Osteochondrosis is a disease of the musculoskeletal system, manifested by thinning of the cartilage of bones and joints. Often, patients are diagnosed with osteochondrosis of the spine, in which intervertebral discs are destroyed in the cervical, lumbar or thoracic region. Intervertebral cartilage is necessary to cushion movements and reduce the load on bone tissue, so the destruction of discs leads to gradual damage to the vertebrae and deformation of the spine. Osteochondrosis can be an aggravation of an injury, a long-term violation of posture or another pathological condition. Treatment of the disease includes manual therapy, physiotherapy and surgical interventions for significant spinal deformities.
Osteochondrosis is one of the most common diseases of the musculoskeletal system in the elderly. Pathology is diagnosed less frequently in adolescents and young adults. The characteristic symptoms of the disease, according to doctors, are severe pain and impaired mobility in the affected joint area. Without treatment, osteochondrosis can be complicated by compression of the spinal cord and dysfunction of internal organs.
Symptoms of osteochondrosis
Manifestations of the disease depend on the area of destruction of the articular discs. The main symptom is aching or sharp pain, aggravated by movement. Therefore, patients often take a forced position. With osteochondrosis of the cervical spine, it is difficult to look around the patient, severe headaches occur. If the disease is complicated by compression of peripheral nerves and spinal cord, symptoms of movement disorders and internal organ dysfunction occur.
Other symptoms and signs:
- Moderate dull pain during the day, aggravated during movements;
- 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 clumsy gait.
If you experience these symptoms, we recommend making an appointment with your doctor. Timely consultation will prevent negative consequences for your health.
The disease can develop over several years. Early stages of cartilage damage do not show any symptoms, but gradually there is constant pain.
Causes of osteochondrosis
Normally, intervertebral cartilage is continuously supplied with blood and receives enough nutrients from the blood to renew cells and maintain its structure. As tissues age, degenerative changes characterized by insufficient cell renewal may occur. Disruption of blood flow occurs when the vessels are compressed against the background of permanent curvature or damage to the spine. Also, osteochondrosis can be the result of excessive physical load.
Causes of the disease:
- Gradual destruction of intervertebral cartilage due to poor posture, heavy lifting, and movement patterns. The reason for the disruption of the structure of the intervertebral discs can even be wearing shoes with a flat sole for a long time;
- Craniovertebral anomalies - violation of the relative position of the cervical spine and skull structures. In this case, compression of blood vessels and disruption of blood supply to tissues often occur.
- 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 to choose 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 complaints and examines the history to identify risk factors for the disease. Then a general examination is carried out to determine the external signs of osteochondrosis and to exclude signs of spinal cord dysfunction. To confirm the diagnosis, the neurologist prescribes special examinations.
Methods of diagnosing osteochondrosis:
- X-ray of the spine. A neurologist prescribes this study to obtain a picture 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 obtained images allow the doctor to detect a hernia or other pathology, as well as determine the degree of damage to the vertebra and intervertebral disc;
- Magnetic resonance imaging is a more informative work that allows the 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 on the tomography table. The diagnosis lasts from 15 minutes to an hour. This is a painless and reliable method for diagnosing osteochondrosis. The results of MRI allow you to immediately rule out 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). A 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 ordinary radiography, but before the study, the doctor injects a contrast substance 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 vertebra.
In a special clinic, safe and reliable diagnostic tests are carried out, which allow to start the treatment of osteochondrosis quickly.
Therapeutic treatment of osteochondrosis
Treatment is carried out after consultation with a neurologist and orthopedist. In the case of instability of the affected cervical segment of the spine, a Schantz collar is applied. A prefabricated orthopedic collar is placed on the neck and secured with bandages. It is necessary to wear a collar to reduce 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 alleviate the patient's condition.
Methods of treatment of osteochondrosis:
- Prescribing non-steroidal anti-inflammatory drugs to relieve pain. The neurologist prescribes nimesulide, celecoxib, or another agent. It is necessary to strictly control the dosage of analgesics and monitor the condition of the liver with long-term use of painkillers.
- Stretch therapy is a method of stretching the spine to increase intervertebral space to relieve compression of blood vessels and nerves. Before the procedure, a massage is performed to relax the muscles. Stretching is done on a special table or in a bath. The device is attached to the patient's body in any 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.
- 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 preparations relieve the inflammatory process in tissues involving therapeutic massage, special exercises and heating.
The neurologist chooses an individual treatment regimen for osteochondrosis, paying attention to the patient's condition. Strict medical supervision of the course of treatment allows 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 is scheduled for consultation with a neurosurgeon. The doctor assesses the severity of the identified pathology and performs surgical intervention if necessary.
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 site 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 by transplantation of artificial materials. This effective operation is suitable for treating intervertebral hernia and alleviating the symptoms of osteochondrosis;
- Operations for narrowing of the spinal canal.This intervention relieves compression of the nerves and spinal cord. After applying anesthesia, the doctor treats the surgical area with an antiseptic and makes wide skin incisions. Pushing the muscle layer back, the neurosurgeon reaches and manipulates the intervertebral joint. The intervention involves the removal of the vertebral arch or the entire joint. The use of X-ray and microsurgical control allows to perform the operation with minimal risk.
The most complex surgical interventions are performed in the surgical department of modern clinics.