Osteochondrosis: what everyone should know?

Osteochondrosis is a problem of the spine, which affects literally every fourth inhabitant of the planet, at least, according to experts of the WHO Statistics Center.

In the top five most common diseases of the world, osteochondrosis occupies an “honorable” triple place, only cardiovascular diseases are ahead of it. In 2012, the British Broadcasting Corporation's media giant, the Air Force, published medical research data that just shocked: more than 5 million people die every year due to illnesses caused by physical inactivity, that is, a sedentary lifestyle. A real pandemic of physical activity reduction has already affected a third of earthlings, and the latest results of scientific studies prove that the culprit for many health problems is not a genetic predisposition or viruses, but an incorrect lifestyle. Almost all back problems — intervertebral hernia (hernia), osteoporosis, osteochondrosis, and many other diseases associated with osteochondrosis — are the result of hours of sitting, whether in front of a TV, at a desk, or in a car seat. About 80% of all the reasons for which the back suffers and spinal diseases develop, relate to an elementary degenerative change of the muscular system and the lack of full-fledged reasonable physical exertion.

[1], [2]

Osteochondrosis and spine

The structure of the spinal column in living beings, whether animal or human, is basically the same. However, only the person owns the proud title of Homo erectus, that is, the man is erectus. Until recently, it was believed that upright walking was the main cause of pathological changes in the spine. As if the vertical position of the body leads to an irregular, uneven load on the spinal column. The static load, which is most susceptible to the lower back and the sacrum, which consists of five vertebrae, is the most dangerous in terms of destructive effects on intervertebral tissue. The dynamic load, which is characterized by movements, is subject to the cervical spine. The structure of the spine is quite complex, it consists of many vertebrae connected by cartilage tissue - the discs. The discs, in turn, are multi-layered rings with a liquid core in the middle, performing the function of depreciation 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 joint 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 strike it. Today, the theory that upright walking is guilty of all degenerative diseases of the spine is in doubt. Relentless statistics convinces clinicians that rather immobility, physical inactivity are a factor that provokes spinal diseases associated with dystrophy and degeneration of intervertebral tissues. In addition, overweight, which really increases the load on the disks, can also exacerbate the destructive processes and provoke osteochondrosis. Conclusion: movement is life. The phrase is not new, it seems painfully beaten, banal, however, it does not require proof. A vivid example of the fact that physical activity and flexibility can serve as a foundation for the health of the spinal column are examples of people who regularly engage in gymnastics, yoga and other types of body training. For children, nature itself makes it possible to be flexible, because children's vertebral discs are very elastic, only up to 80% of fluid is found in disk nuclei. With age, the amount of life-giving "lubrication" can decrease, but it can be saved by consciously performing simple exercises and observing the elementary rules of a healthy lifestyle. Osteochondrosis is a disease of people who have to sit or lie down for hours, for any reason, for whatever reason - on duty or on their own, by virtue of commitment, laziness, or simply through ignorance.

[3], [4], [5], [6], [7], [8]

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, starting from 1999, really a group of diseases with typical manifestations in the form of pain in the spine, not associated with visceral causes, is defined as dorsopathy. Osteochondrosis, which is fixed as dorsopathy, is in turn 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 spinal mobility.
3. Other, other dorsopathies - degenerative changes, accompanied by hernias, protrusions.

Thus, osteochondrosis or osteochondrosis (from Greek words - bone, cartilage and pain) is the common name for all problems in the spine that are caused by degeneration and malnutrition of paravertebral tissues (degeneration and dystrophy). During intervertebral deformity, the depreciation disk becomes thinner, becomes flat, this leads to overloading of the vertebrae and their even greater deformation to such an extent that it begins to go beyond the normal boundaries of the spine. Nerve roots with such pathology pinch, inflame, pain appears.

Osteochondrosis affects almost the entire back, and depending on which part of the spine has suffered more, it is called a disease 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 common osteochondrosis. There are also cross pathologies - lumbosacral or, for example, cervicothoracic.

Symptoms of osteochondrosis can be very diverse, but all of them sooner or later grow and become clinically manifest. Of course, to treat osteochondrosis is much easier and faster in the early stages of its development, when the following symptoms are noticeable:

• Dull, dull pain in the affected spinal segment of the degenerative process.
• Chronic muscle tension (especially characteristic of cervical osteochondrosis).
• Crunch when turning the body, neck.
• Headache, including tension headache (for cervical osteochondrosis).
• Aching pains in the chest, often resembling cardiac pain (in chest osteochondrosis).

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

• Irradiation of pain in the limb.
• Numbness of fingers or toes.
• Irradiation of pain in the fingertips of the limbs.
• Severe pain in the spine when performing simple physical activities.
• Increasing pain with small shocks, shocks, for example, when traveling in transport.
• The inability to perform simple work associated with turning or bending the body.
• General limitation of mobility, motor activity.

The factors that can trigger spinal problems, called osteochondrosis, are very diverse, but the already mentioned hypodynamia is in the first place. Among other reasons are the following:

• Functional - monotonous work with 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 the inflammatory process.
• Metabolic - overweight or underweight.

The factors provoking osteochondrosis, that is, the deformation and dystrophy of intervertebral discs, as a rule, act as a complex and are almost never isolated.

The development of osteochondrosis is divided into the following stages:

1. Changes in disk biomechanics as a result of tissue degeneration and dystrophic changes. This is a preclinical stage, when the signs, if any, are very weak, unmanifested. At this stage, the fibrous ring surrounding the disk begins to stretch or vice versa.
2. The second stage is characterized by greater disk instability, the fibrous ring does not just stretch, its fibers are stratified, the ring begins to break. Because of the infringement of the nerve roots, pain in the spine appears, degenerative changes are progressing. Collagen tissue continues to collapse, reducing the normal height of the intervertebral distance.
3. The disc is often torn completely, this pathology is accompanied by inflammation, loss of hernia and infringement of nerve endings. Protrusion (prolapse) causes a characteristic pain not only in the damaged part of the spine, but is also reflected in the limbs and surrounding parts of the body.
4. The most difficult stage is when spondylosis and other compensatory diseases of the spine join dystrophy. To compensate for lost functions, the vertebra is often flattened, and the elastic tissue of the fibrous ring is gradually replaced by cicatricial and bone fouling.

Osteochondrosis of the cervical spine

Practically everyone who is involved in intellectual activity, from schoolchildren to the elderly, suffers from some form of osteochondrosis of the cervical spine. Osteochondrosis of the cervical spine is considered a disease associated with increased dynamic loads causing degeneration of intervertebral discs and their subsidence. Hardening and proliferation of cartilage tissue leads to a violation of the depreciation properties of this area of the spine, head movement - 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 in the early stages of the development of the disease are not specific and are similar to signs of other pathologies that are not related to the skeletal system. The list of manifestations of osteochondrosis, which must be differentiated and clarified in order to determine the correct diagnosis, is as follows:

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

[9], [10], [11], [12], [13], [14], [15]

Consequences and complications

Before treating osteochondrosis, however, like any other disease, it is necessary to find out its causes, which is very difficult when it comes to degenerative pathologies of the spinal column. The factors provoking the deformation of the intervertebral discs of the cervical spine are associated with the anatomical specificity of this zone. The vertebrae of the neck are almost constantly experiencing stress due to insufficient general motor activity. If we take into account the total “sedentary” lifestyle of more than half of the working population, then 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 that feeds the brain - all this makes the cervical zone extremely vulnerable. Even the smallest reduction of the intervertebral space leads to the infringement of the nerve roots, swelling, inflammation and, accordingly, to a deterioration in the blood supply to the brain. Often, mental decline is associated with the fact that a person develops osteochondrosis of the cervical spine. There is a historical anecdote that goes away in not so distant times when Margaret Hilda Thatcher scolded her employee with the words: “Your problem is not in a headache or in your own view of a question put to a vote. The fact is that your spine is simply not connected to your brain, John. " This famous quotation from the “iron” lady characterizes the condition that causes osteochondrosis of the cervical region, when sometimes it happens - the spine does not give the proper “nutrition” to the head. As for “nutrition,” in fact, it involves not only the canal of the spinal cord, but also the canal of the artery that passes through the transverse nerve processes. The vertebral artery goes to the skull in order to feed the cerebellum, and this artery also supplies the vestibular apparatus with nutrients and oxygen. The slightest disturbance of blood flow through these channels can either provoke or aggravate the course of the vascular syndrome. In addition to the IRR, osteochondrosis of the cervical region causes typical symptoms of radicular syndrome (radiculitis), when pain radiates to the fingertips or with one finger, the paleness 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. In this disease, the aponeurosis (tendon plate) of the palm is affected and the flexion function of the fingers is disturbed.

[16], [17], [18], [19], [20]

Diagnosis of osteochondrosis of the cervical spine

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

[21], [22], [23], [24], [25], [26]

Treatment of osteochondrosis of the cervical spine

A complete cure for osteochondrosis of the cervical spine is possible only in its initial stages, however, it is possible to save a person from the painful symptoms of this disease, prevent exacerbations, 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?

It is not easy to treat osteochondrosis; as a rule, therapy is prescribed in the most comprehensive way, including all the means available to modern medicine. In addition to conservative medical treatment, proven phytotherapeutic drugs, acupuncture, therapeutic exercise, and sometimes surgery to eliminate hernia, subluxation of the vertebrae are also used. Admittedly, osteochondrosis and treatment are two concepts that a sick person will face for quite some time, sometimes for the rest of their lives. In addition to the initial stage, which aims to relieve a pain symptom, therapy involves constant restorative, rehabilitative and preventive actions. Complex, multi-component diseases are always treated for a long time. If a diagnosis is made - osteochondrosis, how to treat - this is the first question that not only the doctor decides, but also the patient himself, since his direct participation and responsible observance, the fulfillment of all prescriptions often play a decisive role in recovery.

[27], [28]

How to treat?

The list of drugs that are most often used as a means of osteochondrosis:

• A comprehensive, effective homeopathic remedy that needs to be applied for a long time, like any other homeopathy - Traumel (in ampoules or in tablet form).
• External effective tool that relieves well muscular and articular pain - ointment of Larkspill or Comfrey.
• Anti-inflammatory nonsteroidal agent - Ibuprofen (in the form of ointment - externally, in tablets - orally).
• The ointment of complex effects from the category of homeopathic remedies - The purpose of T.
• Ortofen - drug in tablet form from the category of NSAIDs (anti-inflammatory nonsteroidal drugs).
• Diclofenac - in ampoules, in tablets in the form of ointment or gel.
• The drug from the category of glucocorticoids - dexamethasone phosphate.
• Ointment from the category of external anti-inflammatory nonsteroidal agents - indomethacin.
• Gel from the category of external anti-inflammatory nonsteroidal agents - ketoprofen.
• The drug from the category of external anti-nonsteroidal anti-inflammatory drugs - cefecon.

If you summarize everything that involves the treatment of such a disease as osteochondrosis, 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 treatment of all degenerative, dystrophic pathologies of the bone and muscular systems. The first thing these drugs do is to reduce the pain symptom, the second is a significant reduction in inflammation.
2. Drugs that are called myelorelaxants, as they are really able to effectively relieve muscle clamps and spasms.
3. Traction therapy - traction treatment. In this rather painful, but effective process, there is a gradual stretching of the tissues, muscles that surround the vertebrae, respectively, the intervertebral distance increases, approaching the norm.
4. Biogenic preparations, vascular agents that supply nutrition to dystrophic tissue sections, vitamins of group B - well restore the functional abilities of the deformed spine.
5. Soothing drugs that normalize the state of the nervous system. Perfectly relieves muscle tension and nerve endings acupuncture.
6. Physical therapy procedures - electrophoresis, phonophoresis, UHF, massages, mud procedures, balneotherapy, magnetic therapy.
7. Correction of the spine during the recovery period is carried out using manual therapy.
8. Osteochondrosis treatment involves, and with the help of constant exercise from the complex physical therapy.

In the most extreme cases, when the course of osteochondrosis enters the last stage, surgical intervention is also shown, which is performed in the zone of localization of the inflammatory process. Most often, a hernia is operated on, possibly removing the deformed bone tissue of the adjacent vertebrae.

[29], [30]

Where to treat osteochondrosis?

Independently treating virtually all diseases is a trend that is observed in almost all countries, but it is especially characteristic of countries of the post-Soviet space, where the traditional structure of health care is still undergoing changes. Entangled in innovations, often simply out of ignorance, many of us are trying to cope with pain in the back, neck or lower back with our own forces. It is possible to call this time the first, though not very effective, stage of treatment, since it is only necessary to treat osteochondrosis with the help of a doctor. The second stage, when independent actions do not lead to the desired, stable result, a person thinks about the visit to the doctor and the question arises before him, osteochondrosis - how to treat, how to treat, and, most importantly, where to treat osteochondrosis? First, you can contact the district therapist, who, most likely, will send the patient for examination - x-ray, blood tests, and will give direction to the neuropathologist. Secondly, you can immediately sign up to a neuropathologist, preferably before consulting at least undergo an X-ray examination of the entire spine. In no case should one go to extremes and look for an experienced massage therapist; any massage primarily involves a preliminary scan of the state of the body, especially the state of the spinal column. Vertebrologists and vertebral neurologists, doctors who specialize in diseases of the spine, also deal with the problem of osteochondrosis.

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

What does history say about osteochondrosis?

The etiology of osteochondrosis is still not clear; moreover, despite the clearly ancient origins of this disease, the spinal column was really seriously involved only in the 18th century. Since then, disputes and discussions about the true "enemy" provoking degenerative changes in intervertebral discs have not abated. Meanwhile, long ago, back in the days of Hippocrates, there were treatises on bone-healing, which indicates that the ancient Greeks also suffered from back pain. Hippocrates himself was also interested in spinal subjects so much that he conducted questionable medical experiments from a modern point of view: his students diligently tied the patient's arms and legs to a horizontal plane with his back up, stretching his limbs as much as possible. Then the great healer stood on the back of the suffering and began to walk on it. The founding father of medicine was sincerely convinced that such fixation, stretching and massage would restore the health of the spine, which, according to the ancient Greek sages, was the key to a happy lot of man. In fairness, we note that Hippocrates subsequently put on the backs of specially trained children, in order to avoid the risk of injury to an already sick spine by the weight of an adult. Since then, for centuries, in a row, their backs and possible osteochondrosis have not been cured - with kulaks, rubbings with healers, spells, acupuncture, cauterization, and even bites from bees and snakes. Of course, when there is no alternative, the patient agrees with the snake, although reliable statistics convincing us that it is the old way of treating osteochondrosis that is a panacea, doctors of past centuries have not collected. Some systematization of techniques that told how to treat osteochondrosis, began only from the end of the XVIIth century. At the same time, a terminology appeared that formalized applied areas in medicine, among which was bestiality. Two centuries later, it was divided into chiropractic and osteopathy. The first direction was purely practical, using force techniques, osteopaths were more theorists and researchers. At the junction of these sciences, manual therapy was gradually born, without which the treatment of osteochondrosis today is almost unthinkable. 

As for the term defining the disease “osteochondrosis”, a typical story has happened to osteochondrosis, which is characteristic of other ailments of unknown etiology. As soon as he was not called - and lumbar ischialgia, and radiculitis, and Schmorl's hernia, and sciatica, and spondylosis. It took the physicians almost a century to get rid of osteochondrosis and reach a common opinion. Today, all pathological disorders and changes in the spinal column are unconditionally called osteochondrosis, with one reservation: osteochondrosis is dystrophic disorders in the intervertebral disc without hernia (hernia) and without protrusion (disc degeneration without breaking the fibrous ring).