Osteochondrosis is a disease of the musculoskeletal system, which is manifested by thinning of the cartilage of bones and joints. Most often, patients are diagnosed with osteochondrosis of the spine, during which the intervertebral discs are destroyed in the cervical, lumbar or chest region. Intervertebral cartilage is necessary to reduce movements and reduce the load on bone tissue, so the destruction of the discs leads to gradual damage to the spine and deformation of the spine. Osteochondrosis can be a complication of an injury, a long-term posture disorder or another pathological condition. Treatment of the disease includes 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. Pathology is less often diagnosed in adolescents and young adults. Typical 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
Manifestations of the disease depend on the area of destruction of the articular discs. The main symptom is aching or sharp pain that worsens with movement. Because of this, patients often take a forced position. During osteochondrosis of the cervical spine, it is difficult for the patient to look around, there is a severe headache. If the disease is complicated by compression of the peripheral nerves and spinal cord, the symptoms of movement disorder and internal organ dysfunction are manifested.
Other symptoms and signs:
- moderate dull pain during the day, aggravated by movement;
- spreading pain in the head, shoulder, pelvis and lower limbs;
- constant muscle tension associated with the affected intervertebral joint;
- reduced performance;
- sleep disturbance;
- Posture changes and clumsy walking.
If you have 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 symptoms, but constant pain gradually appears.
Causes of osteochondrosis
Normally, intervertebral cartilage is constantly supplied with blood and receives enough nutrients from the blood to renew cells and maintain its structure. As the tissues age, degenerative changes can occur, characterized by insufficient cell renewal. Disruption of blood flow occurs when arteries are compressed against the background of permanent curvature of the spine or injury. Also, osteochondrosis can be a result of excessive physical activity.
Causes of the disease:
- Gradual destruction of intervertebral cartilage due to poor posture, heavy lifting and movement patterns. The reason for breaking the structure of the intervertebral discs can be wearing flat-soled shoes for a long time;
- Craniovertebral anomalies - a violation of the relative position of the cervical spine and skull structures. In this case, blood vessels are often compressed and the blood supply of tissues is disturbed.
- metabolic disorders accompanied by insufficient production of hydrophilic cartilage components;
- Inflammatory or autoimmune cartilage damage, in which the body's defense system attacks healthy tissues;
- A herniated disc is a disease characterized by cartilage displacement and disc protrusion in the spinal canal.
To choose the right treatment, it is important to find out the cause of osteochondrosis.
Diagnosis of osteochondrosis
When symptoms of osteochondrosis appear, it is necessary to visit a neurologist. The clinic doctor asks the patient about the complaints and examines the history to determine the risk factors of the disease. Then a general examination is carried out to determine the external signs of osteochondrosis and exclude symptoms of spinal cord dysfunction. To confirm the diagnosis, the neurologist will prescribe special examinations.
Methods of diagnosis of osteochondrosis:
- X-ray of the spine. The neurologist prescribes 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 obtained images allow the doctor to detect a hernia or other pathology, as well as to determine the degree of damage to the spine 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 tomography table. Diagnosis takes 15 minutes to an hour. This is a painless and reliable method of diagnosing osteochondrosis. MRI results make it possible to immediately rule out other diseases with similar symptoms, such as bone tuberculosis or malignant tumors. If MRI is contraindicated, myelography is indicated.
- Examination of the subarachnoid space of the spinal cord (myelography). A neurologist prescribes this procedure to rule out syringomyelia, oncology and other pathological conditions of the meninges. The method of obtaining the 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 performed, which allows you to quickly start treating osteochondrosis.
Therapeutic treatment of osteochondrosis
Treatment is carried out after consultation with a neurologist and orthopedist. In case of instability of the damaged cervical segment of the spine, a Schanzi collar is used. A prefabricated orthopedic collar is placed on the neck and fixed with a bandage. Wearing a collar is necessary to relieve the load on the injured 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 physical therapy to alleviate the patient's condition.
Methods of treatment of osteochondrosis:
- Prescribing non-steroidal anti-inflammatory drugs to relieve pain. A neurologist will prescribe nimesulide, celecoxib, or another agent. It is necessary to strictly control the dose of painkillers and monitor the condition of the liver during long-term use of painkillers.
- Traction therapy is a method of stretching the spine to widen the intervertebral space to eliminate compression of blood vessels and nerves. Before the procedure, a massage is performed to relax the muscles. Traction is performed on a special table or in a bathroom. 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.
- Use of anticonvulsants for complications of osteochondrosis. The neurologist prescribes the patient a short course of carbamazepine or another drug.
- 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 drugs alleviate 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 a severe compression of the spinal canal, the patient is advised to consult a neurosurgeon. The doctor assesses the severity of the detected 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 in a predetermined place. After pressing the muscle layer with a special tool, the doctor removes the damaged intervertebral disc. If necessary, the removal of the vertebral arch is also performed. Plastic surgery of the spine segment is performed by transplanting 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 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 on the skin. Pushing back the muscle layer, the neurosurgeon reaches the intervertebral joint and performs manipulation. The intervention involves the removal of the vertebral arch or the entire joint. The use of X-ray and microsurgical control allows the operation to be performed with minimal risk.
The most difficult surgical interventions are performed in the surgical department of modern clinics.