Osteochondrosis and regular back pain affect 60-80% of the population older than 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 manifested by back pain and what to do if signs of osteochondrosis of the spine appear.
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 articular apparatus or as a pathology resulting from damage to the spine, for example, after injury.
The development of osteochondrosis is influenced by many factors, so researchers have 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 of the intervertebral discs occur as a result of metabolic failure, 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 is triggered by another. Thus, for example, due to age-related changes and a decrease in the number of vessels in the disc, nutrition is disrupted, leading to a breakdown in biochemical processes and damage to the intervertebral disc.
As degenerative and dystrophic changes develop in the spine, muscle tone and the work of nerve roots that exit the spinal cord through the natural openings in the spine are disrupted. This leads to consequences on the nervous and musculoskeletal system.
Symptoms of osteochondrosis of the spine
Osteochondrosis is a chronic disease with periodic exacerbations, caused by injuries, sedentary lifestyle, heavy lifting, hypothermia and psycho-emotional stress. The most common and characteristic symptom of dystrophic disorders in the nucleus of the intervertebral discs is regular painful pain in the back 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 cramps or vasodilation, muscle twitching, weakening of muscle strength. Symptoms of compression occur due to compression (usually formed by a herniated spine) of the nerves and manifest as loss of sensation in the affected segment (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, back or forward;
- violation of sensitivity and nervous regulation: there is a feeling of crawling on the skin, rocking heat and cold on the skin of the back and extremities, numbness of the arms or legs;
- weakening of limb muscle strength;
- frequent urination - up to 10-12 times a day.
Where can osteochondrosis give?
The pain of osteochondrosis is localized not only in the back. They extend to the upper and lower extremities. In the footsteps of:
- buttocks;
- posterior and lateral thighs;
- lower leg and inner ankle;
- back of foot;
- fingers;
- pete.
Also, the pain can spread to the hands at:
- deltoid muscle;
- the outer edge of the hand, all the way to the fingers;
- back of hand;
- three middle fingers;
- little 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 methods of examination are determined at the consultations.
The doctor begins the diagnosis by taking a medical history: identifies the probable causes of back pain, determines the location of pain and their duration, identifies the presence of concomitant pathologies, for example, allergies, congenital diseases and drug intolerance. Then he goes on to inspect. A 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 skin color. For a detailed picture of the disease, it is necessary to consult with related specialists: neurologist, neurosurgeon, oncologist, rheumatologist and phthisiologist.
A neurologist diagnoses "osteochondrosis" if:
- regular back pain;
- increased pain when lifting weights, sneezing, coughing;
- numbness and pain in the joints;
- reduced range of motion in the joints;
- muscle spasm;
- nerve root damage;
- changes on X-ray of the spine.
Do I need an X-ray of my spine?
X-ray or spondylography of the spine is one of the mandatory examinations for osteochondrosis, which can be used to determine structural abnormalities of the spine. Spondylography allows you to find pathological changes, for example, thinning of the intervertebral disc. Usually for the cervical, thoracic, and lumbosacral spine, X-rays are taken in two (and sometimes three) projections for more detail.
Computed tomography and magnetic resonance imaging allow the identification of pathologies associated with osteochondrosis: disc herniation and reduction of the spinal canal lumen, protrusion of the intervertebral disc into the spinal canal and spinal cord compression.
Osteochondrosis of the cervical spine
In cervical osteochondrosis of the spine, two main symptoms occur - cervicago and cervicalgia. Cervicago is an acute painful cervical lumbago that occurs when moving the head 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 numbness and a feeling of crawling on the skin.
If the defeat of the nucleus of the intervertebral discs of the neck progresses, cervical radiculitis appears - painful sensations in the back of the head. The pain is characterized by regularity, in addition, it occasionally intensifies, especially when moving the head.
This triad - cervicalgia, cervical sciatica and cervicago - can be complicated by nocturnal hand dysaesthesia syndrome, in which sensitivity is distorted. For example, a warm object may be cold with your fingers, but if you shake it with your hands, the sensitivity returns.
Osteochondrosis of the thoracic spine
Osteochondrosis of the thoracic spine is most characterized by painful lumbago in the chest (dorsalgia). Chest pain is stronger when you move your arms, sneeze, cough and lift weights. Most often, the pain is a girdle. Also, paresthesias often occur in the chest. Sometimes damage to the nuclei of intervertebral discs can be disguised as diseases of internal organs, for example, gastritis or angina pectoris, because the pain can be localized in the upper abdomen and in the heart.
How to say - heart pain or osteochondrosis?
Pectalgic syndrome is pain in the front wall of the chest that can resemble heart pain. Pectalgia can be a sign of both osteochondrosis and heart problems.
However, the pain of angina pectoris and heart attack is different from the pectal syndrome in osteochondrosis. The peculiarities of pain in angina pectoris and myocardial infarction are that they are of a compressive nature and spread to the left shoulder blade, arm and jaw.
The pectal syndrome in osteochondrosis does not exceed the boundaries of the front wall of the chest, does not extend to 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, it is necessary to consult a doctor and do electrocardiography, which will detect arrhythmia 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 relieved by taking trinitroglycerin and lasts more than 10-15 minutes, it is necessary to call an ambulance.
Why is osteochondrosis of the lumbar spine dangerous?
In osteochondrosis of the lumbar spine, lumbago or lumbodia most often occurs - regular lumbago and pain in the lumbar region. Due to the constant pain, the movements are limited: the person cannot bend down, do exercises or lift a heavy object.
Lumbago can pass on its own. However, they are prone to exacerbations, and any deterioration indicates an additional shift of the intervertebral disc into the spinal canal. If the destruction of the intervertebral disc progresses, lumbosacral radiculitis develops, followed by pain in the lower back, 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: 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, it is manifested by calmness and increased mobility, and in spondyloarthritis, 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 convulsive character. Also, 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 roots of the spinal cord, which is accompanied by pain along the affected nerves. In fact, they are two different diseases, but sciatica is a common complication of osteochondrosis, so 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 disturbances, and sometimes movement disorders. Sciatica is characterized by the fact that the pain goes beyond the back and spreads to the hips, buttocks, lower legs and feet.
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 intervertebral discs.
Vegetovascular dystonia has a mental origin - it is a neurosis associated with intrapersonal conflicts or childhood trauma. Externally, VSD and osteochondrosis can be similar to each other: headache, dizziness, pain in the front wall of the chest.
To differentiate diseases, it is necessary to perform instrumental diagnostics - X-ray of the cervical spine and other parts, computer and magnetic resonance imaging. As a result of the diagnosis of VSD, there will be no organic changes, unlike osteochondrosis.
Treatment of vegetovascular dystonia
Vegetovascular dystonia is treated with medication, psychotherapy, and lifestyle adjustments. Patients are prescribed symptomatic treatment: sedatives, anti-anxiety drugs, hypnotics, restorative agents, as well as vitamins. The task of psychotherapy with VSD is to teach the patient to regulate negative emotions and increase resistance to stress. Also, the lifestyle is adjusted: it is necessary to balance the way 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, because 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 is caused, for example, by kidney disease;
- it is impossible to objectively assess the effectiveness of treatment without control diagnostics;
- the patient cannot adequately choose the treatment for himself, and folk remedies do not have a base of evidence, and therefore are most likely ineffective and can cause side effects.
You can be treated at home in one case - only after consulting a doctor who will correctly diagnose, prescribe adequate treatment and periodically monitor the effectiveness of therapy using X-rays, 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 therapy, and lifestyle adjustments. Of the drugs, 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, ie 1-3 days after the pain is eliminated, it is necessary to walk, run, exercise in the pool or ride a bike. It is also important to change the lifestyle to active, because sedentary is one of the factors in the development of back pain and destruction of the intervertebral disc nuclei.
Surgical treatment is applied when conservative therapy was ineffective within 2-4 weeks, and in cases when there are pronounced structural changes in the spine. What kind of surgery is needed will be determined by the surgeon after consulting a neuropathologist and studying the research data. For example, in the treatment of osteochondrosis of the cervical spine, methods are used that relieve the spinal cord from pressure from the vertebrae or hernia (discectomy and decompression).
If you experience back pain, accompanied by lumbago in the spine or neck, painful chest pain, weakened muscles in the arm or leg, uncomfortable tactile sensations on the skin and numbness, consult a neurologist for advice.