Osteochondrosis intervertebral. Osteochondrosis of the spine: symptoms, causes, treatment

Osteocondritis of the spine is an inflammatory-degenerative disease in which the intervertebral discs, vertebrae, vertebral vessels, and nerves are affected.

The first diagnosis of osteochondrosis was made only 100 years ago. Before that, he was not known to medicine. But in just one century, the prevalence of the disease has skyrocketed. So much so that osteochondrosis began to be called the disease of the century. About 30 years ago, Soviet researchers pointed out that the symptoms of osteochondrosis are detected in every fifth person after 30 years.

Until recently, this pathology was considered the lot of older people. Today, osteochondrosis is “getting younger”. With complaints of back pain, people aged 15-20 years old are increasingly turning to doctors. At 30-40, many patients already have complications associated with osteochondrosis. The disease was diagnosed even in a 7-year-old child.
Today, many new methods of treating osteochondrosis have appeared. But the prevalence of the disease is still on the rise.

Anatomical features of the spinal column

intervertebral disc- anatomical formation, which is located between the bodies of two adjacent vertebrae.

The structure of the intervertebral disc:

• nucleus pulposus. It is located in the central part of the disk. Has high elasticity. Inside the nucleus, in its center, there is a small cavity.
• annulus fibrosus. It is a dense fiber of connective tissue that surrounds the nucleus pulposus. The density of the fibrous ring is not the same everywhere. Behind it is weaker.

What anatomical structures support the normal functioning of the spinal column and prevent the occurrence of osteochondrosis?

• Intervertebral joints. Each vertebra has two upper and two lower articular processes. With the help of them, it articulates with the superior and inferior vertebrae.
• Bundles. If excessive movements constantly occurred in the spine, this would lead to permanent injury to the intervertebral discs and the rapid development of osteochondrosis. This does not happen due to the presence of ligaments. Their main purpose is to limit the movement of the spine.
• muscles. They provide not only movement, but also the maintenance of the normal configuration of the spinal column. So, while holding a pose, the muscles of men are able to develop a force of 120 kg, and women - 70 kg.

Spinal roots and arteries

With osteochondrosis, as a result of a decrease in the height of the intervertebral discs, the lumen of the intervertebral foramina decreases, nerves and arteries are compressed. Inflammation joins. This is due to many of the symptoms of the disease.

Why does osteochondrosis most often develop in the cervical and lumbar spine?

The cervical and lumbar regions are mobile, so the intervertebral discs bear higher loads here. This is a prerequisite for a simpler and faster development of the degeneration process.

Causes of osteochondrosis

• Increased load on the spinal column.
• Sedentary lifestyle.
• Constant long work in an uncomfortable tense position. For example, osteochondrosis is an "occupational" disease of all people who work at a computer.
• Inadequate nutrition.
• Frequent infections, hypothermia.
• Posture disorders, scoliosis.
• Congenital anomalies of the vertebrae. They are quite common and most often occur in the lumbar spine.
• Autoimmune reactions, allergies.
• Spinal injury. It is believed that the so-called whiplash injury is of great importance in the development of osteochondrosis. It often happens to motorists when braking hard and hitting an obstacle. In most cases, whiplash occurs almost imperceptibly for a person, but over time, repeating, it leads to the development of complications, including osteochondrosis.

Stages of osteochondrosis (cervical, thoracic, lumbar)

Osteochondrosis of the cervical spine

What are the symptoms of cervical osteochondrosis?

Treatment of cervical osteochondrosis*

Conservative methods of treatment of cervical osteochondrosis**. There are no drugs that would be able to completely eliminate the cause of the disease. Therefore, the treatment of osteochondrosis is mostly symptomatic. The action of drugs is aimed at eliminating pain and inflammation.
Analgin. Synonyms: Baralgin M Metamizole Sodium.	The most common and popular pain reliever. It can be used for osteochondrosis and a wide range of other pathologies accompanied by pain.	Analgin is used in tablets and in the form of injections. Application in tablets: Take in tablets of 0.5 g, one tablet 2 to 3 times a day. The maximum daily dose for adults is 2 g. Application in injections: Inject intramuscularly 1 ml of a 50% solution of analgin. Contraindications: bronchial asthma, severe liver and kidney disease, severe disorders of the hematopoietic system. Analgin is contraindicated in pregnant and lactating women.
Ketorolac(synonym - Ketorol)	The most powerful non-narcotic pain reliever. It is used for very severe pain strictly according to the doctor's prescription.	Ketorolac is available as tablets and solution for intramuscular injection. Application in tablets: Take 1 tablet of Ketorol (0.01 g) every 6 to 8 hours. Application in injections: Inject intramuscularly in 1 ml of a 3% solution every 6 to 8 hours. The course of treatment with Ketorolac lasts no more than 5-7 days. Contraindications: Peptic ulcer of the stomach, severe damage to the liver and kidneys, impaired hematopoiesis, breastfeeding and pregnancy, children under 16 years of age.
ibuprofen	One of the most powerful and safe drugs that has analgesic, anti-inflammatory effect.	Ibuprofen is available in tablets of 0.2, 0.4, 0.6 g. Adults should take 1 tablet 3 times a day. The first tablet is taken in the morning before meals so that it is absorbed faster. The other two tablets are taken during the day after meals. Contraindications: Gastric and duodenal ulcers, increased bleeding, arterial hypertension, ulcerative colitis, heart failure during pregnancy.
Ortofen Synonyms: Diclogen diklo Diklobene Clofenac	It has a powerful analgesic and anti-inflammatory effect. Superior in this regard to ibuprofen, but can cause more side effects.	Diclofenac is available as tablets and injections. Application in tablets: Take one tablet (0.025 g) 2 to 3 times a day (for adults). Injection: It is used in ampoules, each containing 75 mg of active ingredient. Enter the contents of one ampoule intramuscularly. Do not use more than 3 ampoules at a time or use diclofenac for more than 3 days. Contraindications: Gastric and duodenal ulcers, bronchial asthma, inflammatory bowel pathologies in the acute phase, impaired liver and kidney function. The drug is contraindicated in pregnant women.
Meloxicam(synonym: Movalis)	Meloxicam has a very strong analgesic and anti-inflammatory effect. Compared with the other listed means, it has less ability to provoke peptic ulcer.	Applied in the form of tablets of 0.0075 g: 1 tablet per day with meals. Relative contraindications(diseases for which it is necessary to take with caution): bronchial asthma; allergic diseases; stomach ulcer; duodenal ulcer; kidney and liver diseases. Meloxicam is contraindicated in pregnancy and lactation, under the age of 15 years.
Ointments
Anti-inflammatory ointments: Fastumgel Bystrumgel Finalgel Ketonal Nurofen Nise gel	These ointments and gels contain anti-inflammatory drugs as the main active ingredient - Diclofenac, Meloxicam, Ketoprofen, etc. (see above). They relieve inflammation and pain. The local action makes them safer than tablets and injections.
Ointments with analgesic and local irritating effect: Kapsikam Nicoflux Finalgon Apizartron	The composition of these ointments includes active ingredients that irritate the nerve endings, increase blood circulation, and have an analgesic effect.	Apply a small amount of ointment to the affected area. Rub into skin. The frequency of use - in accordance with the annotation and doctor's prescriptions.
Chonroprotectors(the most common drug from this group is Chondroxide).	Chondroprotectors are drugs that have a beneficial effect on the condition of articular cartilage and intervertebral discs. They protect the disc from further damage and enhance its regenerative processes. Chondroprotectors are not able to completely restore the disc to its original state: drugs that would have such an effect have not yet been created.	Apply a small amount of ointment to the affected area. Rub into skin. The frequency of use - in accordance with the annotation and doctor's prescriptions.
Homeopathic ointments: Target T Traumeel C	According to the mechanism of action, they are similar to anti-inflammatory and analgesic ointments.	Apply a small amount of ointment to the affected area. Rub into skin. The frequency of use - in accordance with the annotation and doctor's prescriptions.
Massage ointments, ointments for athletes: Artrocin gel Balm Dikul ointment Shungite ointments with bee and snake venom	They have a complex effect. Relieve pain and inflammation. Improve and accelerate the regeneration of tissues of the spinal column.	Apply a small amount of ointment to the affected area. Rub into skin. The frequency of use - in accordance with the annotation and doctor's prescriptions.
Massage for cervical osteochondrosis
Massage for osteochondrosis is undesirable to carry out in the acute stage. It is performed only when the exacerbation passes a little, and all symptoms subside. During an exacerbation, in some cases, you can massage the back, chest, shoulder girdle, but not the neck itself. The first massage sessions are performed as sparingly as possible, mainly strokes are used, the duration of the session is 5-7 minutes. During subsequent sessions, massage more intensively, for 12 minutes. Areas that are massaged with cervical osteochondrosis: upper back the entire spinal column chest muscles shoulders, forearms and hands, if the pain spreads to them shoulder girdle head The goals of massage for cervical osteochondrosis: eliminate muscle and ligament tension, thereby reducing pain improve blood circulation and lymph flow in the spinal column enhance the regeneration of intervertebral discs During massage with cervical osteochondrosis, the patient should lie on his stomach. Sometimes massage can be done while sitting, while the patient puts his hands on the table and leans his forehead on them. During the massage, you can not use rough techniques and cause pain.
What exercises and gymnastics are effective for the treatment and prevention of cervical osteochondrosis?
A set of exercises for the neck	A set of exercises for the neck with osteochondrosis is designed to strengthen muscles, reduce pain, restore mobility in the cervical spine. Gymnastics begins to be done after the next exacerbation of the disease passes.	Exercises (each performed for 7 minutes, then the time increases): turning the head to the right and to the left; tilting the head forward and backward; head tilts to the right and left; raising and lowering the shoulders; head rotation clockwise and counterclockwise; turns and tilts of the head with simultaneous opposition by the hand.
Swimming	Swimming is one of the most useful sports for patients with osteochondrosis of the cervical and other parts of the spine. In water, muscles relax, stretching of the spinal column.	After the exacerbation of osteochondrosis subsides, you can sign up for a pool and visit it once a week. You must first consult with your doctor.
Physiotherapy for cervical osteochondrosis
Electrophoresis with anesthetics (usually with analgin)	Electrophoresis is a physiotherapeutic procedure in which the medicinal substance enters the body through the skin under the influence of a constant weak electric current.	Can be done in a clinic or hospital. Two electrodes are placed on the patient's skin in the neck and shoulder girdle, one of which is moistened with Analgin's solution. Usually the procedure is carried out within 15 minutes, the general course is 10 procedures.
Magnetotherapy	For the treatment of cervical osteochondrosis, a low-frequency magnetic field is used. It acts on cells and their constituent molecules. A strong analgesic and anti-inflammatory effect is achieved. Magnetotherapy is safe and practically has no contraindications.	The procedures are carried out in a clinic or hospital. The patient is in a supine or prone position. A magnet is placed on the neck or shoulder girdle. The average duration of treatment is 10 procedures.
Underwater traction	The procedure is carried out in specialized clinics. There is a stretching of the spinal column, elimination of pinched nerve roots.	A special collar made of wood or other floating material is placed around the patient's neck, and a load of a certain mass is suspended from the legs. In this position, the patient is in a pool of water for a certain time.
Paraffin wraps	Paraffin warms the tissues, helps to eliminate pain and inflammation.	It can be carried out at home, in a hospital or in a sanatorium. Usually 10 procedures are prescribed.
Wearing orthopedic devices.	During an exacerbation, patients with cervical osteochondrosis are prescribed to wear a Shants collar. With the right size, it limits the movement of the neck and helps to eliminate pain.	During an exacerbation of cervical osteochondrosis, the Shants collar is worn constantly, taking it off only at night. After the symptoms subside, wearing it for a long time is not indicated, as this leads to a weakening of the neck muscles.

How to eliminate pain in cervical osteochondrosis?

Why does a headache occur with cervical osteochondrosis?

• Compression of the spinal nerves. They run along the cervical spine and rise to the back of the head. There is severe pain in the neck and neck on one side. Pain sensations spread to the parietal and temporal region on the side of the same name. The pain can last up to 10 hours.
• Compression of the occipital nerves. When they are affected, the pain is very severe, spreading to the entire head.
• Syndrome of the vertebral artery (see above). In this case, pain occurs on both sides. At the same time, dizziness, visual disturbances, nausea and vomiting are noted.
• Increased intracranial pressure. It occurs as a result of a violation of the outflow of blood from the cranial cavity during compression of blood vessels.

Treatment of cervical osteochondrosis with folk remedies

• Take 1 tablespoon of peppermint leaves and St. John's wort flowers. Mix. Pour in a glass of boiling water.
• Insist for 10 minutes, decant.
• Melt two tablespoons of Vaseline in a water bath.
• Mix petroleum jelly with herbal infusion, add 1 teaspoon of hellebore infusion.
• Rub a small amount of ointment into the neck several times a day.

• Take 2 teaspoons of yarrow. Mix with a tablespoon of St. John's wort flowers
• Melt 2 tablespoons of Vaseline in a water bath
• Mix the Vaseline with the herbal mixture. Add a teaspoon of hellebore infusion
• Rub a small amount of ointment on the neck several times a day

• Take 1 teaspoon of pine needles. Pour a glass of boiling water and boil for 1 minute
• Let it brew for 30 minutes. Express
• Take a quarter cup of decoction 3 times a day

Bath with sage and carrot juice

• Take 50 g of fresh carrot juice and 500 ml of sage infusion. mix
• Add the whole mixture to a warm bath
• Take a bath for 10-15 minutes. The procedure can be repeated within 12 days

What types and degrees of cervical osteochondrosis are there?

• cervicalgia- Pain in the neck area only
• cervicocranialgia- neck pain, headaches
• cervicobrachialgia- pain in the neck and shoulder girdle, arm
• radiculo-ischemia- damage to nerve roots and blood vessels

Thoracic osteochondrosis

What are the symptoms of thoracic osteochondrosis?

• Pain. Initially occurs in the back, in the interscapular region. Over time, it can spread to the chest, shoulder girdle, lower back. By nature it is aching, pulling, burning, stabbing. Increases during physical exertion and prolonged stay in an uncomfortable monotonous position. Due to a violation of muscle tone, patients with thoracic osteochondrosis often complain that during a night's sleep, their back seems to be “squeezed with pincers”. In severe cases of thoracic osteochondrosis, the pain intensifies during coughing, patients cannot travel in transport.


• Movement disorders in the thoracic spine. Usually extension. This symptom is relatively rare in thoracic osteochondrosis, since normally the thoracic vertebrae are rigidly fixed by the ribs.


• Violation of the sensitivity of the skin. Revealed in thoracic osteochondrosis very clearly. In some patients, skin sensitivity decreases, while in others it increases.


• Motor dysfunction. Manifested in the weakening of the muscles located below the chest, reducing their tone, reducing reflexes. Most often, the muscles of the legs and abdominals are affected.


• Vascular disorders. When pain occurs in the thoracic spine, a spasm of the vessels of the legs occurs. It manifests itself in blanching and cooling of the skin, the appearance of unpleasant sensations (tingling, "crawling").


• Pain in the region of the heart. They can occur behind the sternum, as in angina pectoris, directly in the region of the heart, give to the shoulder. By nature - compressive, pressing, girdle. Increased during physical exertion, deep breathing, coughing and sneezing.
• Stomach ache. Relatively rare symptom of thoracic osteochondrosis. They can have a different character, arise as a result of irritation of the solar plexus.

Treatment of thoracic osteochondrosis***

Alternative methods of treatment of thoracic osteochondrosis: as in cervical osteochondrosis.

Osteochondrosis of the lumbar spine

What are the symptoms of lumbar osteochondrosis?

• pain. Most often dull, aching, pulling. They are provoked by a long stay in an uncomfortable position, physical exertion, hypothermia. With lumbar osteochondrosis, pain is noted in the lower back, sacrum, gluteal region, one or both legs. Sometimes pain occurs in the lower part of the thoracic spine. Often, due to pain, it is difficult for the patient to straighten up after he has been in a position with a bent lower back for a long time.
• Lumbago- Lumbar shots. Characterized by the occurrence of severe pain during physical exertion, most often weight lifting. It lasts for hours or days.
• Skin sensitivity disorders. Most often, the sensitivity of the skin in the lumbar region, buttocks, and lower extremities decreases. Sometimes, on the contrary, there is a pathological increase in sensitivity. Some patients are disturbed by unpleasant sensations: numbness, tingling, "crawling", etc.
• Muscle disorders. Manifested by a weakening of the muscles of the legs, a decrease in their tone, a decrease in the severity of reflexes. Over time, muscle atrophy develops - a decrease in their volume.
• Vascular disorders. During an attack of pain and changes in the weather, the skin of the legs turns pale and becomes cold. There are specific stabbing, burning, itching pains.
• Vegetative manifestations associated with a violation of the nervous regulation of blood vessels and sweat glands when squeezing the nerve roots. Manifested in the form of blue skin of the legs, excessive sweating or, on the contrary, dryness and peeling.

How to treat osteochondrosis of the lumbar spine?****

Treatment method		Description		Application
Drug therapy, the use of ointments and physiotherapy for lumbar osteochondrosis - see "methods of treatment of cervical osteochondrosis."
What exercises do doctors recommend for osteochondrosis of the lumbar spine?
Gymnastics complex for the lower back	Before doing gymnastics, you should consult with your doctor. In the acute period of the disease, a set of exercises is performed in the prone position. After the exacerbation subsides, a set of exercises in a standing position.		Exercises from the starting position lying down (start with 5 repetitions, then increase): raise your arms up and stretch while inhaling, lowering while exhaling; bending the legs at the knee joints, without lifting the heel off the floor; alternately lifting straight legs up; alternately abducting the legs to the side; flexion in the neck; exercise "bicycle"; lying on your side: raise the straight upper leg. Exercises from a standing position (start with 5 reps, then increase): tilts back and forth (on inhalation and exhalation, respectively); tilts to the right and left; turns right and left; alternate abduction of the legs to the sides; alternately lifting the legs bent at the knees to the chest.
Massage for lumbar osteochondrosis Massage rules for osteochondrosis of the lumbar spine: Massage is done after the exacerbation subsides, when there is no pain. First massage the healthy side, and then the one on which there is a lesion. The position of the patient during the massage of the lower back: on the stomach, on a flat hard surface (couch or massage table), a massage pillow is placed under the lower back, so that it does not sag. Perform massage of the lumbar, sacral region, buttocks, thighs, legs, feet (if necessary), back. On average, patients with osteochondrosis of the lower back undergo a massage course 1-2 times a year. The duration of the procedure, depending on the severity of the process, is from 8 to 20 minutes. The total number of sessions is 10.

Alternative methods of treatment of lumbar osteochondrosis: as in cervical osteochondrosis.

Osteochondrosis of the sacral spine

Causes of symptoms of lumbosacral osteochondrosis:

• spread of the pathological process from the lower back to the sacrum, degeneration of the intervertebral disc located between the last lumbar and the first sacral vertebra;
• inflammation of the nerve roots emerging from the sacral openings;
• damage to the sacrococcygeal joint.

What are the symptoms of lumbosacral osteochondrosis?

• Pain. Aching, pulling. Occurs in the buttock area, spreads to the leg. It is provoked by physical exertion, prolonged uncomfortable position, hypothermia.
• Sensory and motor dysfunctions. Similar to those for lumbar osteochondrosis.
• Disorders of the organs located in the pelvic cavity. Patients with lumbosacral osteochondrosis have frequent urge to urinate, urinary incontinence or, conversely, urinary retention. Men have erection problems.
• Vascular disorders similar to those in lumbar osteochondrosis.
• Coccygodynia - damage to the coccyx, in which there are severe pains in the coccyx, anus.

How to treat osteochondrosis of the sacral spine?

Treatment method		Description		Application
Drug therapy, the use of ointments and physiotherapy for lumbosacral osteochondrosis - see "methods of treatment of cervical osteochondrosis."
What exercises do doctors recommend for osteochondrosis of the sacral spine?
A set of exercises for the legs in the supine position.	Therapeutic exercises are performed after the exacerbation subsides, when there is no pain. All exercises are performed from the starting position lying on your back.		A set of exercises (in the supine position): bending the legs at the knee joints without lifting the heels off the floor alternately lifting the right and left straight legs up alternating abduction of the right and left legs to the sides alternately bending the legs and bringing them to the chest simultaneous lifting of straightened legs rotation in the ankle joints exercise "bike"
Massage for lumbosacral osteochondrosis Rules for massage with lumbosacral osteochondrosis: a massage course is carried out after an exacerbation, when the pain subsides; during the procedure, the patient lies strictly on his back on a hard surface; the lower back, gluteal region, lower limbs are massaged; the first massage sessions should be light and accurate, in the future the force of the impact increases; full course - 10 massage sessions; it is desirable for patients with lumbosacral osteochondrosis to undergo a course of therapeutic massage 1-2 times a year. The purpose of the procedure: to strengthen muscles, reduce pain, improve blood flow, stimulate tissue regeneration.

Alternative methods of treatment of lumbosacral osteochondrosis: as in cervical osteochondrosis.

What is common osteochondrosis of the spine?

Surgical treatment of osteochondrosis

• complications of osteochondrosis, causing compression of the spinal cord: disc herniation, subluxation of the vertebrae, spondylolisthesis;
• dysfunction of the pelvic organs: urination, defecation;
• cauda equina syndrome: pinching of the nerve roots extending from the lumbar segment of the spinal cord;
• conditions in which a doctor may recommend surgical treatment for osteochondrosis: persistent pain that is not amenable to conservative treatment, frequent exacerbations, severe violations of sensitivity and motor functions.

• foraminotomy- expansion of the opening through which the roots of the spinal nerves exit;
• laminectomy- removal of the back of the vertebral arch, which puts pressure on the spinal cord;
• laminotomy– expansion of the spinal canal;
• discectomy- removal of the intervertebral disc, sometimes it is replaced with an artificial one;
• corpectomy- complete removal of the vertebra and the installation of a bone graft instead;
• spinal fusion- fixation of the vertebrae by connecting them to each other.

How is the prevention of osteochondrosis carried out?

• Physical activity. Usually there is enough gymnastics in the morning and a weekly visit to the pool. This helps to maintain normal mobility of the spine and strengthen the natural muscle corset.
• Massage. Even a healthy person is useful once a year to undergo a massage course.
• The fight against excess weight. Excess body weight puts additional stress on the spinal column.
• Timely fight against postural disorders in schoolchildren and scoliosis. These conditions often precede osteochondrosis.
• Optimum mode of work and rest. This is especially true for people who constantly work in a monotonous position. It is necessary to arrange periodic breaks during which to walk, stretch.
• Complete nutrition. The body must receive all the necessary vitamins and minerals.
• Limit hard physical labor. And if you have to do such work, then wear a special corset.
• Try to keep your back straight as you walk..
• hardening(water and sunbathing) has a very beneficial effect on the condition of the spinal column.

MRI and CT for osteochondrosis, what are the indications and signs?

	Computed tomography (CT)	Magnetic resonance imaging (MRI)
Method principles	The use of x-rays to obtain an image of the layers of the organ under study - slices of tomograms. The image is displayed on a computer, printing on film is possible.	The use of electromagnetic waves in the magnetic field of hydrogen atoms - magnetic resonance. That is, MRI is not an X-ray method of examination. Also, sections of tomograms are obtained on a computer, and, if necessary, on film.
Indications	CT is informative for pathologies of the bone structures of the spine: intervertebral hernia, protrusion; severe scoliosis; spinal injury, especially in the presence of hematomas (hemorrhages); osteochondrosis of the cervical spine with impaired cerebral circulation; spondylarthrosis; deforming spondylosis; tuberculosis or syphilis of the spine; vertebral tumors; preparation for surgical interventions on the spine.	MRI is more informative for pathologies of the soft structures of the spine: the need to assess the state of the spinal cord, for example, with the development of paralysis; osteochondrosis, accompanied by chronic radiculitis; preparation for operations on the spine; spinal injuries, especially if necessary, assess the condition of the muscles, spinal cord, nerve roots; diagnosis of tumors of the spine and surrounding tissues; congenital anomalies of the spinal column.
Contraindications	There are no absolute contraindications. Relative contraindications to CT: pregnancy, any term; early childhood - often requires the use of anesthesia for immobilization during the examination; patients with mental disorders, including those with claustrophobia; obesity (the patient may not climb into the apparatus).	the presence of any metallic inclusions in the body: prostheses, metal plates and other devices for restoring the integrity of bones, metal dental crowns and so on; availability of electronic devices: pacemaker, hearing implants; obesity, weight over 120 kg; mental disorders; severe condition of the patient.
Advantages	accurate assessment of the condition of the vertebrae and intervertebral discs; great opportunities in the analysis of the results obtained, the possibility of obtaining a reconstruction of a three-dimensional image; the possibility of research with the introduction of a contrast agent (if necessary, assess the condition of the vessels); convenient archiving and electronic transfer of the results.	X-rays are not used; you can effectively assess the state of the vessels and each nerve root, spinal cord; high accuracy and information content; high technology allows you to accurately evaluate the results; electronic archive, transfer of the results.
Flaws	a large number of contraindications; high cost, higher than with computed tomography.
Signs of osteochondrosis on tomograms	increasing the density of the plates, which are covered with cartilage (vertebral bodies, articular processes); with complications - signs of inflammation of the nerve roots; possible depression of the vertebrae - intervertebral hernia; protrusion - protrusion of the intervertebral discs; violation of the integrity of the bone in spondylarthrosis and other concomitant pathologies; with severe or widespread osteochondrosis, the development of severe scoliosis is possible.
What does osteochondrosis look like on tomograms (photo)	CT, signs of osteochondrosis of the thoracic spine.	MRI, signs of early stages of osteochondrosis of the thoracic spine.

MRI and CT are very informative in diseases of the spine, sometimes these diagnostic methods have the last word in the accurate diagnosis, determination of complications and the amount of necessary therapy, especially with regard to surgical treatment.

Can osteochondrosis feel sick, stomach ache, body temperature rise? Does osteochondrosis affect the eyes, potency, heart function, blood pressure, depression?

Osteochondrosis, protrusions and herniated discs, what are the causes and principles of treatment?

Protrusions of the intervertebral discs- protrusion of the intervertebral disc while maintaining the integrity of the fibrous ring. This pathology occurs with osteochondrosis due to circulatory disorders in the fibrous rings of the intervertebral joints, that is, insufficient supply of amino acids and other nutrients. Because of this, the fibrous capsule becomes thinner, microcracks form in it, through which the intervertebral disc protrudes (there is no complete rupture of the capsule). This process, in addition to osteochondrosis itself, is also affected by an incorrect center of gravity on the vertebrae, that is, the presence of deformation of the spinal column (scoliosis, lordosis and kyphosis).

Protrusions of the intervertebral discs often occur in the cervical or lumbar spine (the departments subject to the greatest physical stress), in the thoracic region they are less common.

The formation of a protrusion goes through three stages:

1. initial stage - the formation of microcracks in the fibrous ring, flattening of the intervertebral disc.

2. Stage of protrusion of the intervertebral disc - the disk can move in any direction:

• into the lumen of the spinal canal;
• outward from the spinal column, in any direction;
• forward of the spinal column.

3. The stage of the beginning of the formation of an intervertebral hernia - over time, protrusions lead to rupture of the intervertebral ring and incomplete prolapse of the intervertebral disc.

Herniated discs- complete prolapse of the intervertebral disc from the annulus fibrosus. This is the outcome of disc protrusion as a result of osteochondrosis. Most often localized in the lumbar and sacral spine.

Disk prolapse, as well as its protrusion, can occur in the spinal canal and out. And when it protrudes into the vertebral body, Schmorl's hernia is formed.

Symptoms of protrusions and herniated discs similar to manifestations of osteochondrosis, the main manifestations are pain and impaired movement, but with disc displacements, their intensity is higher. In severe cases, numbness of the extremities is possible, and with complete compression of the roots of the spinal nerves, paralysis of the lower extremities may develop. But with minor disc displacements, there may be no symptoms.

The course of disc herniations and protrusions is chronic, with periods of attacks (exacerbations) and remissions. The period of exacerbation usually lasts up to 6 weeks.

But the main method for diagnosing protrusions and hernias are X-ray methods (radiography and computed tomography) and MRI, without such studies it is not possible to make a diagnosis.

Treatment of protrusions and hernias of intervertebral discs.

Treatment is necessary only in the presence of pain and movement disorders. During the period of remission, the patient does not need therapy.

Principles of treatment of protrusions and hernias of intervertebral discs:

1. Medical therapy:

• anti-inflammatory and pain medications for internal and external use (tablets, injections, ointments, gels and creams containing diclofenac, nimesulide, ibuprofen, etc.);
• hormonal preparations for external use (ointments, creams Hydrocortisone, Deperzolon, Elokom and others).

Is it possible to completely cure osteochondrosis?

The goal of treating osteochondrosis is to eliminate pain and other symptoms of the disease and achieve a stable (that is, long-term) remission. The outcome is called favorable if the remission lasts 5-10 years or more.

The prognosis for osteochondrosis depends on many factors:

• Early detection of the disease , even before the development of complications, and its correct treatment contributes to a relatively rapid remission of the process and the development of stable remission, that is, the sooner the better.
• Elimination of factors contributing to the development of osteochondrosis (active lifestyle, massage, correct posture, dosed physical activity, weight normalization) also positively affects the transition of osteochondrosis to the stage of stable remission.
• The development of various complications , for example, protrusions and hernias of the intervertebral discs, worsens the course and outcome of osteochondrosis, contributes to more frequent and prolonged exacerbations, stiffness of movements in the spine and a decrease in the period of remission. That is, it is impossible to start osteochondrosis before the development of irreversible complications.
• The presence of comorbidities for example, spinal injuries, spinal anomalies also worsens the prognosis of osteochondrosis.
• The duration of remission depends not so much on drug treatment as on rehabilitation period and further lifestyle . No drugs, chiropractors and even surgical interventions will not get rid of the problem of osteochondrosis, if you do not keep the spine "in good shape" and after eliminating the pain syndrome.
• Patient's age young people have a better prognosis for this disease than older people.

Which doctor is better to contact with osteochondrosis?

When identifying the first symptoms of diseases of the spine, you should contact a specialist who will prescribe an effective treatment, and not self-medicate.

Chondroprotectors for osteochondrosis, what are the types and effectiveness?

Chondroprotectors are a group of drugs that improve the condition of cartilage tissue.

Preparations of chondroprotectors may contain the following substances:

• hyaluronic acid salts - they are not used for osteochondrosis, since the drugs must be injected directly into the joint, which is difficult for the spine;
• chondroitin sulfate sodium;
• glucosamines;
• Excipients: B vitamins, vitamin D, sulfur, herbal preparations (for example, dandelion root).

Expected effects from taking chondroprotectors:

• providing cartilage with “building material”;
• cessation of the process of destruction of cartilage tissue;
• partial restoration of already damaged cartilage tissue;
• prevention of the development of protrusions and hernias of intervertebral discs;
• prevention of the spread of scar tissue, and as a result - almost complete restoration of flexibility, depreciation and functions of the spinal column.

• shortening of periods of exacerbations;
• prevention of exacerbations;
• prolongation of periods of remission;
• decrease in the percentage of development of complications of osteochondrosis.

What chondroprotectors are used for osteochondrosis?

When are chondroprotectors prescribed?

When are chondroprotectors contraindicated?

• pregnancy and lactation;
• allergic reactions to the drug or its components;
• children's age up to 15 years;
• blood clotting disorders and others.

What drugs improve cerebral circulation in osteochondrosis?

This condition has a very negative effect on the general well-being of the patient, his mental and mental activity, vision, and so on. Therefore, it is very important to normalize the tone of the vertebral vessels. To do this, use drugs that improve cerebral circulation. They will improve blood flow to the brain and save the patient from various complaints and irreversible consequences, such as stroke, arterial hypertension, atherosclerosis of cerebral vessels, and so on.

Preparations for improving cerebral circulation in cervical osteochondrosis.

In addition to improving blood circulation in the brain, data drugs improve the condition of the intervertebral discs in osteochondrosis due to:

• improvement of blood circulation of the fibrous rings of the spine;
• improving the nutrition of cartilage tissue of the discs;
• normalization of blood circulation of the muscles of the neck and back.

What should be a pillow and mattress for osteochondrosis?

Orthopedic mattresses and pillows will give a good effect.

How to choose an orthopedic pillow for cervical osteochondrosis?

Unfortunately, it is not always possible to choose the correct and suitable pillow for you the first time. But there are signs by which you can judge that the selected pillow is not suitable:

• after waking up, the neck and head hurt;
• in a dream, a hand is substituted under the pillow;
• poor sleep, feeling overwhelmed.

But in addition to a comfortable and proper pillow, you need to sleep on the right and comfortable mattress.

How to choose an orthopedic mattress?

• the mattress should lie on a flat hard surface;
• the mattress itself should also be flat and moderately hard (semi-hard);
• the mattress should not have jumpers, rough folds that can press during sleep;
• mattress fillers are different (latex, polyurethane foam, holofiber, coconut coir and many others), but the Memorix class, which remembers the position of the body, is considered the best.

In addition to the selected mattress and pillow, it is also important to observe the correct posture in bed. Of course, this is impossible in a dream, but during the period of exacerbation of osteochondrosis with severe pain, this can be followed. The best position is sleeping on your back with a roll under the knee pits.

Corset and Shants collar for osteochondrosis, how to wear them correctly and for how long?

Positive effects of wearing a corset for osteochondrosis:

• reduces the load on the spinal column, the corset performs the functions of a frame, which are normally back muscles;
• relieves pain;
• helps to relax the muscles, relieve fatigue and strengthen the muscular frame;
• maintaining correct posture, treatment and prevention of scoliosis;
• warming effect;
• prevention of such complications as protrusions and hernias of intervertebral discs, infringement of nerve roots, and so on.

Depending on which part of the spine is affected, one or another is used. corset type:

• neck corset and Shants collar;
• corset for the thoracic spine;
• for the lumbar;
• combined corset for the thoracic and lumbar regions.

What should be the corset?

• It is best if the corset is made individually, it will come in handy if you need to wear it for a long time, for example, after surgery, but you can buy standard corsets in specialized pharmacies;
• the corset is made of a plastic frame and dense fabric, the materials should not be deformed while wearing, the price of the product depends on their quality;
• the fabric component of the corset must be warm, and the inner lining may contain natural wool;
• for convenient use, the corset should be fixed with fasteners, the most convenient fastening is in the form of Velcro.

When is a corset prescribed?

• Only a doctor can prescribe a corset, he must also indicate which corset is needed and how to use it;
• usually a corset is prescribed during an exacerbation of osteochondrosis for a faster recovery;
• after surgery on the spine;
• after a spinal injury;
• it is also desirable to use a corset during the recovery period, especially with increased physical exertion.

How to wear a corset for osteochondrosis?

• The corset is put on and fixed in the prone position;
• it can be worn both on a naked body and on knitwear;
• how many hours a day to wear a corset - only the doctor determines, he can recommend its use throughout the day, several hours a day, or only if physical activity is necessary;
• during sleep or in the prone position, the corset must be removed, however, there are situations when a round-the-clock stay in the corset is recommended;
• it is also important to decide how tightly the corset will be fastened, for example, after the operation, the corset is tightened quite tightly;
• the duration of wearing a corset can be from 1 to 6 months, some patients use it regularly to prevent exacerbations.

Shants collar features

• the Shants collar is a corset-tire for the cervical spine;
• to all the advantages of a corset, such a collar helps to relieve vertebral artery syndrome and improves cerebral circulation;
• the Shants collar is soft, semi-rigid and rigid, with osteochondrosis, a soft collar is most often used;
• it is very important to choose the right collar size, which depends on the height of the neck, to determine it, measure the distance from the lower jaw to the collarbone;
• with the right choice, the collar will fit snugly along the back of the neck;
• when fixing the Shants collar, pay attention to the fact that the head must be fixed evenly, and movements in the neck are sharply limited;
• the time of wearing the collar is determined individually by the attending physician.

Is it possible to cure osteochondrosis at home?

When you can not be treated at home and you need to see a doctor urgently?

• With numbness of the limbs;
• severe pain in the back or neck that cannot be treated;
• impaired movement in the limbs;
• dizziness, severe headaches, incoordination and other brain symptoms;
• with a sharp restriction of movements in the spine (the patient cannot get out of bed).

1. In an acute period restrict movement required bed or semi-bed rest.
2. Massage and therapeutic exercises (LFK)- You can start after the removal of an acute pain attack. It is important to carry out these procedures regularly and systematically.
3. Necessary local warmth, wrap yourself in a blanket, bandage with a warm woolen scarf, you can apply a compress, mustard plasters.
4. Ointments, gels, creams:

• anti-inflammatory (Diclofenac, Ibuprofen and others);
• irritating ointments (with essential oils of menthol, eucalyptus, flax, snake and bee venom);
• combination drugs.

More information about the drug and non-drug treatment of osteochondrosis of a certain section of the spine can be found in the article.

Monastery Tea.

Recently, Monastic Tea is often recommended for the treatment of osteochondrosis. In principle, it contains useful natural ingredients that have an anti-inflammatory effect, contain a large amount of vitamins and trace elements, antioxidants.

Ingredients of Monastic tea:

• rose hip;
• St. John's wort;
• oregano;
• elecampane;
• black or green tea.

How is Monastic Tea taken?

Such tea should be fresh and can be drunk without restrictions during the day (like regular tea). The course of treatment is 1 month. Repeat these courses twice a year.

This is a chronic disease in which degenerative changes occur in the vertebrae and the intervertebral discs located between them. Depending on the location of the lesion of the spine, there are: osteochondrosis of the cervical region, osteochondrosis of the thoracic region and osteochondrosis of the lumbar region. For the diagnosis of osteochondrosis of the spine, it is necessary to conduct x-rays, and in case of its complications (for example, a herniated disc) - MRI of the spine. In the treatment of osteochondrosis of the spine, along with medical methods, reflexology, massage, manual therapy, physiotherapy and physiotherapy exercises are widely used.

Etiology and pathogenesis

To some extent, osteochondrosis of the spine develops in all people of age and is one of the processes of aging of the body. Sooner or later, atrophic changes occur in the intervertebral disc, however, injuries, diseases and various overloads of the spine contribute to the earlier onset of osteochondrosis. The most common osteochondrosis of the cervical and osteochondrosis of the lumbar spine.

About 10 theories of osteochondrosis have been developed: vascular, hormonal, mechanical, hereditary, infectious-allergic, and others. But none of them gives a complete explanation of the changes occurring in the spine, rather they are complementary to each other.

It is believed that the main point in the occurrence of osteochondrosis is the constant overload of the spinal motion segment, which consists of two adjacent vertebrae with an intervertebral disc located between them. Such an overload can occur as a result of a motor stereotype - posture, an individual manner of sitting and walking. Posture disorders, sitting in the wrong position, walking with an uneven spinal column cause additional stress on the discs, ligaments and muscles of the spine. The process can be aggravated due to the peculiarities of the structure of the spine and the insufficiency of the trophism of its tissues, due to hereditary factors. Most often, defects in the structure are found in the cervical region (Kimerli anomaly, craniovertebral anomalies, Chiari anomaly) and lead to vascular disorders and early onset of signs of osteochondrosis of the cervical spine.

The occurrence of osteochondrosis of the lumbar spine is more often associated with its overload during bending and lifting weights. A healthy intervertebral disc can withstand significant loads due to the hydrophilicity of the nucleus pulposus located in its center. The core contains a large amount of water, and liquids are known to be poorly compressible. Rupture of a healthy intervertebral disc can occur with a compression force of more than 500 kg, while a disc changed as a result of osteochondrosis ruptures with a compression force of 200 kg. A load of 200 kg is experienced by the lumbar spine of a person weighing 70 kg, when he holds a 15-kilogram load in the position of tilting the body forward by 200. Such a large pressure is due to the small size of the nucleus pulposus. With an increase in inclination to 700, the load on the intervertebral discs will be 489 kg. Therefore, often the first clinical manifestations of osteochondrosis of the lumbar spine occur during or after lifting weights, doing housework, weeding in the garden, etc.

With osteochondrosis, the pulpous nucleus loses its hydrophilic properties. This is due to disturbances in its metabolism or insufficient intake of necessary substances. As a result, the intervertebral disc becomes flat and less elastic, and radial cracks appear in its fibrous ring under load. The distance between adjacent vertebrae decreases and they shift relative to each other, while displacement occurs in the facet (facet) joints connecting the vertebrae.

Destruction of the connective tissue of the fibrous ring of the disc, ligaments and capsules of the facet joints causes a reaction of the immune system and the development of aseptic inflammation with swelling of the facet joints and surrounding tissues. Due to the displacement of the vertebral bodies, the capsules of the facet joints are stretched, and the altered intervertebral disc no longer fixes the bodies of neighboring vertebrae so firmly. Instability of the spinal segment is formed. Due to instability, it is possible to pinch the spinal nerve root with the development of radicular syndrome. With osteochondrosis of the cervical spine, this often occurs during head turns, with osteochondrosis of the lumbar spine - during torso tilts. It is possible to form a functional block of the spinal motion segment. It is caused by compensatory contraction of the vertebral muscles.

A herniated disc is formed when the disc shifts backward, ruptures the posterior longitudinal ligament, and protrudes part of the disc into the spinal canal. If at the same time the nucleus pulposus of the disc is squeezed into the spinal canal, then such a hernia is called ruptured. The severity and duration of pain with such a hernia is much greater than with an unruptured one. A herniated disc can cause radicular syndrome or spinal cord compression.

With osteochondrosis, bone tissue grows with the formation of osteophytes - bone outgrowths on the bodies and processes of the vertebrae. Osteophytes can also cause compression of the spinal cord (compression myelopathy) or cause radicular syndrome.

Symptoms of osteochondrosis of the spine

The main symptom of osteochondrosis of the spine is pain. The pain can be acute with high intensity, it increases with the slightest movement in the affected segment and therefore forces the patient into a forced position. So, with osteochondrosis of the cervical spine, the patient holds his head in the least painful position and cannot turn it, with osteochondrosis of the thoracic region, the pain intensifies even with deep breathing, and with osteochondrosis of the lumbar spine, it is difficult for the patient to sit down, get up and walk. This pain syndrome is typical for compression of the spinal nerve root.

In about 80% of cases, there is a dull pain of a constant nature and moderate intensity. In such cases, when examining a doctor, it is necessary to differentiate the manifestations of osteochondrosis of the spine from myositis of the muscles of the back. Dull pain in osteochondrosis is due to excessive compensatory tension in the muscles that hold the affected spinal motion segment, inflammatory changes, or significant stretching of the intervertebral disc. In patients with such a pain syndrome, there is no forced position, but limitation of movements and physical activity is revealed. Patients with osteochondrosis of the cervical spine avoid sharp turns and tilts of the head, with osteochondrosis of the lumbar spine - slowly sit down and stand up, avoid tilting the body.

All symptoms of osteochondrosis, manifesting only in the region of the spinal column, belong to the vertebral syndrome. All changes localized outside the spine form an extravertebral syndrome. It can be pain along the peripheral nerves when their roots are compressed at the exit from the spinal cord. For example, lumboischialgia - pain along the sciatic nerve with osteochondrosis of the lumbar spine. With osteochondrosis of the cervical spine, these are vascular disorders in the vertebrobasilar basin of the brain, caused by compression of the vertebral artery.

Complications of osteochondrosis of the spine

Complications of osteochondrosis are associated with a herniated disc. These include compression of the spinal cord (discogenic myelopathy), which is characterized by numbness, weakness of certain muscle groups of the limbs (depending on the level of compression), leading to the appearance of paresis, muscle atrophy, changes in tendon reflexes, impaired urination and defecation. An intervertebral hernia can cause compression of the artery that feeds the spinal cord, with the formation of ischemic areas (spinal cord infarction) with the death of nerve cells. This is manifested by the appearance of a neurological deficit (disturbance of movement, loss of sensitivity, trophic disorders), corresponding to the level and prevalence of ischemia.

Diagnosis of osteochondrosis of the spine

Diagnosis of osteochondrosis of the spine is carried out by a neurologist or vertebrologist. At the initial stage, an X-ray of the spine is performed in 2 projections. If necessary, they can make a survey of a separate vertebral segment and a survey in additional projections. Magnetic resonance imaging (MRI of the spine) is used to diagnose intervertebral hernia, assess the condition of the spinal cord and identify complications of osteochondrosis. MRI plays an important role in the differential diagnosis of osteochondrosis and other diseases of the spine: tuberculous spondylitis, osteomyelitis, tumors, ankylosing spondylitis, rheumatism, infectious lesions. Sometimes in cases of complicated osteochondrosis of the cervical spine, it is necessary to exclude syringomyelia. In some cases, if MRI is not possible,

In the drug therapy of osteochondrosis, non-steroidal anti-inflammatory drugs (NSAIDs) are used: diclofenac, nimesulide, lornoxicam, meloxicam, ketoralac. With intense pain, analgesics are indicated, for example, the centrally acting analgesic flupirtine. To relieve muscle tension, muscle relaxants are used - tolperisone, tizanidine. In some cases, it is advisable to prescribe anticonvulsants - carbamazepine, gabapentin; antidepressants, among which preference is given to serotonin reuptake inhibitors (sertraline, paroxetine).

In the event of a radicular syndrome, the patient is shown inpatient treatment. Perhaps local administration of glucocorticoids, decongestant therapy, the use of traction. In the treatment of osteochondrosis, physiotherapy, reflexology,

Intervertebral osteochondrosis is a disease of the spine caused by changes in discs of a dystrophic nature, resulting in a decrease or loss of depreciation properties and a decrease in elasticity and mobility of the entire spine.

Although intervertebral osteochondrosis is traditionally attributed to the field of orthopedic diseases and partly to neuropathology, recently it has been included in all classifications of rheumatological diseases. This is due to the fact that degenerative lesions of the discs, intervertebral facet (facet) joints, and subsequently the bodies of the vertebrae themselves are in many ways similar to. In addition, degenerative lesions of the spinal column are often combined with.

Causes of the disease

Osteochondrosis of the intervertebral discs develops primarily as a result of metabolic disorders in them, which leads to malnutrition and subsequent degenerative changes in these formations.

Intervertebral discs play an important role in the physiology of movements, ensuring the ability of the spine to withstand significant loads of a static and dynamic nature. In everyday life, a person is often forced to stay in an uncomfortable position for a long time, which is a rather serious test for the spine. The spinal column is also subjected to overload when running, jumping, falling, hitting, even ordinary walking. The traumatic effect of these factors is significantly mitigated or neutralized due to the elasticity and resilience of the discs.

Violation of posture is one of the causes of osteochondrosis

The thickness of the discs varies to a certain extent depending on the location: in the lumbar spine it is larger than in the thoracic and cervical, since the lower part has to withstand a greater load.

With osteochondrosis of the intervertebral discs, their change or destruction occurs. This process is largely due to age-related changes, including:

• loss of a certain amount of fluid, as a result of which the discs can no longer correctly perform a shock-absorbing function, dry out, narrow and lose mobility to some extent;
• the formation of microcracks or ruptures in the outer disc membrane, as a result of which the pulpous nucleus (gelatinous substance located in the inner part of the disc) begins to be squeezed out through the gaps in the annulus, and some part of the disc protrudes and ruptures.

The development of intervertebral osteochondrosis is facilitated by the diffuse method of disc nutrition, due to the fact that as a person grows older, the vascular bed is reduced in them, and the discs begin to receive nutrients from the surrounding tissues by diffusion. This greatly complicates the recovery process after significant stress and injury. Other factors also contribute to the development of the pathological process, the loss of strength and elasticity of the cartilage, the change in its shape and structure, and the development of osteochondrosis of the intervertebral discs:

• lack of physical fitness or poor training;
• a sharp refusal to play sports;
• sedentary lifestyle;
• professions involving a long stay in an uncomfortable position;
• heavy physical labor;
• the presence of excess weight;
• fall, bruises or other injuries of the spinal area;
• smoking;
• malnutrition;
• genetic predisposition, which determines the features of the musculoskeletal system;
• violation of posture, curvature of the spine;
• flat feet;
• constant wearing of uncomfortable shoes or walking in heels, leading to an uneven distribution of the load on the spine;
• hypothermia;
• change of climate zone;
• negative environmental factors;
• diseases that provoke hormonal or metabolic disorders.

Stages of the disease

During osteochondrosis of the intervertebral discs, three stages are distinguished, depending on which further treatment is prescribed:

• The first stage is characterized by dysfunction of the disc against the background of pain in the affected area.
• The second stage is characterized by long-term instability in the affected part of the spine, which is accompanied by episodic attacks of pain.
• In the third stage, the damaged segment stabilizes as a result of the formation of bony growths, which leads to a reduction in pain attacks.

Kinds

Classification of the disease is carried out in accordance with the localization of the pathological process. Allocate:

1. intervertebral osteochondrosis of the cervical region;
2. intervertebral osteochondrosis of the thoracic region (the most rare form);
3. intervertebral osteochondrosis of the lumbar;
4. common form (covers several sections of the spine at the same time).

Each of these types is characterized by its own symptoms and methods of treatment.

Clinical manifestations

Manifestations of intervertebral osteochondrosis are diverse. The first symptoms in most cases are pains of varying (sometimes quite high) intensity that periodically occur in the spine. Features of the disease are due to the severity of disc damage and the localization of the lesion. Complaints of a general nature in intervertebral osteochondrosis are:

• increased fatigue: occurs not only as a result of physical exertion, but also during mental stress;
• feeling of discomfort in different parts of the spinal column;
• pains can have a pulling, cutting character, quite often there are also “backaches”;
• radiating pain emanating from the nerve trunks;
• feeling of "goosebumps", tingling, numbness, soreness of the extremities (upper or lower - depending on the localization of the lesion).

With the formation of a protrusion as a result of osteochondrosis of the intervertebral discs, the clinical picture depends on its direction.

• Anterior hernias are sometimes asymptomatic.
• With posterior hernias penetrating the spinal column, sciatica occurs. Their cause in most cases is not the pressure of the resulting protrusion, but the inflammatory process in the nerve roots, epidural tissue, and venous congestion.

Symptoms of the cervical form of pathology

The first signs of intervertebral osteochondrosis are periodically occurring discomfort in the cervical region. This type of disease is the most dangerous due to the presence of a large number of nerves and important vessels in this area. Degenerative changes in the discs lead to their compression, malnutrition of the brain. In this case, the following symptoms appear:

• headaches of varying intensity and localization (often in the back of the head);
• pain in the neck, sometimes radiating to the shoulder blade;
• dizziness;
• hearing loss;
• the appearance before the eyes of flies, spots, blurred vision;
• balance disorders due to dysfunction of the vestibular apparatus;
• sudden fall (not accompanied by loss of consciousness);
• temporal lobe epilepsy may develop;
• sudden loss of consciousness (accompanied by muscle dysfunction);
• memory impairment;
• psycho-emotional disorders (irritability, depression, etc.);
• dysfunction of the cardiovascular system;
• insomnia;
• pronounced meteorological dependence.

Features of the manifestation of thoracic osteochondrosis

The main manifestations of this form of intervertebral osteochondrosis are:

• pain in the chest area, in the interscapular space: they can be aching, dull or shooting, aggravated after physical exertion, as well as as a result of a long stay in a stationary position;
• the spread of pain along the chest, on its front part, irradiation to the shoulder or hypochondrium;
• pain when trying to raise a hand (right or left), when tilting and turning the body;
• increased pain with deep breathing;
• the appearance of pain in the intercostal region while walking;
• feeling of tightness in the chest;
• a feeling of crawling, numbness of some parts of the body;
• burning sensation, itching or coldness in the lower extremities;
• disorders of the gastrointestinal tract in the form of diarrhea, constipation, flatulence (may lead to difficulty in diagnosis).

Symptoms of the lumbar form of the disease

At the initial stage, the manifestations of intervertebral osteochondrosis with localization in the lumbar spine are rather mild and are observed mainly with oblique movements in the form of unpleasant sensations. As the disease progresses, the following symptoms begin to appear:

• pain in the lower back, often radiating to the buttocks and lower limb, may be sciatic in nature;
• tension of the lumbar paravertebral muscles (the so-called symptom of the reins);
• smoothness of the lumbar lordosis;
• it is possible to develop antalgic scoliosis as a result of reflex muscle tension;
• sharp pain during palpation of the intervertebral disc affected by osteochondrosis (called the symptom of Osna and Shkolnikov);
• limb weakness;
• paresthesia;
• violations of the organs of the reproductive system;
• a decrease in the level of the tendon reflex or its complete absence;
• symptom of Lasegue (appearance of pain along the back of the thigh, along the sciatic nerve when lifting a straightened leg);

The occurrence of bilateral neurological symptoms in intervertebral osteochondrosis indicates a massive prolapse of the disc.

Treatment

Medical therapy

For the treatment of intervertebral osteochondrosis, a set of measures is being carried out. In the acute stage, drugs are prescribed to relieve pain and eliminate inflammation:

• Ibuprofen and preparations based on it: Ibupron, Nurofen, Reumafen, Dolgit;
• anti-inflammatory ointments: Indomethacin, Voltaren, Artrotsid, Diclofenac, Ortofen;
• Muscle relaxants (to eliminate muscle spasm and improve blood circulation): Scutamil-C, Baclofen, Mydocalm, Sirdalud;
• chondroprotectors (restore cartilage tissue, increase joint mobility in the affected area, have an anti-inflammatory effect): preparations with Chondroitin and Glucosamine: Teraflex, Collagen Ultra ointments, Chondroxide;
• group B vitamins (to restore the sensitivity of damaged nerve fibers, improve the transmission of nerve impulses, reduce pain): Milgamma, Neurobion, Neuroplex, Neurorubin;
• other vitamins and minerals to improve metabolic processes (including calcium metabolism), restore damaged tissues.

Other conservative therapies

Of the methods of treatment of intervertebral osteochondrosis, the most commonly used are:

• traction using a special installation on a horizontal plane (with the lumbar form of the disease) or on a special chair with a vertical bar and a loop thrown over it, covering the occipital and chin parts of the head (with intervertebral osteochondrosis in the cervical region);
• vertical underwater traction using a load;

• massage;
• ionogalvanization with the use of novocaine, potassium iodide;
• dehydration therapy;
• spa treatment (radon baths are especially effective);
• wearing a medical orthopedic corset (indicated in the presence of pain syndrome).

Operation

With the ineffectiveness of conservative methods of treatment of osteochondrosis of the intervertebral discs, surgical intervention is prescribed:

1. In osteochondrosis without a hernia, it is advisable to perform an anterior fusion.
2. In the presence of a hernia, a laminectomy is performed with the removal of the formation protruding into the spinal canal.

After the operation, the patient must wear an orthopedic corset for a certain time.

Video: Underwater vertical traction

Osteochondrosis is a disease of the spine, which is characterized by degeneration of the intervertebral disc, accompanied by a significant decrease in its height, the rapid growth of marginal osteophytes and sclerosis of the disc surfaces of the vertebrae. It is osteochondrosis of the intervertebral discs that is one of the most common causes of back pain, most often people begin to feel its manifestations after 35 years.

What happens with osteochondrosis?

The spinal column consists of 33-35 vertebrae, which are connected by elastic intervertebral discs. These discs are composed of an elastic central core and dense connective tissue surrounding it. With osteochondrosis, for one reason or another, the core and connective tissue of the disc are damaged, and it loses its strength and elasticity. As a result, the vertebrae are displaced, compression of blood vessels and nerve endings occurs. The affected cartilage tissue of the discs hardens and decreases in size. A change in the structure of the intervertebral discs in osteochondrosis negatively affects the entire spine - it is bent, deformation of individual vertebrae occurs, sharp bone growths appear on the thickenings of their processes, and the ligaments of the spine also ossify.

Causes

Despite the fact that osteochondrosis is an almost natural age-related change, there are many reasons for its development and exacerbation, in addition to age. But, as a rule, osteochondrosis occurs due to a combination of adverse factors: Violation of posture, curvature of the spine, flat feet. genetic predisposition. Excess weight. Poor physical fitness, sedentary lifestyle. Bruises and injuries of the spine. Metabolic disorders, infections. Prolonged exposure to uncomfortable positions or work associated with constant lifting of weights, excessive physical exertion. Abrupt cessation of constant physical activity, such as professional sports. Wearing uncomfortable shoes and heels. Adverse environmental or weather conditions, hypothermia.

Complications of osteochondrosis

Osteochondrosis of the intervertebral discs is fraught with the occurrence of protrusions and hernias. So, protrusion of the intervertebral disc occurs when the protrusion of this disc without rupture of the connective tissue (annulus fibrosus). If the fibrous ring surrounding the core of the disc cracks and its contents leak out, a herniated disc is formed, which is already fraught with other complications. This may be discogenic myelopathy (compression of the spinal cord), changes in tendon reflexes, the appearance of muscle atrophy, paresis, impaired urination and bowel movements. Also, a herniated disc can compress the arteries that feed the spinal cord and lead to a heart attack.

Types of osteochondrosis

The disease is classified according to localization: osteochondrosis of the cervical spine (the most common type); osteochondrosis of the thoracic region (most rare); osteochondrosis of the lumbosacral region; widespread osteochondrosis (affecting several areas). Each of these types of disorders has its own symptoms, methods of diagnosis and treatment.

Cervical osteochondrosis

Osteochondrosis of the cervical spine is the defeat of 1-7 vertebrae, resulting in their deformation, blood supply and nerve conduction in the neck are disturbed. Due to the fact that the vertebrae of the cervical region are the smallest, and the muscular frame of the neck is not pronounced, this area is most vulnerable to the appearance of osteochondrosis. Symptoms: shooting pain in the neck (sometimes in the collarbone and shoulder), especially after being in an uncomfortable position; neck muscle tension; headaches localized in the back of the head; feeling of heaviness in the head, crunching when turning the head; feeling of numbness and tingling in the arms and shoulders. Diagnosis is based on an external examination of the patient and radiography, and, if necessary, magnetic resonance imaging.

Treatment for osteochondrosis of the cervical spine

In the vast majority of cases, cervical osteochondrosis is treated with conservative methods - symptomatic therapy with painkillers and anti-inflammatory drugs, as well as antispasmodics, taking chondroprotectors to restore the structure of the intervertebral discs. External agents with warming, anti-inflammatory and analgesic properties are also shown - for example, Nise Gel ointment. Courses of massage, physiotherapy and exercise therapy are required.

Thoracic osteochondrosis

Due to the fact that the movements of the vertebrae of the thoracic region are limited by the ribs and sternum, the main cause of osteochondrosis in this case are spinal injuries. Thoracic osteochondrosis is manifested by back pain, sometimes long aching, sometimes shooting. The pain syndrome can spread to the front of the chest, to the shoulder or hypochondrium. Such pains are often confused with the manifestation of diseases of the gastrointestinal tract, therefore, when diagnosing osteochondrosis of the thoracic spine, it is detected by special pressure on the spinous processes of the vertebrae, which should bring pain.

Treatment for osteochondrosis of the thoracic spine

The most effective treatment for the thoracic spine is traction of the spine in combination with the use of non-steroidal anti-inflammatory and analgesic drugs. Usually, the use of Nise® Gel is sufficient for this, but in some cases novocaine blockades are prescribed. In addition, ultrasound, UHF, back massage are shown.

Lumbar osteochondrosis

The lumbosacral spine is especially vulnerable to the appearance of osteochondrosis, but at first its symptoms are mild - unpleasant sensations in the lumbar region that appear when bending over. After a couple of years, the pain syndrome will begin to spread to the gluteal and inguinal regions. Lumbar osteochondrosis develops slowly, therefore, an X-ray or MRI is performed to clarify the diagnosis.

Treatment for osteochondrosis of the lumbosacral spine

Therapy for lumbar osteochondrosis involves stretching the spine, massage sessions and taking analgesics, vitamins and sedatives. Outwardly, anti-inflammatory ointments are prescribed (Nise® Gel proved its effectiveness in osteochondrosis in clinical studies), which also relieve pain. From physiotherapy, electrophoresis, ultrasound and lumbar irradiation with ultraviolet radiation are used. A mandatory point of treatment is special gymnastics. With exacerbations, treatment is carried out in a hospital.

Degenerative changes in the discs located between the vertebrae - this is intervertebral osteochondrosis. The problem is familiar to many. Some have neck pain, others have back pain. We will try to figure out what this disease is, how it is treated, and whether it can be avoided.

Why does the disease develop?

The causes of changes in the intervertebral discs are varied:

• body aging;
• vertebral injuries;
• chronic overload of the spine;
• congenital or acquired anomalies of the spinal column (curvature, weakness of muscles and ligaments);
• metabolic and hormonal disorders (diabetes mellitus, menopause, diseases of the thyroid gland, adrenal glands, hormonally active tumors of the pituitary gland);
• chronic diseases of the cardiovascular, respiratory system and blood diseases (anemia);
• overweight;
• bad habits (smoking);
• physical inactivity.

The mechanism of the development of the disease

The first changes in cartilage appear at the age of 11–16 years. Over time, the nucleus pulposus, located in the center of the intervertebral disc, loses fluid and becomes less elastic. The distance between the vertebrae decreases, the cartilage is flattened. The nucleus pulposus is fragmented, begins to squeeze out part of the fibrous ring. There is a protrusion. If the fibrous fibers can no longer withstand the load, then they break, the nucleus pulposus comes out, and a hernia is formed. Increased loads accelerate the process of degeneration of the intervertebral discs.

There is another variant of hernias - Schmorl's hernia. This is a condition when the nucleus pulposus penetrates the body of the upper or lower vertebra. Such changes are often hereditary. They appear as a result of the rapid growth of the body or excessive loads, for example, jumping from a height. The disease begins to manifest itself already in adulthood. But such hernias can also form in the elderly due to a decrease in bone density, as well as in the young when heavy lifting or injury.

This is how a hernia is formed.

Another important point is the malnutrition of cartilage tissue. Nutrients penetrate the intervertebral disc by diffusion from the capillaries of the vertebral bodies and the outer plates of the annulus fibrosus. The lack of oxygen, glucose and changes in acid-base balance that occur in various diseases contribute to the development of cartilage destruction. Metabolic changes are also observed with insufficient load and overload of the spine.

As a result of all these processes, intervertebral osteochondrosis develops, inflammation of the cartilage and tissues surrounding it. There is pain on movement. Pain is aggravated by reflex muscle spasm. If lateral hernias appear, putting pressure on the spinal roots, then radicular pains are observed. When the spinal cord is compressed by posterior hernias, signs of myelopathy are revealed. Anterior hernias do not show themselves for a long time. Over time, they can reach the anterior ligament, which is accompanied by the appearance of pain.

Clinical manifestations of the disease

The main symptoms of damage to the intervertebral discs:

• Smoothness of the physiological curves of the spinal column.
• Restriction of movement of the thoracic, cervical or lumbar spine.
• Pain, aggravated by movement, can be stabbing, aching, burning in nature.
• Violations of the sensitivity and function of the arm or leg - a burning sensation, crawling, numbness along the nerves, weakness in the limb. These are manifestations of the radicular syndrome.
• Dysfunction of the limbs and pelvic organs - myelopathy.

Disc changes in the lumbar region

The lumbar spine experiences the greatest load, so it is he who most often suffers. At the same time, there are:

• Pain in the lumbar region and sacrum, which radiate to the buttock on the right or left. It depends on the affected root. Pain and sensory disorders extend to the corresponding leg to the very toes.
• There may be weakness in the leg.
• If the hernia is large enough, then with compression of the spinal cord, paralysis of both legs gradually develops, the work of the bladder and intestines is disturbed.

Irradiation of pain from the lumbosacral region to the left leg

Disc changes in the thoracic region

In the pathology of the thoracic spine, it is characteristic:

• Pain appears between the shoulder blades, in the region of the heart, behind the sternum, can be observed in one half of the chest or covers it entirely. It hurts to breathe, cough and turn around.
• Pain may radiate to the upper abdomen.
• The radicular syndrome is manifested by pain along the intercostal space, where there is also a burning sensation, goosebumps or numbness.
• With compression of the spinal cord at this level, the consequences are approximately the same as with a hernia of the lumbar.

Disc changes in the neck

Pathology of the cervical spine is the most dangerous.

1. Here are the vessels through which blood enters the posterior parts of the brain. If there is pain in the neck, then a reflex spasm of the vertebral arteries may occur, which is accompanied by the appearance of a headache.
2. You may feel dizzy, nausea appears, hearing and vision impairments are likely. All this is often accompanied by palpitations and sweating.
3. Hernias can compress the vertebral arteries, leading to the development of acute cerebrovascular accident.
4. With radicular syndrome, pain in the corresponding arm and shoulder is noted, numbness and weakness are characteristic.
5. If a hernia of the cervical region puts pressure on the spinal cord, then pains appear in both arms and legs. Over time, paresis and paralysis first of the lower and then of the upper limbs develop, the work of the internal organs is disrupted.

Diagnosis of the disease

If there are complaints indicating a lesion of any part of the spinal column, you should consult a doctor. The earlier intervertebral osteochondrosis is diagnosed, the more likely it is to stop the progression of the disease and prevent the development of complications. Especially dangerous is the appearance of chest pain, which may be a manifestation of thoracic chondrosis or a sign of acute myocardial infarction.

The diagnosis is established on the basis of:

• complaints made;
• external examination data;
• radiography;
• CT and MRI.

MRI of the spine: 1 - normal, 2 and 3 - Schmorl's hernia

According to the indications, ENMG (electroneuromyography) of the upper and lower extremities is performed, which helps to identify signs of damage to the peripheral nervous system. To assess the condition of the spinal cord, myelography is performed.

Therapeutic measures

The treatment of the disease is carried out exclusively by a doctor. Self-treatment may not give a positive result. In some cases, this can cause irreparable harm to health.

Drug therapy

To alleviate the condition and treatment, various drugs are used.

• Painkillers with a pronounced anti-inflammatory effect: Nimesulide, Meloxicam, Aceclofenac, Lornoxicam, Ibuprofen, Diclofenac.
• Drugs to reduce muscle spasm: Tizanidine, Tolperisone.
• Chondroprotectors: Teraflex, Alflutop, Artra, Chondroxide.
• Hormonal preparations are used for blockade or intramuscular injection with severe pain syndrome: Dexamethasone, Prednisolone.
• With pain that occurs against the background of a hernia, blockades with novocaine and lidocaine help.
• Vitamins help improve the condition of the nervous system. Prescribed drugs such as Milgamma, Kombilipen, Compligam V.
• In the chronic course of the disease and prolonged pain syndrome, the appointment of antidepressants and anticonvulsants helps: Pregabalin, Diazepam, Venlafaxine.
• Ointments based on chondroprotectors and NSAIDs are applied locally.

Non-pharmacological treatment can also bring tangible benefits.

1. Physiotherapy: DDT, amplipulse therapy, electrophoresis with hydrocortisone, UVI.
2. Therapeutic mud and hydrotherapy.
3. Manual therapy, massage, acupuncture.
4. If necessary, appoint to wear a corset or a special collar.
5. Physiotherapy.
6. Hardware traction.

With the ineffectiveness of all measures taken for six months or more, surgical treatment is indicated.

What to do to avoid illness

Timely prevention will help to stay healthy for many years. And you don't need much.

1. Lead a healthy lifestyle, eat right.
2. Move more, but don't overexert yourself.
3. Take breaks in work if you have to stay in an uncomfortable position for a long time or move too actively.
4. Provide yourself with a comfortable bed with an orthopedic mattress and pillow.
5. Timely treat existing diseases.
6. Regularly engage in physical activity or fitness.

Everyone has problems with the spine sooner or later. But it is in our power to slow down the development of the disease. You should not spare money for a good mattress and pillow. It is not necessary to visit an expensive fitness club - you can do it at home. In any case, prevention is much cheaper than expensive treatment.