Why does osteochondrosis occur 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 disease of the spine in which degenerative and dystrophic lesions of the intervertebral discs occur.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 lower back;As it progresses, the pain “radiates” to the arms, chest, shoulders and upper thighs.With the negative dynamics of osteochondrosis, atrophy of muscle tissue, sensory disorders and dysfunction of internal organs, caused by their compression and displacement, begin.In the absence of 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 inadequate load distribution is the habit of carrying a bag on the shoulder or in one hand, incorrect sitting position, sleeping on an excessively soft mattress, high pillow and wearing anatomically incorrect types of footwear.

Additional risk factors include physical inactivity, a sedentary lifestyle, being overweight, 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 overload of the body;
• neuroemotional exhaustion;
• metabolic disorders, poisoning, diseases of the gastrointestinal tract that prevent the full absorption of nutrients;
• occupational risks, in particular, work on vibrating platforms;
• genetic predisposition;
• poor posture during the period of active growth, scoliosis;
• wear uncomfortable shoes (tight, high heels);
• prolonged and/or regular dehydration;
• poor diet, hypovitaminosis;
• smoking;
• pregnancy, especially multiple pregnancy, in combination with an undeveloped musculo-ligamentous apparatus (due to a change in the body's center of gravity).

Stages of development of osteochondrosis

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

• Stage 1 (grade) osteochondrosis is characterized by the initial stage of pathology in the nucleus pulposus of the intervertebral disc.Due to excessive load, the process of dehydration (dehydration) of the nucleus begins, which leads to a decrease in the height of the disc and the appearance of cracks in the fibrous ring.Symptoms at this stage, as a rule, are absent;slight discomfort may occur during prolonged stay in an uncomfortable static position or active movement;
• In stage 2, a decrease in the height of the discs leads to a decrease in the distance between the vertebrae and sagging of the spinal muscles and ligaments.This causes increased mobility of the vertebrae with affected discs, which is dangerous due to their displacement or slipping.During the second phase of the disease, discomfort and pain occur, especially with certain types of load, movements, positions;
• Stage 3 (grade) osteochondrosis is characterized by the formation of prolapses and protrusions of the intervertebral discs, which may be accompanied by subluxations and/or the development of arthrosis of the intervertebral joints.With some types of movement, patients feel stiffness, lack of mobility, and tingling and numbness in the limbs may occur.At this stage of osteochondrosis, pain is clearly felt in the back, neck, lumbosacral region or coccyx region, depending on the location of the affected discs;
• in stage 4 osteochondrosis, the body tries to correct the consequences of vertebral hypermobility and adapt to the impaired functionality of the spine.Osteophytes, new bone formations, improve the fixation of the vertebrae, they form at the points of contact between the vertebrae.However, in some cases, osteophytes can cause pinched nerves and damage the vertebrae.Fibrous ankylosis begins in the intervertebral discs and joints.In the absence of microtraumas and pinched nerve roots, the symptoms of the disease decrease.

Osteochondrosis symptoms

The main symptoms of osteochondrosis are a feeling of discomfort and/or pain in the neck and back.The severity of the 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 felt by the patient include a periodic or permanent feeling of fatigue in the back, mild or severe pain, depending on the stage of the disease.The pain can be located in the neck, back, chest, shoulder girdle, making movement of the upper extremities difficult and restricted.

The clinical picture of osteochondrosis largely depends on the location of the pathology, the degree of development of the process and the individual characteristics of patients.Pathology of intervertebral discs, dislocations, protrusions, hernias and the growth of osteophytes lead to various consequences.Among the most common are disorders of normal blood circulation in tissues, pinching of nerve endings, dysfunction of the spinal canal, edema, fibrosis of tissues and structures.Such consequences can be accompanied by various symptoms, leading to incorrect diagnoses of diseases.

The most common and characteristic symptoms of osteochondrosis include the following:

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

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

• in osteochondrosis of the cervical spine, pain predominates in the neck, arms and shoulder girdle, radiating to the scapula and shoulder region;headaches, dizziness, blinking “spots” or spots before the eyes and tinnitus are observed;
• if the thoracic spine is affected, the pain is localized in the chest, heart, inner surface of the shoulder, armpit area, respiratory discomfort is also noted, shortness of breath is possible;
• Osteochondrosis of the lumbosacral spine is manifested by low back pain radiating to the legs, 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 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 differentiated according to several principles.Depending on the localization of the pathology, osteochondrosis is distinguished from cervical, thoracic, lumbar, sacral or mixed diseases, combined types.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, neck pain, cervicocranialgia, cervicobrachialgia with different manifestations (vegetative-vascular, neurodystrophic, musculo-tonal) are identified;
• If the test result for radicular syndrome is positive, discogenic damage to the roots of the cervical spine is diagnosed.

For pathology of the thoracic level there are:

• for reflex syndromes - chest pain with vegetovisceral, neurodystrophic or muscle-tone manifestations;
• due to root injury – discogenic of the roots of the thoracic region.

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

• depending on the type of reflex syndrome - low back pain (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

To make a diagnosis, instrumental examination methods are used:

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

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

• spinal computed tomography (CT);
• nuclear magnetic resonance (NMR);
• magnetic resonance imaging (MRI).

Therapy instructions for osteochondrosis

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

Therapy for osteochondrosis disease 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 series of exercises.Surgical treatment in almost all situations cannot be the first choice method 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 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 blocks of nerve endings, which also help to reduce the severity of the muscle-tonic syndrome.The following types of blocks are distinguished: trigger point block, 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 uses are ultrasonic waves, magnetic fields, low-frequency currents and laser beams;
• methods of physiotherapy (physiotherapy) and kinesiotherapy.A set of special exercises, when performed regularly and correctly, helps to correct posture, strengthen the muscular corset, ligamentous apparatus, normalize muscle function, reduce compression of nerve fibers and help prevent complications of osteochondrosis.Exercise therapy methods and kinesiotherapy procedures are aimed at normalizing metabolic processes, restoring adequate nutrition to intervertebral discs, restoring the location of the vertebrae and discs between them and evenly distributing the load on 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 body's nervous system;
• manual therapy.Manual therapy methods are selected individually.A targeted effect on the musculoskeletal system of the body helps to improve blood circulation, lymphatic circulation, improves metabolism, helps to 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 with special equipment.The purpose of 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 aim to reduce the severity of symptoms by improving the processes of blood supply to tissues and their regeneration.Osteochondrosis cannot be cured with medication alone;therapy must 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 may 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 (thiotic acid);
• means for improving blood supply to tissues, B vitamins (mainly B3);
• preparations for regeneration and/or prevention of degeneration of cartilage tissue, hyaluronic acid.

Medications can be prescribed either in the form of ointments, creams for local use for pain, or for oral administration and injectables.

In case of acute complications, medications are used to block the 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, 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 meat, poultry, fish, fresh vegetables, fruits, nuts and seeds, cereals and mushrooms.It is especially recommended to include meat and fish jelly, jellied meat, jellied dishes in the diet and use extra virgin olive oil without heat treatment (for dressing salads).

Preferred food processing methods: steaming, roasting, boiling.Limit your intake of flour and confectionery products, fatty foods, spicy, salty dishes and seasonings, canned and smoked foods, strong meat broths, vegetables, sugar and fruits with a high sugar content (grapes).During the day, you should drink at least 1.5 liters of liquid, giving preference to clean mineral water, dried fruit compotes, unsweetened fruit juices and herbal teas.You should limit the amount of strong black tea, coffee, sweet soda and alcohol.

Complications of osteochondrosis

Failure to comply with prescribed treatment, prolonged avoidance of doctors 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:

• intervertebral disc herniation (spinal hernia);
• boss;
• kyphosis;
• radiculitis;
• salt deposits in the intervertebral space;
• strokes in the spinal cord;
• 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 severe symptoms and pain, advanced osteochondrosis is the most dangerous for the development of serious complications and can lead to the patient's disability.

Prevention of osteochondrosis

The causes of osteochondrosis are mainly related to lack of attention to the body's needs, poor nutrition and excessive stress on the body.To prevent the appearance 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 other activities that involve remaining 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 must choose the right chairs, chairs that support the spine, ensure compliance with the standards for positioning hands on the table, feet on the floor or special support, learn to maintain posture (back straight, shoulders relaxed);
• to sleep at night, you need to select an elastic mattress, preferably orthopedic, with a flat surface, avoiding high or very flat pillows;
• if necessary, lift and/or carry heavy objects, avoid jolts when lifting weights in the semi-squat position, use special belts that support the lower back;
• Choosing the correct orthopedic shoes: with a width suitable 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 pregnancy.In summer, you should not neglect the opportunity to walk barefoot on uneven surfaces;strengthens the foot muscles and relieves tension from 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 with a muscular spasmodic reaction to stress, it is worth learning relaxation methods, as well as regularly taking restorative massage courses.