Osteochondrosis and regular back pain affect 60-80% of the population over 30 years old. 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 spinal osteochondrosis 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 spinal structures 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 as a result of vertebral damage, for example, after an 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 spinal cord injuries lead to premature cartilage aging, 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 in them, which supply blood with nutrients, decreases.
The development of osteochondrosis is a cascade in which one pathological process begins another. Thus, for example, due to age-related changes and a decrease in the number of vessels in the disc, food is disturbed, which leads to a failure in biochemical processes and damage to the intervertebral disc.
Since degenerative and dystrophic changes develop in the spine, muscle tone and the work of nerve roots emerging from the spinal cord through natural openings in the vertebrae are interrupted. This leads to consequences from the nervous and musculoskeletal system.
Symptoms of osteochondrosis of the spine
Osteochondrosis is a chronic disease with periodic exacerbations, which are caused by injuries, a sedentary lifestyle, weight lifting, hypothermia and psycho-emotional stress. The most common and characteristic symptom for dystrophic disorders in the nucleus of intervertebral discs is regular back pain in different 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 are manifested in the form of spasm or vasodilation, muscle tightening, weakening of muscle strength. Compression symptoms develop due to compression (usually formed by a spinal hernia) of the nerves and manifest as loss of sensation in the affected segment (neck, arms, or lower back).
Osteochondrosis is also characterized by the following symptoms:
- tension and pain in the muscles of the neck and back;
- curvature of the spine on the side, back or front;
- violation of sensitivity and nervous regulation: there is a feeling of crawling on the skin, shaking of 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 in osteochondrosis is localized not only in the spine. They extend to the upper and lower extremities. Walking to:
- buttocks;
- back and sides of thighs;
- the lower leg and the inside of the ankle;
- the back of the legs;
- toes;
- takat.
Also, the pain can spread to the arms in:
- 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 study, physical examination and instrumental examination methods. Specific examination methods are defined in consultation.
The doctor begins the diagnosis by taking the anamnesis: he identifies the possible causes of back pain, determines the localization of pain and their duration, identifies the presence of concomitant pathologies, for example, allergies, congenital diseases and drug intolerance. It then passes the inspection. Physical examination is done standing or sitting. The doctor can detect spinal curvature, assess muscle strength and reflexes, and look at 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 aches;
- increased pain during weight lifting, sneezing, coughing;
- numbness and joint pain;
- reducing the range of motion in the joints;
- muscle spasms;
- nerve root damage;
- changes in the x-ray of the spine.
Do I need a spine radiograph?
Spinal radiography or spondylography is one of the mandatory examinations for osteochondrosis, with which structural abnormalities of the spine can be identified. Spondylography allows you to find pathological changes, for example, thinning of the intervertebral disc. Usually for the cervical, thoracic, and lumbosacral spines, X-rays are done in two (and sometimes three) projections for greater detail.
Computed tomography and magnetic resonance imaging make it possible to identify pathologies associated with osteochondrosis: disc herniation and reduction of the lumen of the spinal canal, lengthening 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 cervical pain. Cervicago is an acute painful lumbago of the cervix that appears when the head moves and due to muscle tension in the cervical spine. Cervicalgia is severe pain and soreness in the neck. Paresthesia is added to cervical pain - a violation of sensitivity in the form of numbness and a feeling of crawling on the skin.
If the loss of the cervical intervertebral disc nuclei progresses, cervical radiculitis appears - painful sensation in the occiput. The pains are characterized by regularity, in addition, they occasionally intensify, especially when you move your head.
This triad - cervicalgia, cervical sciatica, and cervicago - 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, the sensitivity returns.
Thoracic spine osteochondrosis
For thoracic spine osteochondrosis, painful lumbago in the chest (dorsalgia) is more characteristic. Chest pain is worse when you move your arms, sneeze, cough and lift weights. Most often, the pain is of the generation. Also, paresthesias often appear 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, as the pain can be localized in the upper abdomen and in the heart.
How to distinguish - heart pain or osteochondrosis?
Pectalgia syndrome is pain in the anterior chest wall that may resemble heart pain. Pectalgia can be a sign of osteochondrosis and heart problems.
However, pain in angina pectoris and heart attack differs from pectalgia syndrome to osteochondrosis. The peculiarities of pain in angina pectoris and myocardial infarction are that they have a compressive character and spread to the left shoulder, arm and jaw.
Pectalgia syndrome in osteochondrosis does not extend beyond the boundaries of the anterior chest wall, does not extend to the arm and scapula, and is not associated with fear of death. However, these are only subjective feelings. Therefore, to rule out cardiac pathology, you should consult a doctor and do an electrocardiogram, which will detect a rhythm disorder or signs of myocardial infarction.
If the pain begins to spread to the left shoulder, arm, jaw, is accompanied by a feeling of fear, is not eliminated by taking trinitroglycerin and lasts more than 10-15 minutes, you should call an ambulance.
Why is lumbar spine osteochondrosis dangerous?
With osteochondrosis of the spine, most often occurs lumbago or lumbodynia - regular lumbago and pain in the lumbar region. Due to the constant pain, the movements are limited: a person cannot bend, do exercises or lift a heavy object.
Lumbago can cross on its own. However, they are prone to irritation, and any deterioration indicates an additional displacement of the intervertebral disc in the spinal canal. If destruction of the intervertebral disc progresses, lumbosacral radiculitis forms, accompanied 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 major difference between them: osteochondrosis affects the nucleus of the intervertebral disc and osteoarthritis affects the intervertebral joints. This makes the difference in symptoms and treatment.
In osteochondrosis the back pain is regular and painful, manifested in calmness and increase in movement, and in spondyloarthritis the appearance of pain is accompanied by elongation and flexion of the spine. Usually, the pain syndrome in osteoarthritis of the spine is one-sided and has a cramping 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 spinal cord roots, which is accompanied by pain along the affected nerves. In fact, these are two different diseases, but the sciatic nerve is a common complication of osteochondrosis, so it is often one of the symptoms of osteochondrosis.
Symptoms of sciatica
With osteochondrosis, radiculitis most often occurs in the cervical and lumbar spine. Sciatica manifests with 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 leg and foot.
VSD or cervical osteochondrosis?
Vegetative-vascular dystonia is a syndrome in which the autonomic nervous system is disrupted. VSD is a functional disorder in which there are no structural changes either in the spine or in the nuclei of the intervertebral discs.
Vegetative-vascular dystonia has a mental origin - it is a neurosis associated with intrapersonal conflicts or childhood trauma. From the outside, VSD and osteochondrosis may be similar to each other: headache, dizziness, pain in the anterior chest wall.
To diagnose diseases, you need to perform instrumental diagnostics - X-ray of the cervical spine and other parts, computed tomography and magnetic resonance imaging. As a result of being diagnosed with VSD, there will be no organic changes, in contrast to osteochondrosis.
Treatment of vegetative-vascular dystonia
Vegetative vascular dystonia is treated with medication, psychotherapy, and lifestyle adjustments. Patients are prescribed symptomatic treatment: sedatives, anti-anxiety, hypnotics, restorative agents, as well as vitamins. The task of VSD psychotherapy is to teach the patient to regulate negative emotions and increase resistance to stress. Also, the lifestyle is adjusted: you need to balance the way of work and rest, exercise and adhere 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 recommendations, the disease can be cured.
How to treat osteochondrosis at home?
Home treatment of osteochondrosis 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 is born, for example, due to kidney disease;
- it is impossible to objectively assess the effectiveness of treatment without a control diagnosis;
- the patient can not adequately choose a treatment for himself, and folk remedies do not have an evidence base, and therefore, most likely, they are ineffective and can give side effects.
At home, you can be treated in one case - only after consulting a doctor who will correctly diagnose, prescribe adequate treatment and periodically monitor the effectiveness of therapy using X-ray, CT or MRI.
Treatment of spinal osteochondrosis
Treatment of osteochondrosis is conservative and surgical. Which method will be the main one depends on the stage of the disease and the negligence of the musculoskeletal system.
Conservative treatment includes medication, exercise therapy, and lifestyle adjustments. Of the medicines, 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, so 1-3 days after the elimination of pain, you should walk, run, exercise in the pool or ride a bike. It is also important to change your lifestyle to an active one, as sitting is one of the factors in the development of back pain and destruction of intervertebral disc nuclei.
Surgical treatment is used when conservative therapy has been ineffective within 2-4 weeks, and in cases where there are marked structural changes in the spine. What type 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 hernias (discectomy and decompression).
If you have back pain, accompanied by lumbago in the back or neck, chest pain, weakening of the arm or leg muscles, unpleasant touching sensation on the skin and numbness, consult a neurologist for advice.