Why does osteochondrosis occur and how is it treated?

Osteochondrosis is a disease characterized by degenerative and dystrophic changes in spinal cartilage tissue, accompanied by structural and functional disorders of the intervertebral disc.Osteochondrosis in the cervical, thoracic, and lumbar regions can be distinguished based on the location of the damaged tissue.

According to medical statistics, 50-90% of the population will experience symptoms of osteochondrosis.The average age of onset of osteochondrosis is 30-35 years old.Signs of osteochondrosis may appear earlier under adverse conditions, especially long-term uneven loading of the back, legs and the consequences of injuries.

What is osteochondrosis?

Osteochondrosis is a disease of the spine in which degenerative and dystrophic changes occur in the intervertebral discs.As osteochondrosis progresses, degenerative dystrophic lesions spread into the vertebral tissue.

The main symptoms of the development of osteochondrosis are neck, back and waist pain; as the disease progresses, the pain can "radiate" to the arms, chest, shoulders and upper thighs.Along with the negative dynamics of osteochondrosis, muscle tissue atrophy, sensory disturbances and visceral organ dysfunction (due to compression and displacement of visceral organs) begin to appear.If left untreated, osteochondrosis can progress to an incurable condition.

Causes of osteochondrosis

The main factor in the occurrence of osteochondrosis is uneven loading of the spine.A common cause of improper load distribution is the habit of carrying bags with one shoulder or hand, incorrect sitting posture, sleeping on too soft a mattress, high pillows and wearing anatomically incorrect shoes.

Other risk factors include physical inactivity, a sedentary lifestyle, excess body weight, back injuries, lower limbs, flat feet and other musculoskeletal system disorders, as well as age-related degenerative processes due to age-related changes in blood supply to the spine.

The following factors may also play a role in the etiology of osteochondrosis:

• physical overexertion;
• Nervous and emotional exhaustion;
• Metabolic disorders, poisoning, and gastrointestinal diseases prevent adequate absorption of nutrients;
• Occupational risks, especially when working on vibrating platforms;
• genetic predisposition;
• Poor posture and scoliosis during active growth period;
• Wearing uncomfortable shoes (too tight, high heels);
• long-term and/or regular dehydration;
• Poor diet, vitamin deficiency;
• smoking;
• Pregnancy, especially multiple gestation, is combined with an underdeveloped musculoligamentous apparatus (due to a shift in the body's center of gravity).

Stages of development of osteochondrosis

The disease dynamics of osteochondrosis go through four stages:

• Stage 1 (degree) osteochondrosis is characterized by the initial stages of nucleus pulposus pathology in the intervertebral disc.Due to the excessive load, the cell nucleus begins a process of dehydration (dehydration), resulting in a decrease in disc height and cracks in the annulus fibrosus.Usually, there are no symptoms during this stage; mild discomfort may occur when you are in an uncomfortable static position for an extended period of time or when you are actively moving.
• In the second stage, the reduction in disc height causes the distance between the vertebrae to decrease and the spinal muscles and ligaments to sag.This can lead to increased vertebral mobility in the affected disc, causing dangers due to disc shifting or slipping.In the second stage of the disease, discomfort and pain occur, especially with certain types of loads, movements, postures;
• Stage 3 (degree) of osteochondrosis is characterized by the development of disc prolapse and herniation and may be accompanied by the development of intervertebral joint subluxation and/or arthrosis.Patients experience stiffness, lack of mobility, tingling, and numbness in their limbs during certain types of exercise.During this stage of osteochondrosis, pain is evident in the back, neck, lumbosacral region, or coccyx, depending on the location of the affected disc;
• In the fourth stage of osteochondrosis, the body attempts to correct the consequences of vertebral hypermobility and adapt to the impaired spinal function.Osteophytes, new bone formation that improves the fixation of the vertebrae, form at the contact points between vertebrae.However, in some cases, osteophytes can cause nerve compression and damage the vertebrae.Fibrous ankylosis begins in the discs and joints.Symptoms of the disease subside without minimal trauma and nerve root compression.

Symptoms of osteochondrosis

The main symptom of osteochondrosis is discomfort and/or pain in the neck and back.The severity of feelings and the presence of other symptoms depends on the stage of the disease.While examining the patient and taking a history, the specialist makes a preliminary diagnosis, suggesting the presence of osteochondrosis by visually detectable spinal curvatures observed in the transverse or longitudinal planes of the spine.Lesions of the cervical and lumbar intervertebral discs are more common than degenerative and dystrophic changes of the sternum.

Symptoms of osteochondrosis experienced by patients include periodic or permanent feelings of back fatigue and mild or severe pain, depending on the stage of the disease.The pain may be concentrated in the neck, back, chest, and shoulder girdle, making upper limb movement difficult and restricted.

The clinical manifestations of osteochondrosis depend largely on the localization of the pathology, the extent of the process, and the individual characteristics of the patient.Disc pathology, displacement, herniation, hernia, and osteophyte growth can lead to various consequences.The most common of these are disorders of normal blood circulation in tissues, compression of nerve endings, spinal canal dysfunction, edema, and tissue and structural fibrosis.This consequence can be accompanied by many different symptoms, leading to misdiagnosis of the disease.

The most common and characteristic symptoms of osteochondrosis include:

• Pain in the back, neck, lower back, shoulder girdle, rib area;
• Discomfort, stiffness during certain body postures, bending, turning, body movements with increased muscle tension;
• A feeling of numbness in the upper and lower extremities;
• Muscle and joint discomfort, muscle spasms;
• Increased headache, dizziness, and fatigue;
• Pain in the heart area;
• Impaired hand sensitivity;
• Muscle hypotonia.

Symptoms of osteochondrosis vary depending on the location of the disease:

• Suffering from cervical osteochondrosis, where pain is concentrated in the neck, arms, and shoulder girdle and radiates to the shoulder blades and shoulder area; headaches, dizziness, flashing "spots" or spots in front of the eyes, and tinnitus;
• If the thoracic spine is affected, the pain is concentrated in the chest, heart, inner surface of the shoulder, and armpit area. Respiratory discomfort may also occur, and shortness of breath may occur;
• Lumbosacral osteochondrosis manifests as low back pain radiating to the legs, upper thighs or pelvic organs, often accompanied by sexual dysfunction.

Superficial symptoms - back fatigue, pain - may indicate not only the presence of osteochondrosis, but also the presence of other diseases or the occurrence of other pathological processes and diseases not related to disc degeneration.The diagnosis of "osteochondrosis" can only be made by a specialist, and self-medication for such symptoms is unacceptable.

Classification of osteochondrosis

Types of osteochondrosis are distinguished based on several principles.Depending on the pathological location, osteochondrosis of the cervical, thoracic, lumbar, sacral or mixed or combined disease types can be distinguished.Based on clinical manifestations, osteochondrosis in different locations is divided into different subtypes based on identified symptoms and overall clinical presentation.

Cervical osteochondrosis:

• Depending on the type of reflex syndrome, neck pain, cervicocranial pain, cervicobrachial pain, as well as various manifestations (vegetative vascular pain, neurodystrophic, myotonic) can be recognized;
• If the test result for radiculopathy syndrome is positive, a discogenic injury to the cervical spine root is diagnosed.

Pathologies at the chest level include:

• For reflex syndrome - chest pain with manifestations of vegetative viscera, neurodystrophies or muscle tone;
• Caused by radicular discogenic lesions at the roots of the thoracic spine.

For osteochondrosis at the lumbosacral level, the diagnosis is as follows:

• Depending on the type of reflex syndrome - lumbago (lumbar pain), lumbago, lumbar pain with vegetative vasculature, neurodystrophic or muscle tone manifestations;
• Radicul syndrome indicates the presence of discogenic damage to the lumbosacral roots;
• Radiculovascular syndrome indicates nerve root ischemia.

Diagnosis of osteochondrosis

To make a diagnosis, instrumental examination methods are used:

• Spine X-ray;
• Myelography;
• Neurological examination sensitivity, reflexes.

Other methods used to differentiate and clarify diagnostic and pathological stages include:

• Spine computed tomography (CT);
• Nuclear Magnetic Resonance (NMR);
• Magnetic resonance imaging (MRI).

Treatment directions for osteochondrosis

Treatment is based on a comprehensive approach, lasting from 1 to 3 months of intensive therapy and 1 year of supportive measures, depending on the stage, to consolidate the results and prevent recurrence.

Treatment of osteochondrosis goes in two directions, depending on the extent of the osteochondrosis and the health of the patient.Conservative treatment of the disease includes medication and a range of exercises.In almost any case, surgical treatment cannot be the first method and is prescribed only in the context of long-term conservative treatment, in the absence of active dynamics or progression of the disease.

In addition to pharmacological treatment methods, it is necessary to follow the general recommendations for osteochondrosis: follow the diet and take the necessary rehabilitation measures.

Conservative treatment of osteochondrosis

The goals of conservative treatment are to relieve pain, normalize spinal function, and prevent negative changes

Conservative treatment of osteochondrosis includes the following types of treatments:

• Medication.Medications for the treatment of osteochondrosis are used to relieve pain syndromes, inflammatory processes in tissues and normalize metabolic processes of the body.If severe pain syndrome occurs, it is recommended to use nerve ending drug blockade, which can also help reduce the severity of muscle tension syndrome.Distinguish between the following types of blocks: trigger point block, intraosseous block, facet block, paravertebral block, epidural block;
• Physical therapy methods.Physical therapy procedures help reduce pain, enhance the effects of medications, and are also used during recovery.The most common uses are ultrasound, magnetic fields, low-frequency currents, and laser beams;
• Methods of physical therapy (physiotherapy) and exercise therapy.A series of special exercises performed regularly and correctly can help correct posture, strengthen muscle bundles and ligament devices, normalize muscle function, reduce compression of nerve fibers, and help prevent complications of osteochondrosis.The purpose of exercise therapy and exercise therapy is to normalize metabolic processes, restore adequate nutrition to the intervertebral discs, restore the position between the vertebrae and the intervertebral discs, and evenly distribute the load on the musculoskeletal system;
• massage.Manual massage techniques are used to improve blood supply to tissues, relieve muscle spasms and tension, and generally improve blood circulation.Hydromassage as a direction of therapeutic activity, in addition to the listed effects, also helps to normalize the functioning of the nervous system of the body;
• Manual therapy.Manual therapy methods are chosen based on individual circumstances.Targeted effects on the body's musculoskeletal system, helping to improve blood circulation, lymph circulation, improve metabolism, help correct the mobility of the musculoskeletal system, enhance the immune system, and prevent complications of osteochondrosis;
• traction therapySpecial equipment is used to (tract) the spine.The purpose of the operation is to increase the intervertebral space to normal parameters and correct structural derangements of the spine.

Osteochondrosis: drug treatment

In the treatment of osteochondrosis, medications are aimed at reducing the severity of symptoms and improving the blood supply to the tissues and their regeneration processes.Medication alone cannot cure osteochondrosis; treatment must be combined and include a range of exercise, diet, and preventive measures.

In the absence of obvious malnutrition changes and pain, taking medications without a specialist prescription may be considered unreasonable.

Medications used to relieve pain and treat osteochondrosis:

• anti-inflammatory group;
• Antioxidant preparations: Vitamin C (ascorbic acid form), E (tocopheryl acetate), N (lipoic acid);
• Means of improving blood supply to tissues, B vitamins (mainly B3);
• Preparations for regeneration and/or prevention of cartilage tissue degradation, hyaluronic acid.

Medications are available in the form of ointments and creams for local pain relief, as well as by mouth and injection.

If acute complications occur, medications may be used to block the nerve endings.

Osteochondrosis: dietary nutrition for patients

The principle of the diet is based on the need to improve metabolic processes, fill the body with essential nutrients, vitamins, minerals and include foods rich in antioxidants, polyunsaturated fatty acids and compounds that promote the regeneration of cartilage tissue.The recommended drinking regimen for osteochondrosis is designed to prevent dehydration of the body, which can have a negative impact on the affected tissue.You need to eat small amounts frequently, 5-6 times a day.

The basis of the diet is dairy and fermented milk products, lean meats, poultry, fish, fresh vegetables, fruits, nuts and seeds, cereals and mushrooms.It is especially recommended to include meat and fish jelly, meat jelly, jelly dishes in the diet and to use extra virgin olive oil without heat treatment (for dressing salads).

Preferred food processing methods: steaming, roasting, boiling.Limit the intake of flour and confectionery products, fatty foods, spicy, salty dishes and seasonings, canned and smoked foods, thick broths, legumes, sugar and fruits with a high sugar content (grapes).During the day, you must drink at least 1.5 liters of fluids, giving priority to clean mineral water, dried fruit preserves, unsweetened fruit drinks and herbal teas.You should limit your intake of strong black tea, coffee, sweetened carbonated drinks, and alcohol.

Complications of osteochondrosis

Non-adherence to prescribed treatment, chronic avoidance of the doctor and lack of osteochondrosis treatment can lead to the progression of the disease and lead to the development of complications, pathology and new diseases, such as:

• Herniated disc (bulging spine);
• protrude;
• Kyphosis;
• Radiculitis;
• salt deposits in the intervertebral spaces;
• spinal cord stroke;
• Reduced muscle mass in the limbs and impaired blood supply leading to muscle atrophy;
• Paralysis of lower limbs.

Although grade 4 osteochondrosis may occur without severe symptoms and pain, advanced osteochondrosis is most dangerous in terms of severe complications that can lead to disability.

Prevent osteochondrosis

The causes of osteochondrosis are mainly related to not paying attention to the body's needs, malnutrition, and excessive physical stress.In order to prevent pathological changes in the spine and suppress the dynamics of existing osteochondrosis, it is recommended to follow the general principles of a healthy lifestyle:

• Eliminate the possibility of physical inactivity: Moderate exercise: exercise, running, swimming, cycling, skiing, gymnastics, non-contact wrestling, etc.;
• When working or other activities that require you to remain stationary for long periods of time, you must take warm-up breaks every 45 minutes to restore blood circulation.If you need to sit for a long time, you should choose a suitable chair, one that provides support for the spine, ensure that the position of your hands on the table and your feet on the floor or on a special support is up to standard, and learn to maintain posture (straight back, relax shoulders);
• To sleep at night, you need to choose a mattress that is elastic, preferably orthopedic, with a flat surface, and avoid pillows that are too high or too flat;
• Lift and/or carry heavy objects if necessary, avoid jerking when lifting heavy objects from a squatting position, use a special belt to support the lower back;
• Choose orthopedically correct shoes: suitable for the width of the foot, do not wear high heels, and replace them in time to reduce the load on the spine, which is especially important for women during childbirth.In summer, you should not ignore the opportunity to walk barefoot on uneven ground; this strengthens the foot muscles and relieves tension on the musculoskeletal system;
• Proper eating and drinking habits contribute to overall health and help maintain a normal metabolism;
• If you're prone to agitation, anxiety and a spasmodic muscle response to stress, it's worth learning relaxation techniques, as well as regular restorative massage sessions.