Osteochondrosis: what does everyone need to know?

Osteochondrosis is a spinal problem that affects literally every fourth inhabitant of the planet, at least this is what experts from the WHO statistics center claim.

In the top five most common diseases in the world, osteochondrosis takes the "honorable" third place, ahead of it only cardiovascular diseases. In 2012, the media giant British Broadcasting Corporation - BBC published data from medical studies that are simply shocking: every year more than 5 million people die due to diseases caused by physical inactivity, that is, a sedentary lifestyle. A real pandemic of decreased physical activity has already affected a third of the earth's population, and the latest results of scientific work prove that the culprit of many health-threatening ailments is not a genetic predisposition or viruses, but an unhealthy lifestyle. Almost all back problems - intervertebral hernias (hernias), osteoporosis, osteochondrosis and many other diseases associated with osteochondrosis - are the result of many hours of sitting, whether in front of the TV, at a desk or in a car seat. About 80% of all reasons why the back suffers and spinal diseases develop relate to elementary degenerative changes in the muscular corset and the lack of adequate, reasonable physical activity.

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Osteochondrosis and the spine

The structure of the spinal column in living beings, whether animal or human, is basically the same. However, only humans have the proud title of Homo erectus, that is, upright man. Until recently, it was believed that it was upright walking that was the main cause of pathological changes in the spine. As if the vertical position of the body leads to an incorrect, uneven load on the spinal column. Static load, which is most exposed to the lower back and sacrum, which consists of five vertebrae, is the most dangerous in terms of destructive effects on the intervertebral tissues. Dynamic load, which is characterized by movements, is exposed to the cervical spine. The structure of the spine is quite complex, it consists of many vertebrae connected by cartilaginous tissue - discs. Discs, in turn, are multi-layered rings with a liquid core in the middle, performing a shock-absorbing function when the spine is set in motion. In addition, the vertebrae are connected by a large number of muscles and other tissues. The elasticity of this entire connecting system ensures the normal condition of the spinal column. Simply put, the more elastic and adaptive the intervertebral discs, the more flexible and healthier the spine, the less risk that osteochondrosis will affect it. Today, the theory that upright walking is to blame for all degenerative diseases of the spine is being questioned. Relentless statistics convince clinicians that rather a sedentary lifestyle, physical inactivity are a factor provoking diseases of the spine associated with dystrophy and degeneration of intervertebral tissues. In addition, excess weight, which really increases the load on the discs, can also aggravate destructive processes and provoke osteochondrosis. Conclusion: movement is life. The phrase is not new, it seems painfully hackneyed, banal, but it does not require proof. A striking example of the fact that motor activity and flexibility can serve as the foundation for the health of the spinal column are the examples of people who regularly do gymnastics, yoga and other types of body training. Nature itself gives children the opportunity to be flexible, because children's spinal discs are very elastic, and the disc nuclei alone contain up to 80% of fluid. With age, the amount of life-giving "lubricant" may decrease, but it can be preserved by consciously performing simple exercises and observing basic rules of a healthy lifestyle. Osteochondrosis is a disease of people who are forced to sit or lie for hours, years, no matter for what reason - due to duty or their own desire, due to obligations, laziness or simply ignorance.

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What is osteochondrosis?

Osteochondrosis is a concept that includes all degenerative and dystrophic changes in the spine. It should be noted that in the European version of the classification of diseases there is not a word about osteochondrosis, there such diseases are classified as rheumatic and dorsopathic. In ICD-10, since 1999, a group of diseases with typical manifestations in the form of pain in the spine, not associated with visceral causes, is really defined as dorsopathy. Osteochondrosis, which is recorded as dorsopathy, in turn, is divided into three large groups:

1. Deforming diseases, dorsopathies – scoliosis, lordosis, kyphosis, subluxation, spondylolisthesis.
2. Spondylopathy – spondylosis, ankylosing spondylitis and other ossifying dystrophic pathologies that limit the mobility of the spine.
3. Other, different dorsopathies are degenerative changes accompanied by hernias and protrusions.

Thus, osteochondrosis (from the Greek words - bone, cartilage and pain) is a general name for all problems in the spine, which are caused by degeneration and nutritional disorders of the perivertebral tissues (degeneration and dystrophy). When deformed, the intervertebral, shock-absorbing disc becomes thinner, becomes flat, this leads to overload of the vertebrae and their even greater deformation to such an extent that they begin to go beyond the normal boundaries of the spine. Nerve roots in such pathology are pinched, inflamed, pain appears.

Osteochondrosis affects almost the entire back, and depending on which part of the spine is affected the most, this is what the disease is called in clinical practice.

The most "popular", known to many is lumbar osteochondrosis, there is also a definition of cervical, which is the second most common, there is sacral, thoracic and widespread osteochondrosis. There are also cross pathologies - lumbosacral or, for example, cervicothoracic.

The symptoms of osteochondrosis can be quite varied, but sooner or later they all increase and become clinically manifested. Of course, it is much easier and faster to treat osteochondrosis in the early stages of its development, when the following signs are noticeable:

• Aching, dull painful sensations in the area of the spine affected by the degenerative process.
• Chronic tension in muscle tissue (especially characteristic of cervical osteochondrosis).
• Crunching when turning the body and neck.
• Headache, including tension headache (with cervical osteochondrosis).
• Aching pain in the chest area, often reminiscent of cardiac pain (with thoracic osteochondrosis).

Osteochondrosis in the inflammatory stage has symptoms that force a person to see a doctor, since they cause more pronounced discomfort:

• Irradiation of pain in the limbs.
• Numbness in the fingers or toes.
• Pain radiates to the fingertips of the extremities.
• Severe pain in the spine when performing simple physical activities.
• Increasing pain with small jolts or shocks, for example, when traveling in transport.
• Inability to perform simple tasks involving turning or bending the body.
• General limitation of mobility and motor activity.

The factors that can provoke problems with the spine, called osteochondrosis, are quite varied, but the first place is taken by the already mentioned hypodynamia. Among other reasons, the following are named:

• Functional - monotonous work while maintaining the same posture.
• Biomechanical – flat feet, congenital anomalies in the development of the spine.
• Hormonal – changes in hormonal levels due to age-related changes.
• Infectious - dystrophy of the intervertebral environment caused by an inflammatory process.
• Metabolic – excess or insufficient body weight.

Factors that provoke osteochondrosis, that is, deformation and dystrophy of the intervertebral discs, usually occur in a complex and are almost never isolated.

The development of osteochondrosis is divided into the following stages:

1. Changes in the biomechanics of discs as a result of tissue degeneration and dystrophic changes. This is a preclinical stage, when signs, if any, are very weak and unmanifested. At this stage, the fibrous ring surrounding the disc begins to stretch or, conversely, to shrink.
2. The second stage is characterized by greater instability of the disc, the fibrous ring is not simply stretched, its fibers are stratified, the ring begins to rupture. Due to the pinching of the nerve roots, pain in the spine appears, degenerative changes progress. Collagen tissue continues to deteriorate, the normal height of the intervertebral distance decreases.
3. The disc often ruptures completely, this pathology is accompanied by inflammation, hernia and pinched nerve endings. Protrusion (loss) causes characteristic pain not only in the damaged area of the spine, but also affects the limbs and nearby parts of the body.
4. The most severe stage, when spondylosis and other compensatory diseases of the spine join dystrophy. Often, the vertebra, in order to compensate for lost functions, flattens, and the elastic tissue of the fibrous ring is gradually replaced by scar and bone growths.

Osteochondrosis of the cervical spine

Almost everyone who is involved in intellectual activity, from schoolchildren to the elderly, suffers from one or another form of osteochondrosis of the cervical spine. Osteochondrosis of the cervical spine is considered a disease associated with increased dynamic loads, causing degeneration of the intervertebral discs and their subsidence. Hardening and proliferation of cartilaginous tissue leads to a violation of the shock-absorbing properties of this section of the spine, head movements - tilts, circular movements, turns become difficult and are accompanied by characteristic signs of osteochondrosis.

Symptoms that can be caused by osteochondrosis of the cervical spine are not specific at the early stages of the disease and are similar to the signs of other pathologies not associated with the skeletal system. The list of manifestations of osteochondrosis that must be differentiated and clarified in order to determine the correct diagnosis is as follows:

• Intense headaches resembling migraine attacks.
• Headache spreading from the back of the head to the neck.
• Headache that gets worse when coughing, turning the head, sneezing.
• Headache radiating to the chest or shoulder.
• Dizziness, sensory disturbances – double vision, difficulty focusing the gaze. Tinnitus, in advanced cases, impaired coordination of movements.
• Symptoms that are similar to cardiac pain, in particular to the pain of angina pectoris - pain in the heart, radiating to the cervical region or arm, under the shoulder blade. The pain may intensify and is not relieved by taking cardiac drugs.
• Pain similar to the painful sensations associated with hypertension (heaviness in the back of the head).

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Consequences and complications

Before treating osteochondrosis, as well as any other disease, it is necessary to find out its causes, which is quite difficult when it comes to degenerative pathologies of the spinal column. Factors that provoke deformation of the intervertebral discs of the cervical region are associated with the anatomical specificity of this zone. The cervical vertebrae are almost constantly under tension due to insufficient general motor activity. If we take into account the total "sedentary" lifestyle of more than half of the working population, the problem sometimes becomes insoluble. In addition, the cervical vertebrae are smaller in size than the vertebrae of other areas of the spine, and the internal canal is much narrower. A huge number of nerve endings, an abundance of blood vessels, the presence of the most important artery feeding the brain - all this makes the cervical zone extremely vulnerable. Even the slightest reduction in the intervertebral space leads to pinching of the nerve roots, swelling, inflammation and, accordingly, to a deterioration in the blood supply to the brain. Often, a decrease in mental activity is associated with the fact that a person develops osteochondrosis of the cervical spine. There is a historical anecdote dating back to not so distant times, when Margaret Hilda Thatcher scolded her employee with the words: "Your problem is not your headache or your own view of the question put to a vote. The fact is that your spine is simply not connected to your brain, John." This famous quote from the "iron" lady perfectly characterizes the condition caused by osteochondrosis of the cervical spine, when sometimes this happens - the spine does not provide the proper "nutrition" to the head. As for the "nutrition", in fact, not only the spinal canal is involved in it, but also the artery canal passing through the transverse nerve processes. The vertebral artery goes to the cranium in order to nourish the cerebellum, this artery also supplies nutrients and oxygen to the vestibular apparatus. The slightest disturbance of blood flow through these channels can either provoke or aggravate the course of vegetative-vascular syndrome. In addition to VSD, cervical osteochondrosis causes typical symptoms of radicular syndrome (radiculitis), when pain radiates to the fingertips or to one finger, and pallor of the skin (marbling) is clearly visible. One of the most unpleasant complications provoked by cervical osteochondrosis is palmar fibromatosis, also called Dupuytren's contracture. With this disease, the aponeurosis (tendon plate) of the palm is affected and the flexion function of the fingers is impaired.

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Diagnosis of osteochondrosis of the cervical spine

Osteochondrosis of the cervical spine is diagnosed by a specialist based on the patient's complaints, and can be confirmed and clarified using X-ray examination, magnetic resonance imaging, and computed tomography.

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Treatment of osteochondrosis of the cervical spine

Complete recovery from cervical osteochondrosis is possible only in its initial stages, however, it is possible to relieve a person from the painful symptoms of this disease, prevent exacerbations, and get rid of some pathological changes in the spine. Therefore, we should not forget about the importance of timely treatment of the disease.

How to treat osteochondrosis?

Osteochondrosis is not easy to treat, as a rule, therapy is prescribed in the most comprehensive manner, including all the means available to modern medicine. In addition to conservative drug treatment, proven herbal medicines, acupuncture, a therapeutic exercise complex, and sometimes surgical operations to eliminate hernias and subluxations of the vertebrae are also used. It should be recognized that osteochondrosis and treatment are two concepts that a sick person will encounter for quite a long time, sometimes for a lifetime. In addition to the initial stage, which is aimed at relieving the pain symptom, therapy involves constant restorative, rehabilitation and preventive actions. Complex, multicomponent diseases are always treated for a long time. If a diagnosis of osteochondrosis is made, how to treat it is the first question that is decided not only by the doctor, but also by the patient himself, since his direct participation and responsible observance, compliance with all instructions often play a decisive role in recovery.

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What to treat with?

List of drugs that are most often used as a remedy for osteochondrosis:

• A complex, effective homeopathic preparation that should be used for a long time, like any other homeopathy - Traumeel (in ampoules or in tablet form).
• An effective external remedy that relieves muscle and joint pain well is Comfrey or Symphytum ointment.
• Non-steroidal anti-inflammatory drug – Ibuprofen (in the form of an ointment - externally, in tablets - orally).
• Complex action ointment from the category of homeopathic remedies – Ziel T.
• Ortofen is a drug in tablet form from the category of NSAIDs (non-steroidal anti-inflammatory drugs).
• Diclofenac - in ampoules, in tablets, in the form of ointment or gel.
• A drug from the glucocorticoid category – dexamethasone phosphate.
• An ointment from the category of external non-steroidal anti-inflammatory drugs – indomethacin.
• A gel from the category of external non-steroidal anti-inflammatory drugs – ketoprofen.
• A drug from the category of external non-steroidal anti-inflammatory drugs – cefekon.

If we generalize everything that is involved in the treatment of a disease such as osteochondrosis, the treatment can be divided into the following stages and types:

1. The use of NSAIDs - non-steroidal anti-inflammatory drugs, is considered the gold standard in the therapy of all degenerative, dystrophic pathologies of the bone and muscle systems. The first thing these drugs do is reduce the pain symptom, the second is a significant reduction in inflammation.
2. Drugs that are called muscle relaxants, because they are really capable of effectively relieving muscle tension and spasms.
3. Traction therapy is a traction treatment. In this rather painful but effective process, there is a gradual stretching of the tissues and muscles that surround the vertebrae, and accordingly, the intervertebral distance increases, approaching the norm.
4. Biogenic drugs, vascular agents that supply nutrition to degenerative areas of tissue, and B vitamins are good at restoring the functional capabilities of a deformed spine.
5. Sedatives that normalize the nervous system. Acupuncture is excellent for relieving muscle and nerve tension.
6. Physiotherapeutic procedures – electrophoresis, phonophoresis, UHF, massages, mud treatments, balneotherapy, magnetic therapy.
7. Spinal correction during the recovery period is carried out using manual therapy.
8. Treatment of osteochondrosis also involves constant exercise from a range of therapeutic physical training exercises.

In the most extreme cases, when the course of osteochondrosis passes into the last stage, surgical intervention is also indicated, which is carried out in the area of localization of the inflammatory process. Most often, a hernia is operated on, and it is possible to remove the deformed bone tissue of adjacent vertebrae.

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Where to treat osteochondrosis?

Self-treatment of almost all diseases is a trend that is observed in almost all countries, but it is especially characteristic of the post-Soviet countries, where the traditional structure of health care is still undergoing changes. Confused by innovations, often simply out of ignorance, many of us try to cope with back, neck or lower back pain on our own. This time can be called the first, although not very effective, stage of treatment, since osteochondrosis should be treated only with the help of a doctor. The second stage, when independent actions do not lead to the desired, lasting result, a person thinks about visiting a doctor and he faces the question, osteochondrosis - how to treat, how to treat, and, most importantly, where to treat osteochondrosis? Firstly, you can contact your local therapist, who will most likely refer the patient for an examination - X-ray, blood tests, and give a referral to a neurologist. Secondly, you can immediately make an appointment with a neurologist, it is advisable to undergo at least an X-ray examination of the entire spine before the consultation. In no case should you go to extremes and look for an experienced massage therapist, any massage, first of all, involves a preliminary scan of the body's condition, especially the condition of the spinal column. The problem of osteochondrosis is also dealt with by vertebrologists and vertebroneurologists - doctors who specialize in diseases of the spine.

Osteochondrosis is a complex disease, but the examples of many people who overcome even severe spinal injuries prove that everything is feasible and achievable. The main thing is to analyze your motor activity and take appropriate measures at the first alarming signals that your back gives you. You can immediately contact a doctor and begin treatment, or, if the disease is not neglected, start moving, because, as Aristotle, the teacher of the great Alexander the Great, who was distinguished by his extraordinary activity, said, “Life requires and needs movement, otherwise it is not life.”

What does history say about osteochondrosis?

The etiology of osteochondrosis is still unclear, moreover, despite the clearly ancient origins of this disease, spinal diseases began to be seriously studied only in the 18th century. Since then, disputes and discussions have not subsided regarding the true "enemy" that provokes degenerative changes in the intervertebral discs. Meanwhile, long ago, back in the days of Hippocrates, there were treatises on chiropractic, which indicates that the ancient Greeks also suffered from back pain. Hippocrates himself was also interested in spinal issues so much that he conducted medical experiments that are questionable from a modern point of view: his students carefully tied the patient by the arms and legs to a horizontal plane with his back up, stretching the limbs as much as possible. Then the great healer stood on the back of the sufferer and began to walk on it. The founding father of medicine was sincerely convinced that such fixation, stretching and massage would restore health to the spine, which, according to the ancient Greek sages, was the key to a person’s happy destiny. In fairness, it should be noted that Hippocrates later put specially trained children on their backs to avoid the risk of injuring an already sick spine with the weight of an adult. Since then, for many centuries in a row, the back and possible osteochondrosis have been treated with everything - punches, rubbing with herbal remedies, spells, acupuncture, cauterization, and even bee and snake bites. Of course, when there is no alternative, the patient agrees to a snake, although doctors of past centuries have never collected reliable statistics convincing us that the ancient method of treating osteochondrosis is a panacea. Some systematization of methods that told how to treat osteochondrosis began only at the end of the 17th century. At the same time, terminology appeared that formalized applied areas in medicine, among which was chiropractic. Two centuries later, it was divided into chiropractic and osteopathy. The first direction was purely practical, using force methods, osteopaths were more theorists and researchers. At the junction of these sciences, manual therapy gradually emerged, without which today the treatment of osteochondrosis is practically unthinkable.

As for the term defining the disease "osteochondrosis", a typical story happened with osteochondrosis, which is characteristic of other ailments of unclear etiology. It was called by many names - lumboschialgia, radiculitis, Schmorl's node, sciatica, and spondylosis. It took doctors almost a century to finally figure out osteochondrosis and come to a consensus. Today, all pathomorphological disorders and changes in the spine are unconditionally called osteochondrosis, with one caveat: osteochondrosis is a dystrophic disorder in the intervertebral disc without hernias (hernias) and without protrusion (degeneration of the disc without rupture of the fibrous ring).