How to treat osteochondrosis?

Pain with osteochondrosis of the spine in a man

Osteochondrosis and regular back pain affects 60-80% of the population over 30 years old. Untreated osteochondrosis reduces the quality of life and can lead to disability and disability, so it is important to recognize it at the initial stages 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 that are manifested by 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 system and the nervous system. Osteochondrosis is also characterized as premature aging of the articular 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 of the spine lead to premature aging of the cartilage, for example, as a result of a sedentary 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 as a result of malnutrition in the intervertebral cartilage due to the fact that with age, the number of blood vessels in them decreases, which supply blood with nutrients.

The development of osteochondrosis is a cascade in which one pathological process starts 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.

Since degenerative and dystrophic changes develop in the spine, muscle tone and the work of nerve roots that exit the spinal cord through natural openings in the vertebrae are impaired. This leads to consequences from the nervous and musculoskeletal systems.

Symptoms of osteochondrosis of the spine

Osteochondrosis is a chronic disease with periodic exacerbations, which are provoked by injuries, a sedentary lifestyle, heavy lifting, hypothermia and psycho-emotional stress. The most common and characteristic symptom for dystrophic disorders in the nucleus 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 spasm or vasodilation, muscle twitching, weakening of muscle strength. Compression symptoms develop due to compression (more often formed by a hernia of the spine) of the nerves and manifest as loss of sensation in the affected segment (in the neck, arms or lower back).

Also, osteochondrosis is characterized by the following symptoms:

  • tension and soreness in the muscles of the neck and back;
  • curvature of the spine to the side, back or forward;
  • violation of sensitivity and nervous regulation: there is a feeling of crawling on the skin, swings of heat and cold on the skin of the back and extremities, numbness of the arms or legs;
  • weakening of the muscle strength of the limbs;
  • frequent urination - up to 10-12 times a day.

Where can osteochondrosis give?

Pain in osteochondrosis is localized not 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.

Also, pain can spread to the arms to:

  • deltoid muscle;
  • the outer edge of the hand, down to the fingers;
  • the back of the hand;
  • three middle fingers;
  • ring finger 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 methods are determined at the consultation.

The doctor begins the diagnosis by taking anamnesis: he identifies the probable causes of back pain, establishes the localization of pain and their duration, identifies the presence of concomitant pathologies, for example, allergies, congenital diseases and drug intolerance. Then proceeds to the inspection. The physical examination is done while standing or sitting. The doctor can detect curvature of the spine, assess muscle strength and reflexes, and look at the color of the skin. To detail the picture of the disease, consultation with related specialists is needed: a neurologist, neurosurgeon, oncologist, rheumatologist and phthisiatrician.

The neurologist makes the diagnosis "osteochondrosis" if:

  • regular aching back pain;
  • increased pain when lifting weights, sneezing, coughing;
  • numbness and aching joints;
  • decreased range of motion in the joints;
  • muscle spasm;
  • damage to the nerve roots;
  • changes in the x-ray of the spine.

Do I need an X-ray of the spine?

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 abnormalities 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) projections for greater 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 compression of the spinal cord.

Spine X-ray - the main method for diagnosing osteochondrosis

Osteochondrosis of the cervical spine

With cervical osteochondrosis of the spine, two main symptoms appear - cervicago and cervicalgia. Cervicago is an acute painful cervical lumbago that appears when moving the head and due to muscle tension in the cervical spine. Cervicalgia is aching and severe pain in the neck. Paresthesias are added to cervicalgia - a violation of sensitivity in the form of numbness and a feeling 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, in addition, they occasionally intensify, especially when moving the head.

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 if you shake it with your hands, sensitivity is restored.

Osteochondrosis of the thoracic spine

For osteochondrosis of the thoracic spine, painful lumbago in the chest (dorsalgia) is most 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 disguised as diseases of internal organs, for example, gastritis or angina pectoris, since pain can be localized in the upper abdomen and in the heart.

How to tell - heart pain 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 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 left scapula, 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 scapula, and is not accompanied by the fear of death. However, these are only subjective feelings. Therefore, in order to exclude cardiac pathology, you need to consult a doctor and do 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, is accompanied by a feeling of fear, is not eliminated by taking trinitroglycerin and lasts more than 10-15 minutes, you need to call an ambulance.

Why is osteochondrosis of the lumbar spine dangerous?

With osteochondrosis of the lumbar spine, lumbago or lumbodynia most often occurs - regular lumbago and aching pain in the lumbar region. Due to constant pain, movements are limited: a person cannot bend down, do exercises or lift a heavy object.

Lumbago can pass on its own. However, they are prone to exacerbations, and each exacerbation indicates an additional displacement of the intervertebral disc into 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 (spondylogenous osteoarthritis) belong to the class of diseases of the musculoskeletal system. However, there is a key difference between them: with osteochondrosis, the nucleus of the intervertebral disc is affected, and with osteoarthritis, the intervertebral joints. This makes the difference in symptoms and treatment.

With osteochondrosis, back pain is regular and aching, manifests itself in calmness and intensifies in motion, and in spondyloarthrosis, the appearance of pain is associated with extension and flexion of the spine. Usually, the pain syndrome in osteoarthritis of the spine is unilateral and has a cramping character. 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 nerves. In fact, these are two different diseases, but sciatica is a frequent complication of osteochondrosis, therefore it is often one of the symptoms of osteochondrosis.

Symptoms of sciatica

With osteochondrosis, most often radiculitis occurs in the cervical and lumbar spine. Sciatica is manifested by pain along the damaged nerve, sensory disturbances and sometimes movement disorders. Sciatica is characterized by the fact that the pain 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 either in the spinal column or in the nuclei of the intervertebral discs.

Vegetovascular dystonia has a mental origin - it is a neurosis that is associated with intrapersonal conflicts or childhood trauma. Externally, VSD and osteochondrosis can be similar to each other: headaches, dizziness, pain in the anterior chest wall.

To distinguish diseases, you need to carry out instrumental diagnostics - X-ray of the cervical spine and other parts, computed and magnetic resonance imaging. As a result of diagnostics 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 task of psychotherapy with VSD is to teach the patient to regulate negative emotions and increase stress resistance. Also, the lifestyle is adjusted: you need to balance the mode of work and rest, exercise and adhere to 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 adhere to the doctor's prescriptions, 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 accurately diagnose osteochondrosis, since back pains have different origins: neurogenic, vascular, viscerogenic (due to 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 adequately choose a treatment for himself, and folk remedies do not have an 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-ray, CT or MRI.

Treatment of osteochondrosis of the spine

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 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 physiotherapy 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 on foot, run, practice in the pool or ride a bicycle. It is also important to change your lifestyle to an active one, since a sedentary one is one of the factors in the development of back pain and destruction of the nuclei of the intervertebral discs.

Surgical treatment is used in the case when conservative therapy was ineffective within 2-4 weeks, and in the case when there are pronounced structural changes in the spine. What kind of operation is 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 shooting in the spine or neck, aching chest pains, weakened muscles in the arm or leg, unpleasant tactile sensations on the skin and numbness, consult a neurologist for advice.