Osteochondrosis and regular back pain affect 60-80% of the population over 30 years of age. Untreated osteochondrosis reduces the quality of life and can lead to disability and disability, so it is important to recognize it in the early stages of development and seek medical help.
In the article, we will talk about osteochondrosis, its symptoms and diagnostic methods, as well as how to distinguish osteochondrosis from other diseases that are manifested by back pain and what to do if signs of osteochondrosis of the spine appear.
What is spinal osteochondrosis?
Osteochondrosis is a chronic disease in which the nucleus of the intervertebral disc is gradually destroyed. Over time, damage to the intervertebral disc involves other structures of the spine in the pathological process and leads to disorders of the musculoskeletal and nervous system. Osteochondrosis is also characterized by premature aging of the joint apparatus or as a pathology as a result of damage to the vertebrae, for example, after injury.
The development of osteochondrosis is influenced by many factors, so the researchers systematized the reasons that explain the origin of the disease:
- involutive - inflammatory processes and other injuries of the spine lead to premature aging of cartilage, for example, as a result of a sedentary lifestyle;
- degenerative - disorders in the intervertebral discs occur as a result of metabolic failure, for example, as a result of an unbalanced diet and alcohol abuse;
- dysmetabolic - osteochondrosis occurs as a result of malnutrition in the intervertebral cartilage due to the fact that with age, the number of blood vessels supplying nutrients to the blood decreases in them.
The development of osteochondrosis is a cascade in which one pathological process initiates another. So, for example, due to age-related changes and a decrease in the number of vessels in the disc, nutrition is disturbed, which leads to a failure in biochemical processes and damage to the intervertebral disc.
As degenerative and dystrophic changes develop in the spine, muscle tone and the work of the nerve roots exiting the spinal cord through natural openings in the vertebrae are disturbed. This leads to consequences for the nervous and musculoskeletal systems.
Symptoms of osteochondrosis of the spine.
Osteochondrosis is a chronic disease with periodic exacerbations caused by injury, sedentary lifestyle, weight lifting, hypothermia, and psycho-emotional stress. The most common and characteristic symptom of dystrophic disorders in the nucleus of the intervertebral discs is regular low back pain in different segments: in the neck, chest and lower back.
There are two types of symptoms of osteochondrosis: reflex and compression. Reflex symptoms develop due to irritation of the spinal cord roots. They manifest themselves in the form of spasm or vasodilation, muscle spasms, weakening of muscle strength. Compression symptoms develop due to compression (most often formed by a herniated spine) of the nerves and manifest as loss of sensation in the affected segment (in the neck, arms, or lower back).
Also, osteochondrosis is characterized by the following symptoms:
- tension and pain in the muscles of the neck and back;
- curvature of the spine to the side, backwards or forwards;
- violation of sensitivity and nervous regulation - there is a tingling sensation on the skin, hot and cold oscillations on the skin of the back and extremities, numbness of the arms or legs;
- weakening of the muscular strength of the extremities;
- frequent urination - up to 10-12 times a day.
Where can osteochondrosis give?
Pain in osteochondrosis is localized not only in the back. They extend to the upper and lower extremities. In feet about:
- buttocks;
- back and side of the thighs;
- lower leg and inner ankle;
- the back of the feet;
- toes;
- high heel shoes.
Also, the pain can spread to the arms to:
- deltoid muscle;
- the outer edge of the hand, up to the fingers;
- the back of the hand;
- three middle fingers;
- ring finger and little finger (rare).
How is osteochondrosis diagnosed?
The diagnosis of osteochondrosis is based on a survey, a physical examination, and instrumental examination methods. Specific examination methods are determined in consultation.
The doctor begins the diagnosis by taking an anamnesis: identifies the probable causes of back pain, establishes the localization of pain and its duration, identifies the presence of concomitant pathologies, for example, allergies, congenital diseases and intolerance to drugs. Then proceed to the inspection. The physical exam is done standing or sitting. The doctor can detect the curvature of the spine, assess muscle strength and reflexes, and observe the color of the skin. To detail the picture of the disease, consultation with related specialists is necessary: neurologist, neurosurgeon, oncologist, rheumatologist and phthisiatrist.
The neurologist makes the diagnosis of osteochondrosis if:
- regular back pain;
- increased pain when lifting weights, sneezing, coughing;
- numbness and pain in the joints;
- decreased range of motion in the joints;
- muscle spasm;
- damage to nerve roots;
- changes in the x-ray of the spine.
Do you need an X-ray of the spine?
X-ray of the spine or spondylography is one of the mandatory examinations for osteochondrosis, with the help of which it is possible to identify structural disorders of the spine. Spondylography allows you to find pathological changes, for example, thinning of the intervertebral disc. Typically, for the cervical, thoracic, and lumbosacral spine, radiographs are done in two (and sometimes three) views to obtain more detail.
Computed tomography and magnetic resonance imaging make it possible to identify pathologies associated with osteochondrosis: herniated disc and decreased lumen of the spinal canal, protrusion of the intervertebral disc in the spinal canal, and compression of the spinal cord.
Osteochondrosis of the cervical spine.
With cervical osteochondrosis of the spine, two main symptoms appear: cervicago and cervicalgia. The cervicago is an acute and painful cervical lumbago that appears when moving the head and due to the muscular tension in the cervical spine. Neck pain is severe and painful pain in the neck. Paresthesias are added to cervicalgia, a violation of sensitivity in the form of numbness and a feeling of dragging on the skin.
If the defeat of the nuclei of the intervertebral discs of the neck progresses, cervical radiculitis appears, painful sensations in the occiput. The pains are characterized by regularity, in addition, they sometimes intensify, especially when moving the head.
This triad, cervicalgia, cervical sciatica and cervicago, can be complicated by the syndrome of nocturnal dysesthesia of the hands, in which sensitivity is perverted. For example, a hot object may feel cold with your fingers, but if you shake it with your hands, sensitivity returns.
Osteochondrosis of the thoracic spine.
For osteochondrosis of the thoracic spine, the most characteristic is painful lumbago in the chest (back pain). Chest pain worsens when moving your arms, sneezing, coughing, and lifting weights. Most often, the pain is in the waist. Also, paresthesias often occur in the chest. Sometimes damage to the nuclei of the intervertebral discs can be disguised as diseases of the internal organs, for example, gastritis or angina pectoris, since the pain can be localized in the upper abdomen and in the heart.
How to know: heart pain or osteochondrosis?
Pectalgic syndrome is pain in the anterior chest wall that can resemble pain in the heart. Pectalgia can be a sign of osteochondrosis and heart problems.
However, the pain in angina pectoris and heart attack differs from pecttalgic syndrome in osteochondrosis. The peculiarities of pain in angina pectoris and myocardial infarction are that they are compressive in nature and extend to the left scapula, arm, and jaw.
Pectalgic syndrome in osteochondrosis does not extend beyond the limits of the anterior chest wall, does not extend to the arm and scapula, and is not accompanied by fear of death. However, these are only subjective feelings. Therefore, to exclude a cardiac pathology, you should consult a doctor and conduct an electrocardiogram, which will reveal a disturbance of rhythm or signs of myocardial infarction.
If the pain begins to spread to the left shoulder blade, arm, jaw, is accompanied by a feeling of fear, is not eliminated by taking nitroglycerin and lasts more than 10-15 minutes, you need to call an ambulance.
Why is osteochondrosis of the lumbar spine dangerous?
With osteochondrosis of the lumbar spine, lumbago or lumbodynia occurs most often - regular lumbago and pain in the lumbar region. Due to constant pain, movements are limited - a person cannot bend over, exercise, or lift a heavy object.
Low back pain can pass on its own. However, they are prone to exacerbations and each exacerbation indicates a further displacement of the intervertebral disc into the spinal canal. If the destruction of the intervertebral disc progresses, lumbosacral radiculitis forms, accompanied by pain in the lumbar area, which radiates to the buttocks and thighs.
What is the difference between osteochondrosis and osteoarthritis?
Osteochondrosis and osteoarthritis (spondylogenic osteoarthritis) belong to the class of diseases of the musculoskeletal system. However, there is a key difference between them: with osteochondrosis, the nucleus of the intervertebral disc is affected, and with osteoarthritis, the intervertebral joints. This makes a difference in symptoms and treatment.
In osteochondrosis, the back pain is regular and painful, manifested in calm and increased movement, and in spondyloarthrosis, the appearance of pain is associated with extension and flexion of the spine. Usually the pain syndrome in osteoarthritis of the spine is unilateral and has a crampy character. Also, spondylogenic osteoarthritis is characterized by morning stiffness, lasting 30 to 60 minutes.
What is the difference between osteochondrosis and radiculitis?
Radiculitis is an inflammation of the roots of the spinal cord, which is accompanied by pain along the affected nerves. In fact, these are two different diseases, but sciatica is a common complication of osteochondrosis, which is why it is usually one of the symptoms of osteochondrosis.
Symptoms of sciatica.
With osteochondrosis, radiculitis occurs most often in the cervical and lumbar spine. Sciatica is manifested by pain along the damaged nerve, sensory disturbances, and sometimes movement disorders. Sciatica is characterized by the fact that the pain extends beyond the back and spreads to the hips, buttocks, calf, and foot.
VSD or cervical osteochondrosis?
Vegetovascular dystonia is a syndrome in which the autonomic nervous system is disturbed. VSD is a functional disorder in which there are no structural changes in either the spinal column or the nuclei of the intervertebral discs.
Vegetovascular dystonia has a mental origin: it is a neurosis that is associated with intrapersonal conflicts or childhood trauma. Externally, VSD and osteochondrosis can be similar to each other: headaches, dizziness, pain in the anterior chest wall.
To distinguish diseases, you need to conduct instrumental diagnostics: radiography of the cervical spine and other parts, magnetic and computerized resonance imaging. As a result of the diagnosis with VSD, there will be no organic changes, unlike osteochondrosis.
Treatment of vegetative-vascular dystonia
Vegetovascular dystonia is treated with medication, psychotherapy, and lifestyle adjustments. Patients are prescribed symptomatic treatment: sedatives, anxiolytics, hypnotics, restorative agents, and vitamins. The task of VSD psychotherapy is to teach the patient to regulate negative emotions and increase resistance to stress. The lifestyle is also adjusted: it is necessary to balance the mode of work and rest, exercise and follow a balanced diet.
Is osteochondrosis treated or not?
Osteochondrosis can be cured. The goal of treatment is to eliminate back pain and stiffness, restore muscle tone, prevent or stop neurological complications, and improve a person's standard of living. If you follow the doctor's prescriptions, the disease can be cured.
How to treat osteochondrosis at home?
Treating osteochondrosis at home is not recommended. There are many reasons for this:
- at home it is impossible to accurately diagnose osteochondrosis, since back pain has different origins: neurogenic, vascular, viscerogenic (due to diseases of internal organs) and psychogenic. That is, a person treats osteochondrosis, but in fact back pain arose, for example, due to kidney diseases;
- it is impossible to objectively evaluate the effectiveness of treatment without control diagnoses;
- the patient cannot properly choose a treatment for himself and home remedies do not have an evidence base and are therefore most likely ineffective and may lead to side effects.
At home, you can be treated in one case, only after consulting a doctor who will correctly diagnose, prescribe the appropriate treatment and periodically monitor the effectiveness of therapy by X-ray, CT or MRI.
Treatment of osteochondrosis of the spine.
Treatment of osteochondrosis is conservative and surgical. Which method will be the main one depends on the stage of the disease and the neglect of the musculoskeletal system.
Conservative treatment includes medications, exercise therapy, and lifestyle adjustments. Of the medications, anti-inflammatories and muscle relaxants are prescribed primarily to relieve pain and normalize muscle tone. In physiotherapy exercises, one of the main conditions for recovery is early activation, that is, 1-3 days after the pain is eliminated, it is necessary to walk, run, practice in the pool or ride a bicycle. It is also important to change your lifestyle to an active one, since being sedentary is one of the factors in the development of back pain and destruction of the nuclei of the intervertebral discs.
Surgical treatment is used when conservative therapy was ineffective within 2-4 weeks, and in the case of pronounced structural changes in the spine. The surgeon will determine what type of operation is needed after consulting a neuropathologist and studying the research data. For example, in the treatment of osteochondrosis of the cervical spine, methods that relieve the spinal cord from pressure from the side of the vertebrae or hernia (discectomy and decompression) are used.
If you experience back pain, accompanied by low back pain in the spine or neck, chest pain, weakened muscles in the arm or leg, unpleasant touch sensations on the skin, and numbness, consult a neurologist.