Osteochondrosis is a disease of the musculoskeletal system that is manifested by thinning of the bones and cartilage of the joints. Most 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 for easing movement and reducing 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 injury, long-term violation of posture or some other 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. In adolescents and young adults, pathology is diagnosed less often. Characteristic symptoms of the disease, doctors include severe pain in the area of the affected joint and reduced mobility. 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, which increases 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 peripheral nerves and spinal cord, symptoms of movement disorders and internal organ function disorders appear.
Other symptoms and signs:
- Moderate dull pain during the day, increased during movement;
- Spreading pain in the head, shoulder, pelvis and lower extremities;
- Constant tension of the muscles associated with the affected intervertebral joint;
- Reduced performance;
- Sleep disorder;
- Change in posture and clumsy gait.
If you experience these symptoms, we recommend that you make an appointment with your doctor. With timely counseling, you will prevent negative consequences for your health.
The disease can progress over several years. Early stages of cartilage damage do not show any 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 regenerate cells and maintain its own structure. Aging of tissues can lead to degenerative changes characterized by insufficient cell renewal. Disturbance of blood flow occurs when the arteries are compressed against the background of permanent curvature of the spine or injury. Also, osteochondrosis can be a consequence of excessive physical exertion.
Causes of the disease:
- Gradual destruction of intervertebral cartilage due to impaired posture, lifting heavy objects and movement. The reason for the violation of the structure of the intervertebral discs can be even long-term wearing of flat-soled shoes;
- Craniovertebral anomalies - violation of the relative position of the structures of the cervical spine and skull. In this case, blood vessels are often squeezed and tissue blood supply is disrupted.
- 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 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 clinical doctor asks the patient about complaints and reviews the medical history to identify risk factors for the disease. Then a general examination is carried out to identify external signs of osteochondrosis and exclude symptoms of spinal cord dysfunction. To confirm the diagnosis, the neurologist prescribes special examinations.
Methods for diagnosing osteochondrosis:
- X-ray of the spine. A 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 apparatus. 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 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 tomography table. Diagnostics takes from 15 minutes to an hour. This is a painless and reliable method for diagnosing osteochondrosis. The results of MR allow to immediately rule out other diseases with similar symptoms, such as bone tuberculosis or a malignant tumor. If magnetic resonance 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 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, 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 Shants collar is placed. A prefabricated orthopedic collar is placed on the neck and secured with bandages. Wearing a collar is necessary to ease 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 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 dose of analgesics and monitor the condition of the liver with prolonged use of painkillers.
- Traction therapy is a method of stretching the spine to increase the intervertebral gap 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 gently stretches the spine. This is a very effective and safe procedure for the treatment of osteochondrosis.
- The use of anticonvulsant drugs for complications of osteochondrosis. The neurologist prescribes a short course of carbamazepine or another drug to the patient.
- 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 relieve the inflammatory process in the tissues, which includes therapeutic massage, special exercises and heating.
The neurologist selects an individual treatment regimen for osteochondrosis, focusing on the patient's condition. Strict medical control 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 advised to 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 giving anesthesia, the neurosurgeon treats the surgical field with an antiseptic and cuts the skin in a predetermined place. 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 administering anesthesia, the doctor treats the surgical field with an antiseptic and makes a wide incision in the skin. Pushing the muscle layer, the neurosurgeon reaches the intervertebral joint and performs the manipulation. The intervention involves removing the vertebral 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.