Chondrolysis is a common degenerative-dystrophic lesion that affects the intervertebral disc, adjacent vertebrae, and nearby ligaments.
The disease does not develop immediately, progressing over many years, while the onset can occur at a fairly young age (18-20 years) and has several stages:
- Stage I – "crack" in the annulus fibrosus and movement in the disc of the nucleus pulposus, but no radiographic signs yet;
- Stage II – the nucleus pulposus continues to deteriorate, the height of the intervertebral disc decreases, the annulus fibrosus "drys", the affected intervertebral joint becomes unstable, and to compensate for this, the back muscles oftenbeing stressed, causing pain and being "overworked", signs of osteoarthritis are clearly visible on X-rays;
- Stage III – the disc ruptures, the nucleus pulposus prolapses, forming a herniation. This stage is characterized by many neurological symptoms, inflammation and edema;
- Stage IV – adjacent parts of the joint are damaged.
Spondylolisthesis can also occur in different parts of the spine and has different names depending on this:
- cervical - most often localized between the fifth and seventh cervical vertebrae (the most mobile joint);
- chest - a variant manifested by pain, which can be confused with diseases of other organs of the chest;
- lumbar - the most popular type due to the greatest mobility of this part and the load placed on it;
- common - involving several parts (eg, cervix).
Reasons for the development of osteoarthritis
There is no comprehensive theory that fully explains the cause of this disease. It has a multifactorial nature, therefore, it is necessary to have a predisposition as a trigger and for its manifestation - a complex of internal and external stimuli.
Exogenous risk factors:
- Excessive stress, manual labor, occupational hazards (moving heavy objects) are common causes of osteoarthritis in men;
- spinal cord injury;
- strong and irregular jerks, body bending and turning;
- sedentary work, no physical activity;
- constantly repetitive movements (carrying a bag on the same shoulder, tilting your head to your ear when talking on the phone);
- weather condition.
Endogenous risk factors:
- male gender (osteochondrosis occurs less often in women);
- overweight and tall;
- Abnormalities in the development of the musculoskeletal system, back muscle weakness;
- bad posture;
- foot disease (arthritis, flat feet);
- violation of nutrition of intervertebral joints;
- pathology of internal organs.
Symptoms of osteoarthritis
Typical signs of this disease: pain in the spine and muscles at rest, limitation of movement, "fatigue" in the affected area. The patient tries to "unload" it by leaning back in a chair, leaning on his hands, trying not to stand for a long time, or massaging and kneading to reduce muscle tension. Depending on the location, the pain may change slightly and include new, more specific symptoms.
With cervical spondylosis, the feeling of discomfort will occur in the occipital region or the neck itself, and will increase when tilting or turning the head. Due to nerve root compression, fingers and palms may experience tingling or burning, or more seriously, limit movement.
But the main danger of the case is that near the spine in this area there are important arteries that supply blood to the brain. Gradually they are compressed, so this type of osteoarthritis is characterized by dizziness and the appearance of "spots" in front of the eyes due to insufficient nutrition of the main organs in the body.
Among all types of osteoarthritis, lesions in the thoracic region are less common than other types and are difficult to diagnose. Pain in this area is similar to heart, lung, esophageal or nerve pain. Therefore, patients first go to a cardiologist, gastroenterologist or pulmonologist, staying away from the specialists they need, until all other pathologies are ruled out or suspected. thoracic osteoarthritis. The feeling of discomfort is localized between the shoulder blades, increasing when bending down, you may have a feeling of tightness in the throat or difficulty breathing, numbness in the chest.
The most common and most typical type is lumbar osteoarthritis. Its symptoms are often related to this disease: pain in the area of the same name, which intensifies when turning, bending or standing for a long time and can spread to one or both legs.
Diagnosis of osteoarthritis
The doctor begins by collecting complaints and history (family, life and illness), analyzing the presence of predisposition, external and internal risk factors, the relationship of thesymptoms and progression of damage.
The inspection includes:
- neuroorthopedics, which evaluates the static and dynamic functions of the spine (posture, presence of scoliosis, muscle tone, and range of motion of the joints and limbs between the vertebrae);
- Neurology – determines reflex and compression vertebral syndromes, motor and sensory functions, nutritional quality of tissue.
The simplest and most accessible instrumental diagnostic method for degenerative cartilage disease in any part of the spine (cervical, thoracic or lumbar) is non-contrast and contrast-enhanced (discography). , venography) X-ray studies show the narrowing of the intervertebral discs, the degree of herniation, protrusion and the condition of the blood vessels. A little less often, more informative magnetic resonance imaging is used, thanks to which you can accurately assess the degree of damage to the intervertebral disc, the size of the herniation, the presence of insertioncompression of the spinal cord, roots and surrounding tissues. If MRI is contraindicated, it will be replaced by computed tomography, which determines the condition of the vertebrae, spinal canal and ligament calcification.
Treatment of osteoarthritis
First of all, it is necessary to minimize as many risk factors as possible, discovered by the doctor during the survey. Eliminate axial load, limit the severity of the load, sometimes change traumatic jobs associated with manual labor, lose weight if you are overweight, introduce sports to a minimuminto your daily schedule if you are not physically active. This will only slightly reduce the severity of osteoarthritis pain and the risk of complications, although it is unlikely to slow the progression of the disease.
Treatment must be comprehensive and combine not only medicinal methods, but also a variety of effects on the vertebral muscles and the spine itself. You cannot take osteoarthritis medication on your own and hope to get better; any procedures and medications can only be prescribed by a neurologist. The specialist makes recommendations based on each specific case and the patient's individual characteristics so that the treatment does not cause more suffering than the disease itself.
For osteoarthritis, exercise therapy is prescribed, which is first performed in a special hospital room so that the doctor is confident that the patient is correctly performing the prescribed exercises. Different locations of damage imply different complexes aimed at maintaining the back muscles, improving blood circulation and nutrition of the intervertebral discs and vertebrae, as well as reducing their friction.
Massage therapy also has beneficial effects in the course of osteoarthritis; Physical therapy, manual therapy, acupuncture, osteopathy, and hardware traction of the spine are performed with caution. The treatment process and method are determined by the doctor based on the level of development of the lesion, pain manifestations and individual characteristics of each specific case.
Prevent osteoarthritis
If you take timely measures to prevent the progression of the disease, treatment may never be necessary. This also needs to be approached comprehensively: reduce the listed risk factors in advance (even before discomfort appears), try to distribute the load evenly, monitor posture from the momentyoung, receive adequate nutrition with all the necessary vitamins and regularly participate in supporting sports (e. g. swimming).
To prevent the development of osteoarthritis, gymnastics plays an important role: there are special exercises that help reduce the load on the spine. You can consult an orthopedist or neurologist about them.
But even regular morning exercises will help maintain muscle tone, reduce spasms and improve blood circulation so that the function of the intervertebral discs is not disturbed. To avoid physical inactivity during sedentary work, it is necessary to periodically warm up and perform prescribed exercises to prevent osteoarthritis.