Osteochondrosis and regular back pain affect 60-80% of the population over 30 years of age. Untreated osteochondrosis reduces 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 manifest as back pain and what to do if signs of osteochondrosis appear in the spine.
What is spinal osteochondrosis?
Osteochondrosis is a chronic disease in which the intervertebral disc nucleus is gradually destroyed. Over time, damage to the intervertebral disc involves other spinal structures in the pathological process and leads to disorders of the musculoskeletal and nervous system. Osteochondrosis is also characterized as premature aging of the joint system or as a pathology due to damage to the vertebrae, for example, after an injury.
The development of osteochondrosis is influenced by several factors, which is why the researchers systematized the reasons that explain the origin of the disease:
- involutive - inflammatory processes and other spinal injuries lead to premature aging of the cartilage, for example, as a result of a sedentary lifestyle;
- degenerative - disorders of 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 that supply nutrients to the blood decreases.
The development of osteochondrosis is a cascade in which one pathological process initiates another. Thus, for example, due to age-related changes and the 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 that exit the spinal cord through natural openings in the vertebrae are disrupted. This leads to consequences on the nervous and musculoskeletal systems.
Symptoms of osteochondrosis of the spine
Osteochondrosis is a chronic disease with periodic exacerbations, caused by injuries, sedentary lifestyle, weight lifting, hypothermia and psycho-emotional stress. The most common and characteristic symptom of dystrophic disorders in the core of the intervertebral discs is regular low back pain in different segments: in the 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 in the form of spasm or vasodilation, muscle spasms, and weakened 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).
In addition, osteochondrosis is characterized by the following symptoms:
- tension and pain in neck and back muscles;
- curvature of the spine to the side, backwards or forwards;
- violation of sensitivity and nerve regulation: there is a crawling sensation on the skin, fluctuations of heat and cold on the skin of the back and extremities, numbness in the arms or legs;
- weakening of limb muscle strength;
- frequent urination - up to 10-12 times a day.
Where can osteochondrosis lead?
The pain in osteochondrosis is not just located in the back. They extend to the upper and lower extremities. Standing on:
- buttocks;
- back and side of thighs;
- leg and inner ankle;
- the back of the feet;
- toes;
- heels.
Also, the pain can spread to the arms 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 a survey, physical examination, and instrumental examination methods. Specific examination methods are determined in the consultation.
The doctor starts the diagnosis by taking an anamnesis: identifying the probable causes of back pain, establishing the location of the pain and its duration, identifying the presence of concomitant pathologies, for example, allergies, congenital diseases and drug intolerance. It then proceeds to inspection. Physical examination is done while standing or sitting. The doctor can detect the curvature of the spine, assess muscle strength and reflexes, and look at the color of the skin. To detail the disease picture, it is necessary to consult with related specialists: neurologist, neurosurgeon, oncologist, rheumatologist and phthisiatrician.
The neurologist makes the diagnosis of osteochondrosis if:
- regular back pain;
- increased pain when lifting weights, sneezing, coughing;
- numbness and joint pain;
- decreased range of motion in joints;
- muscle spasm;
- damage to nerve roots;
- changes in spinal radiography.
Do you need an X-ray of your spine?
Spinal radiography or spondylogram is one of the mandatory tests for osteochondrosis, with which it is possible to identify structural disorders of the spine. Spondylogram allows finding pathological changes, for example, thinning of the intervertebral disc. Typically 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 the identification of pathologies associated with osteochondrosis: disc herniation and decreased vertebral canal lumen, intervertebral disc protrusion into the vertebral canal and spinal cord compression.
Cervical spine osteochondrosis
In cervical osteochondrosis of the spine, two main symptoms appear - neck pain and neck pain. Cervicago is an acute painful cervical lumbago that arises from moving the head and due to muscle tension in the cervical spine. Neck pain is painful and severe in the neck. Paresthesias are added to neck pain - a violation of sensation in the form of numbness and a crawling sensation in the skin.
If the defeat of the neck intervertebral disc nuclei progresses, cervical radiculitis appears - painful sensations in the occiput. The pains are characterized by regularity, moreover, they occasionally intensify, especially when moving the head.
This triad - cervicalgia, cervical sciatica and cervicago - can be complicated by nocturnal dysesthesia of the hands syndrome, in which the sensitivity is perverted. For example, a hot object may feel cold with your fingers, but if you shake it with your hands, sensitivity is restored.
Thoracic spine osteochondrosis
For osteochondrosis of the thoracic spine, low back pain in the chest (dorsalgia) is the most characteristic. Chest pain is worse when moving the arms, sneezing, coughing, and lifting weights. Most of the time, the pain is in the waist. In addition, paresthesias often occur in the chest. Sometimes damage to the nuclei of the intervertebral discs can be disguised as diseases of Organs internal organs, eg gastritis or angina pectoris, as the pain may be located in the upper abdomen and heart.
How to know - heart pain or osteochondrosis?
Pectalgia syndrome is pain in the anterior chest wall that can resemble heart pain. Pectalgia can be a sign of osteochondrosis and heart problems.
However, pain in angina pectoris and heart attack differs from the pectalgia syndrome in osteochondrosis. The peculiarities of pain in angina pectoris and myocardial infarction are that they have a compressive character and spread to the left scapula, arm and jaw.
The 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 just subjective feelings. Therefore, to rule out cardiac pathology, you need to see a doctor and have an electrocardiogram, which will reveal a rhythm disturbance or signs of myocardial infarction.
If the pain starts to spread to the left shoulder, arm, jaw, is accompanied by a feeling of fear, is not eliminated by taking nitroglycerin, and lasts longer than 10-15 minutes, you need to call an ambulance.
Why is osteochondrosis of the lumbar spine dangerous?
With osteochondrosis of the lumbar spine, low back pain or low back pain occurs more frequently - regular low back pain and acute pain in the lower back. Due to constant pain, movement is limited: a person cannot bend down, exercise or lift a heavy object.
The lumbago can pass alone. However, they are subject to exacerbations, and each exacerbation indicates 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 lower back that radiates to the buttocks and thighs.
What is the difference between osteochondrosis and osteoarthritis?
Osteochondrosis and osteoarthritis (spondylogenous osteoarthritis) belong to the class of diseases of the musculoskeletal system. However, there is a fundamental difference between them: in osteochondrosis, the intervertebral disc nucleus is affected, and in osteoarthritis, the intervertebral joints. This makes a difference in symptoms and treatment.
In osteochondrosis, back pain is regular and painful, manifests itself calmly and increases movement, and in spondyloarthrosis, the onset of pain is associated with the extension and flexion of the spine. The pain syndrome in osteoarthritis of the spine is usually unilateral and cramping in character. In addition, spondylogenic osteoarthritis is characterized by morning stiffness, which lasts from 30 to 60 minutes.
What is the difference between osteochondrosis and radiculitis?
Radiculitis is an inflammation of the spinal cord roots, which is accompanied by pain along the affected nerves. They are actually two different diseases, but sciatica is a frequent complication of osteochondrosis, so it is often one of the symptoms of osteochondrosis.
sciatica symptoms
In osteochondrosis, radiculitis most often occurs in the cervical and lumbar spine. Sciatica presents with pain along the damaged nerve, sensory disturbances, and sometimes movement disturbances. Sciatica is characterized by the fact that the pain extends beyond the back and spreads to the hips, buttocks, leg, and foot.
VSD or cervical osteochondrosis?
Vegetovascular dystonia is a syndrome in which the autonomic nervous system is compromised. VSD is a functional disorder in which there are no structural changes in the spine or intervertebral disc nuclei.
Vegetovascular dystonia has a mental origin - it is a neurosis associated with intrapersonal conflicts or childhood trauma. Externally, VSD and osteochondrosis can be similar: headache, dizziness, pain in the anterior chest wall.
To distinguish the diseases, it is necessary to perform instrumental diagnoses - radiography of the cervical spine and other parts, computerized image and magnetic resonance. As a result of the diagnosis of 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 receive symptomatic treatment: sedatives, anxiolytics, hypnotics, restorative agents and also vitamins. The task of VSD psychotherapy is to teach the patient to regulate negative emotions and increase resistance to stress. Lifestyle is also adjusted: you need to balance the way you work and rest, exercise and stick to 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 prescription, the disease can be cured.
How to treat osteochondrosis at home?
It is not recommended to treat osteochondrosis at home. There are several reasons for this:
- at home it is not possible to accurately diagnose osteochondrosis, since back pain has different origins: neurogenic, vascular, viscerogenic (due to diseases of Organs internal organs) and psychogenic. That is, the person treats osteochondrosis, but in fact, back pain arises, for example, due to kidney diseases;
- it is impossible to objectively assess the effectiveness of treatment without control diagnoses;
- the patient cannot adequately choose a treatment for himself and folk remedies do not have an evidence base and therefore are most likely ineffective and may cause side effects.
At home, you can be treated for a case - only after consulting a doctor who will diagnose correctly, prescribe the appropriate treatment and periodically monitor the effectiveness of the therapy through X-rays, CT or MRI.
Treatment of spinal osteochondrosis
The 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 therapy, and lifestyle adjustments. Among medications, anti-inflammatory drugs and muscle relaxants are mainly prescribed to relieve pain and normalize muscle tone. In physiotherapy exercises, one of the main conditions for recovery is early activation, that is, 1 to 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 lifestyle, as being sedentary is one of the factors in the development of back pain and destruction of the intervertebral disc cores.
Surgical treatment is used when conservative therapy has been ineffective within 2-4 weeks and where there are pronounced structural changes in the spine. The type of operation required will be determined by the surgeon after consulting a neuropathologist and studying the survey data. For example, in the treatment of osteochondrosis of the cervical spine, methods are used that relieve the spinal cord of pressure on 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 muscles in the arm or leg, unpleasant tactile sensations in the skin and numbness, consult a neurologist for advice.