What is osteochondrosis? In the original sense of the word, osteochondrosis is a disorder in the transformation of cartilage cells into bone cells during bone formation (Osteochondrosis dissecans). When it comes to osteochondrosis of the spine, this disease is usually a congestion-related change in the disc cartilage and the adjacent vertebral body to understand. It is also called osteochondrosis intervertebralis.
Osteochondrosis of the spine: causes
The disc is due to poor posture, for example, by a spinal curvature to the side (scoliosis), burdened for years on one side, changes and wears. Your shock absorber effect diminishes, it loses in height. The bones of the vertebral bodies are more heavily loaded and the vertebral body becomes unstable. Bony lateral appendages (spondylophytes) are said to catch the increased pressure, a process called spondylosis.
Normally, the base plate and cover plate of the vertebra adjacent to the "diseased" disc represent a barrier between bone and disc. As a result of wear, enzymes attempt to dissolve the disc nucleus of the disc. This also causes metabolic products in the adjacent vertebral bone, which reacts with an extremely painful edema, ie a kind of bone swelling. The spine loses its natural S-shape and stiffens increasingly.
Osteochondrosis: course and stages
The course of osteochondrosis intervertebralis is divided accordingly into three stages:
- Modic I means edema
- Modic II means greasy degeneration of the bone
- Modic III refers to bone sclerosis, ie the hardening of the bone
Back pain unavoidable
If vertebral arches are affected by osteoarthritis due to wear, it is called spondylarthrosis. Not only miscarriage, but also previous disc herniation and disc surgery, rarely inflammation of the disc, can lead to osteochondrosis of the lumbar spine (LWS) or osteochondrosis of the cervical spine (cervical spine).
Often, the bulging disc compresses a nerve (root compression) away from the vertebral arches and causes severe pain and / or paralysis. Even with osteochondrosis of the cervical spine, spondylosis of the vertebra causes a narrowing of the nerve outlet openings. Back pain and tension are unavoidable.
Osteochondrosis: treatment and therapy
Osteochondrosis therapy in osteochondrosis intervertebralis is highly dependent on individual findings. Painkillers, cortisone-free anti-inflammatory drugs and muscle-relaxing medications can be used to combat pain. Once acute pain has been alleviated, physiotherapy can improve the mechanical conditions on the intervertebral disc as well as the vertebral body.
In the case of osteochondrosis of the lumbar spine, it is still possible in an early phase to prevent the progression of osteochondrosis through consistent muscle building on the abdomen and back as well as postural training. Physical measures such as heat in the form of red light, mud, massage or electrotherapy are also helpful. In advanced osteochondrosis therapy may consist of the combination of brace (orthosis) and muscle building.
If there is osteochondrosis of the cervical spine, osteochondrosis therapy is more difficult. However, it is possible to relax the tense muscles by physiotherapy. Excessive nerve irritation can be reduced by targeted pain medication injections. In case of osteochondrosis of the lumbar spine and osteochondrosis of the cervical spine, stabilization surgery and implantation of an intervertebral disc prosthesis are possible in the advanced stage.
OCD: osteochondrosis as a bone formation disorder
An osteochondrosis with the significance of a bone decomposition (osteochondritis dissecans, OCD) as a result of a bone formation disorder below the articular cartilage occurs mainly in the knee joint, in the upper ankle and in the elbow joint. The causes are not yet clear. However, it is considered certain that there are initially bony circulatory problems below the cartilage.
The bone tissue gradually dissolves. Initially, the cartilage is still well supplied by the synovial fluid, but then it changes and softens. The cartilage cover may tear or cartilage bone pieces may detach into the joint.
Therapy of osteochondritis dissecans depends on the size of the changes. First, the joint must be immobilized for months if possible, ie no sports and the use of forearm crutches are important. If there is no improvement or if the symptoms are more severe, osteochondrosis requires jointoscopy and surgery, possibly with bone and / or cartilage cell transplantation.