Spinal osteochondrosis: symptoms and treatment.

Osteochondrosis is a disease with a wide distribution, at the age of 35-40 years 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 its 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, namely dehydration. Remember that the disc is made up of the nucleus pulposus and the annulus fibrosus that surrounds it. Due to desiccation, the disc loses its cushioning functions, which leads to gradual destruction. In the development of the disease four stages are distinguished, which differ in certain changes in the disc and in the 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 annulus fibrosus and in the nucleus pulposus. Penetrating into the cracks, the core irritates the nerve endings of the fibrous ring;
• Second stage. While further irritation of the annulus fibrosus occurs due to nucleus pulposus pathology, the fixation 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 fibrous ring, and then there is a rupture of the annulus and the formation of an intervertebral hernia (extrusion);
• Fourth stage. 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 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 depends on
on the degree of damage to the intervertebral disc and surrounding tissues.

cervical osteochondrosis	Thoracic osteochondrosis	lumbar osteochondrosis
Soreness or sharp pain in a muscle of the neck, or part of the neck, or the entire neck. Severe headaches. Nerve root syndrome: spread of pain to the 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 disorders, swallowing problems, hearing loss, loss of consciousness. Paresthesia of the upper limbs: feeling of numbness in the hands (one or both), goosebumps, tingling, false sensation of swelling of the limbs. Selective muscle atrophy and reduced limb reflexes.	The main types of osteochondrosis are considered to be 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 throbbing or aching pains in the back. Girdle of pains in the chest. Pain in the chest wall and pain in the region of the heart. Pain in the back muscles, radiating to the buttocks, groin, or thigh. Irradiation of pain in the region of the kidneys or gallbladder. Spinal stiffness. Pain when moving and bending over. 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 the internal organs: constipation and problems urinating. Flexible.	Abnormalities are most commonly seen in the lumbar spine. Low back pain can occur in 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 on probing of lumbar vertebrae IV-V. Spasms of the back muscles. Weakness of the leg muscles. Changes in the vertebrae numbered III and IV cause pain when bending the knee joint in the supine position. Damage to the V vertebra causes pain on the outside of the leg down to the foot and loss of sensation. Violation of defecation and urination. Neuralgia of the sciatic nerve, unilateral or bilateral. Further development of radicular syndrome may be atrophy of the leg muscles and impaired reflexes.

It was mentioned above that the etiology of osteochondrosis is not fully understood. However, we can name 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 spine of varying intensity. For example, the work of a loader (carrying weights) or a miner (being in unnatural positions for hours and a great physical load), a driver (vibration and sedentary lifestyle) or an office worker (sedentary lifestyle sedentary lifestyle;
• Back injury;
• Weak physical development or excess weight;
• Not maintaining the correct posture and slouching;
• As a result, flat feet and muscle imbalance lead to 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.

Preliminary diagnosis of the disease (osteochondrosis) occurs 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 can indicate exactly where (in the vertebrae of the neck, chest, lower back) compression of the nerves occurred. nerves.

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

On frontal X-ray images, irregularity of the plates, an increase or sharpening of the uncinate processes, are detected. On profile images, a decrease in height, a change in shape, a herniated disc, osteophytes, and other changes in the vertebral body are noted. Small degenerative changes are not visible on a plain x-ray and contrast x-ray examination is done to detect them. The most complete information can be provided 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 high-tech methods of investigation are computed tomography (hereinafter - CT) and magnetic resonance imaging (hereinafter - MRI). Although the first CT and MRI machines appeared in the 1970s and 1980s, the technologies are still being actively developed and improved, although they remain quite inaccessible to the general population due to the high cost of examinations or the lack of machines. at local hospitals.

Methods of treatment of osteochondrosis of the spine

Treatment of osteochondrosis is a long periodic complex process. Its goal is 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 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, deworming 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 specialty is available at the clinic, due to his specialization in spinal diseases.

Summarizing, 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. reduction of squeezing;
5. Improved blood flow;
6. Prevention of further deterioration.

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

physiotherapy treatment

Physiotherapy procedures are aimed at improving blood microcirculation in the affected spinal area, eliminating pain and relieving edema. In addition, physiotherapy helps reduce the doses of the drugs 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 spasms and improve blood flow;
• Kinesiotherapy is a treatment through movement and special physical exercises. In fact, this 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. It allows performing exercises with spinal damage for those patients who find it difficult to perform them. For example, the elderly, people who are overweight or have 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;
• Therapy with impulse currents, UHF therapy, neurostimulation, magnetotherapy, massages and others.

Acupuncture

A unique method that comes from oriental medicine. Its essence lies in the use of very fine special needles that penetrate into special points on the body literally under the influence of gravity. These points were discovered by thousands of years of experience of Eastern healers, later verified by official medicine. Acupuncture helps to get rid of 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 cartilaginous 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, as soon as they are canceled, in the absence of other procedures necessary for the treatment of osteochondrosis, their effect will quickly wear off. 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 classified as primary and secondary treatment. They are often necessary to improve the patient's life. They are used to relieve pain (therapeutic blockade), 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 permanent long-term effect.

home treatment

Home treatment of osteochondrosis consists of manual therapy (exercise therapy, Shants 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 effective treatment that relieves unpleasant symptoms and improves the general condition. In this case, special attention should be paid to proper nutrition and 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, because the spinal column is deprived of its blood supply system, and the intervertebral disc can receive nutrients only through the 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 "normal" skeletal structure, relieves excess muscle tension. It even directly affects the vertebrae.

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