Osteochondrosis and common back pain affect 60-80% of the population over the age of 30 years. Untreated osteochondrosis reduces quality of life and can lead to disability and disability, so it’s important to recognize it at an early stage 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 indicated 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 structures of the spine 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 due to damage to the vertebrae, for example, after injury.
The development of osteochondrosis is influenced by many factors, so the researchers compiled the reasons that explain the origin of the disease:
- involuntary - inflammatory processes and other injuries to the spine lead to premature aging of cartilage, for example, as a result of an inactive lifestyle;
- degenerative - disorders in 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 due to lack of nutrients in the intervertebral cartilage due to the fact that with age, the number of blood vessels in it decreases, which supplies the blood with nutrients.
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 disrupted, leading to failure in biochemical processes and damage to the intervertebral disc.
As degenerative and dystrophic changes develop in the spine, muscle tone and nerve root work exiting the spinal cord through natural openings in the vertebrae are disrupted. This leads to consequences of the nervous and musculoskeletal systems.
Symptoms of spinal osteochondrosis
Osteochondrosis is a chronic disease with periodic exacerbations, provoked by injury, inactive lifestyle, weight lifting, hypothermia and psycho-emotional stress. The most common and characteristic symptom for dystrophic disorders in the nucleus of the intervertebral disc is frequent back pain in different parts: in the neck, chest and lower back.
There are two types of symptoms of osteochondrosis: reflex and compression. Reflex symptoms develop as a result of irritation of the spinal cord roots. They manifest themselves in the form of cramps or vasodilation, muscle twitching, weakening of muscle strength. Symptoms of compression develop as a result of compression (usually formed by a spinal hernia) of the nerve and manifest as a loss of sensation in the affected segment (in the neck, arms or lower back).
Also, osteochondrosis is characterized by the following symptoms:
- tension and pain in the muscles of the neck and back;
- curvature of the spine laterally, posteriorly or forward;
- violation of sensitivity and nervous regulation: there is a feeling of crawling on the skin, hot and cold swings on the skin of the back and legs, numbness of the arms or legs;
- weakening the muscle strength of the limbs;
- frequent urination - up to 10-12 times a day.
Where can osteochondrosis be given?
Pain in osteochondrosis is localized not only in the back. They extend to the top and bottom. At the foot:
- back;
- back and sides of thighs;
- the lower part of the foot and the inside of the ankle;
- the back of the foot;
- toes;
- heels.
Also, the pain can spread to the arms to:
- deltoid muscle;
- outer edge of hand, down to finger;
- back of hand;
- three middle fingers;
- ring finger and little finger (rare).
How is osteochondrosis diagnosed?
The diagnosis of osteochondrosis is based on survey, physical examination and instrumental examination methods. Specific examination methods are determined during the consultation.
The doctor begins the diagnosis by taking anamnesis: he identifies the possible causes of back pain, prescribes the localization of pain and its duration, identifies the presence of corresponding pathologies, for example, allergies, congenital diseases and drug intolerance. Then proceed with the inspection. Physical examination is performed while standing or sitting. Doctors can detect the curvature of the spine, assess muscle strength and reflexes, and look at skin color. To detail the picture of the disease, consultation with relevant specialists is required: neurologist, neurosurgeon, oncologist, rheumatologist and phthisiatrician.
A neurologist diagnoses "osteochondrosis" if:
- frequent back pain;
- increased pain when lifting weights, sneezing, coughing;
- numbness and joint pain;
- reducing the range of motion in the joints;
- muscle cramp;
- damage to nerve roots;
- changes in spinal x-rays.
Do I need a spine X-ray?
Spinal X-ray or spondylography is one of the mandatory examinations for osteochondrosis, which makes it possible to identify structural abnormalities of the spine. Spondylography allows you to look for pathological changes, for example, thinning of the intervertebral disc. Typically for the cervical, thoracic and lumbosacral spines, x-rays are performed in two (and sometimes three) projections for 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 intervertebral disc into the spinal canal and spinal cord compression.
Osteochondrosis of the cervical spine
With osteochondrosis of the cervical spine, two main symptoms appear - cervicago and cervicalgia. Cervicago is an acutely painful cervical lumbago that appears when moving the head and is caused by muscle tension in the cervical spine. Cervicalgia is aching and severe pain in the neck. Paresthesias is added to cervicalgia - a violation of sensitivity in the form of numbness and a creeping feeling on the skin.
If the defeat of the nucleus of the intervertebral disc of the neck persists, cervical radiculitis appears - a painful sensation in the occiput. Pain is characterized by regularity, in addition, they sometimes increase, especially when moving the head.
These triads - cervicalgia, cervical sciatica and cervicago - can be complicated by nocturnal dysesthesia syndrome on the hands, in which sensitivity is distorted. For example, a hot object may feel cold with your fingers, but if you shake it with your hands, sensitivity is restored.
Osteochondrosis of the thoracic spine
For osteochondrosis of the thoracic spine, a painful lumbago in the chest (dorsalgia) is the most characteristic. Chest pain is worse when moving hands, sneezing, coughing and lifting weights. Often, the pain is a belt. Also, paresthesia often occurs in the chest. Sometimes damage to the nucleus of the intervertebral disc can be disguised as a disease of internal organs, for example, gastritis or angina pectoris, because the pain can be localized in the upper abdomen and in the liver.
How to tell - heart disease or osteochondrosis?
Pectalgic 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 is different from pectalgic syndrome in osteochondrosis. The peculiarity of pain in angina pectoris and myocardial infarction is that they have the characteristic of compression and spread to the left scapula, arm and jaw.
Pectalgic syndrome in osteochondrosis does not extend beyond the boundaries of the anterior chest wall, does not extend to the arms and scapula, and is not accompanied by fear of death. However, this is only a subjective feeling. Therefore, to exclude cardiac pathology, you need to consult a doctor and perform electrocardiography, which will reveal arrhythmias or signs of myocardial infarction.
If the pain begins to spread to the left shoulder blade, arm, jaw, accompanied by fear, is not eliminated by taking trinitroglycerin and lasts more than 10-15 minutes, you need to call an ambulance.
Why is lumbar spine osteochondrosis dangerous?
With osteochondrosis of the lumbar spine, lumbago or lumbodynia most often occurs - common lumbago and aching pain in the lumbar region. Due to the constant pain, movement is limited: a person cannot bend, perform exercises or lift heavy objects.
Lumbago can pass on its own. However, they are prone to exacerbations, and each exacerbation indicates additional displacement of the intervertebral disc into the spinal canal. If destruction of the intervertebral disc takes place, 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 (spondylogenous osteoarthritis) belong to the class of diseases of the musculoskeletal system. However, there are major differences between them: with osteochondrosis, the nucleus of the intervertebral disc is affected, and with osteoarthritis, the intervertebral joint. This makes a difference in symptoms and treatment.
In osteochondrosis, back pain is common and painful, manifesting itself in calmness and an increase in movement, and in spondyloarthrosis, the appearance of pain is associated with extension and flexion of the spine. Usually, the pain syndrome in spinal osteoarthritis is unilateral and has the character of spasm. 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 roots of the spinal cord, which is accompanied by pain along the affected nerve. Actually, these are two different diseases, but sciatica is a frequent complication of osteochondrosis, so it is often one of the symptoms of osteochondrosis.
Sciatica symptoms
With osteochondrosis, radiculitis most often occurs in the cervical and lumbar spine. Sciatica is manifested by pain along damaged nerves, sensory disturbances 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 feet.
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 either in the spinal column or in the nucleus of the intervertebral disc.
Vegetovascular dystonia has a mental origin - it is a neurosis associated with intrapersonal conflict or childhood trauma. Externally, VSD and osteochondrosis can be similar to each other: headache, dizziness, pain in the anterior chest wall.
To differentiate the disease, you need to carry out instrumental diagnostics - X -rays of the cervical spine and other parts, magnetic resonance imaging and calculations. As a result of diagnosis with VSD, there will be no organic changes, in contrast to osteochondrosis.
Treatment of vegetative-vascular dystonia
Vegetovascular 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 job of psychotherapy with VSD is to teach patients to control negative emotions and increase stress resistance. Also, a coordinated lifestyle: you need to balance work and rest, exercise and adhere to a balanced diet.
Is osteochondrosis treatable or not?
Osteochondrosis can be cured. The goal of treatment is to relieve 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 prescription, the disease can be cured.
How to treat osteochondrosis at home?
It is not recommended to treat osteochondrosis at home. There are several reasons for this:
- at home, it is impossible to diagnose osteochondrosis accurately, because back pain has different origins: neurogenic, vascular, viscerogenic (caused by diseases of internal organs) and psychogenic. That is, a person treats osteochondrosis, but in fact back pain has arisen, for example, due to kidney disease;
- it is impossible to objectively assess the effectiveness of treatment without control diagnostics;
- the patient cannot choose an adequate treatment for himself, and folk remedies have no 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 -rays, 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 neglect of the musculoskeletal system.
Conservative treatments include medication, exercise therapy, and lifestyle adjustments. Instead of medications, anti-inflammatory drugs and muscle relaxants are mainly prescribed to relieve pain and normalize muscle tone. In physiotherapy training, 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, work out in the pool or ride a bike. It is also important to change your lifestyle to an active one, as being inactive is one of the factors in the development of back pain and the destruction of the intervertebral disc nucleus.
Surgical treatment is used when conservative therapy is ineffective within 2-4 weeks, and in cases when there are significant structural changes in the spine. What type of surgery is needed will be determined by the surgeon after consulting with a neuropathologist and reviewing 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 sides of the vertebrae or hernia (discectomy and decompression).
If you experience back pain, accompanied by lumbago in the spine or neck, chest pain, weak muscles in the arms or legs, unpleasant tactile sensations on the skin and numbness, consult a neurologist for advice.