Hondrolife Official site
Share this

Osteochondrosis

Anatomical model of the human spine

What is spinal osteochondrosis in simple words?

Osteochondrosis of the spine is a chronic disease based on degenerative-dystrophic changes of the intervertebral disc, and subsequently the adjacent vertebrae, intervertebral joints and spinal ligaments are affected in the process.

The word "osteochondrosis" has two Greek roots: οστό - bone and χόνδρος - cartilage.

Vertebrae are formations made of spongy bone.They are connected by discs.There are ligaments along the front and back surfaces of the vertebrae.The discs prevent the vertebrae from touching and the ligaments from moving apart.Thanks to the coordinated work of the discs and ligaments, the spine is flexible, and this allows it to perform vital functions:

  • ensuring balance in a vertical position,
  • cushion shocks and bumps when walking and jumping,
  • protects the skull and the brain located inside it from the shock caused by excessive shocks.

In the case of osteochondrosis, protrusions of the intervertebral plates are formed beyond the vertebral bodies.Depending on the direction and size of the protrusion, pain, numbness, muscle problems and other symptoms develop.

ICD-10 codes:

  • M42 Osteochondrosis of the spine
  • M42.0 Juvenile osteochondrosis of the spine
  • M42.1 Osteochondrosis of the spine in adults
  • M42.9 Osteochondrosis of spine, unspecified
  • M43.1 Spondylolisthesis
  • M47 Spondylosis
  • M47.0 Anterior spinal or vertebral artery compression syndrome
  • M47.1 Spondylosis with other myelopathy
  • M47.2 Other spondylosis with radiculopathy
  • M48.0 Spinal stenosis
  • M50.0 Damage to intervertebral disc of cervical spine with myelopathy
  • M50.1 Damage to the intervertebral disc of the cervical spine with radiculopathy
  • M50.2 Displacement of intervertebral disc of cervical spine of other types
  • M50.3 Other cervical intervertebral disc degeneration
  • M51.0 Lumbar and other intervertebral disc lesions with myelopathy
  • M51.1 Lesions of lumbar discs and other radiculopathic parts
  • M51.2 Other specified intervertebral disc displacement
  • M51.3 Other specified intervertebral disc degeneration
  • M53 Other dorsopathies not elsewhere classified

Types of osteochondrosis

Depending on which part of the spine there are changes, the disease has several variants:

  • cervical,
  • chest,
  • lumbar,
  • sacred
  • mixed versions (cervicothoracic, lumbosacral).

Depending on the duration of the symptoms, the disease can be:

  • acute (up to 3 weeks),
  • subacute (3-12 weeks),
  • chronic (more than 12 weeks).

According to the prevailing neurological manifestation:

  • myelopathy (damage to the spinal cord),
  • with radiculopathy (pinched and inflamed nerve roots).

Causes of osteochondrosis

To date, there is no exact data on the causes of osteochondrosis.

The role of genetic predisposition, mechanical injuries and inflammation can be recognized in the appearance of early wear of the intervertebral discs.

Intervertebral discs do not have their own blood or lymphatic vessels.The vessels of the vertebrae play a role in their nutrition and cleaning of harmful substances.With age and/or exposure to harmful effects, the blood and lymph flow decreases, the discs receive less oxygen and nutrients, and harmful substances can accumulate in them.This leads to gradual wear and tear.The rate and speed of disc wear increases when exposed to risk factors.

Risk factors:

  • congenital abnormalities of the vertebrae and spinal canal;
  • flat feet;
  • occupational hazards (vibration, heavy lifting, being in an uncomfortable position for a long time, exposure to toxic substances);
  • sedentary lifestyle;
  • obesity;
  • a diet that is not balanced in protein, fat, vitamin and mineral content;
  • insufficient consumption of clean water;
  • smoking;
  • pollution.

Symptoms of osteochondrosis of the spine

Listed by frequency of occurrence:

  • pain;
  • reduced range of motion;
  • numbness, loss of sensitivity;
  • decreased muscle strength;
  • dysfunction of organs whose innervation is connected to the problematic part of the spine.

Clinically significant manifestations of osteochondrosis of the spine are observed in 51 people per 1000 inhabitants.

The location of the pain and other symptoms depends on the problematic part of the spine.

Cervical osteochondrosis:

  • pain in the arms, shoulders, neck, aggravated by turning and tilting the head;
  • headache;
  • decreased muscle strength in the arm;
  • noise in the head, dizziness, flashing "floaters", colored spots in front of the eyes combined with a burning, throbbing headache (vertebral artery syndrome).

The health of the brain depends on the condition of the cervical spine, as the arteries leading to the brain pass through a channel formed by the processes of the vertebrae.If the lumen of the canal narrows due to osteochondrosis, blood flow through the arteries is interrupted, and the brain experiences a lack of oxygen and nutrients.

Thoracic osteochondrosis:

  • pain in the chest, under the shoulder blade, in the area of the heart, which is aggravated by turning the body, coughing, sneezing;
  • dysfunction of the gallbladder, stomach, esophagus.

Lumbar and/or sacral osteochondrosis:

  • pain in the lower back, back and side of the thigh;
  • numbness of the toes;
  • more frequent urination (10-12 times a day, possibly more), involuntary loss of urine during physical activity;
  • sexual disorders.

Due to frequent pain, half of osteochondrosis sufferers show signs of constant emotional stress.

Developmental stages and course of osteochondrosis

The initial stage of osteochondrosis is manifested by a dull aching pain in the back or lower back, which occurs after prolonged standing, walking or running;neck pain aggravated by turning and tilting the head.

As the pathology of the intervertebral disc(s) progresses, it can bulge (herniate) and, as a result, compress the nerve root (radiculopathy).This leads to intense pain radiating to the arm or leg, muscle weakness, skin sensitivity, vascular tone, and disturbances in the functioning of the organs receiving innervation from the problematic part of the spine.In the most severe cases, compression of the spinal cord can occur, which can lead to paresis or paralysis.

Osteochondrosis is a chronic disease.After proper treatment, remission occurs, that is, the symptoms decrease or disappear completely.If a new protrusion of the intervertebral disc is formed, there will be an aggravation, and the pain and other symptoms will return again.

Diagnostics

  1. Examination by a neurologist.

  2. Basic instrumental research methods:

    • magnetic resonance imaging (MRI),
    • computed tomography (CT).

  3. More:

    • spondylography (in-depth X-ray examination of the spine),
    • electromyography (EMG),
    • electroneuromyography (ENMG),
    • bone densitometry (to detect osteopenia/osteoporosis).

  4. Basic laboratory methods:

    • general blood test,
    • general urinalysis,
    • biochemical blood test (glucose, creatinine, urea, electrolytes, bilirubin, liver and pancreatic enzymes; glycated hemoglobin, C-reactive protein),
    • coagulogram.

  5. More:the concentration of calcium and phosphates in the blood.

Treatment of osteochondrosis

Conservative treatment

This should be done if the patient does not have acutely progressive neurological symptoms.

Objectives:

  • reduction or relief of pain,
  • correction of muscle tone,
  • reduction of inflammation and swelling,
  • preventing the progression of dystrophic changes occurring in the structure of the spine,
  • correction of impaired functioning of internal organs,
  • increasing the patient's daily activity,
  • teaching the patient how to cope with pain.

Conservative treatment of osteochondrosis includes:

  • adherence to a rational motor regime,
  • use of drugs,
  • physiotherapy,
  • massage,
  • Exercise therapy (after pain relief and condition stabilization),
  • acupuncture,
  • manual therapy.

Drug treatment

We list the main groups of drugs that can relieve or relieve pain and stabilize the condition of a patient with osteochondrosis.Only the doctor can choose an appropriate treatment regimen, taking into account the characteristics of the clinical picture of the given patient.

  1. Nonsteroidal anti-inflammatory drugs(NSAIDs):

    • for oral administration,
    • for intramuscular injections,
    • for intravenous administration,
    • for insertion into the rectum (rectal suppositories),
    • for external use (ointment, gel).

  2. Muscle relaxants(medicines that reduce muscle spasms).

    It is used for severe tension and painful muscle spasms.

  3. Diuretics(to reduce local swelling).

  4. Medicines that improve the condition of cartilage tissue(chondroprotectors):

    • chondroitin sulfate sodium,
    • a combination of sodium chondroitin sulfate and glucosamine.

  5. B vitamins:

    • thiamine (B1),
    • pyridoxine (B6),
    • cyanocobalamin (B12),
    • B1+B6+B12 combination.

In the acute period, with severe pain, bed rest for 1-2 days is possible, which helps to relax the muscles and reduce the pressure inside the disc.It is advisable to wear a stabilizing waist belt or Shants collar.

As the intensity of the pain decreases, the treatment is supplemented with special therapeutic exercises aimed at stretching the spine and relaxing the muscles, with the gradual introduction of exercises aimed at developing the muscle ligament.Therapeutic manual massage is recommended.

With proper therapy, the pain will gradually decrease and may disappear completely.Neurological symptoms also regress.The improvement of the condition is caused by the reduction in the size of the disc herniation and the associated inflammatory changes in the surrounding tissues.

Surgical treatment

Emergency neurosurgery is recommended for pelvic disorders with numbness of the anogenital area and paresis of the ascending leg (cauda equina syndrome).

The need for surgery may arise even if conservative therapy is ineffective within 3-6 months.

Prevention of back pain

  • Avoid excessive physical activity (lifting heavy objects, carrying a heavy bag in one hand, etc.).

  • Avoid prolonged static load (sitting, uncomfortable posture).

    If your work involves such stress, it is recommended to take a 10-minute break every 45 minutes, during which you should walk.

  • Avoid hypothermia.

  • Maintain an appropriate level of physical activity through regular exercise, swimming and/or walking.

  • Sleep on a medium firm mattress.

Nutrition for osteochondrosis

A balanced diet and adequate fluid intake ensure normal blood supply and nutrition to the vertebrae and, consequently, the discs.As a result, metabolism and energy are normalized, and harmful products do not accumulate.

Principles:

  1. Daily calorie content, calculated individually, taking height, age and gender into account.

    Calorie intake should be limited in overweight or obese patients.

  2. The drinking system- drink at least 1 liter of clean water, mineral water and medicinal tea per day, ideally 30 ml/kg body weight.

  3. Daily use:

    • whole grain products (buckwheat, millet, oats);
    • sufficient amount of protein (taking into account age and kidney function): animal - lean beef, chicken, turkey, rabbit, chicken eggs (4-5 pieces per week);vegetables - beans, lentils, peas;
    • healthy fats containing monounsaturated and polyunsaturated fatty acids (fish, seafood, unrefined vegetable oils, unroasted and unsalted nuts, seeds);
    • vegetables (both fresh and cooked), salad, herbs and leafy greens;
    • berries - blueberries, blackberries, raspberries, cherries.

  4. Exclusion from the diet:

    • white bread and baked goods made from premium flour;
    • sugar, industrial sweets - candies, cookies, cakes, gingerbread, waffles;
    • industrial drinks with added sugar - carbonated water, packaged fruit juices;
    • processed meat products - sausage, sausage, canned.