Osteochondrosis is a disease of the musculoskeletal system, manifested by 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. The intervertebral cartilage is necessary to soften the movements and reduce the load on the 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 postural disorder, or another pathological condition. Treatment of the disease includes manual therapy, physical therapy and surgical interventions for significant spinal distortions.
Osteochondrosis is one of the most common diseases of the musculoskeletal system in the elderly. In adolescents and young people, the pathology is diagnosed less often. Among 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 compression of the spinal cord and dysfunction of internal organs.
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 that worsens during movement. Because of this, patients often take 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 disorders of the functions of internal organs appear.
Other symptoms and signs:
- Moderate dull pain during the day, aggravated by movement;
- The spread of pain in the head, shoulder, pelvis and lower limbs;
- Constant tension of the muscles associated with the affected intervertebral joint;
- Reduced ability to work;
- Sleep disturbance;
- Change in posture and clumsy gait.
If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.
The disease can progress over several years. The early stages of cartilage damage do not show any symptoms, but gradually there is constant pain.
Causes of osteochondrosis
Normally, the intervertebral cartilage has a continuous blood supply and receives enough nutrients from the blood to renew cells and maintain its own structure. As tissues age, degenerative changes can occur, characterized by insufficient cell renewal. Disruption of blood flow occurs when the arteries are compressed against the background of 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 poor posture, heavy lifting, and movement patterns. The reason for the disruption of the structure of the intervertebral discs can be even wearing flat-soled shoes 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 often occur.
- Metabolic disorders accompanied by insufficient formation of hydrophilic cartilage 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 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 of the clinic questions the patient about the complaints and examines the history to identify the risk factors for the disease. After that, 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:
- X-ray of the spine. The neurologist appoints 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 to determine the degree of damage to the vertebrae and intervertebral disc;
- Magnetic resonance imaging is a more informative study 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 CT table. The diagnosis takes from 15 minutes to an hour. This is a painless and reliable method for diagnosing osteochondrosis. MRI results immediately allow to rule out other diseases with similar symptoms, such as bone tuberculosis 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 a picture does not differ from conventional radiography, but before the examination, 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 spine.
In a specialized clinic, safe and reliable diagnostic tests are performed, which allow you to quickly start the treatment of osteochondrosis.
Therapeutic treatment of osteochondrosis
Treatment is carried out after consultation with a neurologist and orthopedist. In case of instability of the affected cervical segment of the spine, a Shantz collar is applied. A prefabricated orthopedic collar is applied to the neck and secured with bandages. Wearing a collar is necessary to relieve the load on the affected spine and prevent the development of complications. With severe osteochondrosis of the lumbar or thoracic spine, the patient needs rest. The doctor of the clinic will also prescribe symptomatic therapy and physiotherapy to alleviate the patient's condition.
Methods of treatment of osteochondrosis:
- Prescribing 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 condition of the liver during long-term use of painkillers.
- 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 done to relax the muscles. Traction is performed on a special table or in a bathtub. The device is fixed on the patient's body in the desired position and slightly stretches the spine. This is a very effective and safe procedure for the treatment of osteochondrosis.
- The use of anticonvulsants in complications of osteochondrosis. The neurologist prescribes the patient a short course of carbamazepine or another drug.
- The use of muscle relaxants. These drugs relax the muscles associated with the affected area of the spine and relieve pain;
- Using corticosteroids to compress the nerves. These drugs relieve the inflammatory process in the tissues, which includes therapeutic massage, special exercises and warming up.
The neurologist chooses 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 surgical intervention.
Options for surgical treatment:
- 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, the spinal arch is also removed. 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 relief of symptoms of osteochondrosis;
- Operations to narrow the spinal canal.This intervention eliminates 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. Pushing back the muscle layer, the neurosurgeon reaches the intervertebral joint and performs manipulation. The intervention involves removal of the spinal arch or the entire joint. The use of X-ray and microsurgical control allows the operation to be performed with minimal risks.
The most complex surgical interventions are performed in the surgical department of modern clinics.