Osteochondrosis is a disease of the musculoskeletal system, which is manifested by thinning of the bones and cartilage of the joints. Most often, patients are diagnosed with osteochondrosis of the spine, which is characterized by destruction of intervertebral discs in the cervical, lumbar or thoracic region. The intervertebral cartilage is necessary to cushion movement and reduce the load on bone tissue, so the destruction of the discs leads to progressive 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, physiotherapy, and surgery 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 frequently. The characteristic symptoms of the disease, doctors include severe pain in the affected joint area and reduced mobility. Without treatment, osteochondrosis can be complicated by compression of the spinal cord and dysfunction of internal organs.
Symptoms of osteochondrosis
The manifestations of the disease depend on the zone of destruction of the articular discs. The main symptom is aching or sharp pain, aggravated during movement. For this reason, patients often adopt 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 the peripheral nerves and spinal cord, symptoms of movement disorders and impaired functions of internal organs appear.
Other symptoms and signs:
- Moderate dull pain during the day, worse when moving;
- The spread of pain in the head, shoulder, pelvis and lower limbs;
- Constant tension of the muscles associated with the affected intervertebral joint;
- Decreased performance;
- Sleep disorder;
- Change in posture and awkward 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 early stages of cartilage damage have no symptoms, but gradually there is constant pain.
Causes of osteochondrosis
Normally, the intervertebral cartilage is continuously supplied with blood and receives a sufficient amount of 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 the arteries are compressed against the background of a permanent curvature of the spine or injury. Also, osteochondrosis can be the result of excessive physical exertion.
Causes of disease:
- Progressive destruction of intervertebral cartilage due to altered posture, heavy loads and movement patterns. The reason for the violation of the structure of the intervertebral discs may even be prolonged wearing of flat-soled shoes;
- Craniovertebral anomalies - a violation of the relative position of the structures of the cervical spine and the skull. In this case, compression of blood vessels and a decrease in blood supply to the tissues often occur.
- Metabolic disorders, accompanied by insufficient formation of hydrophilic cartilaginous components;
- Inflammatory or autoimmune cartilage damage, in which the body's defense system attacks healthy tissue;
- A herniated disc is a disease characterized by displacement of the cartilage and protrusion of the disc into the spinal canal.
Clarifying the cause of osteochondrosis is important for choosing the right treatment.
Diagnosis of osteochondrosis
When symptoms of osteochondrosis appear, it is necessary to make an appointment with a neurologist. The doctor in the clinic asks the patient about his 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 examinations.
Methods of diagnosis of osteochondrosis:
- X-ray of the spine. 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 doctor to detect a hernia or other pathology, as well as determine the degree of damage to the vertebrae and intervertebral disc;
- Magnetic resonance imaging is a more informative study that allows a neurologist to study layered images of the spine in different projections. During the examination, the patient is asked to remove all metal jewelry and lie down on the CT table. Diagnosis takes 15 minutes to an hour. This is a painless and reliable method for diagnosing osteochondrosis. The results of an MRI can immediately exclude other diseases with similar symptoms, such as tuberculosis of the bones or a 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 begin treatment for osteochondrosis.
Therapeutic treatment of osteochondrosis
The 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 relieve the load on the affected spine and prevent the development of complications. In severe osteochondrosis of the lumbar or thoracic spine, the patient needs rest. The clinic doctor will also prescribe symptomatic therapy and physiotherapy to relieve the patient's condition.
Methods of treatment of osteochondrosis:
- Prescribe nonsteroidal anti-inflammatory drugs for pain relief. The neurologist prescribes nimesulide, celecoxib or another agent. It is necessary to strictly control the dosage of painkillers and monitor the condition of the liver with prolonged use of painkillers.
- Traction therapy is a method of stretching the spine to increase 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 on the patient's body in the desired position and gently stretches the spine. This is a very effective and safe procedure for the treatment of osteochondrosis.
- The use of anticonvulsants for complications of osteochondrosis. A neurologist prescribes a short course of carbamazepine or another drug to a patient.
- The use of muscle relaxants. These drugs relax the muscles associated with the affected area of the spine and relieve pain;
- Use of corticosteroids for nerve compression. These drugs alleviate the inflammatory process in the tissues, which includes therapeutic massage, special exercises and warming 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 you to achieve the best prognosis.
Surgical treatment of osteochondrosis
If the diagnostic results reveal an intervertebral hernia or severe compression of the spinal canal, the patient should consult a neurosurgeon. The doctor assesses the severity of the identified pathology and, if necessary, performs surgery.
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 the transplantation of artificial materials. This effective operation is suitable for the treatment of intervertebral hernia and the relief of symptoms of osteochondrosis;
- Operations for the narrowing of the spinal canal.This procedure eliminates compression of the nerves and spinal cord. After applying anesthesia, the doctor treats the surgical field with an antiseptic and makes a large skin incision. Pushing back the muscle layer, the neurosurgeon reaches the intervertebral joint and performs manipulation. The operation consists of 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.