There are several different views on the definition. Some experts believe that it is more correct to use the general name - dorsalgia, i. e. non-specific back pain. Difficulties in definition also arise due to the fact that different specialists work with this disease - neurologists, orthopedists, neurosurgeons and general practitioners. Sometimes a person with a diagnosis of osteochondrosis of the spine turns to a cardiologist, because 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 spinal movement segment.
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 due to the hidden course of the process after admission, patients enter the complication 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 disorders caused by diseases of internal secretion organs;
- poor nutrition and overweight;
- 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
Osteochondrosis of the spine is divided according to the degree of damage, each type has its own characteristic features and features of treatment.
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 region. Prone to complications such as intervertebral disc protrusions and the appearance of hernias, single and multiple. In case of complications, it can be accompanied by dysfunction of the pelvic organs and muscle atrophy 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. Neck muscles require special training, in the absence of which they simply cannot bear 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 most developed muscular corset. It is difficult to diagnose due to the long asymptomatic course and imitation of other diseases (coronary artery disease, intercostal neuralgia, lung disease).
Usual process
The pathology simultaneously covers several departments, occurs rarely and against the background of congenital diseases of the musculoskeletal system and is practically not treated.
Stages of osteochondrosis and possible complications
In 1971, Osna proposed a description of four stages of osteochondrosis of the spine. They are not used to formulate a diagnosis, but they allow us to understand how the disease progresses.
- Intervertebral discs become less elastic. The disc may be slightly deformed internal nucleus pulposus within the disc. This phase is either not manifested at all or less pain occurs.
- In the second stage, cracks may appear on the disc, and the surrounding ligaments weaken. The connection of the vertebrae becomes unstable. Attacks of acute pain with reduced ability to work occur.
- The third stage is characterized by complete damage to the intervertebral disc. When the nucleus pulposus extends beyond the disc, a herniated intervertebral disc occurs. Deformation of the spine or pinching of nerve roots may occur.
- In the fourth stage, surrounding tissues are affected - vertebrae, ligaments, spinal membranes. As a result, a segment of the spine can completely lose mobility.
As a result of osteochondrosis of the spine, various complications arise in some cases. Intervertebral disc problems, herniation and protrusion can lead to narrowing of the spinal canal, compression of the spinal cord and disability.
Depending on the degree of damage, various problems with nerve root involvement are possible. These are intercostal neuralgia, disorders of sensitivity and motor functions of the upper and lower extremities, and disorders in the work 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 vertebral vessels. If the blood flow in the vertebral arteries, which pass in the cervical region and supply the brain, is disturbed, brain disorders, problems with vision or hearing, breathing or heart function may develop.
Diagnosis of osteochondrosis
In official medicine, the diagnosis of osteochondrosis includes an examination by a neurologist to determine the degree of damage to the nerve roots, examination of 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 it allows you to make a three-dimensional image of the area being studied and detect even small displacements of the vertebrae;
- MRI is specialized for the study of soft tissues, allows you to assess 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.
Osteochondrosis therapy is complex.
- The first and very important drug 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 treatment of osteochondrosis of the spine, a neurologist or a general practitioner can prescribe medication. Most often, non-steroidal anti-inflammatory drugs are prescribed - this is the standard treatment for osteochondrosis of the spine. They reduce pain and inflammation. Muscle relaxants help reduce muscle spasms. Vitamins and antioxidants are prescribed to protect nerve tissue from damage. However, every drug has side effects, for example, NSAIDs can adversely affect the stomach.
- In addition to drugs, physiotherapy is also used, for example, massage for osteochondrosis of the spine, as well as manual therapy. In case of severe complications of osteochondrosis, surgery may be required, but it is prescribed only if there is no effect of long-term conservative treatment.