used. There are dozens of types of physical therapy. Here are some of them:

• Reflexology is the impact on acupuncture points with needles, electricity, laser. Helps relieve spasm and improve blood flow;
• Kinesiotherapy is a treatment through movement and special physical exercises. In fact, it is therapeutic gymnastics, but in an expanded sense. This includes training on simulators, group exercises under the guidance of a physician, spinal stretching;
• Therapeutic swimming. It allows performing exercises with spinal injuries for those patients who have difficulty performing them. For example, the elderly, people who are overweight or people with physical disabilities. It is important to note that due to the lifting force of the water, there is a uniform distribution of loads in the column;
• Impulse current therapy, UHF therapy, neurostimulation, magnetotherapy, massage and others.

Acupuncture

A unique method that came from oriental medicine. Its essence lies in the use of very fine special needles that enter special points on the body, literally, under the influence of gravity. These points were discovered by thousands of years of experience of oriental healers, later proven by official medicine. Acupuncture helps to eliminate even excruciating pain, has a positive effect on the nervous system as a whole and on nerve diseases.

Surgical intervention

Surgery is indicated only if there is no positive effect of non-invasive treatment or in case of serious complications. The main method of surgical treatment is discectomy - removal of a damaged disc. However, even after the operation with minimally invasive methods, rehabilitation will take at least 6 months.

At the same time, surgery will not eliminate the need for regular treatment of osteochondrosis. Since 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 cartilage tissue of the spine.

Medical treatment

This type of treatment is most effective in the short term. Medications immediately reduce pain, eliminate inflammation, relieve spasms, etc. However, once they are canceled, in the absence of other necessary procedures for the treatment of osteochondrosis, their effect will quickly wear off. At the same time, you cannot spend a lifetime with drugs, sooner or later they will have a side effect on the body.

Medications can be classified as primary and secondary treatment. They are often needed to improve the patient's life. They are used to relieve pain (therapeutic blockage), eliminate inflammation, relieve muscle spasms, improve blood flow. In recent years, another type of drug is being used more and more - chondroprotectors. However, medications alone cannot achieve a long-term permanent effect.

treatment at home

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

The listed procedures in combination with medications provide an effective treatment that relieves unpleasant symptoms and improves the general condition. In this case, special attention should be paid to proper nutrition and excess weight regulation.

Physiotherapy

Thanks to gymnastics, the mobility of the vertebrae is restored, the muscles and their circulatory system are strengthened. The latter is of great importance as the spine is deprived of its blood supply system and the intervertebral disc can only receive nutrients through adjacent tissues. In this case, it is necessary to distinguish between therapeutic exercises and any other training.

Manual therapy

One of the most effective methods. Since the manual therapist affects the muscles, ligaments and bones. Improves posture, restores the "normal" structure of the skeleton, relieves excess muscle tension. It even directly affects the vertebrae.

Manual therapy for osteochondrosis should be performed regularly, from once a year to several times, depending on the need. It should be noted that this is not a single, multidimensional procedure, lasting 10 to 20 sessions. Only then will it have a positive long-term effect.