Osteochondrosis of the spine - Find a specialist and information

07.11.2023
Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Osteochondrosis" refers to changes in the cartilage and bones. Osteochondrosis can occur throughout the entire body; in the past, these changes were also referred to as "aseptic bone necrosis". Osteochondrosis can also occur in the cervical, thoracic and lumbar spine and is then referred to as"osteochondrosis intervertebralis", a localized degeneration of cartilage and bone in the spine. While the affected structures hurt during certain movements at the beginning of the disease, the pain also occurs at rest in advanced stages.

Below you will find further information and specialists for the treatment of osteochondrosis.

ICD codes for this diseases: M42.1

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Brief overview:

  • What is intervertebral osteochondrosis? A disease of the bones and articular cartilage of the cervical, thoracic and lumbar spine, possibly also in combination with changes to the intervertebral disc.
  • Causes: Incorrect or excessive strain, accidents, axial deviations of the spine scoliosis, local circulatory disorders and/or growth disorders can cause the disease.
  • Symptoms: Back pain that worsens over time is the main symptom. The patient's posture can then lead to further muscle pain, tension, headaches and nerve pain.
  • Forms: The disease can occur in various forms and in many regions of the skeleton; osteochondrosis intervertrebalis due to wear and tear is the manifestation of the spine. Other selected forms: Osteochondrosis dissecans, femoral head necrosis, Osgood-Schlatter disease, Ahlbäck disease, Scheuermann's disease, Perthes disease.
  • Diagnosis: The doctor makes a suspected diagnosis based on the patient interview and a physical examination. MRI and ultrasound confirm the diagnosis and determine the degree of severity.
  • Treatment: The aim of treatment is to alleviate pain and enable the patient to regain full mobility. Painkillers, anti-inflammatory medication, physiotherapy and exercise are the mainstays of treatment.

Article overview

Osteochondrosis in the area of the spine is a gradual disease that the affected person does not even notice at first. At first, pain occurs sporadically. Later, the back also hurts when lying down or sitting, so that the suffering of those affected is great.

Osteochondrosis of the spine: what exactly is it?

Osteochondrosis intervertebralis is a change in the vertebral joints, the intervertebral discs and the vertebrae in the cervical, thoracic and/or lumbar spine (cervical spine, thoracic spine, lumbar spine). Theoretically, this can lead to increased wear and tear of these structures, which doctors refer to as degeneration.

The causes of such osteochondrosis of the spine are not yet fully understood. Local circulatory disorders in the bone, changes in growth or prolonged overloading or incorrect loading of the back may play a role. Osteochondrosis can also develop as a result of changes to the intervertebral disc.

Symptoms of osteochondrosis

Osteochondrosis of the spine can cause pain, which can also worsen over time. Patients often adopt a relieving posture due to the pain in order to relieve the affected structures. However, smaller osteochondroses can also remain without symptoms and are sometimes discovered as incidental findings, e.g. during an MRI scan. As a rule, this is no cause for concern.

Possible symptoms of a pronounced disease are

Back and neck pain are common in cases of extensive osteochondrosis of the spine. Headaches and restricted movement are possible side effects. In some cases, pain can also radiate. If the disease is very advanced, doctors refer to it as erosive (advanced) osteochondrosis. If several joints are affected at the same time, this is known as multisegmental osteochondrosis.

Forms of the disease

Osteochondrosis has many faces. The most common form is intervertebral osteochondrosis. This is a change in the vertebral joints, the intervertebral discs and the vertebrae of the spine. If this is accompanied by signs of wear and tear, it is often referred to as spondylosis.

Spondylosis is a non-specific wear and tear in the area of the spine. This leads to overloading of the affected joint and the bone is slowly broken down. The body counteracts the wear and tear by producing bone mass. However, this leads to ossification of the affected segment. The transition from the lumbar spine to the pelvis (L5/S1) is most frequently affected.

Osteoch-iv.jpg
Osteochondrosis between the 4th and 5th lumbar vertebrae; by Dr. Jochen Lengerke - Praxis Dr. Jochen Lengerke, CC BY-SA 3.0 de, Link

Other forms of the disease:

1. osteochondrosis dissecans (activated osteochondrosis)

This is a change in bone metabolism involving the articular cartilage. This disease mainly occurs in the ankle, knee or elbow joint. At a late stage, the cartilage-bone fragment is rejected into the joint, which can lead to painful pinching symptoms.

2 Scheuermann's disease (juvenile osteochondrosis)

Scheuermann's disease is a growth disorder of the thoracic spine and is the most common spinal disorder in adolescents. The changes usually begin between the ages of 11 and 13, and boys are more frequently affected than girls. The actual cause of this disease is not yet fully understood. In addition to a hereditary component, one-sided strain on the spine and poor posture due to weak trunk muscles contribute significantly to the development of Scheuermann's disease.

3 Perthes' disease

Perthes' disease is an osteochondrosis in the area of the femoral head that occurs between the ages of 5 and 9. Children complain of pain in the hip or knee area, which is caused by the changes in the femoral head and the accompanying joint effusion. If left untreated, Perthes' disease can lead to permanent deformation of the femoral head once growth is complete. As the patient grows, the disease can often be cured through targeted surgical procedures.

Diagnosis of osteochondrosis

Most patients come to the practice with acute or chronic pain. The medical history, clinical examination and analysis of posture and gait form the basis of the diagnosis. However, the doctor will carry out additional imaging to confirm the diagnosis. Various X-rays, magnetic resonance imaging (MRI) and ultrasound examinations help to determine the severity of osteochondrosis.

Therapy: pain relief & improvement of mobility

First and foremost, treatment depends on the patient's clinical picture and the stage of the disease. The basis of non-surgical (conservative) therapy is painkillers and exercise therapy. Painkillers (analgesics) not only relieve the pain - they are also helpful for muscle tension. Sometimes inflammation also occurs in the affected regions, which is why the doctor administers anti-inflammatory medication.

As an accompanying therapy, physiotherapy treatments help to alleviate the pain and improve mobility. Physical measures such as magnetic therapy, oxygen therapy, electrotherapy, heat treatments (fango or mud packs) or massages have no relevant influence on bone metabolism and cannot heal the disease. At most, such procedures should be used as an accompanying therapy, e.g. to relax the muscles. Scientific studies have also shown that relieving pressure (e.g. on UA crutches) does not have any lasting benefit.

Sport is recommended for osteochondrosis with muscular weakness in order to stabilize the muscles surrounding the joint. However, make sure that the type of sport does not put additional strain on your joints. Gentle sports, in particular

  • swimming
  • Nordic walking
  • cycling,

are ideal in this respect. Also make sure you eat a wholesome, Mediterranean diet.

Conclusion

Osteochondrosis can occur in the entire skeleton of the body, and the spine is frequently affected. The treatment of osteochondrosis depends on the affected joint and the stage of the disease. In addition to conservative treatment, there are successful orthopaedic-surgical treatment methods to alleviate the condition and prevent possible secondary damage.

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