Osteochondrosis: causes, symptoms, treatment, prevention

Osteochondrosis is a common degenerative dystrophic condition that affects the intervertebral discs, adjacent vertebrae, and nearby ligaments.The disease does not appear immediately and lasts for many years, but the onset may occur quite young (18-20 years) and has several stages:

• Stage I - There is a "crack" in the annulus fibrosus and the nucleus pulposus moves within the intervertebral disc, but there are no radiological signs yet;
• Stage 2 - The nucleus pulposus continues to deteriorate, the intervertebral disc height decreases, the annulus fibrosus "dries out", and the affected intervertebral joints become unstable. To compensate for this, the back muscles continue to tense, leading to pain and "overexertion", Signs of osteochondrosis may be seen on radiographs;
• Stage III - Disc rupture and herniation of the prolapsed nucleus pulposus, this stage is characterized by extensive neurological symptoms, inflammation and edema;
• Stage 4 - Lesions involve adjacent elements of the joint.

Spinal osteochondrosis can also occur in different parts of the spine and has different names depending on the condition:

• Cervical Vertebrae - most commonly located between the fifth and seventh cervical vertebrae (the most mobile joint);
• Chest - a variant manifested by pain, which may be confused with diseases of other organs of the chest;
• Lumbar spine - the most common type, due to the greatest mobility of this part and the loads placed on it;
• Common - multiple segments involved (e. g. cervicothoracic segment).

Causes of osteochondrosis

No comprehensive theory can fully explain the cause of this disease. It is multifactorial and, therefore, requires a tendency that acts as a trigger and causes it to manifest itself - a complex of internal and external stimuli.Exogenous risk factors:

• Excessive stress, physical labor, and occupational hazards (carrying heavy objects) are common causes of osteochondrosis in men;
• spinal injuries;
• Violent and uneven jerking, bending, and turning of the body;
• Sedentary work and lack of physical activity;
• Repeated movements (carrying a bag on the same shoulder, tilting head to ear while talking on the phone);
• climate conditions.

Endogenous risk factors:

• Men (osteochondrosis occurs less frequently in women);
• Being overweight and tall;
• Abnormal development of the musculoskeletal system and weakness of the back muscles;
• bad posture;
• Leg disorders (arthritis, flat feet);
• Violates the nutritional function of intervertebral joints;
• Pathology of internal organs.

Symptoms of osteochondrosis

Typical symptoms of this disease: pain in the spine and muscles at rest, limited movement, "fatigue" in the affected area. Patients try to "unload" it by leaning in a chair, putting their hands on the floor, trying not to stand for long periods of time, or by kneading to relieve muscle tension. Depending on the location, the pain may vary slightly and new, more specific symptoms may be added.With cervical osteochondrosis, an unpleasant sensation occurs in the occipital area or in the neck itself, which is exacerbated when the head is tilted or turned. Fingers and palms may experience a tingling or burning sensation due to pinched nerve roots, and more severe injuries may limit movement.But the main danger in this case is that this area near the spine contains important arteries that supply blood to the brain. Gradually, they become squeezed, so this osteochondrosis is characterized by dizziness and the appearance of "spots" in front of the eyes due to a lack of nutrition in the main organs of the body.Of all types of osteochondrosis, lesions in the chest area are less common than other osteochondrosis and can be difficult to diagnose. Pain in this area is similar to heart pain, lung pain, esophageal pain, or nerve pain. Therefore, patients first turn to cardiologists, gastroenterologists, or pulmonologists, long-term avoidance of the specialized physicians they need until all other conditions are ruled out or thoracic osteochondrosis is suspected. The discomfort is concentrated between the shoulder blades and is exacerbated when you bend over. You may feel a lump in your throat or difficulty breathing, as well as numbness in your chest. The most common and typical type is lumbar osteochondrosis. Its symptoms are most commonly associated with the disease: soreness in the eponymous area, worsened when turning, bending or standing for long periods of time, and can radiate to one or both legs.

Diagnosis of osteochondrosis

Doctors first collect chief complaints and medical history (family, life and disease), and analyze whether there is susceptibility, external and internal risk factors, and the relationship between symptoms and disease progression.Inspections include:

• Neuro-orthopedics, which evaluates the static and dynamic functions of the spine (posture, presence of scoliosis, muscle tone, and range of motion of intervertebral joints and limbs);
• Neurology – Reflexes and compressed vertebral syndromes, motor and sensory functions, determination of tissue nutritional quality.

The simplest and easiest instrumental diagnosis of osteochondrosis in any part of the spine (cervical, thoracic or lumbar) is non-contrast and contrast (discography, intravenous laminography) X-ray examination showing disc stenosis, herniation at the level of the disc andVascular conditions. Less commonly, more information-rich magnetic resonance imaging is used, which allows for an accurate assessment of the extent of damage to the disc, the size of the hernia, and whether the spinal cord, roots, and surrounding tissue are compressed. If MRI is contraindicated, computed tomography is used instead, which can determine the status of calcifications in the vertebrae themselves, the spinal canal, and the ligaments.

Treatment of osteochondrosis

First, it is necessary to minimize the risk factors discovered by doctors during the investigation. Eliminate axial loads, limit the severity of what you are carrying, sometimes change traumatic jobs associated with manual labor, lose weight if you are overweight, and include minimal exercise in your daily schedule if you are physically inactive. This will only slightly reduce the pain levels and risk of complications caused by osteochondrosis, but it will hardly slow its progression.Treatment must be comprehensive, combining not only pharmacological methods, but also various actions on the vertebral muscles and the spine itself. You can't just take osteochondrosis medications on your own and hope for a cure; any surgery and medications can only be prescribed by a neurologist. Experts base their recommendations on each specific case and the patient's individual characteristics so that treatment does not cause more suffering than the disease itself.For osteochondrosis, exercise therapy is required, first of all in a special ward so that the doctor is sure that the patient is performing the prescribed exercises correctly. Different parts of the disease imply different complexes designed to maintain the muscles of the back, improve blood circulation and nutrition to the discs and vertebrae themselves, and reduce their friction.Therapeutic massage also has a beneficial effect on the course of osteochondrosis; physiotherapy, manual therapy, acupuncture, osteopathy, spinal hardware traction, etc. must be performed with caution. The course and method of treatment are determined by the doctor based on the progression of the lesion, the manifestation of pain, and the individual characteristics of each specific case.

Prevent osteochondrosis

If you take prompt steps to stop the progression of the disease, treatment may never be needed. This should also be addressed comprehensively: reduce the listed risk factors in advance (even before discomfort occurs), try to distribute the load evenly, monitor posture from childhood, receive adequate nutrition and all necessary vitamins and regularly participate in supportive exercises (For example, swimming).To prevent the development of osteochondrosis, gymnastics plays an important role: there are special exercises that reduce the load on the spine. You can consult an orthopedic surgeon or neurologist.But even regular morning exercises can help maintain muscle tone, relieve spasms, and improve blood circulation so that the nutritional function of the joint discs is not disrupted. To avoid physical inactivity during sedentary work, it is necessary to warm up regularly and perform exercises to prevent osteochondrosis.