March 30, 2020
According to the International Classification of Diseases, osteochondrosis is included in the group of diseases of the musculoskeletal system, mainly the spine, and connective tissue
According to the International Classification of Diseases, osteochondrosis is included in the group of diseases of the musculoskeletal system, mainly the spine, and connective tissue. Wearing out, collapsing and flattening over time, the intervertebral disc loses its shock-absorbing and protective function. The intervertebral space narrows, where the radicular nerves and blood vessels become compressed. This leads to various unpleasant symptoms, which force a person to see a doctor.
Based on localization, they distinguish between cervical, thoracic, lumbar, sacral and widespread osteochondrosis. The most commonly diagnosed osteochondrosis is lumbar osteochondrosis (over 50% of cases), cervical (over 25%) and widespread (about 12%).
Symptoms of osteochondrosis.
- pain in various parts of the spine;
- dysfunction of organs that are innervated by the nerves of the affected area of the spine;
- headache;
- disturbances and loss of tendon (muscle) reflexes (they can be increased, decreased, uneven or not evoked at all).
At the stage of collecting anamnesis, the doctor assesses the symptoms inherent in each individual segment of the musculoskeletal system.
Thus, with cervical osteochondrosis, headaches are observed, aggravated by turning the neck, dizziness, flickering “spots” in the eyes, fainting, and others. Sometimes a headache is accompanied by nausea or vomiting, sensations of noise in the head, ringing in the ears, visual disturbances in the form of flickering, pain in the eye, and perhaps a sensation of a foreign body in the throat.
With lumbar osteochondrosis - acute pain (“shooting”) in the back and below, numbness of the legs, disturbances in the functioning of the genitourinary organs. Osteochondrosis of the thoracic spine is characterized by pain in the interscapular region. Often the pain in the chest becomes girdling and is felt in the area of the ribs.
Referral for consultation
Osteochondrosis of the cervical spine is studied and treated by a doctor specializing in vertebrology, rheumatology, neurosurgery, arthrology, and neurology. It is to them that the therapist (in some cases, the family doctor) sends them for consultation or registration. Let's consider the main features and tasks of each of them.
Vertebrologist
People with any spinal pathologies usually rush to see him. The specialist, using the achievements of modern medicine, diagnoses the patient and establishes the exact cause of the development of the pathology. After analyzing the results obtained, a complex of drug therapy, exercise therapy, massage and a number of physiotherapeutic procedures are prescribed. A disease such as cervical osteochondrosis is his direct specialization, so if you suspect it, you should try to get an appointment with this particular doctor. But they are usually available only in the staff of highly specialized clinics.
Neurologist
A neurologist cannot be called a doctor who treats osteochondrosis, since his main specialization is pathologies of the nervous system. But when diagnosing this disease, the patient is recommended to undergo a consultation with him. Since degenerative processes in the vertebrae are usually accompanied by neurological diseases due to constant compression of the nerve endings by the vertebrae in the spinal canal. They are formed due to thinning of the cartilage and narrowing of the space between the joints.
In what cases is an immediate consultation with a neurologist required?
Which doctor should I contact for scoliosis?
- Acute pain syndrome is felt in different parts of the back.
- Inability to move or perform physical activities normally.
- The pain does not stop even at rest.
- Reduced sensitivity of the limbs.
- A feeling of numbness appears periodically.
- Paralysis develops in the arms or legs.
- Constant drowsiness and headaches.
- Frequent loss of consciousness is observed.
Such ailments arise due to a sharp disruption of metabolic processes in the spine. A neurologist will promptly identify the cause of the symptoms and determine tactics to combat the pathology, as well as ways to restore the normal functioning of the musculoskeletal system.
Rheumatologist
A specialist in the field of rheumatology deals with the diagnosis and diseases of the spine, including osteochondrosis, if its cause was rheumatism. Inflammatory pathology affects many joints and ligaments of the thoracic region, lower back, and sacrum, significantly reducing the patient’s quality of life. The doctor knows methods of diagnosing and treating systemic connective tissue pathologies and uses innovative treatment methods.
X-ray is an informative way to determine the stage of osteochondrosis. The therapist prescribes it on your first visit.
Arthrologist
Patients with any joint diseases, regardless of the area, should go to him. There are more than 40 vertebrae in the human body, and dull pain can appear in any of the departments. The specialist is quite specialized and cannot be found in a regular clinic; the services of such doctors are offered by private medical organizations. The patient must necessarily undergo consultation and treatment with such a specialist if, in addition to the primary signs of osteochondrosis, the following is also observed:
- poor posture;
- vertebral displacement;
- stiffness of movements;
- inability to rotate the body;
- bone growths have formed;
- atrophy of the joint capsules appeared.
An arthrologist will help cure problems with joints and ligaments and prescribe an effective treatment regimen for vertebral pathology. Usually, in addition to drug therapy, the exercises of Dr. S.M. Bubnovsky, physiotherapy, and the Shishonin neck complex are additionally recommended.
Neurosurgeon
If therapeutic methods do not give the expected result, then patients with osteochondrosis are referred to a neurosurgeon for additional examination and surgical solution to the problem. A specialist in this field will help get rid of osteophytes, growths, or install a prosthetic intervertebral disc if the old one is worn out and the patient is at risk of paralysis. They resort to radical treatment only as a last resort, when other methods have not helped or cannot restore the patient’s health. At an early stage, it is not needed, since traditional methods can effectively cure the disease.
Rehabilitologist
This is a specialist who helps the patient recover after severe radical surgery on the spine. An individual program is selected for each patient, including a daily routine, gymnastics, nutrition and other activities that allow complete restoration of spine mobility. The doctor monitors its implementation and adjusts it as the patient recovers.
Osteochondrosis of the neck and lumbar region requires consultation with various specialists who give recommendations on normalizing the condition, taking medications or performing exercise therapy. There is no clear answer to who can completely cure the pathology, since several doctors are involved in the fight against its manifestation.
Causes of osteochondrosis.
Osteochondrosis is a consequence of biological aging of the body. As the intervertebral disc wears out, collapses and flattens over time, it loses its shock-absorbing function. The intervertebral space narrows, and the radicular nerves and blood vessels become pinched in it. This leads to the above-mentioned unpleasant symptoms.
Other causes of this disease include:
- sedentary, sedentary lifestyle;
- excessive loads (lifting objects with a large mass, physical overload);
- autoimmune diseases;
- metabolic disorders with critical excess body weight;
- imbalance of calcium in the body;
- pregnancy (provokes osteochondrosis in women due to depletion of the body in calcium and inadequate distribution of increasing body weight relative to the vertical axis);
- spinal injuries;
- flat feet or daily wearing of shoes with too high heels;
- household or professional lifestyle features (long standing, sitting on uncomfortable furniture, sleeping on an uncomfortable mattress, etc.).
A common consequence of osteochondrosis is the formation of a herniated intervertebral disc, which may require surgical intervention. Depending on the degree of complication, symptoms can range from mild to severe.
Diagnostics.
Most often, the diagnosis of “osteochondrosis” is made by a neurologist. At the initial examination, the doctor conducts an examination in connection with the patient's complaints of pain or limited mobility of the spine. The patient's spine is examined in standing, sitting and lying positions, in states of rest and movement.
Feeling the spine allows you to supplement the examination data (presence or absence of deformation), determine the location, degree and nature of pain. When palpated, tension in the muscles located next to the spine is noted. The patient is asked to bend or squat to determine the range of motion in various parts.
The final diagnosis is made by a neurologist based on a physical examination, as well as the results of radiography, CT or MRI. With the help of these examinations, the level of damage is determined, the diagnosis is specified, and hidden pathologies are revealed. After diagnosis, the attending physician determines treatment tactics and selects the most effective treatment method.
Diagnosis of the cause of neck pain
After an oral interview, the doctor examines the patient: palpates the surface of the neck, checks the sensitivity of the arms and legs, the state of reflexes, and determines the presence of muscle spasms and hypertonicity.
The following hardware techniques are used:
- radiography;
- MRI;
- CT scan;
- electromyography (EMG);
- Doppler ultrasound (USDG) of neck vessels.
Blood and urine tests can be taken to identify inflammatory processes in the body.
Treatment of osteochondrosis.
The first stage of treatment is pain elimination. For this, the patient is prescribed nonsteroidal anti-inflammatory drugs (NSAIDs), for example, Movalis, Voltaren. It should be noted that these medications are not recommended to be taken without a doctor’s prescription, since most of them have a detrimental effect on the gastrointestinal tract.
Further treatment of osteochondrosis can be conservative or surgical, depending on the severity and advanced stage of the disease. As a medical treatment, the patient is also prescribed B vitamins and muscle relaxants, for example Mydocalm, to relieve muscle hypertonicity and relieve pain. In some situations, the doctor may recommend physiotherapy.
After the pain has been relieved, that is, the symptoms of the disease have subsided, the patient is recommended physical therapy and massage. Physical therapy exercises help strengthen the muscular corset of the spinal column, develop the flexibility of the ligamentous apparatus, thereby increasing the amplitude of movements. By strengthening the muscles, decompression of the nerve roots occurs, as a result of which blood circulation and metabolism in the intervertebral discs are normalized. As a result, pain in the spine is significantly reduced. Therapeutic massage, in turn, relieves muscle spasms. Controversial treatments that are not traditional medicine include manual therapy, osteopathy and reflexology.
It is also worth noting that osteochondrosis, like any chronic disease, has periods of exacerbation and remission. Sometimes pain appears depending on the time of year or weather conditions. Knowing the characteristics of your body, you can prevent exacerbations in advance.
Methods for treating pain and stiffness in the cervical spine
Treatment for neck soreness may include:
- Physiotherapy sessions (magnetic therapy, electrophoresis, ultrasound therapy, shockwave therapy).
- Prescription of painkillers, sedatives, anti-inflammatory drugs, muscle relaxants.
- Methods of holistic medicine (acupuncture, massage, moxotherapy, hirudotherapy, stone therapy, vacuum therapy).
- Physical therapy, proper organization of the workplace, control of posture.
- Surgical intervention. Radical methods of surgical treatment are prescribed only if conservative methods are ineffective or for a more serious diagnosis that initially requires surgical intervention.
Prevention of osteochondrosis.
The main recommendation for those who want to maintain the health of the osteoarticular system is an orthopedic regimen. It is important to learn how to sit correctly, stand correctly, lift and carry heavy objects, and sleep. For example, the patient is advised to avoid upholstered furniture, including for sleeping. The work chair should have lumbar support. It is not recommended to stand in one position for a long time; it is advisable to periodically warm up. It is not recommended to lift and carry things weighing more than 15 kilograms. Every morning it is recommended to do short exercises for 15-30 minutes to pre-warm up the muscles.
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