Many people associate the word "osteochondrosis" with old age. There is an opinion that this is a disease of grandparents, in which it "shoots in the lower back" and "hurts the back". However, there is only a hint of truth to this disappointment: in fact, osteochondrosis isdegenerative(i. e. caused by a local metabolic disorder)changes in the spine, whichthey inevitably appear in all older people. However, osteochondrosis is found today in 9 out of 10 people over the age of 45, and the first manifestations of the disease can begin as early as 25.
This disorder is also called"the disease of civilization", since the main cause of osteochondrosis is improper "exploitation" of the spinal column. The fact is that a modern person puts him under 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 complicated. Because a person thinks he is resting when he is sitting. But in reality, the spine in a sitting position works with greater stress.
How the spine works
To understand what osteochondrosis is, it is necessary to understand what the human spine is. We all know that the spine is made up 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, another 5 vertebrae, which grow together, they form the sacrum and, finally, the coccygeal region consists of other five (or four - depending on individual characteristics) vertebrae. The vertebrae are, in fact, bones, and are immobile, but so that they can move freely, providing mobility to our whole body, and also so that they do not collapse due to shocks and friction, there is a layer of gelatinous substance between each vertebranucleus pulposus) surrounded by robust multilayer plates (fibrous ring). Collectively, this is called the intervertebral disc.In addition, the structure of the spinal column contains numerous ligaments, vessels, nerves. This is a very complex organ that largely determines the work of almost all systems of the body, as it protects the spinal cord and affects its work.
Vertebrae and intervertebral discs are continually renewed throughout a person's life. This is possible due to the fact that they are well supplied with blood and are always supplied 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 ring, and the vertebrae themselves begin to shift indifferent directions and approach each other. All this leads to a number of dangerous deviations, mainly ainflammation in both the spine itself and surrounding tissues, and 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 that occur in the spines are called"hernias", "myofascial pain", "disc lesions", "dorsopathy". So, if you've heard something similar about yourself, then you have osteochondrosis of the spine. As forintervertebral hernia, it is considered 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 appears to be squeezed out and mixed with the ringfibrous, but does not break it. When there is a rupture of the fibrous ring, it is referred to as an intervertebral hernia.In the last, most severe stage of osteochondrosis,the intervertebral discs are completely worn out, the vertebrae begin to rub against each other and even collapse, pathological bone growths and osteophytes appear on them. In the last stage, the spine becomes, as it were, "petrified", ie it loses its mobility, which can lead to disability.
Causes of Spinal Diseases
Why 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 very uncomfortable, "hunched", the cervical and thoracic regions experience tensionand they do not receive the necessary nutrition. Also, osteochondrosiscan 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, poor nutrition, insufficient water intake and, consequently, dehydration, smoking and alcohol abuse.
Women often encounter the first manifestations of osteochondrosis during pregnancy, therefore, when young mothers have to feed a baby in uncomfortable positions for themselves and often carry it in their arms, the condition of the spine deteriorates considerably.
Symptoms of osteochondrosis
The symptoms of osteochondrosis are varied and depend on the exact department where the complaints occurred. Pain is the main manifestation of this pathology, however, until therupture of the fibrous ringis weak, it can be dull, pressing, and patients may not even pay attention to it.Most 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 in the limbs may appear.
With osteochondrosisin the cervical spine, headaches, sometimes very severe, dizziness, nausea, ringing in the ears may appear. The development of a hernia, which leads to compression of the nerve endings, can lead to disruption of 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 disappears, 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 the internal organs and determine the source of pain. Today, the most reliable method for diagnosing diseases of the spine is magnetic resonance imaging.
X-rays are also reliable, but less informative. On an x-ray, 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 the displaced vertebrae. In addition, MRI allows you to distinguish osteochondrosis from other dangerous diseases, including malignant tumors and Bechterew's disease.
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 necessaryto completely change the styleof life - do physical therapy, swim, take courses regularlymassage or manual therapy, start eating well 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, presumably, strengthen the annulus fibrosus, their effectiveness has not been sufficiently proven, but since they certainly do not bring harm, they can be used to treatosteochondrosis.
For severe pain, your doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants (drugs that relax the muscles), and analgesics.
Used in the treatment of osteochondrosis andvitamins, as their lack causes further destruction of the intervertebral disc:B vitamins, for example, contribute to theimprovement of protein metabolism between tissues, and from then protein is the main building material in the body, so the normalization of protein metabolism contributes to the restoration of nervous and cartilage tissue. Vitamin A improves blood circulation. However, taking vitamins, like any other medicine, you need to be careful, as they can cause serious adverse reactions and can only be taken after consulting a doctor and under his supervision.
Surgical treatment of osteochondrosis is also possible, but, as a rule, significant narrowing of the spinal canal and excessive compression of the nerves and spinal cord by the resulting hernias are used. 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 serious 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 actively being introduced into medical practice, when doctors manage to preserve the integral structure of the vertebrae by removing a part of the nucleus pulposus using anendoscope. The device is inserted into the site of the spinal injury through small incisions in the skin, which prevents large blood loss. Since the entire disc is not removed during the operation, the biomechanics of the spine are generally not disturbed and this shortens the recovery period. Patients often stand up within a day of the operation. However, any surgery on the spine is still fraught with complications and subsequent relapses of the disease, so experienced specialists will try to delay surgical treatment until the last. And here it all depends on the patients themselves: if they follow all the recommendations of doctors and take care of their health, then even in the presence of hernias, they will be able to do without surgery.