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 disabilities and disabilities, so it is important to identify it at the early stages of development and seek medical help.
In this article we are going to talk about osteochondrosis, its symptoms and diagnostic methods, how to distinguish osteochondrosis from other diseases that are manifested by back pain and what to do when there are signs of osteochondrosis of the spine.
What is spinal osteochondrosis?
Osteochondrosis is a chronic condition in which the core 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 as premature aging of the joint apparatus or as a pathology as a result of damage to the vertebrae, 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 injuries to the spine lead to premature aging of the cartilage, for example, from 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 of the intervertebral cartilage, because with age, the number of blood vessels in them that supply nutrients to the blood decreases.
The development of osteochondrosis is a cascade in which one pathological process sets another in motion. For example, age-related changes and a decrease in the number of vessels in the intervertebral disc disrupt nutrition, which leads to a failure of biochemical processes and damage to the intervertebral disc.
As degenerative and dystrophic changes develop in the spine, it disrupts muscle tone and the work of the nerve roots that exit the spinal cord through natural openings in the vertebrae. This leads to consequences for the nervous and musculoskeletal system.
Symptoms of osteochondrosis of the spine
Osteochondrosis is a chronic condition with periodic exacerbations caused by injury, sedentary lifestyle, heavy lifting, hypothermia, and psycho-emotional stress. The most common and characteristic symptom of dystrophic disorders in the core of the intervertebral discs is regular aching 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 roots of the spinal cord. They manifest themselves in the form of cramps or vasodilation, muscle twitching, weakening of muscle strength. Compression symptoms develop from compression (usually formed by a break in the spine) of the nerves and manifest as loss of sensation in the affected segment (in the neck, arms, or lower back).
Osteochondrosis is also characterized by the following symptoms:
- Tension and pain in the neck and back muscles;
- Curvature of the spine to the side, back or front;
- violation of sensitivity and nerve regulation: crawling on the skin, fluctuations in heat and cold on the skin of the back and extremities, numbness of the arms or legs;
- weakening of the muscular strength of the limbs;
- frequent urination - up to 10-12 times a day.
Where can osteochondrosis exist?
Pain in osteochondrosis is not localized only in the back. They extend to the upper and lower extremities. In feet on:
- Buttocks;
- Back and side of the thighs;
- lower leg and inner part of the ankle;
- the back of the feet;
- Toes;
- Heels.
Pain can also spread to the arms to:
- Deltoid muscle;
- the outer edge of the hand to the fingers;
- the back of the hand;
- three middle fingers;
- Ring finger and little finger (rarely).
How is osteochondrosis diagnosed?
Diagnosis of osteochondrosis is based on a survey, physical examination and instrumental examination methods. The concrete examination methods are determined in the consultation.
The doctor begins the diagnosis with an anamnesis: he identifies the probable causes of back pain, determines the location of the pain and its duration, identifies the presence of concomitant diseases, for example allergies, congenital diseases and drug intolerance. Then it goes on to the inspection. The physical exam is performed while standing or sitting. The doctor can detect a curvature of the spine, assess muscle strength and reflexes, and look at the color of the skin. To make the clinical picture in more detail, it is necessary to consult with related specialists: a neurologist, neurosurgeon, oncologist, rheumatologist and phthisiatrist.
The neurologist diagnoses osteochondrosis if:
- regular aching back pain;
- increased pain when lifting weights, sneezing, coughing;
- Numbness and sore joints;
- decreased range of motion in the joints;
- Muscle cramp;
- damage to the nerve roots;
- Changes in the x-ray of the spine.
Do I need a spine x-ray?
An X-ray of the spine or spondylography is one of the mandatory examinations for osteochondrosis, with which it is possible to detect structural abnormalities in the spine. With spondylography, you can find pathological changes, for example, a thinning of the intervertebral disc. Usually x-rays of the cervical, thoracic, and lumbar spine are done in two (and sometimes three) projections to get more detail.
Computed tomography and magnetic resonance imaging make it possible to identify pathologies associated with osteochondrosis: disc herniation and a decrease in the lumen of the spinal canal, protrusion of the disc into the spinal canal, and compression of the spinal cord.
Osteochondrosis of the cervical spine
There are two main symptoms associated with cervical osteochondrosis of the spine - cervicago and cervicalgia. Cervicago is an acute painful lumbago of the cervical spine that occurs with movements of the head and due to muscle tension in the cervical spine. Cervicalgia is painful and severe pain in the neck. Paresthesia is added to cervicalgia - a violation of sensitivity in the form of numbness and creeping on the skin.
As the defeat of the nuclei of the intervertebral discs of the neck progresses, cervical radiculitis occurs - painful sensations in the back of the head. The pain is characterized by its regularity, and it occasionally increases, especially when the head is moved.
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 warm object may feel cold with your fingers, but shaking it with your hands will restore sensitivity.
Osteochondrosis of the thoracic spine
Most characteristic of osteochondrosis of the thoracic spine is painful lumbago in the chest (dorsalgia). Chest pain is worse when you move your arms, sneeze, cough, and lift weights. Most of the time the pain is a belt. Paresthesia is also common 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 pain in the upper abdomen and heart can be localized.
How to say - heart pain or osteochondrosis?
Pectalgic syndrome is pain in the anterior chest wall that can resemble heartache. Pectalgia can be a sign of both osteochondrosis and heart problems.
However, pain in angina and myocardial infarction are different from pectalgic syndrome in osteochondrosis. The peculiarities of pain in angina and myocardial infarction are that they are compressive in nature and spread to the left shoulder blade, arm and jaw.
Pectalgic syndrome in osteochondrosis does not extend beyond the boundaries of the anterior chest wall, does not extend 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 need to see a doctor and do an electrocardiography, which shows a rhythm disturbance 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 trinitroglycerin, and it lasts for more than 10-15 minutes, you need to call an ambulance.
Why is lumbar spine osteochondrosis dangerous?
With osteochondrosis of the lumbar spine, the most common lumbago or lumbodynia occurs - regular lumbago and aching pain in the lumbar area. Because of the constant pain, movements are restricted: a person cannot bend down, do an exercise, or lift a heavy object.
Lumbago can go on on its own. However, they are prone to exacerbations, and each exacerbation indicates additional displacement of the disc into the spinal canal. With the progressive destruction of the intervertebral disc, 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 arthrosis (spondylogenic arthrosis) belong to the class of diseases of the musculoskeletal system. However, there is one major difference: in osteochondrosis the core of the intervertebral disc is affected, in osteoarthritis the intervertebral joints. This makes all the difference in symptoms and treatment.
With osteochondrosis, back pain occurs regularly and painfully, is expressed in rest and increased movement, and with spondyloarthrosis, the appearance of pain is associated with extension and flexion of the spine. Usually the pain syndrome in osteoarthritis of the spine is one-sided and has a cramp-like character. Spondylogenic osteoarthritis is also characterized by morning stiffness that lasts for 30 to 60 minutes.
What is the difference between osteochondrosis and radiculitis?
Radiculitis is inflammation of the roots of the spinal cord that is accompanied by pain along the affected nerves. In fact, these are two different diseases, but sciatica is a common complication of osteochondrosis and, therefore, 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 itself as pain along the damaged nerve, impaired sensation, and sometimes movement disorders. Sciatica is characterized by the fact that the pain extends beyond the back and spreads to the hips, buttocks, lower legs, 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 the spine or in the nuclei of the intervertebral discs.
Vegetovascular dystonia has a mental origin - it is a neurosis associated with intrapersonal conflict or childhood trauma. Outwardly, VSD and osteochondrosis can be similar: headache, dizziness, pain in the anterior chest wall.
To distinguish diseases, you need to conduct instrumental diagnostics - x-ray of the cervical spine and other parts, computer and magnetic resonance imaging. In contrast to osteochondrosis, diagnosis with VSD does not result in any organic changes.
Treatment of vegetative-vascular dystonia
Vegetovascular dystonia is treated with medication, psychotherapy, and lifestyle adjustments. Symptomatic treatment is prescribed to patients: sedatives, anti-anxiety, hypnotics, tonics, as well as vitamins. The task of psychotherapy with VSD is to teach the patient to regulate negative emotions and increase stress resistance. Lifestyle is also adapted: you have to balance your work and rest, do sports and maintain 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 stick to medical prescriptions, the disease can be cured.
How to treat osteochondrosis at home
It is not recommended to treat osteochondrosis at home. There are mutliple reasons for this:
- at home it is impossible to accurately diagnose osteochondrosis, since back pain has different causes: neurogenic, vascular, viscerogenic (due to diseases of the internal organs) and psychogenic. That is, a person is treating osteochondrosis, but actually back pain has occurred due to, for example, kidney disease;
- without control diagnostics, the effectiveness of the treatment cannot be objectively assessed;
- the patient cannot adequately choose treatment for himself, and folk remedies have no evidence base, and therefore, most likely, they are ineffective and can cause side effects.
At home, you can be treated in one case - only after consulting a doctor who will make a correct diagnosis, prescribe appropriate treatment and regularly monitor the effectiveness of therapy with X-ray, CT or MRI.
Treatment of osteochondrosis of the spine
Treatment for osteochondrosis is conservative and surgical. Which method is the most important depends on the stage of the disease and 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 physical therapy exercises, one of the main conditions for recovery is early activation, that is, 1-3 days after the pain is eliminated, you need to walk, run, exercise in the pool or ride a bike. It is also important to change your lifestyle to an active one, as a sedentary lifestyle is one of the contributing factors in causing back pain and the destruction of the spinal disc nuclei.
Surgical treatment is used when conservative therapy has been ineffective within 2-4 weeks, and when there are pronounced structural changes in the spine. What type of surgery is required is determined by the surgeon after consulting a neuropathologist and studying the research data. For example, in the treatment of osteochondrosis of the cervical spine, procedures are used that relieve the spinal cord of lateral vertebrae or hernias (discectomy and decompression).
If you have back pain accompanied by lumbago in the spine or neck, painful chest pain, muscle weakness in the arm or leg, uncomfortable feeling on the skin, and numbness, consult a neurologist.