There are several different views on the definition. Some experts believe that it is more correct to use the general name - dorsalgia or nonspecific back pain. The difficulties of definition are also due to the fact that several specialists work with the disease - neurologists, orthopedists, neurosurgeons and general practitioners. Sometimes a person diagnosed with spinal osteochondrosis turns to a cardiologist, as the manifestations of the disease are very similar to heart pain.
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 of the spine characterized by degenerative-destructive disorders of the vertebrae and intervertebral discs. The danger of the disease is due to the hidden course of the process; Upon admission, the patient enters the complications phase, when severe pain begins.
Causes of osteochondrosis
Osteochondrosis of the spine occurs as a result of the influence of predisposing factors on the human body. The disease does not differ by gender. Triggers for the development of osteochondrosis:
- heredity;
- back injuries;
- congenital or acquired defects in the structure of the musculoskeletal system (flat feet, changes in posture);
- metabolic dysfunctions caused by diseases of the internal secretion organs;
- poor nutrition and excess weight;
- viral and bacterial infections;
- lifestyle: lifting and carrying heavy objects, working in drafts, constant exposure to vibrations, sedentary lifestyle;
- 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 characteristics 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 in this particular region. Prone to complications such as protrusion of intervertebral discs and the occurrence of single and multiple hernias. 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 ranking 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 the long asymptomatic course and mimicry of other diseases (coronary artery disease, intercostal neuralgia, lung diseases).
Common process
Pathology covers several departments at once, occurs rarely and against the background of congenital diseases of the musculoskeletal system and is practically intractable.
Stages of osteochondrosis and possible complications
A description of the four stages of spinal osteochondrosis was proposed by Osna in 1971. They do not serve to formulate a diagnosis, but allow understanding how the disease progresses.
- The intervertebral discs become less elastic. The disc may be slightly deformed; the inner nucleus pulposus moves within the disc. This stage either does not manifest itself or there is minor pain.
- In the second stage, cracks may appear in the disc and the surrounding ligaments weaken. The connection of the vertebrae becomes unstable. Acute pain attacks occur with a decrease in working capacity.
- 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 compressed nerve roots may occur.
- At the fourth stage, surrounding tissues are affected - vertebrae, ligaments, spinal membranes. As a result, the spinal segment may completely lose mobility.
As a result of spinal osteochondrosis, in some cases various complications arise. Problems with intervertebral discs, hernia and protrusion can lead to narrowing of the spinal canal, compression of the spinal cord and disability.
Depending on the level of damage, several problems with nerve root involvement are possible. These are intercostal neuralgia, disturbances in sensitivity and motor function of the upper and lower extremities, and disturbances in the functioning of internal organs. Inflammation of the sciatic nerve, or sciatica, not only causes severe pain, but can also lead to pelvic disease and infertility.
In addition to 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 can occur.
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, reflex and sensitivity tests.
The following instrumental methods can be used:
- Vascular ultrasound can reveal the degree of circulatory disorder, for example, in the vertebral arteries;
- spine x-ray;
- CT also uses X-ray methods, but it 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, allows you to assess the condition of the spinal cord and visualize the internal structure of the intervertebral disc.
For differential diagnosis, laboratory tests, general blood and urine tests and calcium metabolism are used.
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 drug treatment of spinal osteochondrosis, a neurologist or general practitioner can prescribe medications. Nonsteroidal anti-inflammatory drugs are most often 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 nerve 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 necessary, but it is prescribed only if there is no effect from long-term conservative treatment.