Osteochondrosis: symptoms, causes, methods of treatment

Excessive tension in the back muscles causes a lot of discomfort and pain.Osteochondrosis, which causes damage to the structure of the vertebrae and intervertebral discs, causes severe compression of nerve endings.Often, the pathology is accompanied by the deterioration of blood circulation, which causes disorders in the nutrition of the brain and internal organs.

Osteochondrosis - what is it?

Osteochondrosis is a chronic relapsing disease accompanied by the destruction of vertebrae and intervertebral discs.Their tissues are disturbed, which subsequently causes a decrease in elasticity with a change in shape.There is a gradual decrease in the intervertebral space.This leads to the loss of stability of the spine in the regions where the pathology develops.

Pathological tissue destruction processes occur against the background of compressed nerve endings directed from the area where the spinal cord is located.As a result, the back muscles are under constant tension.In such a situation, patients complain of back pain and other symptoms.

Cervical, thoracic and lumbosacral types of the pathological process are distinguished based on the characteristics of the localization of spinal structures affected by degenerative changes.The main symptom of the development of osteochondrosis is pain, the intensity and severity of which usually increases during physical activity.

There is also stiffness in the movements.In addition, the clinical picture is characterized by the presence of vertebral-type symptoms - headaches, changes in blood pressure, deterioration of visual function, hearing, etc.

Mechanism of development

The development of osteochondrosis is related to the loss of the hydrophilic qualities of the pulpous nucleus.This semi-fluid structure contains connective tissue fibers and chondroitin, a gelatinous substance.During the development and growth of the human body, the processes of vascular bed reduction in the intervertebral discs take place actively.Nutrients are given diffusely, which is manifested by a spontaneous stabilization of the concentration.This feature makes it difficult to fully restore damaged or overstressed cartilage in the spine.

Pathological deviations are more evident due to disturbances in hormonal levels and human nutrition.Cartilage tissue begins to experience a lack of nutrients necessary for its normal development.Thus, disorders manifest themselves in the following forms:

• decrease in strength and flexibility;
• changes in sequence settings and configuration properties.

Against the background of flattening of the intervertebral discs, radial cracks are formed in the fibrous rings.As a result, the intervertebral distance decreases and the facet joints begin to slip.Over time, pathological changes involve connective tissues associated with fibrous rings and ligaments.

As the tissue breaks down, the immune system produces increasing amounts of immunoglobulins.This leads to the development of an aseptic inflammatory process and swelling occurs in the area where the facet joints are located.They also spread to nearby soft tissues.

Due to the stretching of the joint capsules, the intervertebral discs lose their ability to straighten the vertebrae.Such instability in the position of the spinal structure increases the risk of compressing nerve roots or compressing blood vessels.This feature is characteristic, for example, of cervical osteochondrosis, which is accompanied by intense oral symptoms.

Causes of disease development

With a decrease in the tone of the skeletal muscles in the spine, the condition of the intervertebral discs can deteriorate.Due to the irrational and asymmetric working of the muscles, when the non-physiological body position is maintained for a long time, the destruction of the cartilage tissue can occur.This violation occurs as a result of carrying heavy bags on the same shoulder, using soft mattresses and high pillows.

Under the influence of a number of negative factors of external and internal nature, the process of destruction of intervertebral discs is accelerated.These include:

• endocrine mechanism disorders and metabolic disorders;
• pathologies of an infectious nature, including chronic ones;
• damage to the spine in the form of compression fractures, bruises;
• regular and long-term hypothermia of the body;
• systemic and degenerative-dystrophic diseases - gout, psoriatic, rheumatoid arthritis, osteoporosis, osteoarthritis;
• abuse of smoking and alcohol, which disrupts the state of the vascular system, disrupts blood circulation and causes nutrient deficiency in the cartilage;
• insufficient physical development, posture problems, flat feet - these defects increase the load on the spine, because shock absorption will be insufficient;
• obesity;
• genetic predisposition;
• regular exposure to stress.

Symptoms

The main clinical symptom of osteochondrosis of any localization (cervical, thoracic or lumbosacral) is pain.In case of relapse, the pain is piercing, spreading to nearby areas of the body.Even with the slightest movement, it gets stronger.This forces the patient to give the body a forced position to minimize discomfort and pain:

• with cervical osteochondrosis, it will be preferable to turn not only the head, but the whole body;
• when the chest form of the disease is present, it is difficult for the patient to take a deep breath, and therefore he tries to minimize the depth and frequency of breathing to avoid acute chest pain;
• Patients with the lumbar type of the disease have difficulty sitting, taking a vertical position, and moving because the spinal nerve is compressed.

Typically, patients complain of dull, constant pain and stiffness 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 skeletal-spinal muscles or osteoarthritis.

Aching and excruciating pains occur due to compensatory tension in the muscle tissue.This position is necessary to stabilize the range of motion of the spine.Persistent mild to moderate pain may also be seen with significant prolapse of the intervertebral disc caused by aseptic inflammatory changes.

Osteochondrosis of a certain localization is characterized by special symptoms:

1. With cervical osteochondrosis, pain is felt in the cervical region and upper limbs.There is pain in the head, numbness in the fingers.If the disease manifests itself in a serious form, compression of the vertebral artery may occur.In this case, the patient begins to complain of a significant deterioration in his health.
2. Thoracic localization is manifested by sharp and painful pain in the back;there is a visceral pain syndrome in the heart region, right hypochondrium and abdomen.Patients complain of numbness, paresthesia of the skin, breathing difficulties, and creaking in the vertebrae.
3. Patients with lumbar osteochondrosis complain of pain in the back and lower limbs with increasing intensity when moving.Disturbances in the work of the genitourinary system, problems with male potency and dysfunctional ovarian disorders are often diagnosed.Pain may decrease during remission.However, exposure to the triggering factor leads to its recovery.

4. When mixed osteochondrosis appears, symptoms can appear in several areas at the same time.This condition is characterized by a more severe course of the disease.

It should be remembered that displacement of the vertebra and the formation of osteophytes cause compression of the vertebral artery.It nourishes the brain and supplies its cells with oxygen.When compressed, nutrition is limited, and therefore the patient has problems with coordination, headaches, tinnitus and arterial hypertension.

Complications if not treated

The reason for the complex course of osteochondrosis is the relatively rapid formation of tears in the intervertebral discs.Their appearance is associated with the posterior displacement of the vertebral structure.This leads to rupture of the posterior longitudinal ligament, resulting in instability of the disc position and protrusion of its individual parts into the area of the spinal canal.The hernia ruptures when the disc with the nucleus pulposus penetrates the canal area.

When pathological abnormalities occur in the vertebral structures, the spinal cord begins to be compressed and the patient develops discogenic myelopathy.Symptoms of this condition are associated with numbness and weakness in certain muscle groups of the upper and lower limbs.Paresis, muscle atrophy and impaired tendon reflexes appear.In some cases, there are problems with emptying the bladder and bowels.

The formation of intervertebral hernias is dangerous due to compression of the vessels that supply the spinal cord.The result of this pathology is the formation of ischemic zones where nerve cells are damaged and killed.Manifestation of the neurological effect is expressed in motor function impairment, decrease in the degree of touch and trophic disorders.

Diagnosis of the disease

The initial diagnosis is based on the patient's complaints and existing symptoms.The specialist examines the condition of the spine in different positions, asks the patient to rest or move.At the next stage, the patient is sent for laboratory diagnostics, which will help to clarify or refute the diagnosis.

Research methods used include:

1. Radiography- provides a complete examination of the spine, assessing the condition of the vertebrae, existing disorders in the form of growths, curvatures.The specialist will be able to determine the position of intervertebral spaces and holes.A two-stage X-ray examination is performed to accurately identify localized osteochondrosis in the thoracic or cervical region.In the first stage, the patient lies on his side, and in the second, directly on his back.
2. Tomography method using MRI or CTprovides highly informative information that helps to study in detail without the intervention of the organs surrounding the spine.The picture shows the nervous and vascular system.MRI helps to determine the symptoms of many diseases of the spine and the location of damage.A CT scan visualizes tears and identifies possible deviations in the structure of the spine.
3. Laboratory examinationto evaluate the condition of the blood and its main parameters.It allows to clarify the diagnosis and determine the probability of developing concomitant diseases.

In many cases, as a result of examinations, doctors determine the presence of some underlying diseases that are potentially dangerous due to their complications.We are talking about, for example, tears, protrusions, radiculitis.Correct diagnosis of problems helps to treat osteochondrosis more effectively.At the same time, in the first stages of development, the disease itself is masked as symptoms of other diseases.

Therapeutic process

Osteochondrosis is treated conservatively or surgically.The choice depends on the severity of the condition, its neglect, the level of tissue deterioration and the reasons for its occurrence.

It should be remembered that it is impossible to completely cure osteochondrosis, because there are no drugs that help to completely restore the discs and vertebrae.The therapeutic effect is aimed at inhibiting the destruction process and increasing the duration and stability of remission.

For symptomatic therapy, chondroprotectors are used, the basis of which is chondroitin or glucosamine sulfate.

The effectiveness of the therapeutic process using chondroprotectors has been clinically confirmed on the basis of long-term trials.If you take these drugs for a long time (from 3 months), partial recovery of cartilage and other elements of the connective type - ligamentous-tendon apparatus, bursa is observed.

Accumulation of glucosamine and chondroitin in the area of intervertebral discs causes analgesic, edema and anti-inflammatory effect.Therefore, there is a real opportunity to optimize the dosage of NSAIDs, glucocorticosteroids and muscle relaxants.You can hope that the patient's medication burden will decrease.

The effectiveness of chondroprotectors is determined by the regularity of their use.Otherwise, there will be no result.Inefficiency is also noted in the treatment of grade 3 osteochondrosis, which is accompanied by significant destruction of cartilage.

The following drug groups can be used to relieve pain:

1. Nonsteroidal anti-inflammatory drugshelps to eliminate inflammatory disorders in soft tissues caused by vertebral displacement.NSAIDs are effective in reducing pain, swelling, and stiffness.
2. Drugs from the group of glucocorticosteroids– blockades are usually used together with anesthesia.They are able to relieve pain, restore the activity of the immune system and have an anti-exudative effect.
3. Muscle relaxants.They are effective in combating muscle spasms due to nerve compression.They help relax skeletal muscles and block polysynaptic spinal-type reflexes, which have an antispasmodic effect.
4. External products with a warming effect.Stimulation of subcutaneous tissue receptors with activation of blood flow is provided by special gels and ointments.These drugs have an analgesic and anti-edema effect.

Symptoms of the vertebrogenic type, which appear due to the localization of pathology in the cervical or thoracic region, can be eliminated by using medical means to activate blood flow.Nootropics and drugs to improve microcirculation are also prescribed.In some cases, it may be necessary to take antidepressants, as well as pharmaceutical drugs with anticonvulsant effects.

Physiotherapy is also used during the treatment of osteochondrosis.UHF therapy, magnetic therapy, laser therapy, reflexology, massage, exercise therapy, hirudotherapy, as well as swimming and yoga can be prescribed.If conservative treatment is ineffective, surgery is performed with microdiscectomy, disc puncture valorization, laser reconstruction, or implant replacement.