Osteochondrosis is a disease of the musculoskeletal system, manifested by the thinning of the bones and cartilage of the joints. Most often, patients are diagnosed with osteochondrosis of the spine, in which there is destruction of the intervertebral discs in the cervical, lumbar, or thoracic region. Intervertebral cartilage is needed to cushion movements and reduce the load on bone tissue, so the destruction of the discs leads to gradual damage to the vertebrae and deformation of the spine. Osteochondrosis can be a complication of an injury, a long-term violation of posture, or another pathological condition. Treatment of the disease involves manual therapy, physical therapy, and surgical interventions for significant spinal deformities.
Osteochondrosis is one of the most common diseases of the musculoskeletal system in the elderly. In adolescents and young adults, the pathology is diagnosed less often. The characteristic symptoms of the disease, doctors include severe pain in the area of the affected joint and impaired mobility. Without treatment, osteochondrosis can be complicated by spinal cord compression and internal organ dysfunction.
Symptoms of Osteochondrosis
The manifestations of the disease depend on the area of destruction of the articular discs. The main symptom is aching or sharp pain, aggravated during movement. Because of this, patients often assume a forced position. With osteochondrosis of the cervical spine, it is difficult for the patient to look around, severe headaches occur. If the disease is complicated by compression of peripheral nerves and spinal cord, symptoms of movement disorders and disturbances of internal organ functions occur.
Other symptoms and signs:
- Moderate dull pain during the day, aggravated by movement;
- The spread of pain in the head, shoulder, pelvis and lower extremities;
- Constant tension of the muscles associated with the affected intervertebral joint;
- Decreased performance;
- sleep disorders;
- Change in posture and clumsy gait.
If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will avoid negative consequences for your health.
The disease can progress over several years. The initial stages of cartilage damage have no symptoms, but gradually there is constant pain.
Causes of osteochondrosis
Normally, intervertebral cartilage is continuously supplied with blood and receives sufficient nutrients from the blood to renew cells and maintain its own structure. As tissues age, degenerative changes can occur, characterized by insufficient cell turnover. Violation of blood flow occurs when arteries are squeezed against the background of a permanent curvature of the spine or injury. In addition, osteochondrosis can be the result of excessive physical exertion.
Causes of the disease:
- Gradual destruction of intervertebral cartilage due to impaired posture, weight lifting, and movement patterns. The reason for the violation of the structure of the intervertebral discs may even be wearing shoes with a flat sole for a long time;
- Craniovertebral anomalies - a violation of the relative position of the structures of the cervical spine and skull. In this case, compression of the blood vessels and impaired blood supply to the tissues usually occurs.
- Metabolic disorders, accompanied by insufficient formation of hydrophilic cartilage components;
- Inflammatory or autoimmune damage to cartilage, where the body's defense system attacks healthy tissue;
- A herniated disc is a disease characterized by displacement of cartilage and protrusion of the disc into the spinal canal.
Clarifying the cause of osteochondrosis is important in choosing the right treatment.
Diagnosis of osteochondrosis
When symptoms of osteochondrosis appear, it is necessary to make an appointment with a neurologist. The clinic doctor asks the patient about the complaints and examines the history to identify risk factors for the disease. Then, a general examination is performed to identify external signs of osteochondrosis and exclude symptoms of spinal cord dysfunction. To confirm the diagnosis, the neurologist prescribes special tests.
Methods for diagnosing osteochondrosis:
- Spinal radiography. The neurologist appoints this study to obtain an image of the affected segment of the spine in two projections. Before the procedure, the patient is asked to undress to the waist and stand in front of the machine. The resulting images allow the physician to detect a hernia or other pathology, as well as determine the degree of damage to the vertebrae and the intervertebral disc;
- MRI is a more informative study that allows the neurologist to study layered images of the spine in different projections. During the exam, the patient is asked to remove all metal jewelry and lie on the CT scan table. Diagnosis takes 15 minutes to an hour. This is a painless and reliable method for diagnosing osteochondrosis. The results of an MRI allow you to immediately exclude other diseases with similar symptoms, such as tuberculosis of the bones or malignant tumor. If MRI is contraindicated, myelography is indicated.
- Examination of the subarachnoid space of the spinal cord (myelography). The neurologist prescribes this procedure to exclude syringomyelia, oncology and other pathological conditions of the meninges. The method of obtaining an image does not differ from conventional radiography, however, before the study, the doctor injects a contrast agent into the subarachnoid space. Before the puncture, the doctor treats the skin with an antiseptic and anesthetizes the tissues. The needle is inserted into the intervertebral space of the lumbar spine.
In a specialized clinic, safe and reliable diagnostic tests are carried out, allowing you to quickly start the treatment of osteochondrosis.
Therapeutic treatment of osteochondrosis
Treatment is carried out after consultation with a neurologist and an orthopedist. In case of instability of the affected cervical segment of the spine, a Shants collar is applied. A prefabricated orthopedic collar is applied to the neck and reinforced with bandages. Wearing a collar is necessary to lighten the load on the affected spine and prevent complications from developing. In severe osteochondrosis of the lumbar or thoracic spine, the patient needs rest. The clinician will also prescribe symptomatic therapy and physical therapy to alleviate the patient's condition.
Treatment methods for osteochondrosis:
- Prescription of non-steroidal anti-inflammatory drugs for pain relief. The neurologist prescribes nimesulide, celecoxib, or another agent. It is necessary to strictly control the dosage of analgesics and monitor the state of the liver with prolonged use of analgesics.
- Traction therapy is a method of stretching the spine to increase the intervertebral space to eliminate compression of blood vessels and nerves. Before the procedure, a massage is performed to relax the muscles. Traction is carried out on a special table or in a bath. The device is fixed to the patient's body in the desired position and gently elongates the spine. This is a very effective and safe procedure for treating osteochondrosis.
- The use of anticonvulsants for complications of osteochondrosis. A neurologist prescribes a short course of carbamazepine or another medication to a patient.
- The use of muscle relaxants. These medications relax the muscles associated with the affected area of the spine and relieve pain;
- Use of corticosteroids for nerve compression. These medications relieve the inflammatory process in the tissues, which includes massage therapy, special exercises, and warm-up.
The neurologist selects an individual treatment regimen for osteochondrosis, focusing on the patient's condition. Strict medical control of the course of treatment allows achieving the best prognosis.
Surgical treatment of osteochondrosis
If the diagnostic results reveal an intervertebral hernia or severe spinal canal compression, the patient should consult a neurosurgeon. The doctor assesses the severity of the identified pathology and, if necessary, performs surgical intervention.
Surgical treatment options:
- Partial or complete removal of the intervertebral disc.The operation is performed under anesthesia. After applying anesthesia, the neurosurgeon treats the surgical field with an antiseptic and cuts the skin at a predetermined location. After pushing the muscle layer with a special tool, the doctor removes the affected intervertebral disc. If necessary, removal of the vertebral arch is also performed. Plastic surgery of the spinal segment is performed with transplantation of artificial materials. This effective operation is suitable for treating intervertebral hernia and alleviating the symptoms of osteochondrosis;
- Operations for the narrowing of the spinal canal.This intervention eliminates the compression of the nerves and spinal cord. After applying anesthesia, the doctor treats the surgical field with an antiseptic and makes a wide incision in the skin. By pushing back the muscle layer, the neurosurgeon reaches the intervertebral joint and performs manipulation. The intervention involves removing the vertebral arch or the entire joint. The use of X-rays and microsurgical control allows the operation to be performed with minimal risk.
The most complex surgical interventions are performed in the surgical department of modern clinics.