How to treat osteonecrosis?

symptoms of osteonecrosis in a man

Bone tumors and back pain frequently affect 60-80% of the population over the age of 30. Untreated osteonecrosis reduces quality of life and can lead to disability and disability, so it's important to recognize it at its early stages of development and seek medical help. .

In this article, we will talk about osteosarcoma, its symptoms and diagnostic methods, as well as how to distinguish osteosarcoma from other diseases that present with back pain and what to do if signs of osteosarcomavertebrae appear.

What is spinal cord tumor?

Osteoma is a chronic disease in which the nucleus of the disc is gradually destroyed. Over time, disc damage pulls on other spinal structures in the pathological process and leads to musculoskeletal and nervous system disorders. Osteochondrosis is also characterized by premature aging of the articular apparatus or as a pathology due to damage to the vertebrae, for example, after an injury.

The development of osteonecrosis is influenced by many factors, so researchers have systematized the reasons for the origin of the disease:

  • invisibility - inflammatory processes and other injuries of the spine lead to premature aging of cartilage, for example, due to a sedentary lifestyle;
  • degenerative - disorders in the intervertebral discs that occur due to impaired metabolism, for example, due to an unbalanced diet and alcohol abuse;
  • Metabolic disorders - osteonecrosis occurs due to malnutrition in disc cartilage due to age, the number of blood vessels supplying nutrients to the blood decreases.

The development of osteonecrosis is a flow in which one pathological process initiates another. So, for example, due to age-related changes and a decrease in the number of blood vessels in the disc, disturbed nutrition leads to failure of biochemical processes and disc damage.

Since degenerative and dystrophic changes develop in the spine, muscle tone and activity of the nerve roots exiting the spinal cord through natural openings in the vertebrae are disrupted. That leads to consequences from the nervous system and musculoskeletal system.

Symptoms of osteonecrosis of the spine

Osteoma is a chronic disease with periodic exacerbations, caused by trauma, sedentary lifestyle, heavy lifting, hypothermia, and psycho-emotional stress. The most common and characteristic symptom of dystrophic disorders in the nucleus pulposus is frequent back pain in different segments: in the neck, chest and lower back.

There are two types of symptoms of osteonecrosis: reflex and compression. Reflex symptoms develop due to irritation of the roots of the spinal cord. They manifest in the form of spasm or vasodilation, muscle twitching, muscle weakness. Compression symptoms develop due to compression (often formed by a spinal herniation) of nerves and manifest as loss of sensation in the affected part (in the neck, arms, or lower back).

In addition, osteonecrosis is characterized by the following symptoms:

  • tension and pain in the muscles of the neck and back;
  • curvature of the spine to the side, back or forward;
  • violation of nerve sensitivity and regulation: there is a sensation of crawling on the skin, heat and cold on the skin of the back and extremities, numbness of the hands or feet;
  • weakening of muscle strength of the extremities;
  • frequent urination - up to 10-12 times a day.

Where can osteonecrosis be found?

Pain in osteonecrosis is not confined to the back. They extend to the upper and lower extremities. By upper foot:

  • butt;
  • the back and side of the thigh;
  • lower leg and inner part of the ankle;
  • instep;
  • the big toe;
  • heel.

Additionally, pain may radiate down the arm to:

  • triangular muscle;
  • the outer edge of the hand, down to the fingers;
  • wrist;
  • three middle fingers;
  • ring finger and little finger (rare).

How is osteonecrosis diagnosed?

Diagnosis of osteonecrosis is based on a survey, physical examination and instrumental examination methods. Specific examination methods are determined at the consultation session.

The doctor begins the diagnosis by taking the history: he determines the possible causes of back pain, establishes the location of the pain and their duration, determines the presence of concomitant pathologies, for example, allergies, congenital diseases and drug intolerances. Then do the test. Physical examination is done while standing or sitting. The doctor can detect the curvature of the spine, assess muscle strength and reflexes, and look at the color of the skin. To find out the details of the picture of the disease, it is necessary to consult the relevant specialists: neurologists, neurosurgeons, oncologists, rheumatologists and specialists. surgery.

A neurologist makes a diagnosis of osteonecrosis if:

  • frequent backaches;
  • pain increases when lifting weights, sneezing, coughing;
  • numbness and pain in the joints;
  • reduced range of motion in the joints;
  • muscle spasms;
  • damage to nerve roots;
  • X-ray changes of the spine.

Do you need a spine X-ray?

X-ray of the spine or spondylolisthesis is one of the mandatory examinations for osteonecrosis, thanks to which it is possible to identify structural disorders of the spine. Spine imaging allows you to find pathological changes, for example, thinning of the disc. Usually for the cervical, thoracic, and back spine, X-rays are taken in two (and sometimes three) projections for more detail.

Computed tomography and magnetic resonance imaging help identify the pathologies associated with osteonecrosis: disc herniation and reduction of the spinal canal lumen, disc protrusion into the spinal canal and spinal cord compression.

Computer diagnosis of osteonecrosis disease

Cervical spine bone tumor

With cervical spondylosis of the spine, two main symptoms appear - cervical pain and cervical pain. Cervicago is an acute low back pain in the cervix that occurs with head movement and is caused by muscle tension in the cervical spine. Cervical pain and intense pain in the neck. Paresthesia is added to cervicitis - a violation of sensitivity in the form of numbness and tingling sensations on the skin.

If the destruction of the nuclei of the intervertebral discs in the neck progresses, cervical myelitis appears - pain in the occipital region. The pain is characterized by frequent, in addition, they increase from time to time, especially when moving the head.

This triad - cervicitis, sciatica, and cervicitis - can be complicated by a syndrome of nocturnal sensory disturbances of the hand, in which sensitization is metamorphic. For example, a warm object may feel cold with your finger, but if you shake it with your hand, sensitivity will be restored.

Tumor of thoracic spine cột

For osteonecrosis of the thoracic spine, low back pain in the chest (back pain) is the most characteristic. Chest pain that is worse with arm movements, sneezing, coughing, and lifting weights. Usually, the pain is low back pain. In addition, paresthesia often occurs in the chest. Sometimes lesions of the nuclei of the discs can be considered as diseases of internal organs, for example, gastritis or angina, because the pain may be localized in the upper abdomen and in the heart.

How to say - heart attack or bone necrosis?

Rectal syndrome is pain in the anterior chest wall that can resemble a heart attack. Rectal pain can be a sign of both osteonecrosis and heart problems.

However, the pain in angina and heart attacks is different from the pectalgic syndrome in osteonecrosis. The peculiarity of the pain of angina and myocardial infarction is that it is compressive in nature and radiates down the left collarbone, arm, and jaw.

Rectal syndrome in osteonecrosis does not extend beyond the boundaries of the anterior thoracic wall, does not extend to the arms and shoulder blades, and is not accompanied by a fear of death. However, these are just subjective feelings. Therefore, to rule out heart disease, you need to consult a doctor and do an electrocardiogram, which will detect arrhythmias or signs of a heart attack.

If the pain begins to radiate down the left shoulder blade, arm, jaw, accompanied by a feeling of dread, which is not eliminated by taking nitroglycerin and persists for more than 10-15 minutes, you need to call an ambulance.

Why is lumbar spine tumor dangerous?

With degenerative lumbar spondylolisthesis, low back pain or paralysis most often occurs - frequent low back pain and soreness in the lumbar region. Due to constant pain, movements are limited: a person cannot bend over, exercise or lift a heavy object.

Low back pain may pass on its own. They are, however, prone to exacerbations, and each exacerbation indicates further displacement of the disc into the spinal canal. If disc destruction progresses, a luminescent inflammatory disease develops, accompanied by pain in the lower back that radiates to the buttocks and thighs.

What is the difference between osteonecrosis and osteoarthritis?

Osteoarthritis and osteoarthritis (spondylosis) belong to the group of diseases of the musculoskeletal system. However, there is a key difference between them: with osteonecrosis, the nucleus of the disc is affected, and with osteoarthritis, the disc joints. This makes a difference in symptoms and treatment.

In spondylosis, back pain is frequent and aching, manifested in a state of calm and increased range of motion, and in spondylosis, the occurrence of pain is associated with stretching and bending. curvature of the spine. Usually, the pain syndrome in spondyloarthritis is unilateral and has cramp-like features. In addition, spondyloarthritis is characterized by morning stiffness, lasting from 30 to 60 minutes.

What is the difference between osteonecrosis and pulpitis?

Root canal inflammation is inflammation of the roots of the spinal cord, accompanied by pain along the affected nerves. In fact, these are two different diseases, but sciatica is a common complication of osteonecrosis, so it is often one of the symptoms of osteonecrosis.

Symptoms of sciatica

With osteonecrosis, pulpitis usually occurs in the cervical and lumbar spine. Sciatica is characterized by pain along the damaged nerve, sensory disturbances, and sometimes movement disturbances. Sciatica presents as pain that extends beyond the back and radiates to the hips, buttocks, legs, and feet.

VSD or cervical osteonecrosis?

Vascular dystonia is a syndrome in which the autonomic nervous system is disrupted. VSD is a functional disorder in which there are no structural changes in the spine or in the nucleus of the disc.

Vascular dystonia of psychogenic origin - it is a neurological disorder that is associated with internal conflict or childhood trauma. Externally, VSD and osteonecrosis may be similar: headache, dizziness, anterior chest pain.

To distinguish the disease, you need to make an instrumental diagnosis - X-rays of the cervical spine and other organs, computed tomography and magnetic resonance imaging. As a result of the diagnosis with VSD, there will be no organic change, in contrast to osteonecrosis.

Treatment of vegetative vascular dystonia

Vascular dystonia is treated with medication, psychotherapy, and lifestyle modifications. Patients are prescribed symptomatic treatment: sedatives, anti-anxiety drugs, sleeping pills, drugs to restore health, as well as vitamins. The mission of psychotherapy with VSD is to teach the patient to regulate negative emotions and increase resistance to stress. The lifestyle is also adjusted: you need to balance the work and rest regime, exercise and adhere to a moderate diet.

Can osteonecrosis be treated?

Bone tumors can be cured. The goals of treatment are to eliminate back pain and stiffness, restore muscle tone, prevent or stop neurological complications, and improve a person's standard of living. If you follow the doctor's instructions, the disease can be cured.

How to treat osteonecrosis at home?

It is not recommended to treat osteonecrosis at home. This has a few causes:

  • It is not possible to accurately diagnose osteonecrosis at home, because back pain has many different origins: neurological, vascular, visceral (due to diseases of internal organs) and psychological. That is, a person is treated for osteonecrosis, but in fact develops back pain, such as kidney disease;
  • it is not possible to objectively assess the effectiveness of treatment without diagnostic controls;
  • Patients cannot fully choose their own treatment, and folk remedies have no proven basis, and therefore, most likely, they are ineffective and can cause side effects.

At home, you can be treated in one case - only after consulting a doctor will make an accurate diagnosis, prescribe an adequate treatment and periodically monitor the effectiveness of therapy using X-radiography, CT or MRI.

Treatment of osteonecrosis of the spine

Treatment of osteonecrosis is conservative and surgical. Which method will be the main depends on the stage of the disease and the neglect of the musculoskeletal system.

Conservative treatment includes medication, exercise therapy, and lifestyle modifications. Among the drugs, anti-inflammatory drugs and muscle relaxants are mainly prescribed to relieve pain and normalize muscle tone. In physiotherapy exercises, one of the main conditions for recovery is early activation, i. e. 1-3 days after the pain is eliminated, you need to walk, run, exercise in the pool orride bicycle. It is important to change your lifestyle to an active one, as a sedentary lifestyle is one of the factors that cause back pain and destroy the nucleus pulposus.

Surgical treatment is used when conservative therapy is not effective within 2-4 weeks and in cases where there are marked structural changes in the spine. What type of surgery is needed will be determined by the surgeon after consultation with the neurologist and studying the study data. For example, in the treatment of osteonecrosis of the cervical spine, methods are used to relieve spinal pressure from the side of the vertebra or hernia (surgical excision and decompression).

If you have back pain, accompanied by low back pain in your spine or neck, pain in your chest, muscle weakness in your arms or legs, skin discomfort and numbness, see a neurologist for advice. .