Osteoarthritis is a group of degenerative-dystrophic progressive pathologies of synovial joints with a chronic course, characterized by damage to the cartilage fiber and the development of a local inflammatory reaction. Osteoarthrosis differs from arthrosis in that this disease always causes deformation of bone structures, which is why the disease is also often called deforming arthrosis. Osteoarthritis of the spine is a deformation of the vertebral joints, which is based on primary inflammation and degeneration of cartilage tissue. The main symptom of the disease is pain, the intensity of which increases as the degenerative processes progress. Various methods of conservative therapy are used for treatment, but physiotherapy, exercise therapy and massage are the most effective.
Osteoarthritis of the spine
What happens to the joints?
To achieve long-term and stable remission and positive dynamics of therapy, you need not only to know how to properly treat spinal osteoarthritis and what measures to take to prevent further progression, but also to understand what osteoarthritis is and what processes occur in the body during this disease.
Dystrophy of cartilaginous joints and its connection with osteoarthritis of the spine
A joint is a movable bone connection (cavitary) that provides the motor function of the articulating bones with the help of paravertebral muscles. One of the main components of the vertebral joints and ribs is hyaline cartilage - an elastic glassy mass with a thickness of 1 mm to 7-8 mm. Between hyaline cartilage and tendons there is fibrocartilage (for example, in intervertebral discs), which is capable of stretching and contracting, while experiencing significant mechanical stress. In its structure, cartilage fiber is a transparent gel, which contains more than 80% water, and the remaining 20% is occupied by organic substances and mineral salts.
Structure of the joint and parts of the cartilage
Cartilage is the most important component of joints, since in addition to its shock-absorbing function it has the following properties:
- provides adhesion of contacting articular surfaces;
- reduces friction of hard surfaces of joints and prevents premature abrasion of bone tissue;
- compensates for the force and impact load on the joints, preventing their damage and destruction.
Dystrophy of cartilage tissue is caused by significant loss of fluid (dehydration) and malnutrition of the articular cartilage, which occurs mainly due to synovial fluid due to the absence of its own blood vessels and nerve bundles. Insufficient supply of minerals and vitamins leads to loss of elasticity, drying and thinning of the cartilage fiber, resulting in friction of the contacting joints and their deformation.
Description of hyaline cartilage
Pathogenetic changes in joints
Dehydrated and thinned cartilage becomes inflamed over time, which leads to the development of a local inflammatory reaction and acute pain, which in most cases significantly limits the patient’s mobility and performance. As a result of inflammatory-dystrophic processes, a violation of the biomechanical properties and biochemical composition of the affected joints and joints occurs, as well as the following changes:
- softening and defibration of hyaline and fibrous cartilage;
- the appearance of erosive and ulcerative changes on the surface of the cartilage fiber;
- thickening of bone trabeculae (plates that make up the bone skeleton);
- changes in the trophic properties of bones caused by impaired blood supply and innervation of the subchondral bone plates (located under the pineal body);
- the formation of osteophytes (bone growths) on the surface of joints and vertebrae.
Healthy joint and joint with osteoarthritis
Note! Often, with osteoarthritis of the spine, subchondral cysts develop, localized mainly in the sacrococcygeal spine. Clinically, such cysts are manifested by severe aching pain (less commonly, moderate lumbago is possible) in the lower back in the coccyx area, which intensifies after prolonged sitting on a hard surface.
Indications for the procedure
Tomography of the lumbosacral spine is prescribed to identify inflammatory processes, deformations as a result of injuries, destructive and other lesions. It is necessary to examine the lumbar spine to clarify the diagnosis if:
- back pain of unknown origin;
- pain in the hip joint area, radiating to the leg;
- stiffness in the lumbar region;
- visible deformities of the spine;
- injuries of the sacral region, including to identify bone fragments in soft tissues.
CT scan of the lumbar region is recommended before performing surgical operations, as well as during the rehabilitation period to monitor recovery processes, tissue regeneration, and timely detection of relapses of the disease.
Tomography of the lumbar and sacral regions is often used as a further examination method. This is necessary, for example, for accurate diagnosis of tumors and bone tissue metastases, clarification of MRI or radiography data, identification of congenital anomalies of the vertebrae, and the anatomical features of their structure.
Causes of deforming arthrosis
There can be many causes of spinal osteoarthritis. These include infectious pathologies leading to inflammation of the joints (often exudative or purulent), and various injuries, as well as chronic diseases of the spine with a degenerative pathogenesis of development.
The main causes of the disease in patients of different age groups include:
- autoimmune disorders (rheumatoid arthritis);
- infectious diseases (tick-borne encephalitis, extrapulmonary tuberculosis, syphilis, osteomyelitis, sexually transmitted infections);
- spinal injuries (including old fractures);
- dysplasia (underdevelopment) of the spinal joints;
- systemic lupus erythematosus;
- pathological decrease in bone mass (osteoporosis);
- disruption of metabolic and metabolic processes in diabetes mellitus, gout and other diseases of the endocrine system;
- vertebrogenic neurodystrophic syndrome and circular fatty atrophy syndrome with cervical periarthritis and iliopsoas syndrome.
Schematic representation of spinal osteoarthritis
All causes of deforming arthrosis are divided into two groups: primary etiological factors and secondary.
Classification of deforming arthrosis due to its occurrence
Main contraindications
You should also consult with your doctor to make sure there are no contraindications to tomography. The examination of the sacral and lumbar regions is not carried out:
- pregnancy period;
- with confirmed cancer;
- for epilepsy, convulsive syndrome;
- for mental disorders;
- with pathological lesions of the liver and kidneys.
Contraindications to CT of the lumbar region may include diabetes mellitus, high body weight, and children under 12 years of age. Breastfeeding mothers need to express breast milk in advance so that there is enough for 48 hours of feeding the baby. During this time, the contrast agent will be completely eliminated from the body naturally. There are also some restrictions on body size and weight. Thus, most tomographs are designed for people weighing no more than 120 kg.
At what age does spinal osteoarthritis most often develop?
The maximum risks of developing vertebrogenic osteoarthritis occur in elderly and senile patients, that is, after 50 years. One of the reasons for pathological changes in the joints and articulations of the spine in patients of this age group is the natural processes of aging, which lead to dehydration of osteochondral tissue and disruption of its mineralization (due to slow absorption of nutrients and circulatory disorders in the vessels of the central spinal canal).
In people under 45-50 years of age, the disease accounts for approximately 7.4% of the total number of spinal pathologies, and more than half of patients with this diagnosis are men who suffer from alcohol addiction, smoking, or regularly experience increased physical activity (loaders, storekeepers, gardeners, builders , handymen).
Reducing joint space in spinal osteoarthritis
Frequency of detection in children and adolescents
Osteoarthritis of the spine in children and adolescents under 18 years of age is detected quite rarely (according to various sources, the number of minor patients with this diagnosis ranges from 3.9% to 11.1%). Experts believe that the main causes of deforming osteoarthritis in children are congenital anomalies of the development of the spine and embryonic defects in the formation of the neural tube, which in the future manifest themselves as a violation of the ossification process, which is completely completed only by 17-25 years.
Important! Various injuries, dysplasia, and severe infectious diseases are also risk factors for the development of osteoarthritis, but with timely and competent correction, the prognosis for future life is considered conditionally favorable.
Decoding the results
After completing the examination, the doctor interprets the results. The patient receives a conclusion on paper and a recording on a disk or flash drive. The conclusion indicates the size of the vertebrae, the characteristics of the tissues in and around the spine, the condition of the intervertebral discs, identified anomalies and pathologies.
Tomography of the lumbar region allows you to identify pathologies in the early stages, when they are still treatable.
This makes it possible to avoid the development of many dangerous complications. It is worth considering that the degree of radiation exposure is determined by the quality of the equipment used in the medical center. If modern tomographs are used, the procedure does not create any danger to the body. Rate this article: (1 rated 5 out of 5)
Stages of the disease
The symptoms of osteoarthritis largely depend on what stage the disease is at and how quickly it progresses. In total, there are three stages of deforming osteoarthritis.
How parts of the spine change with osteoarthritis
Stages of vertebral (spinal) osteoarthritis
| Stage | What changes occur in the joints? |
| First (initial) | Symptoms of the disease at this stage are practically absent, since changes concern only the biochemical properties of the synovial fluid. It is from this fluid that the hyaline and fibrous cartilages receive the necessary water and minerals, therefore the first stage of osteoarthritis is characterized by the onset of degenerative changes in the articular cartilages |
| Second | The destruction of the joint begins, and severe deformation of the bones occurs. Most patients at this stage complain of severe pain, which increases after physical or physical activity. On the x-ray, you can see bone growths (osteophytes), which injure not only the joints that articulate with the affected segment, but also the nearby muscles, ligaments and tendons. Neurotrophic changes and impaired reflex activity of paravertebral muscles are clearly expressed |
| Third (severe, stage of disability) | The deformation of the bone structures is severe, the central axis of the vertebral skeleton is greatly changed. Pathology at this stage is combined with severe kyphosis or pathological lordosis (depending on the location of the degenerative process). Passive movements in the joint are sharply limited. The inflammatory process becomes chronic, which provokes severe pain and is a factor in permanent disability |
Clinical picture: symptoms and features
The main clinical sign of deforming arthrosis is severe pain, which limits the patient’s motor capabilities and his ability to perform physical labor. In severely ill patients, the ability to self-care may decrease (eating, hygiene measures, dressing). Distinctive characteristics of pain in osteoarthritis of the spine are intensification at rest, when walking, as well as morning stiffness in the neck and back, which does not go away within 15-20 minutes.
Diagnostics
The main diagnostic methods for suspected spinal osteoarthritis are radiography and magnetic resonance imaging. Serological diagnostics and blood tests to identify rheumatoid factors can be used as auxiliary methods.
If you want to learn in more detail how the MRI procedure of the spine is performed, and also consider when a magnetic resonance examination is indicated, you can read an article about this on our portal.
Preparing for the examination
No special preparation is required for a CT scan of the lumbar spine. But if the tomography is done using a contrast agent, it is better not to eat or drink 2 hours before the CT scan. This will help avoid the risk of nausea and vomiting. Before such an examination, it is recommended to do a test for the body’s sensitivity to iodine-containing compounds.
In preparation for a tomography of the lumbosacral region, it is necessary to remove all metal jewelry and warn the doctor about the presence of metal prostheses, a pacemaker and other non-removable devices or metal elements.
Treatment: exercise, medications, nutrition
Treatment of deforming arthrosis of the spine should be carried out comprehensively using medications, physiotherapy and other methods aimed at restoring normal joint mobility and relieving pain.
Physiotherapy
This is an essential element in the complex treatment of osteoarthritis (regardless of its location), the purpose of which is not only to strengthen the musculo-ligamentous system and increase the flexibility of the spine, but also to stimulate the vital functions of the body: breathing, metabolism, digestion, etc.
Exercise therapy for this disease has several features, failure to comply with which can lead to the development of complications and even greater deformation of the damaged joint, so it is recommended to practice under the guidance of a medical professional. During classes you should adhere to the following rules:
- all exercises are performed in lightweight poses that eliminate vertical load on the spine;
- if painful sensations appear, the activity should be stopped immediately;
- training is not allowed during periods of acute inflammation;
- Jumping, skipping and exercises with heavy weights in a standing position should be avoided.
Exercises for flexibility and strengthening of the lower back
Swimming, exercises in water (aqua aerobics), walking and skiing, and cycling are useful for patients with deforming arthritis. The physical therapy complex for home exercises necessarily includes exercises with equipment (ball, expander, gymnastic tape, etc.).
Massage
Massage is necessary to restore normal blood supply to articular cartilage and slow down the progression of arthrosis. The duration of one session should not exceed 25 minutes (for the cervical and thoracic region - 15 minutes). The course consists of 10-12 procedures.
If you want to learn in more detail how to properly massage the lower back, as well as consider the technique and instructions, you can read an article about this on our portal.
Drugs
Drug therapy for deforming osteoarthritis is aimed primarily at reducing pain and restoring the compensatory function of the spine. This may include the following medications: