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Osteochondrosis

Symptoms of osteochondrosis

Osteochondrosis is a chronic relapsing disease characterized by degenerative changes in the spine involving neighboring vertebrae and joints. A characteristic symptom of osteochondrosis is pain in the back, lower back and neck. This musculoskeletal disorder is considered multifactorial because it is caused by a combination of several causes.

Main symptoms: pain in the back, arms, neck, lower back or chest, reduced volume and range of motion, muscle tension, impaired sensitivity in various parts of the spine, numbness, muscle weakness, impaired organ function, fatigue after minor physical exertion.

Treatment is carried out by: neurologists, traumatologists and orthopedists.

An article for patients with a doctor-diagnosed illness. Does not replace a visit to the doctor and cannot be used for self-diagnosis.

Causes of osteochondrosis

Osteochondrosis is one of the most commonly diagnosed diseases of the musculoskeletal system. Both older and middle-aged people are affected by the disease. To date, there is no accurate information about the causes of osteochondrosis and other degenerative diseases of the spine. There are several theories about the origin of the disease.

The main reasons for the development of osteochondrosis:

  • involutive;
  • mechanical (injuries);
  • immune function;
  • hormonal changes;
  • metabolic disorders;
  • infectious processes;
  • dysfunction;
  • hereditary diseases.

Risk factors for osteochondrosis:

  • congenital malformations of the spine;
  • staying in an uncomfortable position for a long time while standing or sitting;
  • history of severe spinal injuries;
  • incorrect movement patterns;
  • Violation of the technique of performing physical exercises during training;
  • sedentary lifestyle;
  • excessive physical activity;
  • Prolonged wearing of shoes that are the wrong size, too tight, or have flat soles;
  • obesity grade 3 or 4;
  • Lack of proteins, fats, vitamins and minerals in the body;
  • alcohol abuse, smoking;
  • unfavorable environmental conditions.
The most common causes of exacerbation of osteochondrosis are reduced immunity, hypothermia, viral infections, colds and chronic stress. Back and lower back pain can be of psychosomatic origin. In this case, the doctor can diagnose stress-related clinical manifestations of osteochondrosis or depression.

Pathogenesis

Osteochondrosis and its symptoms are caused by complex physiological mechanisms.

  1. Degeneration of the intervertebral discs – the main structures that absorb the load on the spine. Degeneration occurs under the influence of various negative factors - age, genetics, injury or damage, intervertebral discs can be subject to degeneration. With osteochondrosis, the intervertebral discs are affected: nutritional disorders occur, there is a sufficient loss of water in the cartilage tissue. This changes the structure of the fabric and the shock-absorbing properties deteriorate.
  2. Formation of osteophytes. This is another important factor in the development of osteochondrosis. As the degeneration of the intervertebral discs progresses, the height of the intervertebral space is lost - the distance between the vertebrae decreases. In response, bone growths, more commonly known as osteophytes, can form on the surface of the vertebrae. Osteophytes further restrict the passage space of the nerve roots, leading to compression, pain and discomfort.
  3. Impaired blood circulation. Disc degeneration leads to poor blood circulation in the spine. An insufficient supply of oxygen and nutrients to cells promotes degenerative processes and causes inflammation.

For the further development of treatment tactics, it is important to understand the causes and mechanisms of the development of the disease.

Symptoms

The general signs of the disease include severe pain in the back, neck and lower back, limited mobility, reduced performance, sleep disorders, gait changes and posture problems. Sometimes a grinding, clicking, or grinding sound can be heard in the back area.

Osteochondrosis can affect different parts of the spine: cervical, thoracic and lumbar. Each of these departments is characterized by its own clinical manifestations.

Cervical osteochondrosis

Key symptoms of cervical osteochondrosis:

  1. Pain in the neck area. May be constant or occur with head movements. The type of pain varies from patient to patient: from intense and paroxysmal to mild and aching. Pain is the main symptom of cervical osteochondrosis.
  2. Headache and dizziness. The pathology often causes headaches (including migraines), as well as a feeling of loss of balance. At the same time, tinnitus, ringing in the head and flickering in front of the eyes can occur.
  3. Numbness of the limbs, weakness and tremor. Compression of the nerve roots in the neck area leads to loss of sensitivity, tingling or weakness. As a result, a person with these symptoms finds it difficult to carry out even ordinary activities.
  4. Severe tension in the neck muscles. Gradually it becomes difficult to turn or tilt your head. In the acute phase of cervical osteochondrosis, the patient is forced to maintain the same position (for example, with a slight deviation of the head to the side).

Osteochondrosis of the thoracic spine:

  1. Pain in the chest area that increases with movement. May spread along ribs due to impact on intercostal nerves.
  2. Decreased sensitivity in the chest area.
  3. Restriction of body mobility.

Damage to the chest area often affects internal organs and systems. Some patients develop diseases such as angina pectoris, dysfunction of the gastrointestinal tract, diseases of the genitourinary system and others.

Osteochondrosis of the lumbar region

This type of osteochondrosis is the most common. Pain usually occurs in the lumbosacral area and radiates to the legs. This disease is called lumbosciatica.

A typical symptom of lumbar osteochondrosis is pain. It is characterized by a painful character, which is intensified by sudden actions or prolonged stay in one position. There is also loss of sensation, numbness in the toes and weakened reflexes. If degenerative disease of the lumbar spine is severe, you may have difficulty walking, standing, and performing everyday tasks.

This type of osteochondrosis is characterized by vegetative manifestations. Patients note dryness and peeling of the skin, cyanosis and increased sweating. General health deteriorates and one feels very tired after physical activity.

classification

Depending on the localization, there are different types of osteochondrosis – cervical, thoracic, lumbar. The disease can affect two or more parts of the spine and is then called generalized.

Stages of development of osteochondrosis

The symptoms and signs of osteochondrosis depend on the stage. At the initial stage of development of osteochondrosis, the patient feels dull and aching pain in the legs. They worsen after standing, walking or running for long periods of time. With cervical osteochondrosis, the first signs of the disease are pain in the neck, which increases when turning the head.

In the next stages of manifestation of osteochondrosis, degenerative changes in the intervertebral disc occur - hernias, bulges and compression of the nerve roots (radiculopathy). Later, the back pain worsens and radiates to the arm or leg. The patient feels muscle weakness, impaired sensitivity and vascular tone. In severe forms of osteochondrosis (acute chondrosis), the symptoms intensify, leading to impaired mobility, paresis and even disability. Depending on the clinical manifestations, the following stages of osteochondrosis are distinguished:

  1. First. The volume of water in the cartilage tissue decreases, the strength and elasticity of the intervertebral disc decreases. This makes it smaller, flatter and creates a hernia.
  2. Second. Defects occur in the annulus fibrosus and the spine loses stability.
  3. Third. At this stage, a break occurs in the cartilage tissue of the fibrous ring. Part of the nucleus pulposus leaks through the defect and a herniated disc occurs. These pathological processes are most often observed in the cervical and lumbar spinal segments.

For different stages of development of osteochondrosis, the classification of A. I. is also used. Osna showing the four stages of degenerative-dystrophic lesions:

  • Stage of chondrosis – a pathological process that occurs within the intervertebral disc when the nucleus pulposus moves and extends beyond the fibrous ring;
  • Stability stage of the damaged intervertebral disc - the vertebrae above are displaced in relation to those below;
  • Stages of formation of hernias and protrusions of intervertebral discs due to violation of the integrity of the fibrous ring;
  • The final stage of osteochondrosis is fibrosis and osteochondral growths, which in turn can cause compression of the nerve roots.

Each stage of development of osteochondrosis occurs one after the other. Since osteochondrosis is a chronic disease, it can progress over many years. At first it may not be noticeable at all, but as it gets worse, the patient feels more pain. At later stages of the development of osteochondrosis, a pronounced impairment of motor function is observed, spondylosis and spondyloarthrosis develop. The affected section of the spine becomes immobile over time, and in this case patients are often diagnosed with disability.

Therefore, when the first symptoms of osteochondrosis appear, it is better not to delay a visit to the doctor: the sooner the pathology is detected, the easier and faster it can be cured.

Possible complications:

  1. Disc prolapse. One of the serious complications of osteochondrosis is protrusion of the nucleus pulposus. This causes compression of the spinal cord or nerve roots, causing severe pain and sensory or motor impairment.
  2. Spinal stenosis. Osteochondrosis is considered the main cause of this disease. Spinal canal stenosis occurs as a result of intervertebral disc degeneration and osteophyte formation. There is excessive strain on the spinal cord and nerve roots. These changes lead to back pain, muscle weakness and poor coordination.
  3. Radiculopathy. The condition is accompanied by pain, numbness, tingling and muscle weakness.
  4. Myelopathy. The progression of osteochondrosis ultimately leads to myelopathy - damage to the spinal cord. The disease is accompanied by a loss of sensitivity and numbness in the damaged part of the spine.
  5. Breathing disorders. They arise due to severe deformation of the vertebrae and subsequent reduction in breast volume.
  6. Lumbodynia. Lower back pain can be acute, moderate, or painfully chronic.
  7. Cramps. They occur when nerve structures become excessively compressed. This leads to changes in muscle tone and cramps.
  8. Coccydynia. A condition characterized by chronic pain in the perineum and coccyx.

Pain and discomfort caused by osteochondrosis limits the patient's physical activity and directly affects the emotional and psychological state. Many people who have suffered from osteochondrosis for several years also need the help of a psychotherapist. Over time, hypertension, hypotension and vegetative-vascular dystonia enter the pathology. Patients are at higher risk of developing heart failure, myocardial infarction and stroke.

In severe cases, osteochondrosis can lead to disability - the patient may become bedridden.

diagnosis

To make an accurate diagnosis and examine patients, it is necessary to contact a neurologist. The specialist determines a list of causes of osteochondrosis, localization of pain, movement disorders and loss of sensitivity. To obtain an objective picture, it is necessary to find out whether the patient has concomitant diseases, allergies or individual drug intolerance. The doctor will clarify under what conditions the pain will subside and whether it was preceded by injuries or other illnesses.

Depending on the patient's complaints, the doctor determines the type of osteochondrosis – compression or non-compression. In the compression form, the main symptoms are pain, loss of sensitivity, muscle weakness and dysfunction of the pelvic organs. The intensity of pain of other manifestations depends on the degree of compression of the nerve roots.

The non-compressed form is characterized by local pain, reflexes and visceral syndrome.

Examination by a neurologist

The general clinical examination includes the assessment of:

  • skin diseases;
  • posture and motor activity;
  • orthopedic status of the patient;
  • muscle strength, reflexes and sensitivity in the innervation zone;
  • the presence of static-dynamic disorders and other complications.

During the physical examination, the patient's posture, gait and movement patterns are assessed. The doctor will examine the condition of the skin to make sure there is no redness, irritation, or rashes. Then the range of motion in different parts of the spine is determined - flexion, rotation and twisting movements.

Instrumental diagnostics

The following examinations help to clarify the extent and type of changes to the spine:

  1. X-ray of the spine. Allows you to obtain an informative picture of the spine: the structure of bone tissue, the presence of congenital anomalies, osteophytes and joint changes. You can visualize both the entire spine and individual sections. It is carried out in two projections – oblique and straight. Preparing for the procedure is simple; the X-ray itself takes a few minutes. In order to obtain a high-quality and detailed image, x-rays with contrast are carried out depending on the indication. A contrast agent is injected into the spinal canal. It more clearly shows the main segments of the spine, neoplasms, inflammation and other degenerative changes.
  2. CT scan of the spine (computed tomography). A modern diagnostic method that uses low-dose X-rays for visualization. In contrast to X-rays, computed tomography helps to obtain layer-by-layer images of the desired area of the spine. The method makes it possible to examine vertebral bodies, vascular systems, ligaments and tissue in high resolution. Thanks to CT, the doctor can assess the degree of compression of the nerve roots, ruptures of the fibrous ring and the degree of vertebral instability. Typically, CT is performed after an X-ray for clarification or differential diagnosis of pathologies.
  3. MRI (magnetic resonance imaging). A diagnostic method based on the use of a magnetic field and radio waves is safer than X-rays or computed tomography. Allows the spine to be displayed layer by layer in multiple projections. MRI data helps to exclude infectious and inflammatory processes, malignant tumors and other bone lesions. The diagnostics take 30 to 60 minutes.
  4. Densitometry. A quick and safe diagnostic method that allows you to assess the condition and structure of bone tissue. During an ultrasound examination, the doctor examines the bone mineral density and determines the likelihood of degenerative processes.

Depending on the symptoms and pathological changes detected, the doctor may refer you for a consultation with an orthopedist, rheumatologist or other specialist.

Treatment of osteochondrosis

The most effective is an integrated approach to the treatment of the disease, combining non-surgical and surgical methods. The aim of therapeutic measures is to stop the development of osteochondrosis, relieve acute symptoms and prevent possible complications.

Drug therapy

Necessary at the stage of exacerbation of the disease, with the aim of eliminating pain, relieving inflammation and normalizing metabolic processes.

According to the clinical recommendations of the Russian Federation, non-steroidal anti-inflammatory drugs are used to relieve back and neck pain. You will be included in the treatment program immediately as soon as the first symptoms appear. The drugs are used orally, topically and also through intramuscular or intravenous injections.

In the treatment of spinal osteochondrosis, applications with anti-inflammatory ointments are used to relieve the local inflammatory process. Your doctor may prescribe NSAIDs in the form of creams or gels. Many products for external use penetrate the deep layers of the skin and reliably block pain receptors there. In the treatment of osteochondrosis of the cervical spine, medical plasters are used to relieve pain.

The main symptoms of exacerbation of osteochondrosis are acute, unbearable pain. In these cases, patients are shown therapeutic blockages. They mainly contain local anesthetics and hormones (glucocorticoids).

You should not take medication yourself without a doctor's prescription - this can only make the problem worse. Treatment of spinal osteochondrosis should be carried out by an experienced specialist. Medications to relieve pain are prescribed by the attending physician depending on the type of pain and severity of the pathology.

physical therapy

For osteochondrosis, a number of techniques are used based on physical factors: light, low-frequency currents, magnetic field, laser radiation. Physiotherapy helps to relieve pain, stimulate blood circulation and accelerate regeneration.

The most common methods:

  • electrophoresis;
  • magnetic field therapy;
  • laser therapy;
  • Ultrasonic;
  • Shock wave therapy (SWT).

Physiotherapy is usually carried out outside the exacerbation phase after relief of acute pain and inflammation. The duration of the sessions and the total duration of the course are individual for each patient. The doctor will prescribe the appropriate type of treatment depending on your condition, symptoms and stage of osteochondrosis. Physiotherapeutic methods shorten treatment time, increase the effectiveness of medications and reduce the risk of side effects from various forms of medication.

massage

Massage is a series of manual techniques on different parts of the body. It has a strengthening effect, improves blood circulation, relaxes the muscles and relieves pain. The procedure should only be performed by professional massage therapists who have experience in working with patients with osteochondrosis.

Thanks to massage techniques, the muscles relax, tension is relieved and flexibility improves. Stimulating blood circulation promotes a more active supply of oxygen and nutrients to the tissue.

Typically, at least 10 massage sessions are required, two to three days apart. Before starting the course, a consultation with a neurologist is required to exclude possible contraindications.

In addition to massage, you may need the help of a chiropractor. The course of manual therapy is carried out strictly according to the instructions of a neurologist. Manual techniques (friction, pressure, rubbing, vibration and others) are aimed at restoring the function of joints and muscles. They help restore the anatomically correct position of the vertebrae and reduce pressure on the intervertebral discs.

Movement therapy

One of the most effective methods for treating back pain. Exercises help to activate blood circulation, expand the intervertebral space and improve metabolic processes in the intervertebral discs. The most important requirements are that physical activity must be strictly dosed; exercises can only be carried out outside of periods of exacerbation of the disease. The exercises are aimed at relaxing the nerve roots, strengthening the muscle corset and developing the correct movement pattern. Exercise therapy helps prevent possible complications of the musculoskeletal system.

Classes must take place regularly and be carried out exclusively under the supervision of a physiotherapy teacher.

Surgical treatment of spinal osteochondrosis

If conservative treatment is ineffective, surgery is indicated. The main goal of the procedure is usually decompression of the nerve roots - the elimination of compression. Compression may be caused by a hernia, adhesions, or bone osteophytes.

Indications for surgical intervention:

  • Prolapse of a herniated disc with development;
  • limited mobility, muscle paralysis;
  • acute pain syndrome not amenable to conservative treatment;
  • Dysfunction of internal organs.

During the consultation, the doctor will explain to you in detail what spinal osteochondrosis is and why you cannot do without surgery in your case.

Prevention of osteochondrosis

How can you keep your back healthy and prevent the development of osteochondrosis?

  1. Strengthen the muscles of your neck, lower back and back. This can be achieved through moderate physical activity and exercise therapy. Exercises strengthen your back, relieve acute pain and reduce the risk of complications.
  2. Follow safety precautions when working out at the gym and playing sports. Some activities put a lot of strain on the spine.
  3. Control your body weight. Excess weight puts additional strain on the spine. To prevent osteochondrosis, consult a professional nutritionist.
  4. Do not jerk off with weights if you are not prepared for the strain. If possible, avoid lifting heavy loads.
  5. Eat a balanced diet. A menu rich in calcium, vitamins D and C helps strengthen bone tissue. Incorporate dairy products, fish, vegetables, herbs and fruits into your daily diet.
  6. Pay attention to your posture, especially when doing long, monotonous tasks. Develop good posture habits.
  7. Avoid bad habits. Smoking is generally harmful to health, and it also impairs blood circulation in the spine and contributes to the development of osteochondrosis.
  8. Take regular breaks at the computer or in the office. To prevent muscle tension, short breaks and a light warm-up are sufficient.
  9. Get enough vitamin D as it is important for bone health. It is better to clarify the dosage with your doctor to achieve a positive effect and not cause complications.

Regular consultations with a doctor play an important role in preventing osteochondrosis. See a neurologist if you experience regular pain or are at risk for musculoskeletal disorders.

forecast

Spinal osteochondrosis in adults is not a death sentence, but an opportunity to change your attitude to life and health. If you monitor your condition, consult a doctor on time and follow the recommendations, you will be able to live actively, without pain and stiffness of movements. In most patients, with properly selected therapy, the symptoms of osteochondrosis weaken or disappear within 6-8 weeks.

However, if you ignore the problem or refuse treatment, the disease can worsen and become chronic. This condition is more difficult to treat and contributes to additional complications and reduced quality of life. Therefore, it is best to contact an experienced neurologist if back or neck pain occurs without postponing the visit "until later".