Why does osteochondrosis occur and how is it treated?

Osteochondrosis is a disease in which degenerative-dystrophic changes in the cartilaginous tissues of the spine are diagnosed, also accompanied by disturbances in the structure and functionality of the intervertebral discs.Depending on the location of the damaged tissue, osteochondrosis of the cervical, thoracic and lumbar regions is distinguished.

According to medical statistics, symptoms of osteochondrosis are observed in 50-90% of the population.The average age of onset of osteochondrosis is 30-35 years.Under unfavorable conditions, signs of osteochondrosis may appear at an earlier period, especially with prolonged uneven loads on the back, legs and the consequences of injuries.

What is osteochondrosis?

Osteochondrosis is a disease of the spinal column in which degenerative and dystrophic lesions of the intervertebral discs occur.With the development of osteochondrosis, degenerative-dystrophic lesions spread to the tissues of the vertebrae.

The main sign indicating the development of the disease osteochondrosis is pain in the neck, back, and lumbar region; as it progresses, the pain “radiates” to the arms, chest, shoulders, and upper thighs.With the negative dynamics of osteochondrosis, muscle tissue atrophy, sensory disturbances, and dysfunction of internal organs, provoked by their compression and displacement, begin.In the absence of timely treatment, osteochondrosis develops to an incurable condition.

Causes of osteochondrosis

The main factor in the development of osteochondrosis is uneven load on the spine.A common cause of improper load distribution is the habit of carrying a bag on one shoulder or in one hand, incorrect sitting position, sleeping on an overly soft mattress, high pillow, and wearing anatomically incorrect types of shoes.

Additional risk factors include physical inactivity, a sedentary lifestyle, excess weight, injuries to the back, lower extremities, flat feet and other disorders of the musculoskeletal system, as well as age-related degenerative processes due to age-related changes in the blood supply to the spinal column.

The following factors may also play a role in the etiology of osteochondrosis:

• physical overstrain of the body;
• neuro-emotional exhaustion;
• metabolic disorders, poisoning, diseases of the gastrointestinal tract that prevent the full absorption of nutrients;
• occupational risks, in particular, working on vibration platforms;
• genetic predisposition;
• poor posture during the period of active growth, scoliosis;
• wearing uncomfortable shoes (tight, heels);
• prolonged and/or regular dehydration;
• poor diet, hypovitaminosis;
• smoking;
• pregnancy, especially multiple pregnancy, in combination with an undeveloped muscular-ligamentous apparatus (due to a shift in the center of gravity of the body).

Stages of development of osteochondrosis

Osteochondrosis in the dynamics of the disease goes through four stages:

• Stage 1 (degree) osteochondrosis is characterized by the initial stage of pathology in the nucleus pulposus of the intervertebral disc.Due to excessive load, the process of dehydration (dehydration) of the nucleus begins, which leads to a decrease in the height of the disc and the appearance of cracks in the fibrous ring.Symptoms at this stage, as a rule, are absent; minor discomfort may occur during prolonged stay in an uncomfortable static position or active movement;
• at stage 2, a decrease in the height of the discs leads to a decrease in the distance between the vertebrae and sagging of the spinal muscles and ligaments.This causes increased mobility of the vertebrae with affected discs, which is dangerous due to their displacement or slipping.During the second stage of the disease, discomfort and pain occur, especially with certain types of load, movements, positions;
• Osteochondrosis stage 3 (degree) is characterized by the formation of prolapses and protrusions of the intervertebral discs, and may be accompanied by subluxations and/or the development of arthrosis of the intervertebral joints.With some types of movement, patients feel stiffness, lack of mobility, and a feeling of tingling and numbness may occur in the limbs.At this stage of osteochondrosis, pain is clearly felt in the back, neck, lumbosacral region or coccyx area, depending on the location of the affected discs;
• at stage 4 of osteochondrosis, the body tries to correct the consequences of vertebral hypermobility and adapt to impaired functionality of the spinal column.Osteophytes, new bone formations, improve the fixation of the vertebrae, form at the points of contact between the vertebrae.However, in some cases, osteophytes can cause pinched nerves and injure the vertebrae.Fibrous ankylosis begins in the intervertebral discs and joints.In the absence of microtraumas and pinched nerve roots, the symptoms of the disease subside.

Symptoms of osteochondrosis

The main symptoms of osteochondrosis are a feeling of discomfort and/or pain in the neck and back.The severity of sensations and the presence of additional symptoms depend on the stage of the disease.When examining the patient and collecting anamnesis, the specialist conducts a primary diagnosis, suggesting the presence of osteochondrosis by a visually detectable curvature of the spine observed in the transverse or longitudinal plane of the spinal column.Pathologies of the intervertebral discs of the cervical and lumbar spine are much more common than degenerative and dystrophic changes in the sternum.

Signs of osteochondrosis felt by the patient include a periodic or permanent feeling of back fatigue, mild or severe pain, depending on the stage of the disease.The pain can be localized in the neck, back, chest, shoulder girdle, making it difficult and constraining the movements of the upper extremities.

The clinical picture of osteochondrosis largely depends on the localization of the pathology, the degree of development of the process, and the individual characteristics of the patients.Pathology of intervertebral discs, displacements, protrusions, hernias and the growth of osteophytes lead to various consequences.Among the most common are disturbances of normal blood circulation in tissues, pinched nerve endings, dysfunction of the spinal canal, edema, fibrosis of tissues and structures.Such consequences can be accompanied by many different symptoms, leading to misdiagnosis of diseases.

The most common and characteristic symptoms of osteochondrosis include the following:

• pain in the back, neck, lower back, shoulder girdle, rib area;
• discomfort, stiffness in body movements that occurs in certain body positions, bending, turning, increased muscle tension;
• feeling of numbness in the upper and lower extremities;
• muscle and joint discomfort, muscle spasms;
• headaches, dizziness, increased fatigue;
• pain in the heart area;
• impaired hand sensitivity;
• muscle hypotonia.

Symptoms of osteochondrosis vary depending on the location of the pathology:

• with osteochondrosis of the cervical spine, pain in the neck, arms, and shoulder girdle predominates, radiating to the area of the scapula and shoulder;headaches, dizziness, flashing “spots” or spots before the eyes, and tinnitus are noted;
• if the thoracic spine is affected, the pain is localized in the chest, heart, inner surface of the shoulder, armpit area, respiratory discomfort is also noted, shortness of breath is possible;
• Osteochondrosis of the lumbosacral spine is manifested by lower back pain radiating to the legs, upper thighs or pelvic organs, often accompanied by sexual dysfunction.

Superficial symptoms - back fatigue, pain - may indicate not only the presence of osteochondrosis, but also the addition of other diseases or the development of other pathological processes and disorders not related to degeneration of the intervertebral discs.The diagnosis of “osteochondrosis” can only be made by a specialist, and self-medication for such symptoms is unacceptable.

Classification of osteochondrosis

Types of osteochondrosis are distinguished according to several principles.Depending on the location of the pathology, osteochondrosis of the cervical, thoracic, lumbar, sacral or mixed, combined types of disease are distinguished.According to clinical manifestations, osteochondrosis of various localizations is divided into subtypes depending on the identified symptoms and the clinical picture as a whole.

Osteochondrosis of the cervical spine:

• depending on the type of reflex syndrome, cervicalgia, cervicocranialgia, cervicobrachialgia with various manifestations (vegetative-vascular, neurodystrophic, muscle-tonal) are identified;
• if the test result for radicular syndrome is positive, discogenic damage to the roots of the cervical spine is diagnosed.

For pathology of the thoracic level there are:

• for reflex syndromes - thoracalgia with vegetovisceral, neurodystrophic or muscle-tonal manifestations;
• by radicular – discogenic lesion of the roots of the thoracic region.

For osteochondrosis of the lumbosacral level, the following is diagnosed:

• depending on the type of reflex syndrome - lumbago (lumbago), lumbodynia, lumboischialgia with vegetative-vascular, neurodystrophic or muscle-tonal manifestations;
• radicular syndrome indicates discogenic damage to the roots of the lumbosacral region;
• radicular vascular syndrome indicates radiculoischemia.

Diagnosis of osteochondrosis

To make a diagnosis, instrumental examination methods are used:

• X-ray examination of the spine;
• myelography;
• neurological examination of sensitivity, reflexes.

Additional methods prescribed to differentiate and clarify the diagnosis and stage of pathology include:

• computed tomography of the spine (CT);
• nuclear magnetic resonance (NMR);
• magnetic resonance imaging (MRI).

Directions of therapy for osteochondrosis

Treatment is based on an integrated approach and, depending on the stage, lasts from 1 to 3 months of intensive therapy and 1 year of supportive measures to consolidate the result and prevent relapses.

Therapy for the disease osteochondrosis is carried out in two directions, depending on the degree of osteochondrosis and the patient’s health condition.Conservative treatment of the disease consists of taking medications and performing a set of exercises.Surgical treatment in almost any situation cannot be the method of first choice and is prescribed in the absence of positive dynamics or progression of the disease against the background of long-term conservative therapy.

In addition to medical methods of therapy, it is necessary to follow general recommendations for osteochondrosis: follow a diet, take measures necessary for rehabilitation.

Conservative treatment of osteochondrosis

Conservative therapy is aimed at relieving pain, normalizing the functionality of the spinal column and preventing negative changes

Conservative treatment of osteochondrosis includes the following types of therapy:

• drug therapy.Medicines for osteochondrosis are used to relieve pain syndromes, inflammatory processes in tissues and normalize the body's metabolic processes.In case of severe pain syndrome, it is recommended to use drug blockades of nerve endings, which also help to reduce the severity of muscular-tonic syndrome.The following types of blockades are distinguished: trigger point blockade, intraosseous, facet, paravertebral, epidural;
• physiotherapy methods.Physiotherapeutic procedures help reduce pain, increase the effect of medications, and are also used during the rehabilitation period.The most common use is ultrasonic waves, magnetic fields, low frequency currents, and laser beams;
• methods of physical therapy (physical therapy) and kinesitherapy.A set of special exercises, when performed regularly and correctly, helps to correct posture, strengthen the muscle corset, ligamentous apparatus, normalize muscle function, reduce compression of nerve fibers and help prevent complications of osteochondrosis.Methods of exercise therapy and kinesitherapy procedures are aimed at normalizing metabolic processes, restoring adequate nutrition of the intervertebral discs, restoring the location of the vertebrae and discs between them, and uniformly distributing the load in the musculoskeletal system;
• massage.Manual massage techniques are used to improve blood supply to tissues, relieve muscle spasms and tension, and generally improve blood circulation.Hydromassage as a direction of therapeutic activity, in addition to the listed effects, helps to normalize the functioning of the body’s nervous system;
• manual therapy.Manual therapy methods are selected on an individual basis.A targeted effect on the musculoskeletal system of the body helps improve blood circulation, lymph circulation, improves metabolism, helps correct the mobility of the musculoskeletal system, strengthens the immune system, and serves as a means of preventing complications of osteochondrosis;
• traction therapy(traction) of the spine using special equipment.The purpose of the manipulations is to increase the intervertebral space to normal parameters and correct structural disorders of the spinal column.

Osteochondrosis: drug therapy

In the treatment of osteochondrosis, medications are aimed at reducing the severity of symptoms, improving the processes of blood supply to tissues and their regeneration.Osteochondrosis cannot be cured by taking medications alone; therapy must be combined, including sets of exercises, diet, and preventive measures.

In the absence of pronounced dystrophic changes and pain, taking medications without the prescription of a specialist can be considered unjustified.

Medicines used to relieve pain and treat osteochondrosis:

• anti-inflammatory group;
• antioxidant preparations: vitamins C (in the form of ascorbic acid), E (tocopherol acetate), N (thioctic acid);
• means for improving blood supply to tissues, B vitamins (mainly B3);
• preparations for regeneration and/or prevention of degeneration of cartilage tissue, hyaluronic acid.

Drugs can be prescribed both in the form of ointments, creams for local use for pain, and for oral administration and injections.

In case of acute complications, medications are used to block the nerve endings.

Osteochondrosis: dietary nutrition of the patient

The principles of the diet are based on the need to improve metabolic processes, saturate the body with essential nutrients, vitamins, minerals, and include foods high in antioxidants, polyunsaturated fatty acids, and compounds that promote the regeneration of cartilage tissue.The drinking regimen recommended for osteochondrosis is aimed at preventing dehydration of the body, which can negatively affect the affected tissues.You need to eat in small portions, 5-6 times a day.

The basis of the diet is dairy and fermented milk products, lean meats, poultry, fish, fresh vegetables, fruits, nuts and seeds, cereals, and mushrooms.It is especially recommended to include meat and fish jellies, jellied meats, jellied dishes in the diet, and use extra virgin olive oil without heat treatment (for dressing salads).

Preferred food processing methods: steaming, baking, boiling.Limit the intake of flour and confectionery products, fatty foods, spicy, salty dishes and seasonings, canned and smoked foods, strong meat broths, legumes, sugar and fruits with a high sugar content (grapes).During the day, you must drink at least 1.5 liters of liquid, giving preference to clean and mineral water, dried fruit compotes, unsweetened fruit drinks, and herbal teas.You should limit the amount of strong black tea, coffee, sweet carbonated drinks, and alcohol.

Complications of osteochondrosis

Failure to comply with prescribed treatment, prolonged avoidance of the doctor and lack of treatment for osteochondrosis contributes to the progression of the disease and provokes the development of complications, pathologies and new diseases, such as:

• herniated intervertebral discs (spinal herniation);
• protrusion;
• kyphosis;
• radiculitis;
• salt deposits in the intervertebral space;
• spinal cord strokes;
• decrease in muscle mass of the limbs, muscle atrophy due to blood supply disorders;
• paralysis of the lower limbs.

Despite the fact that grade 4 osteochondrosis can occur without severe symptoms and pain, advanced osteochondrosis is the most dangerous for the development of serious complications and can lead to disability of the patient.

Prevention of osteochondrosis

The causes of osteochondrosis are mainly related to lack of attention to the body's requirements, poor nutrition, and excessive stress on the body.To prevent the onset of pathological changes in the spine and curb the dynamics of existing osteochondrosis, it is recommended to adhere to the general principles of a healthy lifestyle:

• eliminating the possibility of physical inactivity: moderate sports: exercise, running, swimming, cycling, skiing, gymnastics, non-contact wrestling, etc.;
• When working or other activities that involve staying in a static position for a long time, you must take breaks to warm up every 45 minutes to restore blood circulation.If you need to sit for a long time, you should choose the right chairs, chairs that provide support for the spine, ensure compliance with the standards for the position of your hands on the table, feet on the floor or a special stand, learn to maintain your posture (straight back, relaxed shoulders);
• for night sleep, you need to select an elastic, preferably orthopedic, mattress with a flat surface, avoid high or too flat pillows;
• if necessary, lift and/or carry heavy objects, avoid jerking when lifting weights from a semi-squat position, use special belts that support the lower back;
• choosing orthopedic correct shoes: with the appropriate width for the foot, without high heels and their timely replacement will help reduce the load on the spine, this is especially important for women during the period of bearing a child.In the summer, you should not neglect the opportunity to walk barefoot on uneven surfaces; this strengthens the muscles of the foot and relieves tension from the musculoskeletal system;
• A proper diet and drinking regimen contribute to overall health and help maintain normal metabolism;
• If you are prone to increased emotionality, anxiety with a muscle spasmodic reaction to stress, it is worth learning relaxation methods, as well as regularly taking courses in restorative massage.