Osteochondrosis of the spine is a complex of dystrophic and degenerative changes in the intervertebral discs and adjacent surfaces of the vertebral bodies, which are associated with tissue destruction and disruption of their structure. Depending on the degree of damage, a distinction can be made between cervical, thoracic and lumbar osteochondrosis.
Symptoms
The main sign by which one can assume the presence of osteochondrosis of the cervical spine is a local change in the configuration of one of the segments of the spine (the development of lordosis, kyphosis or scoliosis) - a distinct visual curvature of the spine in the longitudinal or transverse plane. The second most common symptom is pain syndrome, which can be localized not only in the vertebral area, but can also be given to the areas of the body innervated by the corresponding nerve root. Another complaint from these patients is a feeling of discomfort and tiredness in the neck.
In cervical osteochondrosis, pain is usually manifested in the neck area and can be applied to the shoulder and scapula, it can be mistaken for pain in myocardial infarction, as it has similar symptoms. Cervical osteochondrosis can also be accompanied by frequent headaches and dizziness. When the arteries supplying the brain are squeezed (squeezed), there may be signs of brain malfunction (neurological symptoms): fainting, nausea, tinnitus, mood swings, anxiety, and others.
Depending on the severity of the pain, they are divided into 3 degrees:
- Pain occurs only with pronounced movements in the spine;
- The pain is relieved by a specific position of the spine;
- The pain is permanent.
to shape
Depending on the syndromes caused in osteochondrosis, there are:
- Compression syndromes - occur with compression (radiculopathy - compression of nerve roots, myelopathy - muscle compression, neurovascular - compression of blood vessels and nerves);
- Reflex (muscle tonic, neurodystrophic, neurovascular);
- Myoadaptive Syndrome (overexertion of healthy muscles when they take over the functions of the affected muscles).
causes
The mechanism of development of the disease is damage to the intervertebral disc for various reasons and its displacement with the loss of depreciation functions (pressure reduction) of the spine. The direct cause of intervertebral disc damage can be age-related degenerative changes that are associated with a circulatory disorder of the intervertebral discs, mechanical damage from injuries and severe physical stress on the spine - for example, if you are overweight.
An important role in the development of osteochondrosis is played by a sedentary lifestyle, in which a violation of the blood supply and the functioning of the intervertebral joints develops. The mechanism of development of the disease is as follows: if the fibrous ring connecting the vertebral bodies is damaged, the intervertebral disc is pushed back and forth - into the lumen of the spinal canal or laterally - with the formation of median and lateral disc hernias. The intervertebral disc can be pressed into the vertebral body itself with the formation of the Schmorl hernia - microscopic fractures of the cartilage tissue of the intervertebral disc into the spongy tissue of the vertebral bone. If the intervertebral disc is dislocated posteriorly, compression of the spinal cord and the roots extending from it is possible with the development of a typical pain syndrome.
diagnosis
The diagnosis of osteochondrosis of the spine is made on the basis of complaints, anamnesis data, clinical examination and instrumental examination methods. Diagnostic measures are designed to find out the reasons that led to the development of neurological symptoms.
From the anamnesis is the presence of an injury, the type of work - constant physical overload (lifting weights), poor posture, peculiarities of work and the position of the spine at the table and when walking, the presence of infections.
General clinical studies (clinical blood test, general urinalysis), biochemical blood tests have no independent value. They are prescribed to assess the current condition, diagnose the underlying disease and any complications that may arise.
Diagnosis is based on the clinical picture of the disease and is carried out by the method of sequential exclusion of diseases with similar clinical symptoms. Of the instrumental diagnostic methods, X-ray examination (spondylography is a non-contrast examination) is the most common and available. It reflects the narrowing of the intervertebral joint gap and enables the identification of osteophytes (bone growths) on the vertebral bodies, but only provides indirect information about the degree of damage to the intervertebral discs.
An exact diagnosis can be made by imaging CT and MRI diagnostics (computer and magnetic resonance tomography) even at an early stage of the disease. CT allows you to determine the minimal abnormalities in bone and cartilage tissue, MRI - to carry out the detailing of soft tissue structures and determine the localization of herniated discs.
A duplex ultrasound scan of the cerebral arteries is performed if there is a suspicion of a circulatory disorder in the brain.
Differential diagnosis is carried out in diseases that have similar clinical manifestations: pathologies that begin with pain radiating to the shoulder and shoulder region (diseases of the liver, gallbladder, pancreatitis - inflammation of the pancreas); cervical lymphadenitis - an increase in cervical lymph nodes, rheumatoid arthritis; oncological diseases (tumors of the vertebrae, roots, spinal cord and membranes), tumors of the pharynx and pharynx, pancost carcinoma (compression of the brachial plexus in cancer of the upper lung), metastases in the neck area; tuberculous spondylitis - an inflammatory disease of the spine caused by Mycobacterium tuberculosis; Arachnoid cysts; Pseudocysts of the dura mater; Spinal abnormalities; Fibromyalgia is a disease that causes pain in muscles, ligaments, and tendons, chest compression syndrome - a disorder caused by excessive pressure on the neurovascular bundle that runs between the anterior and middle scalene muscles, across the first rib and under the clavicle, myofascial neck muscleSyndrome and shoulder girdle - a chronic, pathological condition caused by the formation of local muscle spasms or seals, represented by pain points.
The main laboratory tests used:
- Clinical blood test;
- Blood chemistry.
The main instrumental studies used:
- X-ray of the spine (spondylography);
- Magnetic resonance imaging (MRI);
- Computed tomography (CT);
- Ultrasound duplex scan of the arteries of the brain (if a violation of the blood supply to the brain is suspected).
Additional instrumental studies used:
- Densitometry - measurement of bone density (depending on the indication).
treatment
Treatment of osteochondrosis of the spine depends entirely on the stage and degree of development of osteochondrosis. In the initial stage, preventive measures, physical therapy exercises, exercises on simulators and fitness can be used. With severe pain syndrome, the patient needs physical rest. Anti-inflammatory and antispasmodic drugs are prescribed. It is possible to perform paravertebral blocks with anesthetics to open the pathological circuit if the pain is causing muscle spasms while compressing the intervertebral disc more, which in turn exacerbates the pain itself.
Warming ointments are applied locally to the skin in the vertebral area to improve local blood circulation and reduce tissue edema. These patients wear a corset. In patients in the initial stages of osteochondrosis, chondroprotectors are effective - drugs that improve the restoration of cartilage tissue, as well as drugs that improve local blood supply, venotonics, vitamins of group B. In cases where the pain syndrome does not stop medically for a long time and there isa clinic for root compression of the spinal cord with herniated disc, the surgical removal of the damaged intervertebral disc is shown. If the spinal cord is completely compressed by an intervertebral disc, an early operation is indicated.
You shouldn't wait for a person to spontaneously urinate or urinate - in which case the damage to the spinal cord may already be irreversible. Magnetic field therapy, ultrasound, massage, manual therapy, acupuncture and physiotherapy exercises are prescribed as physiotherapeutic procedures.
Complications
Possible vegetative-vascular dystonia and heart disorder, stroke, hypotension and hypertension (decrease and increase in blood pressure), balance disorders (impaired movement coordination), vertebral artery syndrome (a disease caused by narrowing of the vertebral artery), periarthrosis (a disease with reduced mobility)Shoulder joint.
prophylaxis
To prevent osteochondrosis, it is necessary to look at the factors that cause it, namely: avoiding spinal injuries, stress on the spine (lifting weights), and fighting obesity. For people who already suffer from the early stages of osteochondrosis, it is recommended to wear corsets at home and during physical exertion. In order for the spine to rest during sleep, it is recommended to sleep on orthopedic mattresses and pillows.
What questions should you ask your doctor?
Are there any exercises to relieve symptoms?
What drugs help with osteochondrosis of the cervical spine?
What if you do not start treatment for the disease on time?
Patient counseling
Exercise, weight loss if you are overweight, the use of cool or warm compresses will help relieve symptoms of thoracic osteochondrosis. It's also important to eat right, monitor your spine, treat chronic conditions, and prevent injury.