Many people associate the word "osteochondrosis" with old age. There is an opinion that it is a disease of grandparents, in which "it shoots in the lower back" and "the back hurts". However, there is only a grain of truth in this deception: in fact, osteochondrosis isdegenerative(that is, caused by a local metabolic disorder)changes in the spine, that inevitably appear in all older people. However, osteochondrosis today is found in 9 out of 10 people over the age of 45, and the first manifestations of the disease can begin as early as 25 years.
This ailment is even called"the disease of civilization", since the main cause of osteochondrosis is improper "exploitation" of the spine. The point 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 it is very complicated. 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 column works
To understand what osteochondrosis is, you need 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, 5 more vertebrae, growing together, form thesacrum and, finally, the coccygeal region consists of another five (or four, depending on individual characteristics) vertebrae. The vertebrae are actually bones, and they are immobile, 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 plaques (annulus fibrosus). Collectively, this is called an intervertebral disc.In addition, the structure of the spine contains numerous ligaments, vessels and 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 continually renewed throughout a person's life. This is possible due to the fact that they are well supplied with blood and are always well nourished. 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 begin to shift indifferent directions and approach each other. All this leads to a series of dangerous diversions, mainly toinflammation in both the spinal column and surrounding tissues, and from compression of the spinal cord and spinal nerves.
It is interesting that a concept like "spinal osteochondrosis" exists mainly in the post-Soviet space. In foreign literature, the changes that occur in the spines are called"hernias", "myofascial pains", "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, degeneratively altered, thenbulgesappear: the nucleus pulposus seems to squeeze and mix with the fibrous ring, but it doesn't break it. When there is a rupture of the fibrous ring, it is referred to as an intervertebral hernia.In the last and most severe stage of osteochondrosis,the intervertebral discs are completely worn, the vertebrae begin to rub against each other and also collapse, pathological bone growths and osteophytes appear. In the last stage, the spine becomes, so to speak, “petrified”, that is, it loses its mobility, which can lead to disability.
Causes of spinal diseases
Why do all the degenerative changesabove 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, "stooped", the cervical and thoracic regionsthey experience stress and do not receive the necessary nutrition. Also, osteochondrosiscan develop due to poor posture.However,sports, especially strength sports, with a violation of exercise technique, can also lead todegenerative changes in the spine.
Another common cause is anyback injury. The development of osteochondrosis can also be influenced by inherited 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 positions that are uncomfortable for them and often carry it in their arms, the condition of the spinenoticeably worsens.
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, evenrupture of the fibrous annulusis 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, radiating to the arms, legs, neck, ribs and chest (in this case, osteochondrosis can easily be mistaken for coronary artery disease).
In addition,may appear numbness and tingling in the extremities.
With osteochondrosisin the cervical spine, headaches, sometimes very intense, dizziness, nausea, ringing in the ears may appear. The development of a hernia, which leads to compression of nerve endings, can lead to disruption of the work of internal organs associated with the affected nerve. For example, with a hernia in the lumbar spine, problems with urination, disappear potency, in the chest (indigestion, in the cervix) 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 of diagnosing diseases of the spine is MRI.
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 compression by the displaced vertebrae. Furthermore, 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, but for this it is necessaryto completely change the way of life: do physical therapy, swim, take courses regularly massage or manual therapy, start eating well and give up bad habits. Sports, massages, proper nutrition, and weight loss can have a significantly greater and long-term healing effect than medications.
Doctors still argue about the effectiveness of chondroprotectors, drugs that restore cartilage tissue and supposedly strengthen the fibrous ring, their effectiveness has not been sufficiently proven, but since they certainly do not cause harm, they can be used to treatosteochondrosis.
For severe pain, your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants (drugs that relax muscles), and pain relievers.
It is used in the treatment of osteochondrosis andvitamins, since their deficiency causes greater destruction of the intervertebral disc:B vitamins, for example, help to improveprotein metabolism between tissues, and since protein is the main building material in the body, then the normalization of protein metabolism contributes to the restoration of nerve and cartilage tissue. Vitamin A improves blood circulation. However, when taking vitamins, like any other medicine, you should 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 is generally used when there issignificant narrowing of the spinal canal and excessive compression of the nerves and spinal cord from 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 serious consequences are caused by osteochondrosis of the cervical and lumbar spine, degenerative changes in the thoracic spine, even in the presence of hernias, they almost never require surgical treatment.
At present,methods of the so-called conservative surgeryare being actively introduced in medical practice, when doctors manage to preserve the integral structure of the vertebrae by extracting a part of the nucleus pulposus using aendoscope. The device is inserted into the site of the spinal injury through small incisions in the skin, preventing a great deal of blood loss. Since the entire disc is not removed during the operation, the biomechanics of the spine are generally not altered and this shortens the recovery period. Often times, patients get up one 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 surgical treatment until the end. And here everything depends on the patients themselves: if they follow all the recommendations of doctors and take care of their health, even in the presence of hernias, they can do without surgery.