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Osteochondrosis

symptoms of osteochondrosis

Osteochondrosis is a chronic relapsing condition that is characterized by degenerative changes in the spine involving adjacent vertebrae and joints. A characteristic symptom of osteochondrosis is pain in the back, lower back, and neck. This disease of the musculoskeletal system is considered multifactorial, as it is caused by a combination of reasons.

Main symptoms: pain in the back, arms, neck, lower back or chest, decreased volume and range of motion, muscle tension, impaired sensitivity in different parts of the spine, numbness, muscle weakness, impaired organ function, fatigue after minor physical exertion.

Treatment is carried out by: neurologist, traumatologist-orthopedist.

An article for patients with a doctor-diagnosed disease. Does not replace a doctor's appointment and cannot be used for self-diagnosis.

Causes of osteochondrosis

Osteochondrosis is one of the most commonly diagnosed diseases of the musculoskeletal system. Both older and middle-aged people face the disease. Until today, there is no accurate information about the causes of osteochondrosis and other degenerative pathologies of the spine. There are several theories about the origin of the disease.

The main reasons for the development of osteochondrosis:

  • involutive;
  • mechanical (injuries);
  • immune function;
  • hormonal changes;
  • metabolic disorders;
  • infectious processes;
  • functional disorders;
  • hereditary diseases.

Risk factors for osteochondrosis:

  • congenital malformations of the spinal column;
  • staying in an uncomfortable position standing or sitting for a long time;
  • history of serious spinal injuries;
  • incorrect movement patterns;
  • violation of the technique of performing physical exercises during training;
  • sedentary lifestyle;
  • excessive physical activity;
  • prolonged wearing of shoes of the wrong size, tight or with flat soles;
  • 3 or 4 degree obesity;
  • lack of proteins, fats, vitamins and minerals in the body;
  • alcohol abuse, smoking;
  • unfavorable environmental conditions.
The most common causes of exacerbation of osteochondrosis are decreased immunity, hypothermia, viral infections, colds, and chronic stress. Pain in the back and lower back can be of psychosomatic origin. In this case, the doctor can diagnose stress-associated clinical manifestations of osteochondrosis or depression.

Pathogenesis

Osteochondrosis and its symptoms are caused by complex physiological mechanisms.

  1. Degeneration of intervertebral discs - the most important structures that absorb the load on the spinal column. Degeneration develops under the influence of various negative factors - age, genetics, injury or damage, discs can undergo degeneration. With osteochondrosis, the intervertebral discs are affected: nutritional disturbances occur, loss of a sufficient amount of water in the cartilaginous tissues. As a result, the structure of the tissue changes and the shock-absorbing properties deteriorate.
  2. Formation of osteophytes. This is another important factor in the development of osteochondrosis. With progressive degeneration of the spinal discs, the height of the intervertebral space is lost - the distance between the vertebrae decreases. In response, bone growths, better known as osteophytes, can form on the surface of the vertebrae. Osteophytes further restrict the space for the passage of nerve roots, causing compression, pain and discomfort.
  3. Impaired blood circulation. Disc degeneration leads to poor circulation in the spinal column. Insufficient supply of oxygen and nutrients to cells enhances degenerative processes and causes inflammation.

Understanding the causes and mechanism of development of the disease is important for the further development of treatment tactics.

Symptoms

General signs of the disease include intense pain in the back, neck and lower back, impaired mobility, decreased performance, sleep disorders, changes in gait, and postural disorders. Sometimes there is a crunching, clicking or grinding sound in the back area.

Osteochondrosis can affect various parts of the spine: cervical, thoracic and lumbar. Each of these departments is characterized by its own clinical manifestations.

Cervical osteochondrosis

Leading symptoms of cervical osteochondrosis:

  1. Pain in the neck area. May be constant or occur with head movement. The nature of pain varies among patients: from intense and paroxysmal to weak and aching. Pain is the leading symptom of cervical osteochondrosis.
  2. Headache and dizziness. The pathology often causes headaches (including migraines), as well as a feeling of loss of balance. At the same time, tinnitus, ringing in the head, and flickering before the eyes may occur.
  3. Numbness of the limbs, weakness and tremors. Compression of the nerve roots in the cervical region leads to impaired sensitivity, tingling or weakness. Subsequently, a person with these symptoms finds it difficult to perform even usual activities.
  4. Severe neck muscle tension. Gradually it becomes difficult to turn or tilt your head. In the acute period of cervical osteochondrosis, the patient is forced to maintain the same position (for example, with a slight deviation of the head to the side).

Osteochondrosis of the thoracic spine:

  1. Pain in the chest area, which intensifies with movements. May spread along the ribs due to impact on the intercostal nerves.
  2. Decreased sensitivity in the thoracic region.
  3. Restriction of body mobility.

Damage to the thoracic region often affects internal organs and systems. Some patients develop diseases such as angina pectoris, dysfunction of the gastrointestinal tract, disorders of the genitourinary system and others.

Osteochondrosis of the lumbar region

This type of osteochondrosis occurs most often. Usually there is pain in the lumbosacral region, radiating to the legs. This disease is called lumboischialgia.

A typical symptom of lumbar osteochondrosis is pain. It is characterized by an aching character, intensifies with sudden actions or staying in one position for a long time. There is also loss of sensation, numbness in the toes and weakened reflexes. If the degenerative disorder of the lumbar spine is severe, you may have difficulty walking, standing, and performing everyday tasks.

This type of osteochondrosis is characterized by vegetative manifestations. Patients note dryness and flaking of the skin, cyanosis, and increased sweating. General health worsens, and after physical activity you feel very tired.

Classification

Depending on the location, there are several types of osteochondrosis - cervical, thoracic, lumbar. The disease can affect two or more parts of the spine, and then it is called generalized.

Stages of development of osteochondrosis

Symptoms and signs of osteochondrosis depend on the stage. At the initial stage of development of osteochondrosis, the patient experiences dull and aching pain in the legs. They get worse after standing, walking or running for a long time. In the case of cervical osteochondrosis, the first sign of the disease will be pain in the neck, which becomes pronounced when turning the head.

At the next stages of manifestation of osteochondrosis, degenerative changes in the intervertebral disc occur - hernias, protrusions and compression of the nerve roots (radiculopathy). Later, the back pain intensifies and radiates to the arm or leg. The patient feels weakness in the muscles, disturbances in sensitivity and vascular tone. In severe forms of osteochondrosis (acute chondrosis), the symptoms intensify, which leads to impaired mobility, paresis and even disability. Depending on the clinical manifestations, the following stages of osteochondrosis are distinguished:

  1. First. The volume of water in the cartilage tissue decreases, the firmness and elasticity of the disc decreases. As a result, it becomes smaller, flattened and a hernia is formed.
  2. Second. Defects in the annulus fibrosus occur and the spinal column loses stability.
  3. Third. At this stage, a rupture occurs in the cartilage tissue of the fibrous ring. Part of the nucleus pulposus leaks through the defect, and a herniated intervertebral disc is formed. These pathological processes are most often observed in the cervical and lumbar segments of the spine.

For different stages of development of osteochondrosis, the classification of A. I. is also used. Osna, which demonstrates the four stages of degenerative-dystrophic lesions:

  • stage of chondrosis - a pathological process that occurs inside the disc when the nucleus pulposus moves and extends beyond the fibrous ring;
  • stage of stability of the damaged disc - the overlying vertebrae are displaced in relation to the underlying ones;
  • stages of formation of hernias and protrusions of intervertebral discs due to disruption of the integrity of the fibrous ring;
  • the final stage of osteochondrosis is fibrosis and osteochondral growths, which, in turn, can cause compression of the nerve roots.

Each stage of development of osteochondrosis occurs sequentially. Since osteochondrosis is a chronic disease, it can progress over many years. At first, it may not manifest itself in any way, but as it worsens, the patient experiences more acute pain. At later stages of development of osteochondrosis, a pronounced impairment of motor function is observed, spondylosis and spondyloarthrosis develop. The affected segment of the spinal column becomes immobilized over time, and patients in this case are often diagnosed with disability.

Therefore, when the first symptoms of osteochondrosis appear, it is better not to delay a visit to the doctor: the sooner the pathology is detected, the easier and faster it will be possible to cure it.

Possible complications:

  1. Intervertebral disc herniation. One of the serious complications of osteochondrosis is protrusion of the nucleus pulposus. This leads to compression of the spinal cord or nerve roots, causing severe pain, sensory or motor impairment.
  2. Spinal stenosis. Osteochondrosis is considered the main cause of this condition. As a result of disc degeneration and osteophyte formation, spinal canal stenosis occurs. There is an excessive load on the spinal cord and nerve roots. These changes lead to back pain, muscle weakness and poor coordination.
  3. Radiculopathy. The condition is accompanied by pain, numbness, tingling and muscle weakness.
  4. Myelopathy. The progression of osteochondrosis ultimately leads to myelopathy - damage to the spinal cord. The disease is accompanied by impaired sensitivity and numbness of the damaged part of the spine.
  5. Breathing disorders. They arise due to severe deformation of the vertebrae and subsequent reduction in the volume of the chest.
  6. Lumbodynia. Pain in the lower back can be acute, moderate or aching, chronic.
  7. Cramps. They occur when there is excessive compression of nerve structures. As a result, changes in muscle tone and cramps occur.
  8. Coccydynia. A condition characterized by chronic pain in the perineum and tailbone.

Pain and discomfort caused by osteochondrosis limit the patient's physical activity and directly affect the emotional and psychological state. Many people who have suffered from osteochondrosis for several years require additional help from a psychotherapist. Over time, hypertension, hypotension and vegetative-vascular dystonia join the pathology. Patients are more likely to develop heart failure, myocardial infarction, and stroke.

In severe cases, osteochondrosis can cause disability - the patient may become bedridden.

Diagnostics

To establish an accurate diagnosis and examine patients, it is necessary to contact a neurologist. The specialist will determine a list of causes of osteochondrosis, localization of pain, movement disorders, and loss of sensitivity. To obtain an objective picture, it is necessary to find out whether the patient has concomitant pathologies, allergies or individual intolerance to drugs. The doctor will clarify under what conditions the pain weakens, whether it was preceded by injuries or other diseases.

Depending on the patient’s complaints, the doctor will determine the type of osteochondrosis - compression or non-compression. With the compression form, the main symptoms are pain, loss of sensitivity, muscle weakness, and dysfunction of the pelvic organs. The intensity of pain of other manifestations depends on the degree of compression of the nerve roots.

The non-compression form is characterized by local pain, reflex and visceral syndrome.

Examination by a neurologist

General clinical examination includes assessment of:

  • skin conditions;
  • posture and motor activity;
  • orthopedic status of the patient;
  • muscle strength, reflexes and sensitivity in the innervation zone;
  • the presence of static-dynamic disorders and other complications.

During the physical examination, the patient's body position, gait and pattern of movements are assessed. The doctor will examine the condition of the skin to make sure there is no redness, irritation, or rash. Then it will determine the range of movements in different parts of the spine - bending, turning, rotational movements.

Instrumental diagnostics

The following examinations will help clarify the extent and nature of changes in the spine:

  1. X-ray of the spine. Allows you to obtain an informative image of the spinal column: the structure of bone tissue, the presence of congenital anomalies, osteophytes and articular changes. You can visualize both the entire spine and its individual sections. It is performed in two projections - oblique and straight. Preparation for the procedure is simple; the x-ray itself lasts a few minutes. According to indications, to obtain a high-quality and detailed image, x-rays are performed with contrast. In this case, a contrast agent is injected into the spinal canal. It more clearly visualizes the main segments of the spine, neoplasms, inflammation and other degenerative changes.
  2. CT scan of the spine (computed tomography). A modern diagnostic method that uses low-dose X-ray radiation for visualization. Unlike X-rays, computed tomography helps obtain layer-by-layer images of the desired area of the spinal column. Using the method, it is possible to examine the vertebral bodies, vascular system, ligaments and tissues in high resolution. Thanks to CT, the doctor will assess the degree of compression of the nerve roots, ruptures of the fibrous ring, and the degree of vertebral instability. Typically, CT is performed after x-rays as a clarifying method or for differential diagnosis of pathologies.
  3. MRI (magnetic resonance imaging). A diagnostic method based on the use of a magnetic field and radio waves is safer than x-rays or computed tomography. Allows you to see layer-by-layer images of the spine in several projections. MRI data helps to exclude infectious and inflammatory processes, malignant tumors and other bone lesions. Diagnostics lasts from 30 to 60 minutes.
  4. Densitometry. A quick and safe diagnostic method that allows you to assess the condition and structure of bone tissue. During an ultrasound scan, the doctor will examine bone mineral density and determine the likelihood of degenerative processes.

Depending on the symptoms and pathological changes detected, the doctor may refer you to a consultation with an orthopedist, rheumatologist or other specialists.

Treatment of osteochondrosis

The most effective is an integrated approach to treating the disease, combining non-surgical and surgical methods. The goal of therapeutic measures is to stop the development of osteochondrosis, relieve acute symptoms and prevent possible complications.

Drug therapy

Necessary in the stage of exacerbation of the disease, aimed at eliminating pain, relieving inflammation and normalizing metabolic processes.

According to the clinical recommendations of the Russian Federation, non-steroidal anti-inflammatory drugs are used to relieve back and neck pain. They are included in the treatment program immediately from the moment the first symptoms appear. The drugs are used orally, externally, and also through intramuscular or intravenous injections.

In the treatment of spinal osteochondrosis, applications with anti-inflammatory ointments are used to relieve the local inflammatory process. Your doctor may prescribe NSAIDs in the form of creams or gels. Many products for external use penetrate into the deep layers of the skin, reliably blocking pain receptors. In the treatment of osteochondrosis of the cervical spine, medical plasters are used for pain relief.

The main symptoms of exacerbation of osteochondrosis are acute, unbearable pain. In these cases, patients are shown therapeutic blockades. They mainly contain local anesthetics and hormones (glucocorticoids).

You cannot use any medications on your own without a doctor’s prescription - this can only worsen the problem. Treatment of spinal osteochondrosis should be carried out by an experienced specialist. Medicines to eliminate pain are prescribed by the attending physician, depending on the nature of the pain and the severity of the pathology.

Physiotherapy

For osteochondrosis, a set of techniques based on physical factors is used: light, low-frequency currents, magnetic field, laser radiation. Physiotherapy helps relieve pain, stimulate blood circulation and speed up regeneration.

The most common methods:

  • electrophoresis;
  • magnetic therapy;
  • laser therapy;
  • ultrasound;
  • shock wave therapy (SWT).

A course of physiotherapy is usually carried out outside the period of exacerbation, after relief of acute pain and inflammation. The duration of sessions and the total duration of the course are individual for each patient. The doctor prescribes the appropriate type of treatment based on your condition, symptoms and stage of osteochondrosis. Physiotherapy methods reduce treatment time, increase the effectiveness of medications and reduce the risk of side effects of various forms of medications.

Massage

Massage is a set of manual techniques on different parts of the body. It has a strengthening effect, improves blood circulation, relaxes muscles and reduces pain. The procedure should be performed only by professional massage therapists who have experience working with patients suffering from osteochondrosis.

Thanks to massage techniques, muscles relax, tension is relieved and flexibility improves. Stimulation of blood circulation promotes a more active supply of oxygen and nutrients to tissues.

Typically, at least 10 massage sessions are required at intervals of two to three days. Before starting the course, a consultation with a neurologist is necessary to exclude possible contraindications.

In addition to massage, you may need the help of a chiropractor. The course of manual therapy is carried out strictly according to the indications of a neurologist. Manual techniques (friction, pressure, rubbing, vibration and others) are aimed at restoring the function of joints and muscles. They help restore the anatomically correct position of the vertebrae and reduce pressure on the intervertebral discs.

Exercise therapy

One of the most effective methods for treating back pain. Exercises help activate blood circulation, expand the intervertebral space and improve metabolic processes in the intervertebral discs. The most important conditions are that physical activity must be strictly dosed; exercises can only be performed outside periods of exacerbation of the disease. The exercises are aimed at decompressing the nerve roots, strengthening the muscular corset, and developing the correct pattern of movements. Exercise therapy will help prevent possible complications of the musculoskeletal system.

Classes must be regular and performed strictly under the supervision of a physical therapy instructor.

Surgical treatment of spinal osteochondrosis

If conservative treatment is ineffective, surgery is indicated. As a rule, the main goal of the intervention is decompression of the nerve roots - eliminating compression. Compression may be caused by a hernia, adhesions, or bone osteophytes.

Indications for surgical intervention:

  • prolapse of disc herniation with development;
  • limited mobility, muscle paralysis;
  • acute pain syndrome that is not amenable to conservative treatment;
  • dysfunction of internal organs.

During the consultation, the doctor will tell you in detail what spinal osteochondrosis is and why in your case you cannot do without surgery.

Prevention of osteochondrosis

How to keep your back healthy and prevent the development of osteochondrosis?

  1. Strengthen the muscles of your neck, lower back and back. This can be done through moderate physical activity and exercise therapy. Exercises help strengthen your back, relieve acute pain, and reduce the likelihood of complications.
  2. Follow safety precautions when working out in the gym and playing sports. Some activities place serious stress on the spine.
  3. Control your body weight. Excess weight creates additional stress on the spine. To prevent osteochondrosis, consult a professional nutritionist.
  4. Do not jerk weights when you are unprepared for the load. Avoid lifting heavy loads whenever possible.
  5. Eat a balanced diet. A menu rich in calcium, vitamins D and C will help strengthen bone tissue. Include dairy products, fish, vegetables, herbs and fruits in your daily diet.
  6. Watch your posture, especially during long, monotonous work. Develop good posture habits.
  7. Avoid bad habits. Smoking is harmful to health in general; in addition, it impairs blood supply to the spine and contributes to the development of osteochondrosis.
  8. Take regular breaks at the computer or in the office. To prevent muscle strain, short pauses and a light warm-up are enough.
  9. Take enough vitamin D as it is important for bone health. It is better to check the dosage with your doctor in order to achieve a positive effect and not cause complications.

Regular consultations with a doctor play an important role in the prevention of osteochondrosis. See a neurologist if you regularly experience pain, or if you are at risk for musculoskeletal diseases.

Forecast

Spinal osteochondrosis in adults is not a death sentence, but an opportunity to change your attitude towards life and health. If you monitor your condition, consult a doctor on time and follow the recommendations, you will be able to live actively, without pain and stiffness of movement. In most patients, with properly selected therapy, the symptoms of osteochondrosis weaken or disappear within 6-8 weeks.

But if you ignore the problem or refuse treatment, the disease can worsen and become chronic. This condition is more difficult to treat and contributes to additional complications and decreased quality of life. Therefore, it is best to contact an experienced neurologist if pain in the back or neck occurs, without postponing the visit "for later. "