Osteochondrosis and regular back pain affect 60-80% of the population over 30 years. 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 this article we will talk about osteochondrosis, its symptoms and diagnostic methods, as well as how to distinguish osteochondrosis from other diseases that manifest themselves with back pain and what to do if there are signs of osteochondrosis of the spine.
What is osteochondrosis of the spine?
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 system and nervous system. Osteochondrosis is also characterized as premature aging of the joint apparatus or as a pathology resulting from damage to the vertebrae, for example after injury.
The development of osteochondrosis is influenced by many factors, so researchers systematize the causes 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 of the intervertebral discs occur as a result of metabolic insufficiency, for example, as a result of 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 in them decreases, which supply the blood with nutrients.
The development of osteochondrosis is a cascade in which one pathological process begins another. For example, due to age-related changes and a decrease in the number of vessels in the disc, nutrition is disrupted, leading to failure in biochemical processes and damage to the intervertebral disc.
As degenerative and dystrophic changes develop in the spine, the muscle tone and the work of the nerve roots, which come out of the spinal cord through the natural openings in the vertebrae, are disturbed. This leads to consequences of the nervous and musculoskeletal system.
Symptoms of osteochondrosis of the spine
Osteochondrosis is a chronic disease with periodic exacerbations that are provoked by injuries, 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 back pain in various segments: neck, chest and lower back.
There are two types of osteochondrosis symptoms: 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 twitching, weakening of muscle strength. Symptoms of compression develop due to compression (usually caused by a herniated spine) of the nerves and manifest as a loss of sensitivity in the affected segment (neck, arms or lower back).
In addition, osteochondrosis is characterized by the following symptoms:
- tension and soreness in the muscles of the neck and back;
- curvature of the spine sideways, backwards or forwards;
- disturbance of sensitivity and nervous regulation: there is a feeling of crawling on the skin, swings of heat and cold on the skin of the back and limbs, tingling in the hands or feet;
- weakening of the muscular strength of the limbs;
- frequent urination - up to 10-12 times a day.
Where can osteochondrosis occur?
The pain of osteochondrosis is localized not only in the back. They extend to the upper and lower limbs. At the feet of:
- rear parts;
- the back and sides of the thighs;
- lower leg and inner ankle;
- the back of the legs;
- toes;
- high-heels.
Also, the pain can spread to the hands to:
- deltoid muscle;
- the outer edge of the hand, down 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 examination, physical examination and instrumental methods of examination. The specific research methods are determined during the consultation.
The doctor begins the diagnosis by taking a medical history: he identifies the probable causes of back pain, determines the location of pain and their duration, identifies the presence of concomitant pathologies, such as allergies, congenital diseases and drug intolerance. Then proceed to the inspection. The physical examination is performed in an upright or sitting position. The doctor can detect a curvature of the spine, assess muscle strength and reflexes, and examine skin color. To detail the picture of the disease requires consultation with related specialists: neurologist, neurosurgeon, oncologist, rheumatologist and phthisiologist.
The neurologist diagnoses "osteochondrosis" if:
- regular back pain;
- increased pain when lifting weights, sneezing, coughing;
- tingling and joint pain;
- reduced range of motion in the joints;
- muscle spasm;
- nerve root damage;
- changes in the X-ray of the spine.
Do I need an X-ray of my spine?
Spinal radiography or spondylography is one of the mandatory examinations for osteochondrosis, with which it is possible to identify structural abnormalities of the spine. Spondylography allows you to detect pathological changes, such as thinning of the intervertebral disc. Usually for the cervical, thoracic and lumbosacral spine, X-rays are taken in two (and sometimes three) projections for greater detail.
Computed tomography and magnetic resonance imaging allow to identify pathologies associated with osteochondrosis: disc herniation and reduction of the lumen of the spinal canal, protrusion of the intervertebral disc in the spinal canal and spinal cord compression.
Osteochondrosis of the cervical spine
In cervical osteochondrosis of the spine, two main symptoms appear - cervicagogue and cervicalgia. Cervicago is an acute painful cervical lumbago that occurs when the head moves and due to muscle tension in the cervical spine. Cervical pain is a painful and severe pain in the neck. Paresthesias are added to cervical pain - a violation of sensitivity in the form of tingling and a feeling of crawling on the skin.
If the damage to the nuclei of the intervertebral discs of the neck progresses, cervical radiculitis appears - painful sensations in the back. The pain is characterized by regularity, in addition, from time to time intensify, especially when moving the head.
This triad — cervicalgia, cervical sciatica, and cervicagogue — can be complicated by nocturnal hand dysesthesia syndrome, in which sensitivity is distorted. For example, a warm object may feel cold with your fingers, but if you shake it with your hands, sensitivity is restored.
Chest osteochondrosis
Chest osteochondrosis is most characterized by painful lumbago in the chest (dorsalgia). Chest pain is more severe when moving the arms, sneezing, coughing and lifting weights. Most often the pain is lumbar. Also, paresthesias in the chest often occur. Sometimes damage to the nuclei of the intervertebral discs can be disguised as diseases of the internal organs, such as gastritis or angina pectoris, as the pain can be localized in the upper abdomen and heart.
How do I know - heart pain or osteochondrosis?
Pectal syndrome is pain in the front chest wall that may resemble heart pain. Pectalgia can be a sign of both osteochondrosis and heart problems.
However, the pain of angina pectoris and heart attack differs from the pectal syndrome in osteochondrosis. The peculiarities of the pain in angina pectoris and myocardial infarction are that they have a compressive nature and spread to the left shoulder blade, arm and jaw.
The pectal syndrome in osteochondrosis does not extend beyond the anterior chest wall, extends into the arm and shoulder blade, and is not accompanied by fear of death. However, these are only subjective feelings. Therefore, to rule out cardiac pathology, you should consult a doctor and do electrocardiography, which will reveal arrhythmia or signs of myocardial infarction.
If the pain begins to spread to the left shoulder, arm, jaw, accompanied by a feeling of fear, is not eliminated by taking trinitroglycerin and lasts more than 10-15 minutes, you need to call an ambulance.
Why is osteochondrosis of the lumbar spine dangerous?
In osteochondrosis of the lumbar spine, lumbago or lumbago most often occurs - 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.
Lumbago can pass on its own. However, they are prone to exacerbations and each exacerbation indicates an additional displacement of the intervertebral disc in the spinal canal. If the destruction of the intervertebral disc progresses, lumbosacral radiculitis forms, accompanied by low back pain that 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: in osteochondrosis the nucleus of the intervertebral disc is affected, and in osteoarthritis - the intervertebral joints. This makes a difference in symptoms and treatment.
In osteochondrosis, back pain is regular and painful, manifested in calm and increased movement, and in spondyloarthritis, the appearance of pain is associated with unfolding and folding of the spine. Usually, the pain syndrome in osteoarthritis of the spine is unilateral and has a grasping character. Also, spondylogenic osteoarthritis is characterized by morning stiffness that lasts 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 often a complication of osteochondrosis, which is why it is often one of the symptoms of osteochondrosis.
Symptoms of sciatica
In osteochondrosis, radiculitis most often occurs in the cervical and lumbar spine. Sciatica is manifested by pain along the damaged nerve, sensory disorders and sometimes motor disorders. Sciatica is characterized by the pain going beyond the back and spreading to the thighs, buttocks, lower legs and feet.
VSD or cervical osteochondrosis?
Vegetative dystonia is a syndrome in which the autonomic nervous system is impaired. VSD is a functional disorder in which there are no structural changes in either the spine or the nuclei of the intervertebral discs.
Vegetative dystonia has a mental origin - it is a neurosis that is associated with interpersonal conflicts or trauma in childhood. Externally, VSD and osteochondrosis may be similar: headache, dizziness, pain in the anterior chest wall.
To distinguish diseases, you need to perform instrumental diagnostics - X-ray of the cervical spine and other parts, computer and magnetic resonance imaging. As a result of diagnosis with VSD there will be no organic changes, unlike osteochondrosis.
Treatment of vegetative-vascular dystonia
Vegetative dystonia is treated with medication, psychotherapy and lifestyle adjustments. Patients are prescribed symptomatic treatment: sedatives, anti-anxiety, hypnotics, restoratives, and vitamins. The task of psychotherapy with VSD is to teach the patient to regulate negative emotions and increase resilience to stress. Also, the lifestyle is adjusted: you need to balance the regime of work and rest, exercise and adhere to a balanced diet.
Is osteochondrosis treatable 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 instructions, the disease can be cured.
How to treat osteochondrosis at home?
Treatment of osteochondrosis at home is not recommended. There are several reasons for this:
- at home it is impossible to accurately diagnose osteochondrosis, as 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 has occurred, for example, due to kidney disease;
- it is impossible to objectively assess the effectiveness of treatment without control diagnosis;
- the patient cannot choose an adequate treatment for himself, and folk remedies have no evidence base and are therefore most likely ineffective and can give side effects.
At home you can be treated in one case - only after consultation with a doctor who will make the correct diagnosis, prescribe adequate treatment and periodically monitor the effectiveness of therapy using 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 medication, exercise and lifestyle adjustments. Of the drugs prescribed mainly anti-inflammatory drugs and muscle relaxants to relieve pain and normalize muscle tone. In physiotherapy exercises, one of the main conditions for recovery is early activation, ie 1-3 days after the removal of pain you should walk, run, play sports in the pool or ride a bike. It is also important to change your lifestyle to active, as sedentary is one of the factors for the development of back pain and destruction of the nuclei of the intervertebral discs.
Surgical treatment is used when conservative therapy is ineffective within 2-4 weeks and in case of pronounced structural changes in the spine. What kind of surgery is needed will be determined by the surgeon after consultation with a neurologist and examination of the study data. For example, in the treatment of osteochondrosis of the cervical spine, methods are used that relieve the spinal cord from pressure from the side of the vertebrae or hernia (discectomy and decompression).
If you experience back pain accompanied by lumbago in the spine or neck, chest pain, weakened arm or leg muscles, unpleasant tactile sensations in the skin and numbness, consult a neurologist for advice.