The spine includes the cervical, thoracic, lumbosacral section and consists of 33-34 vertebrae, located one above the other and connected in one chain.To evenly distribute the load on the spine during daily physical activity and when the body is in an upright position, the spine has physiological (normal) curves.Two convex curves 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 that 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 subsequent involvement in the process of adjacent vertebrae and surrounding tissues.
Currently, doctors more often use the broader term "dorsopathy" to denote pain in the back and neck, sometimes replacing the term "osteochondrosis" with it.Dorsopathy includes pain in the neck (cervicalgia), neck and head (cervicocranialgia), neck and shoulder (cervicobrachialgia), chest pain (thoracicalgia), lower back pain (lumbodynia), lower back pain radiating to the leg (lumboischialgia).
Causes of osteochondrosis of the spine
To date, there are no exact data on the causes of degenerative changes in the spine.There are a number of theories that consider different factors: involution (involution - reverse development, backward movement), mechanical, immune, hormonal, dysmetabolic (metabolic), vascular, infectious, functional and hereditary.The most widespread is the involutive theory, according to which local (local) premature aging of cartilage and bone 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 the corresponding clinical manifestations is due to the influence of various endogenous (internal) and exogenous (external) factors.
The probability of osteochondrosis increases with age, in the presence of excess weight, a sedentary lifestyle and poor physical fitness, on the one hand, and heavy physical work and exposure to vibration, on the other.
The load on the spine increases in proportion to the increase in body weight, so overweight people suffer from overload even under conditions of moderate activity;the situation is aggravated by a tendency to physical inactivity due to poor tolerance to physical activity.
Psychoemotional stress, combined 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 the physiological curves) also contributes to the deformation of the intervertebral discs.
Classification of the disease
By localization:
- osteochondrosis of the cervical spine;
- osteochondrosis of the chest;
- osteochondrosis of the lumbar and sacral spine.
According to 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-tonic disorders (muscle spasms), vascular, vegetative, dystrophic - develop when pain receptors are irritated.
- Compression syndromes often develop against the background of protrusion (protrusion, protrusion of the intervertebral disc outside the spine without violating the integrity of the annulus fibrosus) or disc herniation due to compression of a nerve root, spinal cord or vessel (radiculopathy, neuropathy, myelopathy, radiculoischemic syndrome are distinguished, respectively).
Depending on the stage of development of the process, there are:
- Stage of intradiscal pathological process (chondrosis).Intradiscal movement of the nucleus pulposus takes place during this period.The nucleus pulposus penetrates its outer fibers through fissures in the annulus fibrosus.As a result, nerve endings are irritated and pain develops.
- The stage of instability or loss of the ability to fix the affected disc, when the upper vertebra is displaced relative to the underlying one.During this period, instability syndrome, reflex and even compression syndromes can form.
- The stage of herniation of the intervertebral discs 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 leads to immobility of the vertebrae and a compensatory increase in the area of their support on defective discs.In some cases, these bony growths, such as disc herniations, can compress adjacent neurovascular structures.
Symptoms of osteochondrosis
Symptoms of osteochondrosis depend on the area of damage to the spine and the degree of changes in it, and the function of internal organs may be impaired.
Osteochondrosis of the cervical spine is characterized by neck pain that intensifies during movement, radiating to the hand and accompanied by numbness in the fingers.
Complaints of headache in the occipital region, dizziness, ringing in the ears, darkening of the eyes or flickering of spots before the eyes are possible.
When the thoracic spine is affected, patients may experience pain in the heart region, in the interscapular region, long-lasting, painful or pressing, often sharp, stabbing, sharp.
They can occur or intensify when breathing deeply, when bending and turning the body, when raising hands, sneezing, coughing.There may be a tingling sensation of the skin in the chest, abdomen and back.
With osteochondrosis of the lumbosacral region, patients note stiffness of movement, pain in the lower back, which can radiate to one or both legs, intensifies when bending, turning the body, walking, lifting heavy objects.
Possible vegetative disorders: cold feet at a comfortable temperature for the rest of the body, pallor of the skin of the feet.There is a feeling of numbness, paresthesia (pins and needles) on the skin of the legs and buttocks.
Diagnosis of the disease
Instrumental diagnostics include radiography of the spine to rule out traumatic injuries, congenital structural anomalies, and to identify bony growths.The examination is also carried out with functional tests - taking pictures during flexion and extension in the cervical and lumbar regions to rule out pathological displacement of the vertebrae relative to each other.