Osteochondrosis of the spine is a destructive, chronic lesion of the inter-articular discs, muscle material, and neurovascular bundles. The signs of osteochondrosis will depend on the lesion in a particular part of the spine.
The main groups of symptoms
The first signs of osteochondrosis are not specific and are associated with the manifestation of concomitant diseases. The possibilities for pain experiences depend on the duration of the disease:
- acute phase (up to 2 weeks);
- subacute phase (2-10 weeks);
- chronic phase (more than 10 weeks).
High intensity and a sharp onset of pain are characteristic of the acute phase of the disease. With the chronicity of the process, pain is drawn back into the background, and a decrease in motor activity comes to the fore. Loss of volume and completeness of movements are associated with the formation of contractures (connective tissue narrowings) in the joint.
Stages of osteochondrosis:
- Violation of the structure of the intervertebral disc due to various reasons. There are prerequisites for trauma. The patient begins to experience less discomfort.
- Destruction of assembly components and narrowing of the common space. The patient complains of recurrent back pain with unclear localization.
- Destruction of the joint surface with the formation of a hernia and deformation of the spine. Sharp, poorly relieved, pronounced pain with clear localization.
- Formation of contractures. Connective tissue constrictions interfere with normal joint movement. Pain, prolonged pain with periods of aggravation.
Static manifestations of osteochondrosis are associated with the loss of support and shock-absorbing functions from the vertebrae. The main supporting function is carried by vertebral bodies and vertebral discs. Additional elements in the joint (ligaments, muscles) strengthen the frame.
When a vertebral body changes, any mechanical load leads to its damage and deformation. With the loss of shock-absorbing properties due to injuries, symptoms of rapid fatigue and muscle stiffness occur.
Extreme destruction of the vertebrae can lead to poor posture or the impossibility of certain movements (bending, elongation, head rotation).
An integral part of osteochondrosis is compression of the nerve roots next to the affected vertebrae. The first is the defeat of the posterior "motor" roots in the spinal cord, so pain and decreased muscle activity appear first of the disease. The anterior "sensitive" roots are included in the second stage.
In the initial stages, there is a slight manifestation of symptoms from the nervous system.
The main symptoms are:
- Local pain cider. If the cervical spine is affected - cervicalgia, if lumbar lumbodynia. On palpation, pain is manifested by direct pressing on the spine or due to reflex excitability in the surrounding zone.
- In 40% of cases, there may be local muscle tension (defense) or reverse muscle hypotension. This phenomenon is associated with direct involvement of a particular muscle group in the inflammation or with reflex irritation.
- Sensitive disorders (dot, goosebumps). They appear much later than the pain syndrome.
- Headache, dizziness, visual and hearing damage. These symptoms are associated with decreased transmission of nerve impulses to the central nervous system through the compressed roots of the spinal cord.
Any neurological disorder depends on the level of the lesion.
This syndrome is associated with a lack of blood supply (ischemia) in the roots and the gradual closure (occlusion) of the feeding artery.
This syndrome is of particular importance in cervical osteochondrosis, as a large vertebral artery is compressed in this area. This phenomenon explains the neurological symptoms due to cerebral hypoxia.
In 85% of the population, the blood supply to the thorax, lumbar and sacral spinal cord passes through the Adamkevich artery. A change in blood circulation through this vessel leads to oxygen starvation and the development of intermittent claudication syndrome. It is characterized by feelings of weakness and numbness in the legs, which are manifested with muscle tension.
With a lack of blood supply, the normal metabolism in the surrounding tissue is disturbed. Compression of the neurovascular bundle leads to disruption of trophism and degeneration of normal cartilage tissue into fibrous dense tissue.The phenomenon of fibrosis is irreversible.
Signs of osteochondrosis depending on the level of spinal lesion
Complaints from patients and tactics for further treatment depend on the degree of damage to the spine.
Symptoms of osteochondrosis with damage to the cervical spine include manifestations not only from the side of the spine. Some of the signs that patients communicate with, ringing and crackling in the ears, visual impairment.
The cause of the development of vertebral artery syndrome is vascular compression and disturbance of normal blood circulation in the brain. As a result, hypoxia of the central nervous system and dysfunction of the auditory and visual center.
- visual impairment (loss of field, flashing "flies" in front of the eyes)
- hearing loss (slight, crackling, hearing loss)
- pronounced pain component;
- decrease in active and passive movements of the upper limbs
- numbness and tingling at exertion.
Upon examination, you can identify:
- Sharp pain on palpation in paravertebral zone.
- Sperling's symptom: tilting towards the lesion increases pain due to further compression of the nerve roots.
- The phenomenon of nocturnal brachialgia (symptom of Putman-Schultz). Pain, decreased sensitivity, manifested exclusively at night and passing during the day.
Thoracic osteochondrosis is manifested as a consequence of scoliosis II - III degree. Taking into account the anatomical and physiological characteristics of this part of the spine, pathology rarely occurs in this area.
The main manifestations will be associated with a slight dysfunction of the upper limbs.
- pain that increases with movement or breathing
- irradiation of pain to adjacent organs (heart)
- numbness in the limbs
- reduced physical activity.
On examination, 70% have a positive Dejerine symptom: coughing or sneezing increases the pain.
Lumbar osteochondrosis is the second most common after cervical osteochondrosis with pronounced symptoms in the clinical picture.
The spine is the most durable in this section and is responsible for the most important static loads. Typical complaints:
- Back pain. As a rule, the painful sensation has an acute onset and intensifies with movement. It is almost impossible to differentiate with sciatica in the early stages.
- Pain in the lower extremities.
- Sensitivity disorders - numbness, tingling.
- Forced position and load limitation. The volume of active and passive movements decreases with the progression of the disease.
After examination, there are some characteristic symptoms:
- Raimistic point. When you press on the spine, there is sharp pain.
- Lasego symptom. In the supine position, the legs are alternately bent at the hip joint. In the knee joints, the legs are extended. From the side of the lesion a sharp tenderness
The sacral area is rarely affected alone. More often there is a picture of lumbosacral osteochondrosis. The reason is in the anatomy - the physiological structure of this part of the spine. The sacral section includes 5 vertebrae tightly welded together and form a strong bone articulation.
The clinical picture is similar to that of the lumbar spine.
On palpation, there are several classic symptoms that indicate the involvement of this department:
- When the spine is stretched, the pain disappears for 5-10 minutes. A horizontal bar or a gym wall is required to check.
- Amos symptom. To get out of bed, the patient must lean with his hands behind his body.
Complaints in osteochondrosis are based on the duration, the level of damage, the nature of the previous treatment. Diagnosis of osteochondrosis will be associated with the individual characteristics of the disease. But the most important points when identifying are:
- Complaints, history and clinical picture.
- Palpation and physical examination.
Instrumental methods are based on:
- Bone densitometry is an assessment of bone density.
- Spondylography is an assessment of the condition of the intervertebral discs.
- Radiography - destruction of vertebral bodies, expansion of the common spaces.
- CT or MRI are the most effective methods today. MRI signs of osteochondrosis make it possible to distinguish it from hernia, tumors, trauma. All components of the joints and inflammatory changes in the surrounding tissue are visible on MRI.
There are no specific laboratory research methods for osteochondrosis. All of these studies are aimed at finding inflammation and differentiated diagnosis. Necessary agreements:
- KLA - shift of the formula, an increase in leukocytes and ESR;
- OAM - change in density, appearance of leukocytes;
- BC - change in the level of calcium, phosphorus, ASLO;
- blood for sugar.
The basis of treatment tactics for acute, chronic or secondary osteochondrosis is drug therapy. Treatment protocols include:
- NSAIDs - act immediately on all syndromes of osteochondrosis. They relieve inflammation and pain, improve microcirculation and metabolism, and improve physical activity.
- With a pronounced pain component, treatment should be started with this symptom. The pills do not relieve pain. The use of blockades is much more effective.
- Muscle relaxants - remove reflex muscle spasms.
- Topically, ointments and gels provide analgesic and anti-inflammatory effects. They are presented in the market in different versions.
Physiotherapy and massage
The main goal of physiotherapy in treatment is the early removal of inflammatory changes. The main options for therapy currently in use are:
- Electrotherapy - exposure to alternating current.
- Magnetotherapy - exposure to strong magnetic fields.
- Extracorporeal shock wave therapy - the effect of high frequency ultrasound.
- Reflexology - action on reflex zones.
Manual therapy and massage restores muscle tone. This is important in chronic injury, as the formation of contractures significantly reduces any motor activity.
Both methods are based on mechanical impact on the zone of the alleged defeat.
Exercises for osteochondrosis are included in the general complex of therapeutic interventions. Exercise therapy provides an increase in trophism and the fastest recovery of motor activity. The set of exercises depends on the level of development and the duration of the lesion.
Use of exercise therapy:
- improves metabolic processes
- reduces the pressure on the roots
- corrects posture
- strengthens the musculo-ligamentous apparatus.
The duration of the course usually does not exceed two weeks for any type of osteochondrosis.
Osteochondrosis syndromes can be treated with home treatment. In the acute phase or with severe clinical manifestations, self-medication is not recommended. Some traditional medicine recipes:
- Dry heat. Heat the sea salt. Wrap it in gauze or a towel and apply it on the affected area for 10-15 minutes.
- Boil potatoes, crush and wrap in a towel. Heat the affected area for 10 minutes.
- Infusion of chamomile flowers, calendula, St. John's wort and 70% alcohol. Take medicinal herbs in equal amounts in 1 teaspoon, mix and place in a container. Pour 200 ml of alcohol solution. Insist for 5 days. Rub the affected area twice a day for 10 minutes for 2 weeks.