There are several views on the definition. Some experts believe that it is more correct to use the general name - dorsalgia or non-specific back pain. The difficulties in definition are also due to the fact that many specialists work with this disease - neurologists, orthopedists, neurosurgeons and general practitioners. Sometimes a person diagnosed with osteochondrosis of the spine 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 movement 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 occurs due to the hidden course of the process, patients enter the stage of complications, when severe pain begins.
Causes of osteochondrosis
Osteochondrosis of the spine develops as a result of the influence of predisposing factors on the human body. The disease does not differ according to gender. Factors causing the development of osteochondrosis:
- heredity;
- back injuries;
- congenital or acquired defects in the structure of the locomotor 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 transporting heavy objects, working in a draft, constant vibration load, 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 characteristics and treatment characteristics.
Osteochondrosis of the lumbar spine.
The most common back disease is osteochondrosis of the lumbar region, which is associated with heavy strain on this region. It is prone to complications such as protrusion of the intervertebral discs and the occurrence of single and multiple herniations. In case of complications, it may be accompanied by dysfunction of the pelvic organs and muscle atrophy of the lower limbs.
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, in the absence of this, they simply cannot cope with 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 muscle ligament. It is difficult to diagnose due to the long asymptomatic course and imitation of other diseases (coronary artery disease, intercostal neuralgia, lung diseases).
A common process
The pathology covers several classes 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
The description of four stages of osteochondrosis of the spine was proposed by Osna in 1971. They are not used to make a diagnosis, but allow us to understand the progress of the disease.
- The intervertebral discs are less flexible. The disc may be slightly deformed, the internal nucleus pulposus shifts within the disc. This stage either does not occur at all, or there is less 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 with reduced work capacity occur.
- The third stage is characterized by complete damage to the intervertebral disc. When the nucleus pulposus protrudes beyond the disc, an intervertebral disc herniation occurs. Deformation of the spine or pinching of nerve roots may occur.
- In the fourth stage, the surrounding tissues are affected - vertebrae, ligaments, spinal membranes. As a result, the spinal segment can completely lose mobility.
As a result of osteochondrosis of the spine, various complications occur 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 extent of the damage, various problems related to nerve root involvement are possible. These are intercostal neuralgia, sensory and motor dysfunctions of the upper and lower limbs, and disorders of 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 disrupted in the vertebral arteries that run in the neck region and supply the brain, brain abnormalities, vision or hearing, breathing or heart function problems can occur.
Diagnosis of osteochondrosis
Within the framework of official medicine, the diagnosis of osteochondrosis includes an examination by a neurologist to determine the degree of damage to the nerve roots, the examination of reflexes and sensitivity.
The following instrumental methods can be used:
- Vascular ultrasound can reveal the extent of circulatory disturbance, for example in the vertebral arteries;
- X-ray of the spine;
- CT also uses x-ray methods, but it allows building a three-dimensional image of the examined area and detecting small displacements of the vertebrae;
- MRI specializes in the examination of soft tissues, it allows assessing the condition of the spinal cord and visualizing the internal structure of the intervertebral disc.
Laboratory tests, general blood and urine tests, and calcium metabolism tests are used for differential diagnosis.
The therapy of osteochondrosis is complex.
- The first and very important remedy in the treatment of osteochondrosis is lifestyle. Normalizing working conditions, moderate and regular exercise, and healthy sleep significantly improve the condition of patients.
- The neurologist or the general practitioner can prescribe drugs for the medical treatment of osteochondrosis of the spine. Most often, non-steroidal anti-inflammatory drugs are prescribed - this is the standard treatment for osteochondrosis of the spine. They reduce pain and reduce inflammation. Muscle relaxants help reduce muscle spasms. Vitamins and antioxidants are prescribed to protect nerve tissue from damage. However, all drugs have side effects, for example NSAIDs can negatively 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 necessary, but it is prescribed only if long-term conservative treatment has no effect.