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About the most modern methods of treating osteochondrosis of the spine

The spine is a unique biokinematic system; It is able to withstand loads without damage, but, like any structure, it wears out over time. At a young age, a stable state is maintained thanks to rapid regenerative capabilities, but after the age of 50, its supply gradually decreases, which leads to the formation of osteochondrosis.

Osteochondrosis is the most common degenerative-dystrophic pathology of the spine, which, as it progresses, spreads to structures close to the spinal segment.

Doctors consider osteochondrosis to be a common pathology of the spine that requires treatment.

Development theories

The etiology of osteochondrosis is unknown. Currently existing theories about the development of this disease:

  1. Metabolic.Changes in the metabolism of the vertebral disc due to its dehydration (the amount of water at a young age is 88%, with age the water content decreases to 60%).
  2. Vascular.Changes in spinal circulation (occurs in adulthood, but earlier development is possible due to injuries, metabolic disorders, infections).

    These theories are sometimes combined into one - involution, which is based on a violation of trophism, especially in those tissues in which there are no vessels. In childhood, there is a vascular network in the intervertebral discs, but after the complete formation of the spinal architecture, this network is closed by connective tissue.

  3. Hormone theorymore controversial. Hormonal status plays a certain role in the development of osteochondrosis, but it is inappropriate to refer only to hormonal levels. This theory is most relevant to postmenopausal women.
  4. Mechanical theorytalks about the connection between the occurrence of osteochondrosis and overload of certain parts of the spine.
  5. Anomaly theory- an isolated case of mechanical theory. Anomalies of the vertebral bodies, fusion of the bodies, non-fusion of the arch due to inadequate biomechanism stimulate overload of the vertebral discs and cause destruction of the bone tissue.

These theories have a right to exist, but none of them are universal. It is more correct to call osteochondrosis a multifactorial disease, characterized by genetic predisposition and provoking factors.

Factors that contribute to the development of the disease

  1. Severity factor:For the spine, any non-physiological displacement is nothing more than a trigger for many muscular reactions.
  2. Dynamic factor:the greater and longer the load on the spine, the more and longer it is subject to trauma (people prone to long-term forced positions; constant lifting of heavy objects).
  3. Dysmetabolic factor:insufficient nutrition of the spine due to autoimmune diseases, toxic effects.

    It is known that eating food from aluminum dishes leads to its accumulation in the bones, which will subsequently contribute to the formation of osteochondrosis. Eating food prepared with an alloy of aluminum and iron has adverse effects on the human body. When preparing food, microparticles enter the gastrointestinal tract and, as they also contain lead, this metal accumulates in the body, the intoxication of which is expressed by neuroosteofibrosis (defective changes in the tissue at the junction of the tendon and muscle).

  4. Genetic factor.Each person has an individual level of flexibility, which directly correlates with the proportion of connective tissue fibers (collagen and elastin) and is genetically inherited. Despite all this, there are norms in the proportion of fibers, deviations lead to faster wear of the spine.
  5. Biomechanical factor– non-physiological movements on the articular surface of the spine. This is caused by muscle atrophy (the clinical symptom is pain that appears when bending and turning).
  6. Aseptic-inflammatory factor– most often a rapid inflammatory process in the intervertebral discs. Microdefects form in the spine due to malnutrition of the spinal disc. In these microdefects, areas of dead tissue form.

Symptoms of osteochondrosis of the spine

The main symptom of osteochondrosis is back pain, which can be constant or periodic, aching or sharp, most often intensifies with sudden movements and physical activity.

Osteochondrosis is a common disease among athletes. It arises from a discrepancy between physiological capabilities and motor loads, which contributes to microtraumas and wear on spinal tissue.

The location of symptoms largely depends on the part of the spine where the pathological process occurs (cervical, thoracic, lumbosacral). If the pathological process is localized in several parts, this condition is called mixed osteochondrosis.

Type of osteochondrosis Cervical Chest lumbosacral Mixed
Clinical condition
  • intense pain in the neck, back, shoulders and arms, numbness in the fingers, muscle weakness;
  • sometimes headaches, dizziness, spots before the eyes or decreased visual acuity.
  • more often night pain in the back, heart, chest, abdomen;
  • numbness and weakness in the limbs;
  • sometimes difficulty breathing.
  • periodic, aching pain in the lower back, radiating to the sacrum, legs (depending on movements);
  • tingling in the legs.

the pain is stable or spreads to all parts of the spine.
Complications
  • migraine;
  • vegetative-vascular dystonia;
  • arterial hypertension.
  • pathologies of internal organs;
  • intercostal neuralgia.

compression myelopathy (compression of the spinal cord by various neoplasms).

all possible complications with cervical, thoracic and lumbosacral osteochondrosis.

The location of back pain is characteristic of osteochondrosis of the thoracic spine

Stages of osteochondrosis

Stages First Second Third Room
Spine changes
  • Intervertebral discs lose elasticity and flexibility.
  • Straightening physiological lordosis.
  • Pathological mobility and subluxations of the vertebrae.
  • Reduced height of intervertebral discs.
 Rupture and displacement of the spinal disc with immersion of other surrounding elements into its cavity, which causes the development of local symptoms of inflammation. Destruction of other elements of the intervertebral joint, pathological arrangement of articular surfaces, marginal bone growths.
Patient complaints Absent or indicate discomfort when remaining in the same position for a long time. Discomfort and pain with certain types of exercise. Pain in the back, neck, lower back, sacrum or coccyx depends on the location. Constant pain throughout the spine.

Differential diagnosis

  1. Acute myocardial infarction.The pain is concentrated in the heart region and only from there radiates (spreads) to the neck, lower jaw and arm. The disease begins for no reason or after physical activity with the appearance of compressive pain not associated with spinal movements. After half an hour, the pain reaches its maximum, the person develops shortness of breath and fear of death. The diagnosis is confirmed by electrocardiogram (ECG) and markers of myocardial necrosis.
  2. Subarachnoid hemorrhage(hemorrhage between the arachnoid and pia mater of the brain). In some cases, due to the toxic effect of spilled blood on the spinal roots, severe pain in the spine may occur. The main clinical sign is the presence of blood in the cerebrospinal fluid.
  3. Spinal abnormalities.Minimum examination: radiography of the skull and cervical spine in frontal and lateral projections. The most common anomalies of the spine are: fusion of the atlas (the first cervical vertebra) with the occipital bone, depression of the edges of the occipital foramen in the cranial cavity, fusion of the vertebrae, changes in the shape and size of the vertebrae.
  4. Cervical lymphadenitisIt may also be accompanied by neck pain, sometimes aggravated by bending and turning. Making a diagnosis is not difficult: enlarged and painful lymph nodes; history of frequent sore throats.
  5. Multiple myeloma.Back pain occurs gradually, against a background of progressive weight loss and periodic fever. The main laboratory sign is protein in the urine.
  6. Tumor or metastases in the spine.Evidence in favor of a malignant neoplasm is: progressive loss of body weight, laboratory changes, as well as ultrasound of the sources of metastasis - kidneys, lungs, stomach, thyroid gland, prostate.
  7. Rheumatic and infectious-allergic polyarthritisdifferentiated by medical history, moderately elevated body temperature, and predominant damage to large joints.
  8. Masked depression.Patients "impose" non-existent pathologies (in this context, symptoms of osteochondrosis), an attempt to explain to them the essence of what is happening runs into a wall of misunderstanding. Signs of masked depression are: decreased mood, concentration and performance; sleep and appetite disorders; suicidal thoughts and actions.
  9. Peptic ulcer of the stomach and duodenum, pancreatitis and cholecystitisare diagnosed by connecting pain with food intake, laboratory tests (FGDS, general blood test, biochemical blood test, activity of pancreatic enzymes, ultrasound examination of abdominal organs).
A differential diagnosis of osteochondrosis and spinal tumor should be carried out

Diagnosis of osteochondrosis

  1. Most often, the patient complains to a neurologist, who collects an anamnesis of the patient's life and illness and conducts a neurological examination. A neurologist examines the spine in three options (standing, sitting and lying down). When examining the back, pay special attention to posture, the lower angles of the shoulder blades, the crests of the hipbones, the position of the shoulder girdle, and the expression of the back muscles. During palpation, deformation, pain and muscle tension are determined.
  2. When establishing the diagnosis of osteochondrosis, additional consultation with specialized specialists is required to exclude pathologies with similar symptoms (cardiologist, therapist, rheumatologist).
  3. Carrying out mandatory laboratory tests (general blood test, general urine test, biochemical blood test).
  4. Confirmatory studies are instrumental:
    • x-ray of the spine in two projections– the simplest method for identifying changes in the spine (narrowing of the space between the vertebrae);

      Depending on the grade, several changes are visible on x-rays:

      Degree First Second Third Room
      X-ray signs No radiological signs. Changes in the height of the intervertebral discs. Protrusion (bulge in the spinal canal) of the intervertebral discs or even prolapse (loss). Formation of osteophytes (marginal bone growths) at the point of contact of the vertebrae.
    • computed tomography (CT) and nuclear magnetic resonance (MRI)– used not only to identify changes in the spine, but also to determine pathologies in other organs;
    • USDG MAG (Doppler ultrasound of the main arteries of the head)– ultrasound examination of the circulatory system of the head and neck, which allows the degree of changes in the blood vessels to be diagnosed as early as possible.
Spinal radiography is a simple and effective method for diagnosing osteochondrosis

What treatment methods are there for osteochondrosis?

Drug therapyit must be strictly individual and differentiated, the prescription of medications is carried out by the doctor after diagnosis.

The main drugs used in the treatment of osteochondrosis:

  1. Pain relief is achieved with the help of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Treatment with NSAIDs should be as short as possible; 5-7 days are enough to relieve the pain. If your pain is poorly controlled and a constant dose of pain-relieving medications is needed, you can take selective COX-2 inhibitors.
  2. Antispasmodics reduce pain and relieve muscle spasms.
  3. Transcutaneous pain relief method: ointment whose active ingredient is an NSAID; anesthetic cream; applications with anti-inflammatories and analgesics; corticosteroids are added for greater effect.
  4. Treatment aimed at regenerating an inflamed or compressed nerve, as well as improving blood microcirculation: B vitamins, neuroprotective medications, nicotinic acid.
  5. Oral chondroprotectors – glucosamine, chondroitin sulfate. They help prevent destructive changes in cartilage when taken regularly. Chondroprotectors are incorporated into the structure of cartilaginous tissue, thus increasing the formation of bone matrix and reducing joint destruction. The most favorable composition: chondroitin sulfate + glucosamine sulfate + glucosamine hydrochloride + non-steroidal anti-inflammatory drugs (NSAIDs). These medications are called combined chondroprotectors.

Non-drug treatment methods:

  1. Neuroorthopedic measures.An important point in the treatment of osteochondrosis is adherence to a rational physical activity regimen. Staying in bed for a long time and doing a minimal amount of physical activity not only does not benefit the spine, but also leads to a permanent symptom - back pain.

  2. Therapeutic exercise (physiotherapy)is prescribed when the patient is in satisfactory condition (especially during the period of decreasing signs of the disease), the main purpose is to strengthen the muscular corset.

    To prevent falls, improve coordination of movements and the functioning of the vestibular apparatus (relevant for elderly patients), balance discs, platforms and paths are used in exercise therapy.

  3. Manual therapywith severe neck pain. It is prescribed with special vigilance and according to strict indications. The main objective is to eliminate pathobiomechanical changes in the musculoskeletal system. The main reason for prescribing manual therapy is the pathological tension of the paravertebral muscles. Do not forget about a number of contraindications to this type of treatment, which are relevant for osteochondrosis - massive osteophytes (pathological growths on the surface of bone tissue), which form at the 4th stage of development of this pathology.

    4. To relieve muscle tension in osteochondrosis, manual therapy is performed

  4. Physiotherapeutic procedures in the acute period:

    • ultrasound;
    • phonophoresis;
    • ultraviolet irradiation;
    • impulsive currents;
    • neuroelectric stimulation.

    Physiotherapeutic procedures in the subacute period:

    • electrophoresis;
    • magnetotherapy.

  5. Massage.Of all types, a superficial and relaxing massage with friction elements is used. As soon as the painful symptom is relieved with the help of massage, they smoothly move on to more intense friction elements. When mastering the acupressure (local) massage technique, preference is given to this type.

    The issue of surgical interventions is decided strictly individually, depending on the indications and the patient's condition.

Preventive actions

Effective exercises to prevent spinal osteochondrosis on a fitball
  1. Competent selection of furniture (especially in the workplace). The task chair consists of a flat, solid back. The bed includes a mattress of moderate hardness, a pillow of medium softness (if possible, an orthopedic mattress and pillow).
  2. Correction of vision, posture, bite.
  3. Rational selection of shoes (especially important for drivers). The maximum heel size is 5 cm.
  4. Use a fastening belt, bandage or corset during work.
  5. Correction of movements: avoid bending and turning, lift weights with your back straight and legs bent at the knees.
  6. Change your body position more often: don't stand or sit for a long time.
  7. Proper nutrition: limit the amount of sweet, salty, fatty and spicy foods. The most dangerous food for bones is white sugar, as it removes calcium from bone tissue. The diet should include fruits, berries, vegetables, eggs, nuts, meat, kidneys, liver, fish, legumes and dairy products.
  8. Protect yourself from sudden changes in temperature: hot water in a bath, sauna, swimming pool, etc. It is especially dangerous, as it relaxes the back muscles and even a small injury in this state is not felt, but it leads to tragic consequences for the spine, and even in general for the musculoskeletal system.
  9. Water procedures are not only a preventive measure, but also a therapeutic one. Swimming combines stretching and relaxing your muscles.
  10. Treatment of chronic diseases.
  11. Active and regular vacations.

Examples of effective exercises to prevent cervical osteochondrosis that can be performed in the workplace:

  • sitting on a chair, looking straight ahead. The brush covers and supports the lower jaw. Press the head forward and downward through resistance (tension phase); relaxing and stretching your neck muscles, slowly move your head back (relaxation phase);
  • sitting on a chair, looking straight ahead. The right palm is on the right cheek. Slowly tilt your head to the left, try to touch your left shoulder with your ear and stay in this position for 3-5 seconds. Left palm on the left cheek and do the same, respectively, on the right shoulder;
  • sitting on a chair, looking straight ahead. Hands are on knees. We tilt our head to the right, hold for 5 to 7 seconds and very slowly return to the starting position. Then we tilt our head to the left and consequently do the same.

Conclusion

The high frequency and social significance of osteochondrosis determine scientific interest in this problem. The disease affects not only the elderly, but is increasingly occurring among young people, which attracts the attention of neurologists, neurosurgeons, orthopedic traumatologists and other specialists. Timely diagnosis and adequate treatment of this pathology guarantee social adaptation and future quality of life.