There are several different opinions on the definition. Some experts believe that it is more correct to use the general name: dorsalgia or nonspecific back pain. Difficulties in definition are also due to the fact that a variety of specialists work with this disease: neurologists, orthopedists, neurosurgeons and general practitioners. Sometimes a person diagnosed with spinal osteochondrosis turns to a cardiologist, since the manifestations of the disease are very similar to pain in the heart.
The term "osteochondrosis of the spine" was proposed by Hildebrandt in 1933 as a multifactorial degenerative disease of the motor segment of the spine.
Spinal osteochondrosis is a pathological process in the spine characterized by degenerative-destructive disorders of the vertebrae and intervertebral discs. The danger of the disease is due to the latent course of the process; Upon admission, patients enter the complications stage, when severe pain begins.
Causes of osteochondrosis
Osteochondrosis of the spine arises as a result of the influence of predisposing factors on the human body. The disease does not differ by gender. Triggers of the development of osteochondrosis:
- inheritance;
- back injuries;
- congenital or acquired defects in the structure of the musculoskeletal system (flat feet, changes in posture);
- metabolic failures caused by diseases of the internal secretory organs;
- poor nutrition and excess weight;
- viral and bacterial infections;
- lifestyle: lifting and carrying heavy objects, working in drafts, constant exposure to vibrations, physical inactivity;
- constant psycho-emotional overload;
- Bad habits: smoking, alcohol, opiates.
Osteochondrosis of the spine: types
Spinal osteochondrosis is divided according to the level of damage, each type has its own distinctive features and treatment features.
Osteochondrosis of the lumbar spine.
The most common back disease is osteochondrosis of the lumbar region, which is associated with a large load on this particular region. Prone to complications such as protrusion of intervertebral discs and the appearance of hernias, both single and multiple. In case of complications, it may be accompanied by dysfunction of the pelvic organs and atrophy of the muscles of the lower extremities.
Osteochondrosis of the cervical spine.
Second place in the classification of back diseases. Pathological processes develop as a result of a sedentary lifestyle and increased load on the shoulder girdle. The neck muscles require special training, without which they simply cannot withstand the load due to their poor development.
Osteochondrosis of the thoracic spine.
The rarest pathology of the back due to the low mobility of the region and the more developed muscular corset. It is difficult to diagnose due to a long asymptomatic course and imitation of other diseases (coronary artery disease, intercostal neuralgia, lung diseases).
Common process
Pathology covers several departments at the same time, occurs rarely and against the background of congenital diseases of the musculoskeletal system and is practically untreatable.
Stages of osteochondrosis and possible complications.
In 1971, Osna proposed a description of the four stages of spinal osteochondrosis. They are not used to make a diagnosis, but they allow us to understand how the disease progresses.
- The intervertebral discs become less elastic. The disc may be slightly deformed; The internal nucleus pulposus moves within the disc. This stage does not manifest itself at all or mild pain occurs.
- In the second stage, cracks may appear in the disc and the surrounding ligaments weaken. The connection of the vertebrae becomes unstable. Attacks of acute pain occur with impaired ability to work.
- The third stage is characterized by complete damage to the intervertebral disc. When the nucleus pulposus extends beyond the disc, an intervertebral disc herniation occurs. Deformation of the spine or pinched nerve roots may occur.
- In the fourth stage, the surrounding tissues are affected: vertebrae, ligaments and spinal membranes. As a result, the spinal segment may completely lose its mobility.
As a result of spinal osteochondrosis, in some cases various complications arise. Problems with intervertebral discs, herniations and protrusions can lead to narrowing of the spinal canal, spinal cord compression and disability.
Depending on the level of damage, various problems with nerve root involvement are possible. These are intercostal neuralgia, alterations in sensitivity and motor function of the upper and lower extremities and alterations in the functioning of internal organs. Inflammation of the sciatic nerve, or sciatica, not only causes severe pain, but can also lead to pelvic diseases and infertility.
In addition to the nerve roots, osteochondrosis can cause compression of the vertebral vessels. If blood flow is interrupted in the vertebral arteries, which run in the cervical region and supply the brain, brain disorders, problems with vision or hearing, breathing or heart function may develop.
Diagnosis of osteochondrosis.
Within the framework of official medicine, the diagnosis of osteochondrosis includes an examination by a neurologist to determine the extent of damage to the nerve roots, tests of reflexes and sensitivity.
The following instrumental methods can be used:
- Vascular ultrasound can reveal the degree of circulatory disturbance, for example, in the vertebral arteries;
- spine x-ray;
- Computed tomography also uses X-ray methods, but allows you to build a three-dimensional image of the area under study and detect even small displacements of the vertebrae;
- Magnetic resonance imaging specializes in the study of soft tissues, it allows us to evaluate the state of the spinal cord and visualize the internal structure of the intervertebral disc.
Laboratory tests, general blood and urine tests, and calcium metabolism are used for differential diagnosis.
Therapy for osteochondrosis is complex.
- The first and very important remedy in the treatment of osteochondrosis is lifestyle. Normalization of working conditions, moderate and regular exercise, as well as healthy sleep significantly improve the condition of patients.
- For the drug treatment of spinal osteochondrosis, a neurologist or general practitioner can prescribe medications. Most often, non-steroidal anti-inflammatory drugs are prescribed; This is the standard treatment for spinal osteochondrosis. They reduce pain and reduce inflammation. Muscle relaxants help reduce muscle spasms. Vitamins and antioxidants are prescribed to protect nervous tissue from damage. However, any medication has side effects, for example, NSAIDs can negatively affect the stomach.
- In addition to medications, physiotherapy is used, for example massage for spinal osteochondrosis, as well as manual therapy. In case of severe complications of osteochondrosis, surgery may be required, but it is prescribed only if long-term conservative treatment does not bring any effect.