Excessive strain on the back muscles causes a lot of discomfort and pain. Osteochondrosis, which causes a violation of the structure of the vertebrae and intervertebral discs, leads to a severe pinching of nerve endings. Often, the pathology is accompanied by impaired blood circulation, which provokes disturbances in the nutrition of the brain and internal organs.
Osteochondrosis: what is it?
Osteochondrosis is a type of recurrent disease that occurs in a chronic form and is accompanied by destruction of the vertebrae with intervertebral discs. Their tissues are altered, which causes a decrease in the degree of their elasticity with a subsequent change in shape. There is a gradual narrowing of the disc space. This causes a loss of stability of the spine in the areas of development of the pathology.
Pathological tissue destruction processes occur in the context 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.
On the basis of the peculiarities of the localization of the structures of the spine, which were covered by degenerative changes, the cervical, thoracic and lumbosacral types of the pathological process are distinguished. The main symptom of the development of osteochondrosis is pain, the intensity and severity of which usually increase during physical exertion.
There is also stiffness in movement. In addition, the clinical picture is characterized by the presence of vertebral-type signs: headaches, changes in blood pressure, impaired visual function, hearing, etc.
Development Mechanism
The development of osteochondrosis is associated with the fact that the nucleus pulposus begins to lose its hydrophilic qualities. This semi-liquid structure contains connective tissue fibers and chondroitin, a gelatinous substance. In the process of development of the human body and its growth, the processes of reduction of the vascular bed in the intervertebral discs actively advance. Nutrients are supplied diffusely, which manifests itself in spontaneous concentration stabilization. This characteristic becomes the reason for the difficulties in the complete restoration of cartilage that has suffered damage or excessive pressure on the spine.
Pathological abnormalities become more conspicuous due to violations in the hormonal background and human nutrition. Cartilage tissue begins to lack the necessary nutrients for its normal development. Therefore, the disorders appear in the form:
- decrease in strength and elasticity;
- changes consistency parameters and configuration properties.
In the context of flattening of the intervertebral discs, the formation of radial cracks occurs in the fibrous rings. As a result, the intervertebral distance is reduced and the facet joints begin to shift. Over time, pathological changes encompass the types of connective tissue associated with the fibrous rings and ligaments.
As tissues are broken down by the immune system, greater amounts of immunoglobulins are produced. This provokes the development of the aseptic inflammation process, edema forms in the area where the facet joints are located. They also spread to adjacent soft tissues.
Due to stretching of the joint capsules, the intervertebral discs lose their ability to fix the vertebrae. Such instability of the position of the spinal structure increases the risks of pinching the nerve roots or squeezing the blood vessels. This feature is typical, for example, of cervical osteochondrosis, which is accompanied by intense verbal symptoms.
Causes of the disease
The condition of the intervertebral discs can worsen with a decrease in the tone of the skeletal muscles of the spine. Due to the irrational and asymmetric work of the muscles, destruction of cartilage tissues can occur with the prolonged preservation of the non-physiological position of the body. This infraction is the result of carrying heavy bags on the same shoulder, using soft mattresses and high pillows.
The process of destruction of the intervertebral discs is accelerated due to the action of a series of negative factors of external and internal nature. These include:
- disorders in the endocrine mechanism and metabolic disorders;
- pathologies of an infectious nature, even in chronic form;
- spinal injuries in the form of compression fractures, bruises;
- regular and prolonged body hypothermia;
- systemic and degenerative-dystrophic diseases: gouty, psoriatic, rheumatoid arthritis, osteoporosis, osteoarthritis;
- smoking and alcohol abuse, which alters the state of the vascular system, alters blood circulation and causes a lack of nutrients in the cartilage;
- insufficient physical development, problems with posture, flat feet - these defects increase the load on the spine, since the amortization will be insufficient;
- obesity;
- genetic predisposition;
- exposure to regular stress.
Symptoms
The main clinical sign of osteochondrosis of any location (cervical, thoracic or lumbosacral) is pain syndrome. With a relapse, the pain is piercing and radiates to nearby areas of the body. Even with a slight movement, it intensifies. This forces the patient to place the torso in a forced position to minimize discomfort and pain:
- with cervical osteochondrosis, it will be preferable to turn not one head, but the whole body;
- when the thoracic form of the disease is present, it is difficult for the patient to breathe deeply, and therefore, to exclude acute chest pain, try to minimize the depth and frequency of breathing;
- in patients with a type of lumbar disease, difficulties arise when sitting, taking an upright position, moving, as the nerve of the spinal location is pinched.
Typically, patients complain of persistent dull pain and a feeling of stiffness in movements in the morning after waking up. In this case, a differential diagnosis will be required to help eliminate the risks of developing myositis caused by inflammation of the spinal skeletal muscles or osteoarthritis.
Throbbing and squeezing pains occur as a result of compensatory tension in muscle tissues. This condition is necessary to stabilize the range of movement of the spine. Consistent mild to moderate pain can occur with significant stretching of the intervertebral disc and be the result of aseptic inflammatory changes.
Osteochondrosis of a separate site is characterized by special symptoms:
- With cervical osteochondrosis, pain is felt in the cervical area, in the upper extremities. Headaches and numbness of the fingers are observed. If the disease manifests itself severely, pinching of the vertebral artery may occur. In this case, the patient begins to complain of a significant deterioration in health.
- The thoracic location is manifested by sharp and aching pain in the back, the visceral pain syndrome is present in the cardiac region, right hypochondrium and abdomen. Patients complain of numbness, paresthesia of the skin, shortness of breath, cracking in the vertebrae.
- Patients with lumbar osteochondrosis complain of pain in the back and lower extremities with increased intensity when moving. Often, disorders in the functioning of the organs of the genitourinary system, problems with male potency, dysfunctional ovarian disorder are diagnosed. During remission, the pain may decrease. However, the impact of a provoking factor leads to its renewal.
- When mixed osteochondrosis occurs, the symptoms can manifest 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. It nourishes the brain by supplying its cells with an oxygen component. When squeezed, food is limited and therefore the patient has coordination problems, headaches, tinnitus, and high blood pressure.
Consequences if left untreated
The reason for the complicated course of osteochondrosis is the relatively rapid formation of hernias in the intervertebral discs. Its appearance is associated with the displacement of the vertebral structure in a posterior direction. This causes a rupture of the posterior ligament of the longitudinal type, which results in instability of the position of the disc, protrusion of its individual sections in the region of the spinal canal. Hernia rupture occurs when a disc with a nucleus pulposus penetrates the canal area.
When pathological abnormalities appear in the vertebral structures, the back of the brain begins to contract, the patient develops discogenic myelopathy. Symptoms of this condition are associated with numbness and weakness in certain muscle groups of the upper and lower extremities. Parasia, muscle atrophy, and tendon reflexes manifest. In some cases, there are problems emptying the bladder with the intestines.
Herniated discs are dangerous by squeezing the arteries that supply the spinal cord. The result of this pathology is the formation of ischemic areas, where nerve cells have suffered damage and death. The manifestation of a neurological effect is expressed in motor function dysfunctions, a decrease in the degree of touch, and a trophism disorder.
Disease diagnosis
The initial diagnosis is made on the basis of the patient's complaints and symptoms. The specialist studies the state of the spine in different positions, suggesting that the patient be at rest or in motion. At the next stage, the patient is sent for a laboratory diagnosis, which will help to clarify the diagnosis or disprove it.
Research methods used include:
- X-ray- provides a comprehensive examination of the spine with an assessment of the state of the vertebrae, existing disorders in the form of growths, curvatures. The specialist will be able to determine the intervals of the intervertebral type, the state of the holes. To accurately identify osteochondrosis, localized in the chest or cervical area, 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.
- The computed tomography or magnetic resonance tomography methodprovides very informative data, which helps to study the vertebrae in detail without interference in the shape of the organs that cover them. The image shows the nerves and vascular system. MRI helps to identify the signs of many diseases of the spine and the location of the damage. With CT, hernias are visualized, possible deviations in the structure of the spine are determined.
- Laboratory testto evaluate the condition of the blood and its main parameters. It allows you to clarify the diagnosis and determine the possibility of developing concomitant diseases.
In many cases, as a result of the examinations, doctors diagnose the presence of some underlying diseases, potentially dangerous due to their complications. We are talking, for example, of hernias, protrusion, radiculitis. The correct diagnosis of problems helps to effectively treat osteochondrosis. At the same time, the disease itself in the early stages of development is disguised as the symptoms of other diseases.
Therapeutic process
Osteochondrosis is treated conservatively or with surgery. The choice depends on the severity of the condition, its negligence, the level of tissue deterioration, the causes.
It is important to remember that osteochondrosis cannot be completely cured, as there are no medications that help fully restore the discs and vertebrae. The therapeutic effect is focused on inhibiting the destruction process and increasing the duration and stability of remission.
For symptomatic therapy, chondroprotectors are used, which are based on chondroitin sulfate or glucosamine.
The efficacy of the therapeutic process with the use of chondroprotectors has been clinically confirmed by long-term tests. If you take these funds for a long period of 3 months, then there is a partial restoration of cartilage and other elements of the connection type - the ligamentous tendon apparatus, bursa.
The accumulation of glucosamine and chondroitin in the area of the intervertebral disc leads to the manifestation of analgesic, anti-oedematous and anti-inflammatory effects. Therefore, there is a real opportunity to optimize the dose of NSAIDs, drugs from the group of glucocorticosteroids, muscle relaxants. You can count on a decreased drug load on the patient.
The effectiveness of chondroprotectors is determined by the regularity of their intake. Otherwise, there will be no result. Ineffectiveness is also recorded in the treatment of osteochondrosis in the third degree, accompanied by significant destruction of cartilage.
The following groups of medications can be used to relieve pain:
- Non-steroidal anti-inflammatory drugshelp eliminate inflammatory soft tissue disorders caused by vertebral displacement. NSAIDs are effective in reducing pain, swelling, and stiffness.
- Means from the glucocorticosteroid group- Blocks are usually used in conjunction with an anesthetic. They are able to relieve pain, restore the immune mechanism and provide an anti-exudative effect.
- Muscle relaxants.They are effective in fighting muscle spasms due to entrapment of nerves. They help to relax skeletal muscles and block polysynaptic spinal reflexes with antispasmodic effect.
- External remedies with warming effect.Irritation of the subcutaneous tissue receptors with activation of blood flow is provided by special gels and ointments. These drugs have analgesic and antiedematous effects.
It is possible to eliminate the symptoms of the vertebrogenic type, which manifests as a result of the localization of the pathology in the cervical or thoracic area, using medical devices to activate blood flow. Nootropics and medications are also prescribed to improve microcirculation. In some cases, you may need to take antidepressants, as well as pharmaceuticals with anticonvulsants.
During the treatment of osteochondrosis, physiotherapy is also used. Procedures for UHF therapy, magnet therapy, laser therapy, reflexology, massage, exercise therapy, hirudotherapy, as well as swimming and yoga may be prescribed. If conservative treatment is ineffective, the operation is performed by microdiscectomy, puncture disc valuation, laser reconstruction, or implant replacement.