Osteochondrosis and regular low back pain affect 60-80% of the population over the age of 30. Untreated osteochondrosis reduces quality of life and can lead to disability and disability, so it is important to recognize it in the early stages of development and seek medical attention.
In this article, we will talk about osteochondrosis, its symptoms and diagnostic methods, how to differentiate osteochondrosis from other diseases caused by low back pain, and what to do if you see signs of osteochondrosis of the spine.
What is spinal osteochondrosis?
Osteochondrosis is a chronic disease in which the nucleus of the intervertebral disc is gradually destroyed. Over time, damage to the intervertebral disc in the pathological process affects other structures of the spine and leads to disorders of the musculoskeletal system and nervous system. Osteochondrosis is also characterized as pathological as a result of premature aging of the joint apparatus or, for example, damage to the vertebrae after injury.
The development of osteochondrosis is influenced by many factors, so researchers have systematized the causes that explain the origin of the disease:
- closed - inflammatory processes and other damage to the spine cause premature aging of cartilage, for example, as a result of a sedentary lifestyle;
- degenerative - disorders of the intervertebral discs occur as a result of metabolic deficiency, for example, as a result of an unbalanced diet and alcohol abuse;
- Dysmetabolic - osteochondrosis occurs as a result of malnutrition in the intervertebral cartilage due to a decrease in the number of blood vessels that feed the blood with age.
The development of osteochondrosis is a cascade in which one pathological process begins in another. Thus, for example, due to age-related changes and a decrease in the number of vessels in the disc, nutrition is impaired, leading to failure of biochemical processes and damage to the intervertebral disc.
As degenerative and dystrophic changes develop in the spine, muscle tone and the function of the nerve roots coming out of the natural holes in the spinal cord are disrupted. This leads to consequences for the nervous and musculoskeletal systems.
Symptoms of osteochondrosis of the spine
Osteochondrosis is a chronic disease with periodic exacerbations caused by injuries, a sedentary lifestyle, heavy lifting, hypothermia and psycho-emotional stress. The most common and characteristic symptom for dystrophic disorders in the nucleus of the intervertebral discs is low back pain with regular pain in various segments: in the neck, chest and lower back.
There are two types of symptoms of osteochondrosis: reflex and compression. Reflex symptoms develop due to irritation of the spinal cord roots. They manifest themselves in the form of spasms or vasodilatation, muscle twitching, weakening of muscle strength. Compression symptoms develop due to nerve compression (mostly caused by a spinal hernia) and manifest as a loss of sensation in the affected area (neck, arms, or back).
In addition, osteochondrosis is characterized by the following symptoms:
- tension and pain in the muscles of the neck and spine;
- lateral, backward or forward curvature of the spine;
- sensitivity and nervous disorders: crawling on the skin, heat and cold on the skin of the back and extremities, numbness of the arms or legs;
- weakening of muscle strength of the limbs;
- frequent urination - 10-12 times a day.
Where can osteochondrosis occur?
Pain in osteochondrosis is localized not only in the back. They extend to the upper and lower extremities. Standing:
- hip;
- back and side of thighs;
- lower leg and inner part of ankle;
- back of legs;
- Foot fingers;
- heels.
In addition, the pain can spread to the arms:
- deltoid muscle;
- outer edge of hand, up to fingers;
- the back of the hand;
- three middle fingers;
- ring finger and little finger (rarely).
How is osteochondrosis diagnosed?
The diagnosis of osteochondrosis is based on questionnaires, physical examination and instrumental examination methods. Specific examination methods are determined in consultation.
The doctor begins the diagnosis by taking a medical history: identifying the probable causes of back pain, determining the location and duration of pain, as well as pathologies, such as allergies, congenital diseases and drug intolerance. Then continue to check. Physical examination is performed while standing or sitting. The doctor can detect curvature of the spine, assess muscle strength and reflexes, and look at the color of the skin. It is necessary to consult with relevant specialists to explain the picture of the disease in detail: neurologist, neurosurgeon, oncologist, rheumatologist and phthisiologist.
The neurologist diagnoses osteochondrosis in the following cases:
- regular aching back pain;
- increased pain when lifting weights, sneezing, coughing;
- numbness and sore joints;
- decreased movement in the joints;
- muscle spasm;
- damage to nerve roots;
- changes in the radiography of the spine.
Do you need a spinal x-ray?
Spinal radiography or spondylography is one of the mandatory examinations for osteochondrosis, which can be used to diagnose spinal disorders. Spondylography allows the detection of pathological changes, such as thinning of the intervertebral disc. Generally, x-rays for the cervical, thoracic, and lumbosacral spine are performed in two (and sometimes three) projections for more information.
Computed tomography and magnetic resonance imaging allow to identify pathologies associated with osteochondrosis: disc herniation and narrowing of the lumen of the spinal canal, protrusion of the intervertebral disc into the spinal canal and compression of the spinal cord.
Osteochondrosis of the cervical spine
With cervical osteochondrosis of the spine, two main symptoms appear - cervical and cervical. Cervicago is a severely painful cervical lumbago that occurs when the head moves and is caused by cervical spine muscle tension. It is a painful and severe pain in the cervical neck. Paresthesias are added to cervicalgia - a sensation of numbness in the form of numbness and a feeling of crawling on the skin.
If the defeat of the nuclei of the cervical intervertebral discs develops, cervical radiculitis appears - painful sensations in the occiput. The pain is characterized by regularity, in addition, it sometimes intensifies when you move your head.
This triad - cervical, cervical sciatica and cervicago - can be complicated by nocturnal dysesthesia of the hands with impaired sensitivity. For example, a hot object may feel cold with your fingers, but if you shake it with your hands, the sensitivity is restored.
Osteochondrosis of the thoracic spine
Painful lumbago (dorsalgia) in the chest is most characteristic of thoracic osteochondrosis. Chest pain is more severe when you move your arms, sneeze, cough, and lift weights. Often the pain is in the girdle. In addition, paresthesias often occur in the chest. Sometimes damage to the nuclei of the intervertebral discs can appear as diseases of the internal organs, such as gastritis or angina pectoris, because the pain can be localized in the upper abdomen and heart.
How to tell - heart pain or osteochondrosis?
Pectal syndrome is a pain in the anterior chest wall that can resemble heart pain. Pectalgia can be a sign of both osteochondrosis and heart problems.
However, pain in angina pectoris and heart attack is different from pectal syndrome in osteochondrosis. Pain in angina pectoris and myocardial infarction is characterized by compression and spread to the left scapula, arm and jaw.
Pectal syndrome in osteochondrosis does not extend beyond the anterior chest wall, does not spread to the arms and scapula, and is not accompanied by fear of death. But these are only subjective feelings. Therefore, to rule out cardiac pathology, you should consult a doctor and have an electrocardiogram, which will detect signs of arrhythmia or myocardial infarction.
If the pain begins to spread to the left shoulder blade, arm, chin, is accompanied by a feeling of fear, is not eliminated by taking nitroglycerin, and if it lasts more than 10-15 minutes, you should call an ambulance.
Why is lumbar osteochondrosis dangerous?
With lumbar lumbar osteochondrosis, lumbago or lumbodynia most commonly occurs - regular lumbago and aching pain in the lumbar region. Due to constant pain, movements are limited: a person cannot bend, exercise or lift anything heavy.
Lumbago itself can pass. However, they tend to flare up, and each flare indicates an additional displacement of the intervertebral disc into the spinal canal. As the destruction of the intervertebral disc progresses, lumbosacral radiculitis occurs, accompanied by low back pain that spreads to the lower back and thighs.
What is the difference between osteochondrosis and osteoarthritis?
Osteochondrosis and osteoarthritis (spondylogenous osteoarthritis) belong to the class of diseases of the musculoskeletal system. However, there is a major difference between them: with osteochondrosis, with the nucleus of the intervertebral disc, and with osteoarthritis, the intervertebral joints. This creates a difference in symptoms and treatment.
In osteochondrosis, back pain is regular and painful, manifests itself at rest and increases with movement, and the appearance of pain in spondyloarthritis is associated with stretching and bending of the spine. In general, the pain syndrome in osteoarthritis of the spine is unilateral and has a cramping character. In addition, spondylogenic osteoarthritis is characterized by morning stiffness lasting between 30 and 60 minutes.
What is the difference between osteochondrosis and radiculitis?
Radiculitis is an inflammation of the spinal cord roots accompanied by pain along the affected nerves. In fact, these are two different diseases, but sciatic osteochondrosis is often a complication, so it is often one of the symptoms of osteochondrosis.
Sciatica symptoms
With osteochondrosis, most cases of radiculitis occur in the cervical and lumbar spine. Pain along the sciatic nerve is manifested by pain, sensory disturbances, and sometimes movement disorders. Sciatica is characterized by pain extending beyond the waist and spreading to the thighs, thighs, lower legs, and feet.
VSD or cervical osteochondrosis?
Vegetovascular dystonia is a syndrome in which the autonomic nervous system is disrupted. VSD is a functional disorder in which there are no structural changes in either the spinal column or the nuclei of the intervertebral discs.
Vegetovascular dystonia has a mental origin - it is a neurosis associated with individual intracranial conflicts or uterine trauma. Externally, VSD and osteochondrosis can be similar to each other: headache, dizziness, pain in the anterior wall of the chest.
To differentiate the disease, it is necessary to conduct instrumental diagnostics - radiography of the cervical spine and other parts, computed tomography and magnetic resonance imaging. Unlike osteochondrosis, the diagnosis of VSD will not result in organic changes.
Treatment of vegetative-vascular dystonia
Vegetovascular dystonia is treated with medication, psychotherapy and lifestyle adjustments. Patients are prescribed symptomatic treatment: sedatives, anti-anxiety, hypnotics, restorative substances and vitamins. The task of psychotherapy with VSD is to teach the patient to regulate negative emotions and increase resistance to stress. The lifestyle has also been adjusted: you need to balance work and rest, exercise and follow a balanced diet.
Is osteochondrosis treated or not?
Osteochondrosis can be treated. The goal of treatment is to relieve back pain and stiffness, restore muscle tone, prevent or stop neurological complications, and improve a person's standard of living. The disease can be treated if you follow the doctor's instructions.
How is osteochondrosis treated at home?
Home treatment of osteochondrosis is not recommended. There are several reasons for this:
- It is impossible to make an accurate diagnosis of osteochondrosis at home, because back pain has different origins: neurogenic, vascular, viscerogenic (due to diseases of the internal organs) and psychogenic. That is, a person is treated for osteochondrosis, but in fact back pain is caused by, for example, kidney disease;
- it is impossible to objectively assess the effectiveness of treatment without control diagnosis;
- The patient can not choose a treatment for himself enough, and folk remedies do not have an evidence base, and therefore are most likely ineffective and can show side effects.
You can be treated at home - only after consultation with a doctor who will correctly diagnose, prescribe adequate treatment and periodically monitor the effectiveness of therapy using X-rays, CT or MRI.
Treatment of osteochondrosis of the spine
Treatment of osteochondrosis is conservative and surgical. Which method will be the main depends on the stage of the disease and the neglect of the musculoskeletal system.
Conservative treatment includes medication, exercise therapy, and lifestyle adjustments. Medications such as anti-inflammatory drugs and muscle relaxants are mainly prescribed to reduce pain and normalize muscle tone. One of the main conditions for recovery in physiotherapy exercises is early activation, ie 1-3 days after pain relief, it is necessary to walk, run, exercise in the pool or ride a bike. It is also important to change your lifestyle to an active lifestyle, because a sedentary lifestyle is one of the factors in the development of low back pain and the destruction of the nuclei of the intervertebral discs.
Surgical treatment is used when conservative therapy is ineffective for 2-4 weeks and when there are obvious structural changes in the spine. The surgeon will determine which surgery is needed after consulting a neurologist and reviewing the research data. For example, in the treatment of cervical osteochondrosis, methods are used to relieve pressure (discectomy and decompression) on the side of the vertebrae or hernia of the spinal cord.
Consult a neurologist for advice if you have lumbago in the spine or neck, chest pain, weakened muscles in the arms or legs, unpleasant tactile sensations in the skin and back pain accompanied by numbness.