Osteochondrosis and regular back pain affect 60-80% of the population over 30. Untreated osteochondrosis reduces quality of life and can lead to disability and disability, so it's important to recognize it early in development and seek medical help.
In the article we will talk about osteochondrosis, its symptoms and diagnostic methods, as well as how to distinguish osteochondrosis from other diseases that arise with back pain and what to do if signs of osteochondrosis of the spine 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 structures of the spine in the pathological process and leads to disorders of the musculoskeletal and nervous systems. Osteochondrosis is also characterized as premature aging of the joint system or as a pathology following 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:
- involutional - inflammatory processes and other injuries of the spine lead to premature aging of the cartilage, for example, due to a sedentary lifestyle;
- degenerative - disorders in the intervertebral discs occur due to metabolic insufficiency, for example, due to an unbalanced diet and alcohol abuse;
- dysmetabolic - osteochondrosis occurs due to malnutrition in the intervertebral cartilage due to the fact that with age, the number of blood vessels that supply blood with nutrients decreases in them.
The development of osteochondrosis is a cascade in which one pathological process begins another. So, for example, due to age-related changes and a decrease in the number of vessels in the disc, nutrition is disturbed, which leads to a failure in biochemical processes and damage to the intervertebral disc.
As degenerative and dystrophic changes develop in the spine, muscle tone and the work of the nerve roots exiting the spinal cord through the natural openings of the vertebrae are disrupted. This leads to consequences from the nervous and musculoskeletal systems.
Symptoms of osteochondrosis of the spine
Osteochondrosis is a chronic disease with periodic exacerbations, caused by injury, a 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 back pain in several 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 themselves in the form of spasm or vasodilation, muscle contractions, weakening of muscle strength. Symptoms of compression develop due to compression (most often formed by a herniated spine) of the nerves and manifest as a loss of sensation in the affected segment (in the neck, arms, or lower back).
In addition, 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 nerve regulation: there is a sensation of crawling on the skin, sudden changes in heat and cold on the skin of the back and extremities, numbness in the arms or legs;
- weakening of the muscle strength of the limbs;
- frequent urination - up to 10-12 times a day.
Where can it give osteochondrosis?
Pain in osteochondrosis is localized not only in the back. They extend to the upper and lower limbs. Standing on:
- buttocks;
- back and sides of the thighs;
- lower leg and inner ankle;
- the back of the feet;
- toes;
- heels.
Also, the pain can spread to the arms to:
- deltoid muscle;
- the outer edge of the hand, up to the fingers;
- the back of the hand;
- three middle fingers;
- ring and little finger (rare).
How is osteochondrosis diagnosed?
Diagnosis of osteochondrosis is based on a survey, physical examination and instrumental examination methods. The specific examination procedures are determined during the consultation.
The doctor begins the diagnosis with anamnesis: identifies the probable causes of back pain, establishes the location of the pain and their duration, identifies the presence of concomitant pathologies, for example allergies, congenital diseases and drug intolerance. Then we proceed to the inspection. Physical examination is performed standing or sitting. Doctors can detect spinal curvature, assess muscle strength and reflexes, and observe skin color. To detail the picture of the disease, consultation with related specialists is required: a neurologist, neurosurgeon, oncologist, rheumatologist and phthisiatra.
The neurologist makes the diagnosis of osteochondrosis if:
- regular aching back pain;
- increased pain when lifting weights, sneezing, coughing;
- numbness and aching joints;
- reduced range of motion in the joints;
- muscle spasm;
- damage to nerve roots;
- changes in the x-ray of the spine.
Do you need a spine X-ray?
X-ray of the spine or spondylography is one of the mandatory examinations for osteochondrosis, with the help of which it is possible to identify structural disorders 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 done in two (and sometimes three) views for more detail.
Computed tomography and magnetic resonance imaging allow to identify pathologies associated with osteochondrosis: herniated disc and decreased lumen of the spinal canal, protrusion of the intervertebral disc into 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 cervicalgia. Cervicago is acute painful low back pain that occurs when the head is moved and due to muscle tension in the cervical spine. Neck pain is aching and severe pain in the neck. Paresthesias are added to neck pain - a violation of sensitivity in the form of numbness and a sensation of creeping on the skin.
If the defeat of the nuclei of the intervertebral discs of the neck progresses, cervical radiculitis appears - painful sensations in the occiput. The pains are characterized by regularity, moreover, they occasionally intensify, especially when moving the head.
This triad - neck pain, cervical sciatica and cervicago - can be complicated by the nocturnal dysesthesia syndrome of the hands, in which sensitivity is perverted. For example, a hot object may feel cold to your fingers, but if you shake it with your hands, sensitivity is restored.
Osteochondrosis of the thoracic spine
For osteochondrosis of the thoracic spine, painful low back pain in the chest (back pain) is more characteristic. Chest pain is worse when moving your arms, sneezing, coughing, and lifting weights. Most often, the pain is girdle. Also, paresthesias often occur in the chest. Sometimes damage to the nuclei of the intervertebral discs can be masked by diseases of the internal organs, for example, gastritis or angina pectoris, since the pain can be localized in the upper abdomen and heart.
How to say: heart pain or osteochondrosis?
Pectalgia syndrome is pain in the anterior chest wall that can resemble pain in the heart. Pectalgia can be a sign of both osteochondrosis and heart problems.
However, pain in angina pectoris and heart attack differs from pectalgic syndrome in osteochondrosis. The peculiarities of pain in angina pectoris and myocardial infarction are that they have a compressive character and spread to the shoulder blade, arm and left 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 exclude heart pathology, it is necessary to consult a doctor and perform an electrocardiography, which will reveal a rhythm disturbance or signs of myocardial infarction.
If the pain begins to spread to the left shoulder blade, arm, jaw, it is accompanied by a feeling of fear, is not eliminated by taking nitroglycerin and lasts more than 10-15 minutes, it is necessary to call an ambulance.
Why is osteochondrosis of the lumbar spine dangerous?
With osteochondrosis of the lumbar spine, low back pain or low back pain most often occurs: regular low back pain and aching pain in the lumbar region. Due to constant pain, movements are limited - a person cannot bend over, exercise, or lift a heavy object.
Low back pain can go away on its own. However, they are prone to exacerbations, and each exacerbation indicates an additional displacement of the intervertebral disc in the spinal canal. If the destruction of the intervertebral disc progresses, lumbosacral radiculitis is formed, 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 fundamental difference between them: with osteochondrosis, the nucleus of the intervertebral disc is affected, and with osteoarthritis, the intervertebral joints. This makes a difference in symptoms and treatment.
In osteochondrosis, back pain is regular and aching, manifests itself in calmness and increases in movement, and in spondylarthrosis, the appearance of pain is associated with the extension and flexion of the spine. Usually, the pain syndrome in osteoarthritis of the spine is one-sided and has a cramp-like character. In addition, spondylogenic osteoarthritis is characterized by morning stiffness, which lasts from 30 to 60 minutes.
What is the difference between osteochondrosis and radiculitis?
Radiculitis is inflammation of the roots of the spinal cord, which is accompanied by pain along the affected nerves. In reality, these are two different diseases, but sciatica is a frequent 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 presents with pain along the damaged nerve, sensory disturbances, and sometimes movement disorders. Sciatica is characterized by the pain that goes beyond the back and spreads to the hips, buttocks, lower leg and foot.
VSD or cervical osteochondrosis?
Vegetovascular dystonia is a syndrome in which the autonomic nervous system is disrupted. VSD is a functional disorder in which there are no structural changes in either the spine or the nuclei of the 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 anterior chest wall.
To distinguish diseases, it is necessary to carry out instrumental diagnostics: x-ray of the cervical spine and other parts, magnetic and computer resonance. As a result of diagnostics with VSD, there will be no organic changes, unlike osteochondrosis.
Treatment of vegetative-vascular dystonia
Vegetovascular dystonia is treated with medications, psychotherapy, and lifestyle adjustments. Patients are prescribed symptomatic treatment: sedatives, anxiolytics, hypnotics, restorative agents and vitamins. The task of VSD psychotherapy is to teach the patient to regulate negative emotions and increase resistance to stress. Lifestyle is also adequate: you need to balance the way you work and rest, exercise and eat a balanced diet.
Is osteochondrosis cured 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 adhere to the doctor's prescriptions, 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, since back pains have different origins: neurogenic, vascular, viscerogenic (due to diseases of the internal organs) and psychogenic. That is, a person treats osteochondrosis, but in reality back pain arose, for example, due to kidney disease;
- it is impossible to objectively evaluate the effectiveness of the treatment without control diagnostics;
- the patient cannot adequately choose a treatment for himself, and folk remedies have no evidence base and therefore, most likely, 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 by X-ray, CT or MRI.
Treatment of osteochondrosis of the spine
Treatment of osteochondrosis is conservative and surgical. Which method will be the main depends on the stage of the disease and the neglect of the musculoskeletal system.
Conservative treatment includes medications, physical therapy, and lifestyle adjustments. Of the medications, 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, that is, 1-3 days after the elimination of pain, it is necessary to walk, run, exercise in the pool or ride a bicycle. It is also important to change your lifestyle to an active one, as a sedentary one is one of the factors in the development of back pain and the destruction of the nuclei of the intervertebral discs.
Surgical treatment is used when conservative therapy has proved ineffective within 2-4 weeks and in the event that there are pronounced structural changes in the spine. The type of operation 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 side of the vertebrae or hernia (discectomy and decompression).
If you experience back pain, accompanied by low back pain in the spine or neck, aching chest pains, weakened arm or leg muscles, unpleasant tactile sensations on the skin and numbness, consult a neurologist for advice.