Osteochondrosis and regular back pain affect 60-80% of the population over the age of 30. Untreated osteochondrosis reduces quality of life and can lead to disability and disability, so it is important to recognize it in the early stages of development and seek medical attention.
In this article we will talk about osteochondrosis, its symptoms and diagnostic methods, as well as how to distinguish osteochondrosis from other diseases manifested by low back pain, and what to do if you see signs of osteochondrosis of the spine.
What is osteochondrosis of the spine?
Osteochondrosis is a chronic disease in which the nucleus of the intervertebral disc is gradually destroyed. Over time, damage to the intervertebral disc in the pathological process involves other structures of the spine and leads to disruption of the musculoskeletal system and nervous system. Osteochondrosis is also characterized as a result of premature aging of the articular apparatus or damage to the vertebrae, for example, as a post-injury pathology.
The development of osteochondrosis is influenced by many factors, so researchers have systematized the causes that explain the origin of the disease:
- involutive - causes premature aging of cartilage as a result of inflammatory processes and other injuries of the spine, for example, a sedentary lifestyle;
- degenerative - disorders of the intervertebral discs occur as a result of metabolic failure, for example, as a result of an unbalanced diet and alcohol abuse;
- Dysmetabolic - osteochondrosis occurs as a result of malnutrition of intervertebral cartilage due to a decrease in the number of blood vessels that supply them with nutrients with age.
The development of osteochondrosis is a cascade in which one pathological process begins with another. Thus, for example, nutrition is impaired due to age-related changes and a decrease in the number of vessels in the disc, which leads to failure of biochemical processes and damage to the intervertebral disc.
As degenerative and dystrophic changes develop in the spine, muscle tone and the function of nerve roots from natural holes in the spinal cord are impaired. This leads to consequences for the nervous and musculoskeletal systems.
Symptoms of osteochondrosis of the spine
Osteochondrosis is a chronic disease accompanied by periodic exacerbations caused by injuries, sedentary lifestyle, heavy lifting, hypothermia and psycho-emotional stress. The most common and characteristic symptom of dystrophic disorders in the nucleus of the intervertebral discs is low back pain, which regularly occurs in various segments: neck, chest and lower back.
There are two types of osteochondrosis: reflex and compression. Reflex symptoms develop due to irritation of the spinal cord roots. They manifest themselves in the form of spasms or vasodilatation, muscle twitching, weakening of muscle strength. Compression symptoms develop due to nerve compression (usually caused by a spinal hernia) and manifest as loss of sensation in the affected segment (neck, arm, or lumbar region).
Osteochondrosis is also characterized by the following symptoms:
- tension and pain in the muscles of the neck and back;
- lateral, posterior or forward curvature of the spine;
- sensitivity and nervous regulation disorders: feeling of crawling on the skin, heat and cold on the skin of the back and extremities, numbness of the arms or legs;
- weakening of muscle strength of limbs;
- frequent urination - up to 10-12 times a day.
Where can osteochondrosis occur?
Pain in osteochondrosis is not only localized in the back. They extend to the upper and lower extremities. On the legs:
- omba;
- back and side of thigh;
- lower leg and inner part of ankle;
- back of legs;
- Foot fingers;
- heel.
Also, the pain can spread to the arms:
- deltoid muscle;
- outer edge of hand, up to fingers;
- back of hand;
- three middle fingers;
- ring finger and little finger (rare).
How is osteochondrosis diagnosed?
Diagnosis of osteochondrosis is based on survey, physical examination and instrumental examination. Special examination methods are determined in consultation.
The doctor begins the diagnosis by taking a medical history: identifies the probable causes of back pain, determines the location and duration of pain, determines the presence of accompanying pathologies, such as allergies, congenital diseases and drug intolerance. Then continue to check. Physical examination is performed while standing or sitting. The doctor can detect the curvature of the spine, assess muscle strength and reflexes, and look at the color of the skin. It is necessary to consult with relevant specialists to detail the picture of the disease: neurologist, neurosurgeon, oncologist, rheumatologist and phthisiologist.
A neurologist diagnoses "osteochondrosis" if:
- regular aching low back pain;
- increased pain when lifting weights, sneezing, coughing;
- numbness and painful joints;
- reduction of range of motion in the joints;
- muscle spasm;
- nerve root damage;
- changes in the radiography of the spine.
Do I need a spinal x-ray?
X-ray or spondylography of the spine is one of the mandatory examinations for osteochondrosis, with the help of which it is possible to identify structural abnormalities of the spine. Spondylography allows you to detect pathological changes, such as thinning of the intervertebral disc. X-rays for the neck, thoracic, and lumbosacral spine are usually performed in two (sometimes three) projections for more information.
Computed tomography and magnetic resonance imaging allow to identify pathologies associated with osteochondrosis: disc herniation and narrowing of the lumen of the spinal canal, protrusion of the intervertebral disc into the spinal canal and compression of the spinal cord.
Osteochondrosis of the cervical spine
With cervical osteochondrosis of the spine, two main symptoms appear - cervical and cervical. The cervix is a severely painful cervical lumbago that occurs during head movements and due to muscle tension in the cervical spine. Cervical pain in the neck is severe and severe. Cervical paresthesias are accompanied by a sensation of numbness and crawling on the skin.
As the defeat of the nuclei of the intervertebral discs of the neck progresses, cervical radiculitis appears - painful sensations in the occiput. The pain is characterized by regularity, in addition, sometimes intensifies, especially when moving the head.
This triad - cervical, cervical sciatica and cervicago - can be complicated by nocturnal dysesthesia of the hands with impaired sensitivity. For example, a hot object may feel cold with your fingers, but if you shake it with your hands, the sensitivity is restored.
Osteochondrosis of the thoracic spine
Painful lumbago (dorsalgia) in the chest is the most characteristic for osteochondrosis of the thoracic spine. Chest pain gets worse when you move your arms, sneeze, cough, and lift weights. Often the pain is in the girdle. Also, paresthesias in the chest often occur. Sometimes damage to the nuclei of the intervertebral discs can be masked by diseases of the internal organs, such as gastritis or angina pectoris, because the pain can be localized in the upper abdomen and heart.
How to tell - heart pain or osteochondrosis?
Pectalgia syndrome is pain in the anterior wall of the chest that can resemble pain in the heart. Pectalgia can be a sign of both osteochondrosis and heart problems.
However, pain during angina pectoris and heart attack is different from pectal syndrome during osteochondrosis. Pain in angina pectoris and myocardial infarction is characterized by their compressive nature and spread to the left back, arm and jaw.
In osteochondrosis, pectalgia syndrome does not extend beyond the anterior wall of the chest, does not spread to the arms and back, and is not accompanied by fear of death. But these are only subjective feelings. Therefore, to rule out heart pathology, you should consult a doctor and perform an electrocardiogram, which will detect signs of arrhythmias or myocardial infarction.
If the pain begins to spread to the left shoulder blade, arm, jaw, is accompanied by a feeling of fear, is not eliminated by taking trinitroglycerin and lasts more than 10-15 minutes, it is necessary to call an ambulance.
Why is lumbar spine osteochondrosis dangerous?
With lumbar spine osteochondrosis, lumbago or lumbodynia most commonly occurs - regular lumbago and aching pain in the lumbar region. Due to constant pain, movements are limited: a person cannot bend, exercise or lift a heavy object.
Lumbago can go on its own. However, they are prone to exacerbation, and each flare indicates an additional displacement of the intervertebral disc into the spinal canal. As the destruction of the intervertebral disc progresses, lumbosacral radiculitis develops in the lumbar region, accompanied by pain, which spreads to the hips and thighs.
What is the difference between osteochondrosis and osteoarthritis?
Osteochondrosis and osteoarthritis (spondylogenic osteoarthritis) belong to the class of diseases of the musculoskeletal system. However, there is a major difference between them: osteochondrosis affects the nucleus of the intervertebral disc, and osteoarthritis affects the intervertebral joints. This makes a difference in symptoms and treatment.
In osteochondrosis, back pain is regular and painful, manifests itself at rest and is associated with increased mobility, and in spondyloarthritis, the appearance of pain is associated with stretching and bending of the spine. Usually, the pain syndrome in osteoarthritis of the spine is unilateral and has the character of cramps. Also, spondylogenic osteoarthritis is characterized by morning stiffness lasting 30 to 60 minutes.
What is the difference between osteochondrosis and radiculitis?
Radiculitis is an inflammation of the roots of the spinal cord accompanied by pain along the affected nerves. In fact, these are two different diseases, but sciatica is often a complication of osteochondrosis, so it is often one of the symptoms of osteochondrosis.
Symptoms of sciatica
Radiculitis with osteochondrosis most often occurs in the cervical and lumbar spine. Pain along the sciatic nerve is manifested by pain, sensory disturbances, and sometimes movement disorders. Sciatica pain is characterized by protrusion from the back and spread to the hips, thighs, lower legs and feet.
VSD or cervical osteochondrosis?
Vegetovascular dystonia is a syndrome in which the autonomic nervous system is disrupted. VSD is a functional disorder in which there are no structural changes in either the spinal column or the nuclei of the intervertebral discs.
Vegetovascular dystonia has a mental origin - it is a neurosis associated with intrapersonal conflicts or uterine trauma. Externally, VSD and osteochondrosis may be similar: headache, dizziness, pain in the anterior chest wall.
To differentiate the disease, it is necessary to conduct instrumental diagnostics - radiography of the cervical spine and other parts, computed tomography and magnetic resonance imaging. Unlike osteochondrosis, the diagnosis of VSD will not result in any organic changes.
Treatment of vegetative-vascular dystonia
Vegetovascular dystonia is treated with medication, psychotherapy, and lifestyle adjustments. Patients are prescribed symptomatic treatment: sedatives, anti-anxiety, hypnotics, restorative substances, as well as vitamins. The task of psychotherapy with VSD is to teach the patient to regulate negative emotions and increase stress resistance. Also, lifestyle is regulated: it is necessary to balance work and rest, exercise and follow a balanced diet.
Is osteochondrosis treated or not?
Osteochondrosis can be treated. The goal of treatment is to relieve back pain and stiffness, restore muscle tone, prevent or stop neurological complications, and improve a person's standard of living. If you follow your doctor's instructions, the disease can be treated.
How to treat osteochondrosis at home?
It is not recommended to treat osteochondrosis at home. There are several reasons for this:
- It is impossible to accurately diagnose osteochondrosis at home, because back pain has different origins: neurogenic, vascular, viscerogenic (due to diseases of the internal organs) and psychogenic. That is, a person treats osteochondrosis, but in fact the back pain is caused by, for example, kidney disease;
- it is impossible to objectively assess the effectiveness of treatment without control diagnosis;
- The patient is unable to choose an adequate treatment for himself, and there is no evidence base of folk remedies, and therefore, it is most likely ineffective and can cause side effects.
At home, it can be treated in one case - only after consultation with a doctor who will correctly diagnose, prescribe adequate treatment and periodically monitor the effectiveness of therapy using X-rays, CT or MRI.
Treatment of osteochondrosis of the spine
Osteochondrosis is treated conservatively and surgically. Which method will be the main depends on the stage of the disease and the negligence of the musculoskeletal system.
Conservative treatment includes medication, exercise therapy, and lifestyle adjustments. Medications, anti-inflammatory drugs and muscle relaxants are mainly prescribed to relieve pain and normalize muscle tone. One of the main conditions for recovery in physiotherapy exercises is early activation, ie 1-3 days after the pain disappears, you need to walk, run, exercise in the pool or ride a bike. It is also important to change your lifestyle to an active lifestyle, because a sedentary lifestyle is one of the factors that lead to the development of back pain and the destruction of the nuclei of intervertebral discs.
Surgical treatment is used when conservative therapy is ineffective for 2-4 weeks and there are obvious structural changes in the spine. Which surgery is needed will be determined by the surgeon after consultation with a neurologist and review of research data. For example, in the treatment of osteochondrosis of the cervical spine, methods are used to relieve pressure on the spinal cord from the vertebral or herniated side (discectomy and decompression).
Consult a neurologist for advice if you have back pain in the spine or neck, chest pain, weakened arm or leg muscles, unpleasant skin sensations, and back pain accompanied by numbness.