There are several different attitudes to the definition. Some experts believe that it is more correct to use the general name - dorsalgia, or non-specific back pain. Difficulties in the definition are also associated with a number of specialists working with this disease - neurologists, orthopedists, neurosurgeons and general practitioners. Sometimes a person diagnosed with osteochondrosis of the spine turns to a cardiologist as 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 spinal motion segment.
Osteochondrosis of the spine is a pathological process in the spine characterized by degenerative-destructive disorders of the vertebrae and the intervertebral discs. The danger of the disease is due to the hidden course of the process when patients enter the stage of complication 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. Triggers for the development of osteochondrosis: Heredity; back injury; congenital or acquired defects in the structure of the musculoskeletal system (flat feet, changes in posture); metabolic failure caused by diseases of the internal secretory organs; poor nutrition and obesity, the disease does not differ from sex. viral and bacterial infections; lifestyle: lifting and carrying weights, working in a row, constant vibrational influences, 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 level of injury, each type has its own characteristic features and treatment characteristics.
Osteochondrosis of the lumbar spine.
The most common back disease is osteochondrosis of the lower back, which is associated with a heavy strain on this particular region. Prone to complications of protrusion of the intervertebral discs and the occurrence of hernia, both single and multiple. In case of complications, it can be accompanied by dysfunction of the pelvic organs and atrophy of the muscles 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 stress on the shoulder girdle. Neck muscles require special training, in the absence of which they simply can not cope with the load, taking into account weak development.
Osteochondrosis of the thoracic spine
The most rare pathology of the back due to the inactivity of the department and the most developed muscular cross. It is difficult to diagnose due to a long asymptomatic course and mimicry of other diseases (CHD, intercostal neuralgia, lung disease).
Pathology covers several wards at the same time, occurs rarely and on the basis of congenital diseases of the musculoskeletal system, is practically not treated.
Stages of osteochondrosis and possible complications
The description of the four stages of osteochondrosis of the spine was proposed by Osna in 1971. They are not used to formulate a diagnosis, but allow you to understand how the disease progresses.
- Intervertebral discs become less elastic. The disc may be slightly deformed, there is a displacement of the inner pulpous core of the disc. This stage either does not show up in any way or there is less pain.
- In the second stage, cracks may appear in the disc and the surrounding ligaments may weaken. The connection of the vertebrae becomes unstable. There are bouts of acute pain with disability.
- The third stage is characterized by complete damage to the intervertebral disc. When the nucleus pulposus leaves the disc, a disc herniation occurs. Spinal deformity or nerve root entrapment may occur.
- In the fourth stage, the surrounding tissues are affected - vertebrae, ligaments, spinal membranes. As a result, the vertebral segment may completely lose mobility.
As a result of spinal osteochondrosis, various complications occur in some cases. Problems with the intervertebral discs, hernia and protrusions can lead to narrowing of the spinal canal, compression of the spinal cord and disability.
Depending on the level of the lesion, various problems with involvement of the nerve roots are possible. These are intercostal neuralgia, violations of sensitivity and motor function of the upper and lower extremities, disturbances in the function of internal organs. Inflammation of the sciatic nerve, or sciatica, not only causes severe pain but can also lead to pelvic organ disease and infertility.
In addition to the nerve roots, osteochondrosis can compress the vertebrae. If blood flow is disrupted in the vertebral arteries that pass through the cervical region and nourish the brain, brain diseases, vision or hearing problems, breathing or heart activity may develop.
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, control of reflexes and sensitivity.
Of the instrumental methods, the following can be used:
- Ultrasound of the vessels allows you to identify the degree of circulatory disorders, for example in vertebral arteries;
- X-ray of the spine;
- CT also uses X-ray methods, but allows you to build a three-dimensional image of the area under examination, to identify even small displacements of the vertebrae;
- MRI specializes in the study of soft tissue, allows you to assess the condition of the spinal cord, visualize the internal structure of the intervertebral disc.
For differential diagnosis, laboratory tests, a general blood and urine test and indicators of calcium metabolism are used.
Therapy for osteochondrosis is complex.
- 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 the patients.
- For drug treatment of osteochondrosis of the spine, a neurologist or general practitioner may prescribe medication. Most often, non-steroidal anti-inflammatory drugs are prescribed - this is the standard treatment for spinal osteochondrosis. They reduce pain and reduce inflammation. Muscle relaxants help reduce muscle spasms. Vitamins and antioxidants are prescribed to protect nerve tissue from damage. However, any medication has side effects, for example, NSAIDs can adversely affect the stomach.
- In addition to medication, physiotherapy is 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 only prescribed if there is no effect of long-term conservative treatment.