The spine includes cervical, thoracic, lumbosacral sections and consists of 33-34 vertebrae, which are located one above the other and connected in a single chain.In order to evenly distribute the load on the spinal column during everyday physical activity and when the body is in an upright position, the spine has physiological (normal) curvatures.Two curves convex forward in the cervical and lumbar regions (lordosis) and two convex backwards in the thoracic and sacral regions (kyphosis).Between the vertebrae there are intervertebral discs - cartilages, which perform a shock-absorbing function and consist of the nucleus pulposus and the fibrous ring surrounding it.
Osteochondrosis of the spine is a chronic disease characterized by the development of degenerative-dystrophic changes in the intervertebral discs, with the subsequent involvement of adjacent vertebrae and surrounding tissues in the process.
Currently, doctors more often use the broader term "dorsopathy" for back and neck pain, sometimes replacing the term "osteochondrosis" with it.Dorsopathy includes pain in the neck (cervicalgia), pain in the neck and head (cervicocranialgia), neck and shoulder pain (cervicobrachialgia), chest pain (thoracalgia), lower back pain (lumbodynia), lower back pain radiating to the leg (lumboischialgia).
Causes of osteochondrosis of the spine
To date, there is no exact data on the causes of degenerative changes in the spine.There are many theories that consider various factors: involution (involution - reverse development, backward movement), mechanical, immune, hormonal, dysmetabolic (metabolic), vascular, infectious, functional and hereditary.The most widespread is the involution theory, according to which local (local) premature aging of cartilage and bones occurs as a result of previous mechanical or inflammatory damage.According to this theory, the development of degenerative changes in the spine is genetically predetermined, and the occurrence of the disease with corresponding clinical manifestations is due to the influence of various endogenous (internal) and exogenous (external) factors.
The probability of osteochondrosis increases with age, on the one hand, in case of overweight, sedentary lifestyle and poor physical fitness, and on the other hand, in case of heavy physical work and vibration.
The load on the spine increases proportionally with the increase in body weight, so overweight people suffer from overload even with moderate activity;the situation is aggravated by a tendency towards physical inactivity due to poor tolerance to physical activity.
Psycho-emotional stress, coupled with a sedentary lifestyle, causes tension in individual muscle groups, changes in muscle tone and movement patterns - posture, gait.The development of scoliosis - lateral curvature of the spine, pathological kyphosis and lordosis (aggravation of physiological curvatures) also contributes to the deformation of the intervertebral discs.
Classification of the disease
By localization:
- osteochondrosis of the cervical spine;
- osteochondrosis of the thoracic spine;
- osteochondrosis of the lumbar and sacral spine.
Depending on the stage of the disease:
- exacerbation (maximum number of clinical manifestations);
- remission (absence of clinical manifestations).
Depending on which formations are pathologically affected, the affected structures of the spine are distinguished:
- Reflex syndromes - reflex tension of innervated muscles, or muscle tone disorders (muscle spasms), vascular, vegetative, dystrophic - develop in case of irritation of pain receptors.
- Compression syndromes often develop against the background of protrusion (bulging, protrusion of the intervertebral disc beyond the vertebral column without endangering the integrity of the annulus fibrosus) or disc herniation due to compression of the nerve root, spinal cord or vessel (radiculopathy, neuropathy, myelopathy, radiculoischaemia syndrome).
Depending on the stage of development of the process, there are:
- The stage of the intradiscal pathological process (chondrosis).Intradiscal movement of the nucleus pulposus occurs during this period.The nucleus pulposus penetrates its outer fibers through the fissures of the fibrous ring.As a result, nerve endings are irritated and pain develops.
- Instability or loss of attachment of the affected disc when the upper vertebra moves relative to the vertebra below it.During this period, instability syndrome, reflex, and even compression syndrome may develop.
- The stage of disc herniation due to the violation of the integrity of the fibrous ring, which can compress the adjacent neurovascular formations, including the spinal nerve root.
- The stage of fibrosis of the intervertebral discs and the formation of marginal osteochondral growths of the vertebral bodies, which results in immobility of the vertebrae and a compensatory increase in their support area on the defective plates.In some cases, these bony growths, like a herniated disc, can compress adjacent neurovascular formations.
Symptoms of osteochondrosis
The symptoms of osteochondrosis depend on the area of damage to the spine and the degree of changes occurring in it, the functioning of internal organs may be impaired.
Osteochondrosis of the cervical spine is characterized by neck pain that intensifies during movement, radiates to the arm and is accompanied by numbness in the fingers.
Possible headache in the occipital region, dizziness, tinnitus, darkening of the eyes or flickering of the spots in front of the eyes.
In the case of involvement of the thoracic spine, patients may experience long-lasting, painful, stabbing, stabbing, sharp pain in the area of the heart, in the interscapular region.
They can occur or intensify when breathing deeply, bending, turning, raising the arms, sneezing, or coughing.There may be numbness of the skin in the chest, abdomen and back.
With osteochondrosis of the lumbosacral region, patients notice stiffness in movement, pain in the lower back, which can radiate to one or both legs, intensifies when bending, turning, walking, lifting heavy objects.
Possible vegetative disorders: coldness of the feet at a pleasant temperature of the rest of the body, paleness of the skin of the feet.There is numbness and paresthesia (stinging sensation) on the skin of the legs and buttocks.
Diagnosis of the disease
Instrumental diagnostics include radiography of the spine to exclude traumatic injuries, congenital structural anomalies, and to identify bone growth.The examination is also carried out with functional tests - in the neck and lumbar regions, images are taken during bending and stretching to rule out pathological displacement of the vertebrae relative to each other.