Spinal osteochondrosis: prevention and effective treatment methods

Osteochondrosis is a disease of the spine characterized by degenerative-dystrophic damage to the discs, vertebral bodies and ligaments.

Osteochondrosis of the spine has a chronic progressive course.The disease does not appear for a long time, and symptoms appear only when complications occur.

According to the statistics of the World Health Organization, 40-80% of the world's population suffers from osteochondrosis.

The majority of patients are over 30 years of age.But recently there was a tendency to rejuvenate osteochondrosis.Osteochondrosis ranks first among spine diseases in terms of patient disability.

Brief Anatomy of the Spine

The spine performs the main functions - the spinal canal, support and movement, and connects the head, shoulder and pelvic girdle.

The structural unit of the spine is a vertebra.

The 24 vertebrae are connected to each other by intervertebral discs, which are the body's shock absorbers.

The spine is divided into five parts: cervical, thoracic, lumbar, sacrum and coccyx.

The normal shape of the spine is S-shaped.

This configuration of the body allows for an even distribution of body weight and load.

Structural and functional elements of the spinal column

A vertebra is a bony formation consisting of a body, arch and processes.

The main load falls on the vertebral body, so it is its most massive part.

Important!The arches of the adjacent vertebrae form the spinal canal - a container for the spinal cord, blood vessels, spinal nerve roots and fatty tissue.

tapesThe spine is represented by the posterior longitudinal ligament, which connects the vertebrae along the posterior surface, and the yellow ligament, the main purpose of which is to connect the vertebral arches.

Vertebral processes.The vertebra has 7 processes that extend from the arch: the spinous process, two transverse processes, two superior and two inferior articular processes.The ligaments and muscles of the spine are attached to the spinous processes.Other processes form the intervertebral joints of the spine.

Intervertebral disca disc-shaped plate consisting of a cartilaginous plate, anulus fibrosus, and nucleus pulposus.The intervertebral disc connects adjacent vertebrae, providing mobility and stability to the spine.

Intervertebral jointsit is formed by the processes of two adjacent vertebrae.The main function of the intervertebral joints is to move the vertebrae relative to each other and to ensure the flexibility of the spine.

Intervertebral foraminathey are located on the lateral sides of the spine and are formed by the articular processes, bodies and legs of the adjacent vertebrae.The spinal nerve roots exit through the intervertebral foramina and blood vessels enter.

Spinal cord- It is a part of the central nervous system that consists of nerve fibers.The spinal cord has three membranes - soft, arachnoid and hard.The dura consists of two sheets that connect and form the dural sac, filled with cerebrospinal fluid.

Spinal nerve roots- These are conductors of nerve impulses from the spinal cord to the internal organs and vice versa.The structure of each spinal nerve root contains vegetative, sensory and nerve fibers.

Paravertebral muscles- these are the muscles of the spine that support and ensure the tilting and turning of the body.

It is the functional unit of the spinespinal motion segment, which consists of two adjacent vertebrae, an intervertebral disc, ligaments and muscles.

Pathogenesis (mechanism of development) of osteochondrosis of the spine.

In the process of development, osteochondrosis goes awayfour stages:

1. First stage.Pathological changes do not extend beyond the borders of the intervertebral disc.The nucleus pulposus dries out, which leads to a decrease in the height of the intervertebral disc.The fibrous ring cannot withstand the load - it cracks and tears.
2. Second stage.Due to the decrease in the height of the intervertebral discs, the ligaments and muscles of the spine sag, which leads to instability of the motion segment of the spine.Vertebrae can slip and move relative to each other.In this case, spondylolisthesis is formed.
3. Third stage.The disease progresses.Protrusion of the intervertebral discs and arthrosis of the intervertebral joints and uncovertebral joints occur.
4. Fourth stage.In this stage, adaptive reactions are activated in the form of bone growth of vertebral bodies (osteophytes).Thus, the body tries to limit the excessive mobility of the vertebrae.Osteophytes damage spinal nerve roots with their sharp edges.Fibrous ankylosis of the intervertebral discs and joints develops, and the spine becomes immobilized.The ankylosis stage is characterized by the cessation of pain.

What leads to osteochondrosis?

Osteochondrosis of the backis a multifactorial disease in which it is impossible to single out a single cause.

The basis of osteochondrosis is a violation of microcirculation and metabolism in the tissues of the spine, which can arise due to incorrect distribution of the load on the spine.

Factors contributing to the development of osteochondrosis are as follows:

• improperly formed posture in childhood (scoliosis, kyphosis, kyphoscoliosis, stoop);
• weakness of the back muscles (incompetent muscular ligament of the spine);
• staying in one position for a long time (working on a computer, working in an office, doing crafts);
• improper weight lifting;
• physical inactivity and sedentary lifestyle;
• metabolic pathology, especially lack of calcium, phosphorus, calcium, vitamins, magnesium, zinc;
• genetic predisposition to osteochondrosis;
• infectious diseases;
• frequent hypothermia of the body;
• chronic stress;
• hormonal imbalance;
• weight-lifting;
• spine injury;
• overweight and obesity.

Symptoms of osteochondrosis

Chronic osteochondrosis can manifest itself with various symptoms.It all depends on the stage of the disease, the degree of spinal damage and the presence of complications.

Clinically, the disease manifests itself when the degenerative-dystrophic process has already reached the rear part of the annulus fibrosus and the posterior longitudinal ligament, then the spinal nerve roots become irritated, pinched and the conduction of nerve impulses is disrupted.

At the same time, compression of the spinal cord and blood vessels occurs, which is manifested by reflex and compression syndromes.

Important!In osteochondrosis, the pain syndrome occurs due to the pinching of the spinal nerve roots in the intervertebral openings, which is caused by osteophytes, spasmodic muscles and displaced vertebrae.

With its symptoms, osteochondrosis often mimics acute coronary syndrome, pleurisy, acute pancreatitis, hepatic and renal colic, acute appendicitis, and adnexitis.

Therefore, a thorough differential diagnosis of the disease is important in order to rule out life-threatening conditions.

Most commonSymptoms of osteochondrosis:

• pain in the neck, lower back, thoracic spine, which can be painful, throbbing or in the form of lumbago.The pain radiates to the head, upper and lower limbs, shoulder blades, heart and stomach.The pain syndrome increases after physical activity, sneezing, laughing, coughing or staying in one position for a long time;
• sensory disturbancedifferent parts of the body at the level of innervation of the pinched nerve;
• spasmmuscles of the neck, back, upper and lower limbs;
• migraine-like headache;
• speciesin the joints of the limbs;
• increased fatiguefrom physical and mental work;
• dizziness and loss of consciousnesswith a sharp turn of the head (vertebral artery syndrome);
• visual impairment(floating or colored spots in front of the eyes);
• reduced hearing acuity, tinnitus;
• pain in the heart;
• painalong the intercostal spaces;
• reduced blood supplyupper and lower limbs, which is manifested in the coldness of their skin;
• paresthesia– creeping, tingling and burning sensation in the spine;
• dry wine;
• sweating disorder;
• urinary disorder(dysuria, enuresis);
• decreased sexual desire, impotence.

Early diagnosis of osteochondrosis greatly facilitates treatment.

Methods of diagnosing osteochondrosis

The neuropathologist diagnoses osteochondrosis.If necessary, patients can refer to a cardiologist, gastroenterologist, orthopedic doctor, surgeon, and others.

During the interview, the nature of the complaints, when they arose, and what the patient associates with them must be precisely determined.Be sure to check the medical history, the patient's profession, and whether he has a close relative with osteochondrosis.

Laboratory tests are not informative in this case.By performing a biochemical blood test, you can pay attention to the level of calcium, phosphorus and other trace elements.

The main place in the diagnosis of osteochondrosis is occupied by instrumental methods, for example, radiography of the spine, computer tomography and magnetic resonance imaging.

X-ray examination of the spine is the simplest, most accessible and extremely informative method for diagnosing osteochondrosis.

Mandatory radiography is performed in the direct and lateral projection of the desired part of the spine.Characteristics of osteochondrosis: a decrease in the height of the intervertebral discs, the presence of osteophytes, osteoporosis and spinal deformity.

Myelography- This is an X-ray examination of the spinal column by injecting contrast material into the spinal canal.This method is dangerous due to the occurrence of allergic reactions to contrast.

Myelography makes it possible to study the internal structure of the spinal canal.The method is valuable for diagnosing Schmorl's hernia (intervertebral hernia).

Computed and nuclear magnetic tomography– these are modern diagnostic methods that visualize the soft tissues and bones of the spine layer by layer.

These methods are expensive, so they are used in severe cases, especially for the differential diagnosis of osteochondrosis and diseases with similar symptoms.

Since osteochondrosis is often disguised as diseases of the heart, lungs, pleura, stomach, intestines, kidneys, liver, differential diagnosis is necessary.

For this purpose, the patient may prescribe an electrocardiogram, an ultrasound examination of the heart and internal organs, a blood test for troponins, an ultrasound examination of blood vessels, a chest radiograph, an electroencephalography and others.

Methods of treatment of osteochondrosis

It can be used to treat osteochondrosisconservative and surgical.

Important!First of all, comprehensive conservative methods are used, and surgical treatment is used only in extreme cases.

Let's see how to properly treat osteochondrosis.KconservativeTreatment methods for osteochondrosis are as follows:

• drug therapy;
• Physiotherapy;
• physiotherapy methods;
• manual therapy;
• massage;
• acupuncture.

Drug treatmentThe goal of osteochondrosis is to relieve pain, relax muscles, relieve swelling of nerves and muscles, improve blood flow and the conduction of nerve impulses.For this purpose, the following drug groups are used:

• non-steroidal anti-inflammatory drugs;
• chondroprotectors, which contain the components of cartilage tissue.These drugs protect the vertebrae and intervertebral discs from the negative effects of various factors;
• diureticswhich remove excess fluid from the body and relieve swelling of spinal nerve roots and paravertebral muscles;
• muscle relaxantsrelax cramped muscles;
• drugs, improves metabolism and microcirculation in spinal tissues (vitamins B1, B6, B12, C, A and E);
• calcium supplements;
• hormonal drugs, which are prescribed when non-steroidal anti-inflammatory drugs are ineffective.

Therapeutic practice- dosed physical activities for the treatment and prevention of osteochondrosis can be performed both at home and at work.

There are many exercises for osteochondrosis.The exercise therapy is prescribed and monitored by a qualified specialist - a physical therapist.

Thanks to properly selected movement therapy, you can relieve pain, improve the mobility and blood supply of the spine, and stop the progression of the disease.

Physiotherapy treatmentOsteochondrosis is treated by a physiotherapist in the special physiotherapy departments of hospitals, sanatoriums and clinics.

Physiotherapy methods include: electrophoresis, magnetic therapy, laser therapy, mud therapy, balneotherapy, ultraviolet radiation of the affected part of the spine, vibration treatment and others.

Manual therapy– this is a dosed manual effect on the spine to restore its mobility, eliminate displacement of the vertebrae and discs.

Manual therapy can only be performed by a qualified chiropractor.

Massage and self-massagein the case of osteochondrosis, it is used to relieve muscle spasm, improve the microcirculation of the paravertebral tissues and increase the mobility of the spine.

Acupuncturemethod for the treatment of osteochondrosis, in which thin needles are injected into active points.

The needles in the body increase the levels of endogenous opiates and cortisol, which have anti-inflammatory and pain-relieving effects.

Prevention of osteochondrosis

In order to preserve your health and spine, to remain mobile until old age, follow several principles of osteochondrosis prevention:

• watch your posture– always keep your back straight, do not slouch;
• choosecorrect posturefor sleeping;
• sit correctly at the table(shoulders are relaxed, back is straight, furniture should match your height);
• during a long stay in one position (office work, sitting in front of the computer, doing needlework) try every 1-1.5 hoursdo some physical exercise, back self-massage, or just get up and walk;
• distribute the load accordinglyon the spine when lifting and carrying various weights;
• wear orthopedic shoes;
• healthy sleepon a flat, hard and medium-hard mattress.It is better to buy an orthopedic mattress and pillow.

Osteochondrosis of the spineis a chronic progressive disease that unfortunately cannot be cured.The effectiveness of the treatment directly depends on its timeliness.

Do not self-medicate so as not to worsen your condition.At the first signs of osteochondrosis, consult a neurologist.