Vertebral osteochondrosis: symptoms and treatment

Osteochondrosis is a widespread disease, at the age of 35-40 it is found in varying degrees in most people. The most likely localization of osteochondrosis is the lower cervical spine, upper thoracic spine 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 weakening of 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, namely dehydration. Remember that the disc is made up of the nucleus pulposus and the annulus fibrosus which surrounds 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 in 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 stage. The formation of cracks in the inner layers of the fibrous ring and in the nucleus pulposus. Penetrating into the cracks, the core irritates the nerve endings of the fibrous ring;
• Second phase. As further irritation of the annulus fibrosis occurs due to the pathology of the nucleus pulposus, the fixation of the vertebrae deteriorates. There is unusual mobility of the spine;
• Third step. Progressive damage to the annulus fibrosus. There is a protrusion of the core (protrusion) beyond the anatomical limits of the fibrous ring, then a rupture of the ring occurs and the formation of an intervertebral hernia (extrusion);
• Fourth step. There is a spread of degenerative changes in the surrounding tissues - vertebrae, ligaments, nerves, blood vessels. As a result of chronic inflammation, the intervertebral disc is 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 should be noted 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
Sharp or sharp pain in a neck muscle, or part of the neck, or the whole neck. Severe headaches. Nerve root syndrome: spread of pain to the collarbone, shoulder, arm, etc. Heart 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, slurred speech, swallowing problems, hearing loss, loss of consciousness. Upper limb paresthesia: feeling of numbness in the hands (one or both), goosebumps, tingling, false sensation of swelling in 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 the early development of severe degenerative changes, especially in young people. Due to the peculiarities of the development of changes in the thoracic spine, neurological symptoms manifest themselves 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, aching or throbbing pain in the back. Belt pains in the chest. Pain in the chest wall and pain in the region of the heart. Pain in the muscles of the back, radiating to the buttocks, groin or thigh. Radiation of pain in the region of the kidneys or gallbladder. Spinal stiffness. Pain when moving and stooping. Pain and impaired sensitivity to pressure in the area of the affected area of the spine. Movement disorders, depending on the degree of damage to one or both legs. Failure of internal organs: constipation and problems with urination. Slumped.	Abnormalities are most often seen in the lumbar spine. Pain in the lower back, can be transmitted to the groin, thigh, buttocks, lower leg. Often the pain radiates to one of the legs. Heaviness and stiffness of movements. Increased body temperature in the acute period. Pain when sounding the IV-V lumbar vertebrae. Back muscle spasms. Weakness of the leg muscles. Changes in the vertebrae numbered III and IV cause pain when bending the knee joint while lying down. Damage to vertebra V leads to pain on the outer part of the leg up 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 leg muscles and impaired reflexes.

It was mentioned earlier that the etiology of osteochondrosis is not completely known. However, the main causes of osteochondrosis of the spine can be named, with a proven effect on the development of the disease:

• Regular dynamic and static loads on the spine of varying intensity. For example, the work of a loader (carrying weights) or a miner (being in unnatural positions for hours and enormous physical load), a driver (vibration and a sedentary lifestyle) or a d'an office worker (a sedentary sedentary lifestyle;
• back injury;
• Low physical development or overweight;
• Failure to maintain correct posture and stoop;
• Flat feet and the resulting 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 process of human aging.

Diagnosis of osteochondrosis of the spine

The preliminary diagnosis of the disease (osteochondrosis) is made on the basis of the patient's complaints, his examination and palpation of the spine. In addition, 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, lower back) the compressionnerves occurred.

The main diagnostic method for diagnosing osteochondrosis is an X-ray examination. On the x-ray of the spine, degenerative changes in the intervertebral joints, discs, narrowing of the intervertebral canal, sclerotic changes in the tissues of the spineare noticeable. At the same time, recognition of vertebral lesions (especially at an early stage) is always difficult, since the processes occurring in this case are characteristic of a number of other diseases (tumors, metastases, ankylosing spondylitis, lesionstuberculosis).

On frontal x-ray images, unevenness of plaques, increase or sharpness of 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 done to detect them. The most complete information can be given by discography - an X-ray examination with the introduction of a contrast agent through a puncture directly into the intervertebral disc.

Another study of the spine is a functional x-ray method. Thanks to the x-ray 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 advanced research methods are computed tomography (hereinafter referred to as CT) and magnetic resonance imaging (hereinafter referred to as MRI). Although the first CT and MRI machines appeared in the 70s and 80s, the technologies are still being actively developed and improved, while remaining quite inaccessible to the general population due to the high cost of examinations or the lack of machines in hospitals. local.

Methods of treatment of osteochondrosis of the spine

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

For the most part, treatment is done 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 give a positive effect.

Osteochondrosis of the spine and its treatment are carried out by doctors of various specialties: a neurologist, an orthopedist, a vertebrologist, a chiropractor and others. However, the diagnosis, the appointment of tests and studies, is usually carried out by a neurologist, as well as a vertebrologist, if a doctor of such a specialty is available at the clinic, due to his specialization in diseases of thespine.

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. Reduced compression;
5. Improved blood circulation;
6. Prevention of further deterioration.

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

Physiotherapy treatment

Physiotherapy procedures are aimed at improving blood microcirculation in the affected region of the spine, eliminating pain and relieving edema. In addition, physiotherapy helps to reduce the doses of drugs used. There are dozens of types of physiotherapy. Here are a few :

• Reflexology is the impact on acupuncture points with needles, electricity, laser. Helps relieve spasms and improve blood circulation;
• Physiotherapy is treatment through movement and specific 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 doctor, stretching of the spine;
• Therapeutic swimming. Allows you to perform exercises with damage to the spine for patients who find it difficult to do them. For example, the elderly, overweight people or people with motor disabilities. It is important to note that due to the lifting force of the water, there is an even distribution of loads on the spine;
• Impulse current therapy, UHF therapy, neurostimulation, magnetic therapy, massage and others.

Acupuncture

A unique method from oriental medicine. Its essence lies in the use of very thin special needles that literally penetrate into special points of the body 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 nervous diseases.

Surgical intervention

Surgery is indicated only if there is no positive effect of non-invasive treatment or if there are serious complications. The main method of surgical treatment is discectomy - the removal of a damaged disc. However, even after the operation using 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. Before the operation, there is always a clear task to eliminate a specific defect: hernia, deformation, subluxation, etc. The operation does not affect the general process of degeneration of the cartilaginous tissue of the spine.

Medical treatment

This type of treatment is the most effective in the short term. Medicines immediately reduce pain, eliminate inflammation, relieve spasms, etc. However, as soon as they are canceled, in the absence of other procedures necessary for the treatment of osteochondrosis, their effect will quickly disappear. At the same time, you cannot spend your whole life on drugs, sooner or later they will have a side effect on the body.

Medications can be categorized as primary treatment and secondary treatment. They are often necessary to improve the life of the patient. They are used to relieve pain (therapeutic blockade), eliminate inflammation, relieve muscle spasms, improve blood circulation. In recent years, another type of drug is increasingly used - chondroprotectors. However, drugs alone cannot achieve a permanent long-term effect.

Home treatment

Home treatment for osteochondrosis consists of manual therapy (exercise therapy, Shants necklace), 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 enhanced.

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 the regulation of excess weight.

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, since the spine is deprived of its blood supply system, and the intervertebral disc can only receive nutrients from adjacent tissues. In this case, it is necessary to distinguish therapeutic exercises from any other training.

Manual therapy

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

Manual therapy of osteochondrosis should be carried out regularly, from once a year to several times, as needed. It should be noted that this is not a one-time, multidimensional procedure, lasting 10-20 sessions. Only then will it have a long-term positive effect.