There are several different views on the definition. Some experts believe that it is more correct to use the general name - dorsalgia or non-specific back pain. Difficulties in definition are also related to the work of different specialists with this disease - neurologists, orthopedists, neurosurgeons and general practitioners. Sometimes a person diagnosed with spinal osteochondrosis consults a cardiologist, because 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 motion segment of the spine.
Osteochondrosis of the spine is a pathological process in the spine, characterized by degenerative-destructive disorders of the vertebrae and intervertebral discs. The danger of the disease is related to the hidden course of the process after admission, patients enter the stage of complications 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. Factors leading to the development of osteochondrosis:
- heredity;
- back injuries;
- congenital or acquired defects in the structure of the musculoskeletal system (flat feet, posture changes);
- metabolic failures caused by diseases of internal secretion organs;
- poor nutrition and overweight;
- viral and bacterial infections;
- lifestyle: lifting and carrying heavy objects, working in a draft, exposure to constant vibration, physical inactivity;
- constant psycho-emotional loading;
- 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 unique 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 heavy load in this particular region. It is prone to complications such as herniation of intervertebral discs and formation of both single and multiple herniations. In the case of complications, it can be accompanied by dysfunction of the pelvic organs and atrophy of the muscles of the lower limbs.
Osteochondrosis of the cervical spine
The 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. Neck muscles require special training, in their absence they cannot cope with the load, given their poor development.
Osteochondrosis of the thoracic spine
The rarest pathology of the back due to the low mobility of the region and the most developed muscle corset. It is difficult to diagnose due to the long asymptomatic course and mimicry of other diseases (coronary artery disease, intercostal neuralgia, lung diseases).
General process
The pathology involves several departments at the same time, occurs rarely and against the background of congenital diseases of the musculoskeletal system and is practically not treated.
Stages of osteochondrosis and possible complications
The description of four stages of spinal osteochondrosis was proposed by Osna in 1971. They are not used to form a diagnosis, but allow us to understand how the disease develops.
- Intervertebral discs become less elastic. The disc may be slightly deformed, the inner nucleus of pulposus changes inside the disc. This stage either does not manifest itself at all, or minor pains occur.
- In the second stage, cracks may appear on the disc and the surrounding ligaments weaken. The connection of the vertebrae becomes unstable. Acute pain attacks occur with impairment of working capacity.
- The third stage is characterized by complete damage to the intervertebral disc. When the nucleus pulposus protrudes from the disc, an intervertebral disc herniation occurs. Deformation of the spine or compressed nerve roots may occur.
- In the fourth stage, surrounding tissues are affected - vertebrae, ligaments, spinal membranes. As a result, the spinal segment can completely lose its mobility.
As a result of osteochondrosis of the spine, various complications arise in some cases. Problems, herniations, and protrusions of the intervertebral discs can cause narrowing of the spinal canal, compression of the spinal cord, and disability.
Depending on the level of damage, different problems with nerve root entrapment are possible. These are intercostal neuralgia, disturbances of sensitivity and motor function of upper and lower limbs, disturbances in the work of internal organs. In addition to causing severe pain, inflammation of the sciatic nerve or sciatica can also lead to pelvic disorders and infertility.
In addition to nerve roots, osteochondrosis can cause compression of vertebral vessels. If blood flow is disrupted in the vertebral arteries that pass through the neck and feed the brain, brain disorders, problems with vision or hearing, breathing, or heart function may occur.
Diagnosis of osteochondrosis
The diagnosis of osteochondrosis in the framework of official medicine includes an examination by a neurologist to determine the degree of damage to the nerve roots, checking reflexes and sensitivity.
The following instrumental methods can be used:
- Vascular ultrasound can reveal the degree of circulatory disorders, for example, in the vertebral arteries;
- X-ray of the spine;
- CT also uses X-ray methods, but allows to build a three-dimensional image of the studied area and detect even small displacements of the vertebrae;
- MRI specializes in the study of soft tissues, allows to evaluate the condition 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.
Treatment of osteochondrosis is complicated.
- The first and very important tool 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 drugs. Non-steroidal anti-inflammatory drugs are most often prescribed - this is the standard treatment for spinal osteochondrosis. They relieve pain and reduce inflammation. Muscle relaxants help reduce muscle spasms. Vitamins and antioxidants are prescribed to protect nerve tissue from damage. However, any drug has side effects, for example, NSAIDs can have a negative effect on the stomach.
- In addition to drugs, physiotherapy is used, for example, massage for spinal osteochondrosis, as well as manual therapy. In case of severe complications of osteochondrosis, surgical intervention may be required, but it is prescribed only if there is no effect of long-term conservative treatment.