In the article, we consider the stages of osteochondrosis of the spine. This disease is a pathological condition, against which there are changes of a degenerative-dystrophic nature in the tissues of the cartilage of the spinal column. Such changes are accompanied by violations in the structure and functional component of the intervertebral discs. Depending on the area of localization, cervical, thoracic and lumbar osteochondrosis are distinguished. The developmental stages are described in detail below.
The dynamic development of the disease goes through several stages.
First stage
It is characterized by the initial stage of development of a pathological condition in the pulpous nucleus of the disk between the vertebrae. Excess load on the spine leads to dehydration of the nucleus, which causes a decrease in the height of the disk and provokes the appearance of cracks in the fibrous ring. As a rule, the initial stage of osteochondrosis takes place in a latent form, without severe symptoms. Sometimes the disease is accompanied by a slight discomfort after a long stay in a static position or, conversely, in active movement.
The second stage of the disease
The second stage of osteochondrosis is characterized by an even greater decrease in the height of the discs, which leads to a narrowing of the distance between the damaged vertebrae and sagging ligaments and muscles of the spinal column. This process is accompanied by an increase in the mobility of the vertebrae with damaged discs, which threatens with their slipping and displacement. Stage 2 osteochondrosis can be manifested by symptoms such as significant discomfort, pain, especially acute with certain types of load, postures or movements.
The third stage of pathology
At the third stage of osteochondrosis, protrusion and prolapse of the intervertebral discs occur, which can lead to subluxation and arthrosis of the joints between the vertebrae. With certain movements, the patient may feel insufficient mobility and stiffness, numbness and tingling in the limbs. At the third stage, pain syndrome is especially pronounced, localized in the neck, back, lower back and the region of the sacrum and tailbone. The affected area depends on the location of the affected disc.
The fourth stage of the disease
Upon reaching the fourth stage of osteochondrosis, the human body tries to compensate for the effects of increased mobility of the vertebrae and to adapt to functional disorders of the spinal column. Where the vertebrae are in contact with each other, osteophytes are formed that are designed to reliably fix the bones. In some cases, however, they can provoke nerve infringement and lead to injury to the vertebra. In the joints and intervertebral discs ankylosis of the fibrous type is formed. If there is no infringement and microtrauma of the nerve roots, the signs of the disease can lose intensity.
Stages of osteochondrosis of the lumbar
Doctors distinguish 4 degrees of osteochondrosis in the lumbar region. This is the most vulnerable spine.
Grade 1 is the initial stage when changes in the discs are barely noticeable. Weak (tolerant) pain accompanies the ailment.
2 degree - pain from the lower back gives to the gluteus muscle and lower leg, movements are limited. Discomfort becomes stronger, because the nerve is impaired due to the narrowing of the lumen between the vertebrae. The shape of the disk changes, it flattenes and protrudes. Relaxing massages and exercises at this stage will no longer help.
Grade 3 can be characterized by the fact that the fibrous ring breaks, and its contents flow into the intervertebral region. A person feels constant pain and discomfort. The effect of medications, exercises and interventions by chiropractors at this stage is barely noticeable.
Grade 4 - the following irreversible changes are observed: cartilage atrophy, leading to overgrowth of the vertebrae. There are problems with movement, and in severe cases - a complete restriction of movement and disability. Spinal nerves and canals are pinched, which causes paresis and paralysis.
Types of disease
Symptoms depend not only on the stage of cervical osteochondrosis, but also on the type of pathology.
The disease is classified according to several signs. According to localization, cervical, thoracic, lumbar and sacral osteochondrosis is distinguished. There are also diseases of mixed or combined localization. The pathology localized in different parts of the spine, depending on the clinical manifestations, is also divided into subspecies.
So, osteochondrosis of the cervical spine can be of the following types:
- According to the type of reflex syndrome, cervicocranialgia, cervicalgia and cervicobrachialgia are distinguished, manifested by muscular-tonal, vegetovascular and neurodystrophic signs. The severity of symptoms depends on the stage of cervical osteochondrosis. At the initial stage, the symptoms are mild.
- Against the background of a positive test for radicular syndrome, the patient is diagnosed with a discogenic lesion of the cervical spine. The stages of osteochondrosis of the cervical spine should be identified by a doctor.
With a disease of the chest, the following subspecies are distinguished:
- Reflex syndrome - thoracalgia, accompanied by neurodystrophic, muscular-tonal and vegetovascular manifestations.
- Radicular syndrome - damage to the roots of the thoracic spine of a discogenic nature.
Against the background of the initial and subsequent stages of lumbar osteochondrosis, the following varieties are distinguished:
- Reflex syndrome - lumbago or lumbago, lumbar ischialgia, lumbalgia with changes in the neurodystrophic, vegetovascular and muscular-tonal type.
- Radicular syndrome is a discogenic lesion of the roots of nerves located in the lumbar region and sacrum.
- Radicular-vascular syndrome indicates the development of radiculoemia.
Conservative treatment
Conservative treatment is aimed at eliminating pain, as well as restoring the functionality of the spinal column and preventing negative changes. Conservative treatment of osteochondrosis includes the following types:
- Drug treatment. Medicines are intended to eliminate the pain syndrome, as well as stopping inflammation and normalizing metabolic processes in the body. The initial stage of osteochondrosis responds well to therapy. If the pain syndrome is severe, a course of drug blockades is prescribed, which reduce the sensitivity of nerve endings and the intensity of the manifestation of the muscular-tonic syndrome. Such types of blockade are distinguished as intraosseous, paravertebral, faceted, epidural and blockade of trigger points.
- Physiotherapeutic methods. Treatment with physiotherapy can reduce pain, increase the effectiveness of medications and prevent possible complications. The most common methods of treating osteochondrosis are magnetic fields, ultrasonic waves, laser beams and low-frequency currents.
- Performing exercises of therapeutic gymnastics and kinesitherapy. Provided that it is regularly performed, the set of exercises helps to correct posture, strengthen the ligamentous apparatus and corset of muscles, reduce pressure on nerve fibers and prevent complications. Methods of kinesitherapy and physiotherapy exercises are designed to restore proper nutrition of the discs between the vertebrae and normalize metabolic processes. In addition, a set of exercises helps to distribute the load in the musculoskeletal system.
- Massage. It allows you to improve the supply of tissue with blood, relieve spasms and clamps from the muscles, improve blood circulation in the body. Especially popular is hydromassage, which is an auxiliary method of treating osteochondrosis.
- Manual therapy. The method of conducting is selected individually, depending on the nature of the lesion, location and type of osteochondrosis. The method consists in a point effect on the system of bones and muscles, which improves metabolic processes, corrects the mobility of the musculoskeletal system and strengthens the immune system. Manual therapy methods help prevent complications and are preventative measures.
- Traction or traction of the spine. It is made using special equipment. The purpose of the procedure is to increase the space between the vertebrae to normal values, as well as to correct violations that occurred in the structure of the spinal column.
Drug treatment
Therapy of osteochondrosis by taking medication involves reducing the intensity of symptoms, improving blood supply to the tissues, as well as the process of their recovery. It is impossible to completely eliminate the disease while taking medications, an integrated approach to treating the disease is important, including the implementation of certain exercises, adherence to special nutrition, prevention and medication. Treatment with drugs in the absence of significant dystrophic changes in bone structures is not recommended.
Preparations
The doctor can prescribe the following groups of drugs for the treatment of osteochondrosis:
- Anti-inflammatory drugs: Nurofen, Ibuprofen, Reoprin, Karipazim, Pantonematogen, etc.
- Antispasmodic drugs: Drotaverin, Baclofen, Miolastan, etc.
- Antioxidants: Vitamins C, E and N.
- Drugs that promote blood supply to tissues: "Theonikol", "Actovegin", "Trental", vitamins of group B.
- Drugs designed to restore and prevent degenerative processes in cartilage tissues: Diacerein, Piaskledin, hyaluronic acid, etc.
In the treatment of stage 1 osteochondrosis, as well as subsequent stages, both local preparations in the form of ointments and creams, as well as agents for oral administration and injection can be used.
Complications
If the doctor's instructions for the treatment of osteochondrosis are not followed, the inevitable progression of pathological processes occurs, which in the future leads to the development of complications in the form of the following diseases:
- Disc herniation between the vertebrae.
- Protrusion.
- Radiculitis.
- Kyphoses.
- Salt deposits with the space between the vertebrae.
- Spinal cord strokes.
- Reduction of muscle mass in the limbs, their atrophy as a result of impaired blood circulation.
- Paralysis of the legs.
The final, fourth stage of osteochondrosis, as a rule, does not manifest itself with severe symptoms. Nevertheless, it is at this stage that the disease poses the greatest danger in terms of the development of complications and consequences.
Prevention
Often, the causes of osteochondrosis are the inattentive attitude of a person to the promises of his own body. The disease can develop against the background of malnutrition, as well as with excessive loads on the spine.
Recommendations for the prevention of osteochondrosis are as follows:
- Prevention of physical inactivity, involving moderate physical activity, including swimming, running, cycling, gymnastics, skiing, etc.
- If a person’s activity is associated with a long stay of the body in a static position, it is recommended to do warm-ups every 45 minutes in order to restore the blood circulation process. If a prolonged sitting position is unavoidable, the right orthopedic chairs should be preferred.
- The mattress for sleep should be elastic and moderately hard, preferably orthopedic. It is also recommended to avoid pillows that are too flat or too tall.
- If it becomes necessary to carry heavy objects, do not jerk when lifting. Athletes are recommended to use special belts or corsets that support the back in the correct position.
- Wearing the right orthopedic shoes. It should correspond to the foot in width, it is better to refuse high heels. In summer, you can walk barefoot, which strengthens the muscles of the foot and relieves tension from the vertebra. Equally important is the timely replacement of shoes.
- Proper nutrition and compliance with the drinking regime contribute to the overall strengthening of the body and the normal functioning of its systems.
Stress is also one of the prerequisites for the occurrence of osteochondrosis, therefore emotional stress should be avoided.