Osteochondrosis -Degenerative-dystrophic damage to the tissues of the spine, characterized by damage to the intervertebral discs, adjacent articular surfaces and vertebral bodies, the ligamentous apparatus of the spine.
Most often, the pathological processes in osteochondrosis first affect the bones and ligaments. The fact that the disease has already started, we usually learn when complications appear: pain, sensory disturbances, muscle atrophy, alteration of internal organs.
Who gets osteochondrosis?
Today, 40 to 90% of the world's population suffers from osteochondrosis. Most often, the disease affects people over the age of 30. However, the first symptoms of osteochondrosis may appear in adolescence.
Stages of development of osteochondrosis of the spine.
- The first stage in the development of osteochondrosis.
Dehydration of the nucleus pulposus begins. This leads to a decrease in the height of the disc. Cracks appear in the annulus fibrosus, but the pathological process does not go beyond the intervertebral disc.
- The second stage in the development of osteochondrosis.
As a result of a decrease in the height of the disc, the points of attachment of the muscles and ligaments that belong to two adjacent vertebrae are brought closer together. Therefore, the muscles and ligaments sag. This can lead to excessive mobility of the two vertebrae with respect to each other, that is, instability of the vertebral-motor segment is formed. This stage is characterized by slipping or displacement of the vertebrae relative to each other with the formation of spondylolisthesis.
- The third stage in the development of osteochondrosis.
During this period, the most pronounced morphological changes occur, which mainly concern the intervertebral discs themselves: prolapses and protrusions of the discs are formed. The articular apparatus of the vertebral-motor segment also suffers. In the intervertebral joints and non-vertebral joints, subluxations occur, osteoarthritis is formed.
- The fourth stage in the development of osteochondrosis.
At this stage, adaptive changes occur in the affected segments of the spine. The body tries to overcome the excessive mobility of the vertebrae, to immobilize the spine to maintain its supportive and protective functions. In this sense, marginal bone growths appear on the adjacent surfaces of the vertebral bodies, that is, osteophytes. An osteophyte that grows "in the wrong place" causes microtraumatization of the nerve root. In the fourth stage, fibrous ankylosis processes generally begin in the intervertebral discs and joints. Ultimately, the vertebral-motor segment turns out to be, as it were, walled in a shell: the clinical manifestations decrease.
Causes of osteochondrosis.
In each of the many existing theories about the development of osteochondrosis, various causes are accepted that are responsible for the onset of the disease, for example, mechanical injury, hereditary predisposition or metabolic disorders. A particular difficulty in determining the cause of osteochondrosis is due to the fact that this disease can occur in both old and young people, both physically fit and less trained. There is a widespread belief that the cause of osteochondrosis is the deposit of salts in the spine: supposedly on x-rays, salt can be seen in the form of "growths" or "hooks" on the vertebrae. If during movement there is a cracking and cracking sound in the joints, as if sand is being poured between them, for many patients the only reason for this condition is the notorious "salt deposition". Such misconceptions are by no means harmless: the correct idea of ways to treat an ailment can be determined based on an analysis of the causes that caused it.
The term "osteochondrosis" comes from the Greek roots osteon - "bone" and chondr - "cartilage". The ending "-oz" means that the bone and cartilage disease is not associated with inflammatory processes, it is degenerative-dystrophic in nature, that is, the basis of the disease is a malnutrition of the tissues and, as a consequence, degeneration of its structure. Like all living tissues, the bone tissue of the vertebrae and the cartilaginous tissue of the intervertebral discs are constantly reorganized and renewed. Under the influence of regular physical exertion, they acquire strength and elasticity, and in the absence of loads, the strength of the tissues decreases.
This is due to the peculiarities of nutrition and blood supply to bone and cartilage tissues. Adult discs do not have their own vessels, they receive nutrients and oxygen from neighboring tissues. Therefore, for proper disc nutrition, it is necessary to activate blood circulation in the tissues surrounding the discs. And this can only be achieved through intense muscle work.
Depending on its composition, the intervertebral disc can be divided into two parts: this is the gelatinous nucleus that gives the disc elasticity, located in the center, and the strong fibrous ring that surrounds it. Due to the deterioration in the nutrition of the intervertebral discs, the complex structure of biopolymeric compounds that make up the nucleus pulposus is destroyed. The moisture content in the gelatinous core decreases and it becomes more brittle. When exposed to even minor overloads, the gelatinous core can disintegrate into fragments. This leads to an even greater decrease in its elasticity. There is also a decrease in the strength of the fibrous disc rings. All these factors create the basis and form the cause of the development of osteochondrosis.
To restore the function of the spine, it is necessary the healing of the damage to the intervertebral disc, the mobilization of the compensatory capacities of the spine, as well as the musculoskeletal system as a whole, and not the reabsorption of "salt deposits" or the removal of "spines" on the vertebrae. When conducting an X-ray examination after the end of treatment, it can be seen that the vertebrae have not changed shape. And the notorious "spines" are not the cause of osteochondrosis, but a consequence of adaptive processes. Marginal growths increase the area of the supporting surface of the vertebral body. As the area increases, the specific pressure decreases, which makes it possible to compensate for the decrease in strength and elasticity of the intervertebral disc.
Degenerative-dystrophic changes that occur in the spine are accompanied by calcification (calcification) of damaged discs, individual sections of joint ligaments, cartilage, and capsules. This process can only be called salt deposition. Therefore, this is not the cause of osteochondrosis, but only a consequence and the final stage of the above process.
The reverse development of structural changes in the spine is almost impossible. But keeping them to a minimum is a very real challenge. If no effort is made to keep the spine in the same condition that was achieved with treatment, pain may return.
Clinical manifestations of osteochondrosis.
The clinical manifestations of osteochondrosis are very diverse. They depend on the stage of development of osteochondrosis. The main clinical symptoms of osteochondrosis occur when the pathological process extends to the posterior part of the fibrous ring and the posterior longitudinal ligament. Depending on the stage of degeneration of the intervertebral discs, there is irritation, compression or altered conduction of the roots of the spinal cord, compression of the vessels or of the spinal cord. Several neurological syndromes develop: reflex and compression.
The main cause of pain in osteochondrosis is the so-called nerve root irritation. In this case, circulatory disorders occur, edema occurs, and in the future fibrosis of the surrounding structures may develop, which is accompanied by an increase in the sensitivity of the roots to various influences (movements in the affected segment of the spine, etc. ).
Vascular disorders in osteochondrosis are often associated with impaired vasomotor innervation. Mechanical compression of blood vessels by osteophytes is also possible, for example in the cervical spine.
Symptoms of osteochondrosis.
One of the characteristics of spinal osteochondrosis that aggravates the process is its too extensive symptoms. The disease can manifest itself in completely different parts of the body. It can be pain or numbness in the extremities or disorders and pain in the internal organs. At the same time, often a person in no way associates pain in the heart region, abnormalities in the functioning of the genital organs, headaches, pain and numbness in the legs with osteochondrosis, and in general with the spine. , dealing with the "treatment" directly of the symptoms of osteochondrosis with the help of various types of painkillers, all kinds of advertised drugs, dietary supplements and other methods. But this path only exacerbates the situation. Osteochondrosis continues to develop and the treatment methods used, at best, simply do not lead to significant improvement except to temporarily relieve pain, and at worst can further damage the body.
Therefore, it is important to carefully analyze your condition and the changes that are taking place in it. It is necessary to start moving in the right direction: consult a doctor in a timely manner, make the necessary diagnoses, and only after determining the correct diagnosis, begin treatment under the supervision of the attending physician.
The main symptoms of osteochondrosis include, first of all, pain and discomfort in the back. At the same time, the pains can be periodic and unstable in nature, now they appear and then disappear. But already the first sensation of discomfort or pain in the spine should make you think. The appearance of the first pains is a signal to at least pay attention to it, try to remember the reason why they appeared. This may be due to lifting a heavy object, a sudden movement, a fall, etc.
Another symptom of osteochondrosis is the accompaniment of back discomfort or pain with pain and numbness of the extremities (arms or legs). The pain most often radiates to the left limb, that is, to the left arm or leg. In addition, pain can manifest itself in the region of the heart, in the back, and not only in the region of the spine, but for example in the ribs, etc. It is especially important in this case to pay attention to the nature of the change in pain depending on the patient's actions, comparing the sensations of pain in the back with pain, for example, in the leg. If the patient has been sitting for a long time and has pain or numbness in the foot, discomfort in the lumbar area, and after a little warming up or walking the pain has disappeared, then this will be an indirect sign that determines lumbar osteochondrosis of the spine . The same image can be with the neck and arm. Summarizing, we can say that the main symptoms of osteochondrosis include pain and discomfort in the back. In the event that these symptoms coincide with pain in other parts of the body, osteochondrosis can be complicated by protrusion, herniated disc, with a pinched nerve.
In addition, I would like to draw attention to the fact that even with the appearance of the first pain in the spine, it is necessary to pay special attention to this discomfort. After all, osteochondrosis can manifest itself weakly or not at all for a long time. At the same time, it will continue to develop successfully in the spine, leading to the degradation of an increasing number of discs. Therefore, a timely visit to a doctor will make it possible to diagnose osteochondrosis at an earlier stage, which will facilitate its treatment.
Osteochondrosis and salt deposition.
Osteophytes, or hook-shaped growths on the vertebrae, appear to reduce the load on the intervertebral discs. In this case, the appearance of osteophytes impairs the mobility of the intervertebral joints.
The common opinion in everyday life that salt deposition is the main cause of osteochondrosis is wrong. Therefore, the treatment of osteochondrosis with a salt-free diet is meaningless.
The most common complaints of osteochondrosis of the spine.
The most common complaints in osteochondrosis are the following:
- Discomfort in various parts of the spine. The pain can range from mild, dull, drawing to severe, sometimes very severe and unbearable, with low back pain.
- Increased fatigue at work, both physical and mental.
- Sensory impairment in the extremities and various parts of the body, chills in the arms or legs.
- Pain that radiates to the legs, along the nerve trunks.
- Pain radiating to the scapula, shoulder, as well as pain in the neck and back of the head.
- A frequent companion of cervical osteochondrosis is headaches, dizziness. An increase in visual fatigue or a decrease in visual acuity is often observed.
- With the defeat of the lumbar-sacral region, disorders of the reproductive system are common - various sexual dysfunctions. Therefore, in most men, after treatment, there is an increase in sexual potency. In women, normal lumbosacral function increases the chance of conception and contributes to a comfortable pregnancy.
Diagnosis of osteochondrosis.
To diagnose osteochondrosis, it is necessary to collect an anamnesis. In this case, it is essential to establish the patient's complaints. Certain symptoms of osteochondrosis are quite typical. Others, on the other hand, must be differentiated from the signs of other diseases. It is important that the nervous, vascular and trophic disorders that occur in osteochondrosis can simulate various diseases, such as angina, gastritis, gastric ulcer, acute surgical diseases of the abdominal organs. Therefore, to avoid a misdiagnosis and the subsequent prescription of an incorrect treatment, each symptom must be subjected to a detailed analysis.
When collecting the anamnesis, including the patient's complaints, the history of the current disease and the patient's life, the doctor pays attention to his age, since osteochondrosis develops more often in older people and the evolution of symptoms from the moment they arise until the patient leaves. to the doctor. For osteochondrosis, slow development is characteristic, in which periods of exacerbation are periodically replaced by periods of remission. Additional research methods are prescribed to clarify the diagnosis.
X-ray exams for osteochondrosis.
The most accessible method of diagnosing osteochondrosis and at the same time quite informative is the X-ray examination. There are several types of X-ray methods for diagnosing this disease:
Plain spine radiography is the simplest X-ray method for diagnosing osteochondrosis. Its essence lies in obtaining an X-ray of the spine as a whole or of its individual segments. Most often, an observation X-ray is performed: based on the symptoms of the disease and the patient's complaints, the location of the spinal injury is determined. On the X-ray image of the spinal segment affected by osteochondrosis, a decrease in the thickness (atrophy) of the intervertebral discs can be seen, manifested in the form of a decrease in the space between the vertebrae, the appearance of bone. outgrowths of the vertebral bodies - osteophytes, partial dissolution - resorption of bone tissue from the vertebral body, a change in the shape of the spinal segment, for example, smoothing of lumbar lordosis.
Myelography is a more complex and dangerous diagnostic method. During this test, a certain amount of contrast liquid is injected into the spinal canal. The risk of this examination method is the possibility of allergic reactions to the contrast agent or the risk of damage to the spinal cord during puncture of the spinal canal. Thanks to myelography, the internal structure of the spinal canal can be determined. This method is especially informative for the determination of spinal hernias.
Computed tomography and magnetic resonance imaging are the most modern, but also the most expensive and difficult to access methods for diagnosing osteochondrosis. These diagnostic methods are often used when it is necessary to differentiate between osteochondrosis and other diseases of the spine, which present similar symptoms, for example, tumors of the spinal canal.
For a comprehensive assessment of the patient's condition, it is mandatory to conduct a neurological examination of the patient with osteochondrosis. Thanks to a neurological consultation, it is possible to clarify the location and degree of motor and sensory disorders.
Treatment of osteochondrosis.
The clinic offers effective treatment for all forms of osteochondrosis. Treatment is done on an outpatient basis. Treatment is based on a comprehensive program aimed at quickly eliminating the underlying syndrome and the cause of suffering. As part of a complex therapy, the following methods can be used:
- acupuncture;
- vacuum therapy;
- gentle manual therapy techniques (post-isometric relaxation);
- laser therapy;
- pharmacopuncture;
- dry traction;
- magnetopuncture;
- electrical stimulation and other treatment methods.
On average, the course of treatment is 10-15 sessions, and the elimination of acute pain syndrome is 1-3 sessions.
The earlier treatment is started, the better the result!
Is the complete removal of osteochondrosis real?
It depends on the form of the disease, the severity, the correctness and the timeliness of the treatment. A complete cure is possible only in the initial stages.
But it is possible to prevent exacerbations of osteochondrosis, not to feel pain for years. If a person had osteochondrosis, but now he does not feel discomfort, this does not mean that it passed without a trace. There may be changes in the column.
The main task is to suspend the development of the disease and do everything possible so that some of the pathological changes in the spine disappear, the symptoms disappear or decrease (back pain, cold wave and numbness of arms, legs, headaches , etc. ).