Many people associate the word "osteochondrosis" with old age. There is an opinion that this is a disease of grandparents, in which “shoots in the lower back” and “aches in the back”. However, there is only a grain of truth in this delusion: indeed, osteochondrosis isdegenerative(that is, caused by a local metabolic disorder)changes in the spine, which inevitably appear in all elderly people. However, osteochondrosis is found today in 9 out of 10 people over 45 years old, and the first manifestations of the disease can begin as early as 25 years old.
This ailment is even called“the disease of civilization”, since the main cause of osteochondrosis is improper “exploitation” of the spine. The fact is that a modern person subjects him to excessive loads, and, paradoxically, not when he runs or lifts weights, but when he sits without getting up from a chair for hours. This load is calledstaticand is very tricky. Because a person thinks he is resting when he is sitting. But in fact, the spine in a sitting position works with increased stress.
How the spine works
To understand what osteochondrosis is, you need to understand what the human spine is. We all know that the spine consists of vertebrae connected in series by intervertebral discs. In total, a person usually has 33-34 vertebrae: 7 of them form the cervical region, 12 - the thoracic region, 5 (or 6 in a small percentage of people) - the lumbar, 5 more vertebrae, growing together, form the sacrum and, finally, the coccygeal region consists ofanother five (or four - depending on individual characteristics) vertebrae. The vertebrae are, in fact, bones, and they are motionless, but so that they can move freely, providing mobility to our entire body, and also so that they do not collapse from impacts and friction, there is a layer of gelatinous substance between each vertebra (the so-callednucleus pulposus) surrounded by strong multilayer plates (annulus fibrosus). Collectively, this is called theintervertebral disc.In addition, the structure of the spine contains numerous ligaments, vessels, nerves. This is a very complex organ that largely determines the work of almost all body systems, as it protects the spinal cord and affects its work.
The vertebrae and intervertebral discs are continuously renewed throughout a person's life. This is possible due to the fact that they are well supplied with blood and are always provided with good nutrition. However, if, for some reason, nutrition begins to flow into the spine in insufficient quantities, the nucleus pulposus loses its properties, the intervertebral disc becomes flat and less elastic, cracks appear in the annulus, and the vertebrae themselves begin to shift in different directions and approach each other. All this leads to a number of dangerous deviations - primarily toinflammation both in the spine itself and in the surrounding tissues, and to compression of the spinal cord and spinal nerves.
It is interesting that such a concept as "spinal osteochondrosis" exists mainly in the post-Soviet space. In foreign literature, the changes occurring in the spines are called“hernias”, “myofascial pains”, “disc injuries”, “dorsopathy”. So if you have heard something similar about yourself, it means you have osteochondrosis of the spine. As for theintervertebral hernia, it is considered to be one of the stages of osteochondrosis.
The disease does not have an acute course and develops gradually: first, the intervertebral disc narrows, becomes degeneratively altered, thenprotrusions appear- the nucleus pulposus seems to be squeezed out and mixed with the fibrous ring, but does not break it. When there is a rupture of the annulus fibrosus, they speak of aintervertebral hernia.At the last, most severe stage of osteochondrosis,the intervertebral discs are completely worn out, the vertebrae begin to rub against each other and also collapse, pathological bone growths and osteophytes appear on them. At the last stage, the spine becomes, as it were, "petrified", that is, it loses its mobility, which can lead to disability.
Causes of spinal diseases
For what reason do all of the abovedegenerative changes occur?As already mentioned, the main reason isan abnormal load on the spine:for example, when a person has to sit a lot in uncomfortable positions, “hunched over”, the cervical and thoracic regions experience tension and do not receive the necessarynutrition. In addition,osteochondrosis can develop due to poor posture.However,sports, especially strength sports, with a violation of the technique of performing exercises, can also lead todegenerative changes in the spine.
Another common cause is anyback injury. The development of osteochondrosis can also be influenced byhereditary genetic predispositions, hormonal disorders, excess weight, unhealthy diet, insufficient water intake and, as a result, dehydration, smoking and alcohol abuse.
Women often encounter the first manifestations of osteochondrosis during pregnancy, then, when young mothers have to feed their baby in uncomfortable positions for themselves and often carry it in their arms, the condition of the spine deteriorates noticeably.
Symptoms of osteochondrosis
The symptoms of osteochondrosis are varied and depend on the exact department in which the disorders occurred. Pain is the main manifestation of this pathology, however, untilrupture of the annulus fibrosusit is mild, can be tedious, pressing, and patients may not even pay attention to it.More often the pain intensifies in the morning or after physical exertion, radiates to the arms, legs, neck, ribs and chest (in this case, osteochondrosis can be easily confused with coronary heart disease).
In addition,numbness and tingling may appear in the limbs.
With osteochondrosisin the cervical spine, headaches may appear, sometimes very severe, dizziness, nausea, whistling in the ears. The development of a hernia, leading to compression of the nerve endings, can lead to disruption in the work of the internal organs associated with the affected nerve. For example, with a hernia in the lumbar spine, problems with urination may appear, potency disappear, in the chest - indigestion, in the cervical - problems with the blood supply to the brain.
Diagnosis of osteochondrosis
Only a doctor can distinguish osteochondrosis from other diseases of internal organs and determine the source of pain. Today, the most reliable method for diagnosing spinal diseases is considered to be magnetic resonance imaging.
X-rays are also reliable, but less informative. On an X-ray image, you can see changes in the intervertebral discs, but you cannot, for example, see a hernia and assess the condition of the spinal cord and the degree of its compression by displaced vertebrae. In addition, MRI can distinguish osteochondrosis from other dangerous diseases, including malignant tumors and ankylosing spondylitis.
Is it possible to cure osteochondrosis?
Unfortunately, it is impossible to cure osteochondrosis, but it is possible to alleviate the patient's condition andstop further destruction of the intervertebral disc, however, for this it is necessary tocompletely change the way of life - do physical therapy, swimming, take courses regularlymassage or manual therapy, start eating right and give up bad habits. Sports, massage, proper nutrition, and weight loss can have a significantly greater and long-term healing effect than drugs.
Doctors still argue about the effectiveness of chondroprotectors - drugs that restore cartilage tissue and, allegedly, strengthen the annulus fibrosus, their effectiveness has not been sufficiently proven, but since they definitely do not bring harm, they can be used to treat osteochondrosis.
For severe pain, your doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants (drugs that relax muscles), and analgesics.
Used in the treatment of osteochondrosis andvitamins, since their lack provokes further destruction of the intervertebral disc:B vitamins, for example, contribute to the improvement of protein metabolism between tissues, and sinceprotein is the main building material in the body, then the normalization of protein metabolism contributes to the restoration of nervous and cartilaginous tissue. Vitamin A improves blood circulation. However, taking vitamins, like any other medicines, you need to be careful, as they can cause severe adverse reactions, and they can be taken only after consulting a doctor and under his supervision.
Surgical treatment of osteochondrosis is also possible, but, as a rule, it is resorted to when there issignificant narrowing of the spinal canal and excessive compression of the nerves and spinal cord by the resulting hernias. In this case, the situation is so difficult that the patient, for example, cannot walk, his internal organs begin to fail, or there is a risk of developing a stroke. Most often, such severe consequences are caused by osteochondrosis of the cervical and lumbar spine, degenerative changes in the thoracic spine, even in the presence of hernias, almost never require surgical treatment.
Today,methods of so-called sparing surgeryare being actively introduced into medical practice, when doctors manage to preserve the integral structure of the vertebrae by removing part of the nucleus pulposus using anendoscope. The device is inserted to the site of the spinal lesion through small incisions in the skin, which avoids large blood loss. Since the entire disc is not removed during the operation, the spine biomechanics is generally not disturbed, and this shortens the recovery period. Often, patients get up on their feet within a day after the operation. However, any spinal surgery is still fraught with complications and subsequent relapses of the disease, so experienced specialists will try to delay the surgical treatment to the last. And here everything depends on the patients themselves: if they follow all the recommendations of the doctors and take care of their health, then even in the presence of hernias, they will be able to do without surgery.