Osteophytes in Osteoarthritis: A Comprehensive Analysis of Bone Spurs

13.05.202121.07.2023 by alexxlab

What are osteophytes in osteoarthritis? What causes bone spurs? How are different types of osteophytes classified histologically? Get detailed answers to these questions and more in this comprehensive article.

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Understanding Osteophytes in Osteoarthritis

Osteoarthritis, a prevalent joint disorder, is characterized not only by cartilage degradation but also by significant changes in the subchondral bone, including the formation of bony outgrowths known as osteophytes. Osteophytes, commonly referred to as bone spurs, are fibrocartilage-capped projections originating from the periosteum, the connective tissue covering the bone.

The pathophysiology of osteophyte formation in osteoarthritis is not yet fully understood, but researchers have been investigating various aspects of this phenomenon to gain a better understanding. One such effort is the development of a comprehensive histological classification system for osteophytes, which can help standardize research and facilitate the comparison of findings across different studies.

Classifying Osteophyte Types in Osteoarthritis

In a study published in the Journal of Bone and Spine in 2016, a team of researchers from Germany set out to propose a histological classification of osteophytes in osteoarthritis. They collected osteophyte samples from the knee joints of 10 osteoarthritis patients undergoing joint replacement surgery, documenting the size and location of each osteophyte.

The researchers then evaluated the histological characteristics of the osteophytes using various staining techniques, such as hematoxylin and eosin, Masson’s trichrome, and immunohistochemistry. Based on their findings, they proposed the following histological classification of osteophytes:

Type I Osteophytes

Type I osteophytes are characterized by a predominant fibrocartilage component, with a well-organized, layered structure. These osteophytes typically have a broad base and a rounded, mushroom-like shape.

Type II Osteophytes

Type II osteophytes are mainly composed of bone, with a smaller fibrocartilage component. They often have a more pointed, beak-like shape and a narrower base compared to Type I osteophytes.

Type III Osteophytes

Type III osteophytes exhibit a mixed composition, with both fibrocartilage and bone components. These osteophytes can have variable shapes, ranging from rounded to more pointed.

Implications of Osteophyte Classification

The proposed histological classification of osteophytes in osteoarthritis provides a standardized framework for researchers to characterize and compare osteophyte formations. This can be particularly useful in understanding the pathogenesis of osteoarthritis, as well as developing targeted therapies that address the complex changes occurring in the affected joints.

Factors Influencing Osteophyte Formation

While the exact mechanisms driving osteophyte formation in osteoarthritis are not fully elucidated, various factors have been implicated in this process. These include:

Mechanical stress and joint instability
Inflammatory mediators, such as cytokines and growth factors
Alterations in bone metabolism and remodeling
Genetic and epigenetic factors

Understanding the interplay of these factors and their role in osteophyte development can help researchers and clinicians better address the multifaceted nature of osteoarthritis.

Clinical Relevance of Osteophytes

Osteophytes in osteoarthritis can have significant clinical implications. While they may initially serve as a compensatory mechanism to stabilize the joint, the presence of osteophytes can also lead to various complications, including:

Joint stiffness and reduced range of motion
Pain and discomfort due to mechanical irritation or impingement
Altered joint biomechanics and increased stress on surrounding structures

Understanding the different types of osteophytes and their characteristics can help clinicians better assess the severity of osteoarthritis and develop more tailored treatment approaches.

Future Directions in Osteophyte Research

The study of osteophytes in osteoarthritis is an active area of research, with ongoing efforts to further elucidate the underlying mechanisms and clinical significance of these bony outgrowths. Some promising avenues for future research include:

Investigating the specific cellular and molecular pathways involved in osteophyte formation
Exploring the role of genetic and epigenetic factors in osteophyte development
Evaluating the potential of targeted therapies that can modulate osteophyte formation
Assessing the utility of osteophyte classification in predicting disease progression and guiding treatment decisions

By continuing to expand our understanding of osteophytes in osteoarthritis, researchers and clinicians can work towards developing more effective strategies for the prevention and management of this debilitating joint disorder.

Differentiation of osteophyte types in osteoarthritis – proposal of a histological classification

. 2016 Jan;83(1):63-7.

doi: 10.1016/j.jbspin.2015.04.008.

Epub 2015 Jun 12.

Susann Junker¹, Grit Krumbholz¹, Klaus W Frommer¹, Stefan Rehart², Jürgen Steinmeyer³, Markus Rickert⁴, Georg Schett⁵, Ulf Müller-Ladner¹, Elena Neumann⁶

Affiliations

¹ Department of Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Benekestraße 2-8, 61231 Bad Nauheim, Germany.
² Department of Orthopaedics and Orthopaedic Surgery, Markus Hospital, 60431 Frankfurt am Main, Germany.
³ Department of Orthopedics, Justus-Liebig-University of Giessen, 35390 Giessen, Germany.
⁴ Department of Orthopedics and Orthopedic Surgery, Justus-Liebig-University of Giessen, 35390 Giessen, Germany.
⁵ Department of Internal Medicine 3, University of Erlangen-Nuremberg, 91054 Erlangen, Germany.
⁶ Department of Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Benekestraße 2-8, 61231 Bad Nauheim, Germany. Electronic address: [email protected].

PMID:
26076655
DOI:
10.1016/j.jbspin.2015.04.008

Susann Junker et al.

Joint Bone Spine.

2016 Jan.

. 2016 Jan;83(1):63-7.

doi: 10.1016/j.jbspin.2015.04.008.

Epub 2015 Jun 12.

Authors

Susann Junker¹, Grit Krumbholz¹, Klaus W Frommer¹, Stefan Rehart², Jürgen Steinmeyer³, Markus Rickert⁴, Georg Schett⁵, Ulf Müller-Ladner¹, Elena Neumann⁶

Affiliations

¹ Department of Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Benekestraße 2-8, 61231 Bad Nauheim, Germany.
² Department of Orthopaedics and Orthopaedic Surgery, Markus Hospital, 60431 Frankfurt am Main, Germany.
³ Department of Orthopedics, Justus-Liebig-University of Giessen, 35390 Giessen, Germany.
⁴ Department of Orthopedics and Orthopedic Surgery, Justus-Liebig-University of Giessen, 35390 Giessen, Germany.
⁵ Department of Internal Medicine 3, University of Erlangen-Nuremberg, 91054 Erlangen, Germany.
⁶ Department of Internal Medicine and Rheumatology, Justus-Liebig-University Giessen, Kerckhoff-Klinik Benekestraße 2-8, 61231 Bad Nauheim, Germany. Electronic address: [email protected].

PMID:
26076655
DOI:
10.1016/j.jbspin.2015.04.008

Abstract

Objective:

Osteoarthritis is not only characterized by cartilage degradation but also involves subchondral bone remodeling and osteophyte formation. Osteophytes are fibrocartilage-capped bony outgrowths originating from the periosteum. The pathophysiology of osteophyte formation is not completely understood. Yet, different research approaches are under way. Therefore, a histological osteophyte classification to achieve comparable results in osteophyte research was established for application to basic science research questions.

Methods:

The osteophytes were collected from knee joints of osteoarthritis patients (n=10, 94 osteophytes in total) after joint replacement surgery. Their size and origin in the respective joint were photo-documented. To develop an osteophyte classification, serial tissue sections were evaluated using histological (hematoxylin and eosin, Masson’s trichrome, toluidine blue) and immunohistochemical staining (collagen type II).

Results:

Based on the histological and immunohistochemical evaluation, osteophytes were categorized into four different types depending on the degree of ossification and the percentage of mesenchymal connective tissue. Size and localization of osteophytes were independent from the histological stages.

Conclusion:

This histological classification system of osteoarthritis osteophytes provides a helpful tool for analyzing and monitoring osteophyte development and for characterizing osteophyte types within a single human joint and may therefore contribute to achieve comparable results when analyzing histological findings in osteophytes.

Keywords:

Basic science; Histological classification; Osteoarthritis; Osteophytes.

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Osteophyte – Physiopedia

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Original Editor – Lucinda hampton

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1 Introduction
2 Pathophysiology
3 Presentation
4 Treatment
5 Differential Diagnosis
6 References

Osteophytes are cartilage-capped bony proliferations (bony spurs) that most commonly develop at the margins of a synovial joint as a response to articular cartilage damage, as seen very commonly in osteoarthritis (OA).^[1]

Three types of osteophytes related to the degenerative spine: (a) traction osteophytes (arrow), (b) claw osteophytes (arrow) and (c) wraparound bumper osteophytes (arrow)

Osteophytes are formed of fibrocartilage and bone, often forming at the peripheral margins of joints at the interface between cartilage and the periosteum. Osteophytes are thought to develop from chondrogenic differentiation of progenitor cells, commonly from within the periosteum. Osteophytes appear to be a cellular repair response to the altered growth factor environment following joint injury. In some cases osteophytes can contribute to the stability of the joints.^[2]

a. Cartilage erosion (arrows) b: Cartilage ulceration (arrow) c: Cartilage repair (arrow) d: Marginal osteophytes (arrows)

Osteophytes are most commonly found in the following areas. Neck, shoulder, knee, lower back, fingers or big toe, foot or heel. Osteophytes cause problems for example if they: cause friction if rubbing against footwear; impinge nerves such as an existing spinal root; restrict movement as may occur in hip and knee OA.^[3] See these pages for conditions where osteophytes are an issue, a sample only:

Hallux Rigidus
Anterior Ankle Impingement Syndrome
Uncovertebral Joints
Lumbar Spinal Stenosis
Vertebral osteophytes are a characteristic of disc degeneration. ^[4]
Cervical Osteoarthritis
Lumbar Spondylosis
Hip Osteoarthritis

Osteophytes when causing issues, for example with OA, can be managed along side management of OA, See link here Osteoarthritis.

Removal of an osteophyte is not usual, unless it’s irritating a nerve in the spine or restricting a joint’s range of movement. If surgery is warranted, a surgeon will explain the procedure’s risks and benefits.^[3]

Syndesmophyte: Thin, vertically oriented ossification of annular ligament (Sharpey fibers) from ankylosing spondylitis^[5]
Enthesophyte: located at an attachment of a ligament, fascia or tendon, not associated with a joint.^[1]
It is difficult to tell the difference between an osteophyte and disc herniation solely by MRI. CT is a helpful adjunct; however, often central canal and foraminal narrowing are caused by a combination of a disc herniation and osteophyte.

↑ ^1.0^1.1 Radiopedia Osteophyte Available:https://radiopaedia.org/articles/osteophyte-2 (accessed 7.9.2022)
↑ Firestein GS, Budd RC, Gabriel SE, McInnes IB, O’Dell JR. Kelley’s Textbook of Rheumatology E-Book. Elsevier Health Sciences; 2012 Aug 31. Available:https://www.sciencedirect.com/topics/medicine-and-dentistry/osteophyte (accessed 7.9.2022)
↑ ^3.0^3.1 NHS Osteophyte Available:https://www.nhs.uk/conditions/osteophyte/ (accessed 7.9.2022)
↑ Czervionke LF, Fenton DS. Imaging Painful Spine Disorders E-Book. Elsevier Health Sciences; 2011 Apr 28.Available:https://www.sciencedirect.com/topics/medicine-and-dentistry/osteophyte (accessed 8.9.2022)
↑ Blankenbaker DG, Davis KW. ExpertDDx: Musculoskeletal E-Book. Elsevier Health Sciences; 2017 Oct 13.Available: https://www.sciencedirect.com/topics/medicine-and-dentistry/osteophyte(accessed 8.9.2022)

Osteophytes of the spine – treatment, symptoms, causes, diagnosis

Many patients, having received information about the presence of osteophytes, begin to associate the presence of back pain with osteophytes in the spine . However, bony growths (osteophytes) by themselves are only a sign of degeneration in the spine, and the presence of osteophytes does not necessarily mean that they are the actual cause of back pain.

In principle, osteophytes are a radiographic marker of degenerative changes in the spine, and their appearance only means involutional changes in the spine. At the age of over 60, osteophytes (bone spurs) in the spine are quite common.

Causes

Everyday stress on the spine eventually leads to degeneration of the intervertebral discs and wear of the joints of the spine. With a combination of factors such as age, injury, poor posture, the impact on the bone structures and joints of the spine increases. As the intervertebral disc wears out, there is a greater load on the ligaments and joints, which leads to thickening of the ligaments, the accumulation of lime in the ligaments, and friction in the joints, in turn, leads to excessive growth of bone formations. This promotes the formation of osteophytes.

Tissue degenerative changes begin already at a young age, but this is usually a slow process and does not affect the neural structures until the person is in their 60s or 70s.

Factors that can accelerate the degenerative process and growth of osteophytes in the spine include:

Congenital features
Food
Lifestyle including poor posture or poor ergonomics
Injuries, especially sports or traffic accidents.

The most common cause of osteophytes is arthrosis of the facet joints, which often contributes to back pain in patients over 55 years of age. Osteoarthritis of the facet joints can lead to lower back pain and stiffness in the morning, the pain syndrome decreases with physical activity, and intensifies again in the evening.

The most common cause of cervical and lumbar osteoarthritis is a genetic predisposition. Patients may notice the onset of symptoms of osteoarthritis between the ages of 40 and 50. Men are more likely to develop symptoms at an earlier age, but women with osteophytes may have more symptoms.

Symptoms

The most common symptoms are back pain or neck pain due to inflammation in the joints and muscle spasm as a reaction to inflammation. Typical symptoms include:

Dull pain in the neck or lower back when standing or walking
Neck pain radiating to the shoulder, sometimes headaches
Low back pain and radiation to the back of the thigh

Symptoms due to osteophytes are aggravated by physical exertion and relieved by rest. In addition, symptoms may improve after leaning forward and bending at the waist. When nerves are compressed by osteophytes , the following symptoms may appear:

Pain in one or both arms or legs
Numbness or tingling in one or both arms or legs
Progressive weakness in one or both arms or legs

In very rare cases, bowel and bladder dysfunction may occur. But such symptoms can be associated not only with osteophytes, but also with diseases such as diabetes mellitus, circulatory disorders in the extremities, spinal cord tumors, spinal fractures, spinal infections. In addition, many symptoms in osteophytes are similar to those in rheumatological diseases (rheumatoid arthritis, SLE), and are also similar to the symptoms of compression of a herniated disc of the nerve roots. Due to the fact that the symptoms of osteophytes are similar to other medical conditions, a full examination is necessary to determine the exact diagnosis.

Diagnosis

Diagnosis begins with a clinical examination. The doctor should first conduct a detailed examination, a neurological examination to evaluate the functioning of the nerve roots and identify signs of compression of the roots or spinal cord. Based on the examination, the history of the disease, the patient’s complaints, the doctor prescribes the necessary examination plan, including the following research methods:

ENMG allows you to determine the conduction disturbance along the nerve fiber and determine both the degree of damage and the level of damage to the nerve fibers. Radiography is often prescribed primarily for the diagnosis of osteophytes and allows visualization of osteophytes in the spine . In addition, radiography can detect other changes in the bone tissues of the vertebrae.

Computed tomography (CT) or MRI can provide more information about changes in the structures of the spine, both bone and soft tissue, and detect the presence of compression of the nerve roots or spinal cord.

Neuroimaging data allow the doctor to choose an adequate treatment strategy, both conservative and, if necessary, surgical, depending on the presence of signs of compression of nerve structures in correlation with clinical data.

Treatment

There is a wide range of treatment options for symptomatic osteophytes .

Most patients with mild to moderate nerve compression and osteophyte irritation can be managed conservatively.

Medications such as anti-inflammatory drugs or muscle relaxers for several weeks.

Rest for a short period of time, which reduces inflammation in the joints.

exercise therapy. After a decrease in pain symptoms, physical exercises are connected with a gradual increase in the amount of load.

Manual therapy and massage can increase the mobility of motor segments, relieve muscle spasm.

Epidural steroid injections may be useful in inflammation of the facet joints, reducing inflammation, swelling, and thus improving symptoms.

Physiotherapy. Currently, there are physiotherapeutic methods of treatment (for example, HILT – therapy or SWT) that allow you to achieve good treatment results.

In cases where conservative treatment is not effective or there is severe compression of the roots or spinal cord, it is necessary to decide on surgical treatment.

The task of surgical methods of treatment is to decompress the nerve structures. Removal of osteophytes allows you to get rid of symptoms in most cases. But sometimes it happens that neurological symptoms may persist in the postoperative period, and in such cases there is a long period of compression of the nerve structures and irreversible changes in the nerve fibers. Or: But in some cases, neurological symptoms may persist in the postoperative period, and then the most likely is a long period of compression of the nerve structures and irreversible changes in the nerve fibers. ).

Studies have shown that age is not the main factor determining the possibility of surgical treatment of osteophytes . However, conditions often associated with age, such as hypertension, diabetes, and heart disease, can increase the risk of surgery and slow recovery, and therefore should be taken into account when deciding on surgical treatment.

Osteophytes of the spine: causes and methods of treatment

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Osteophytes of the spine are growths of bone tissue that resemble hooks or spikes in shape. They arise as a result of a protective reaction of the body to overload and injury. In a neglected state, this pathology is not cured completely. Therefore, seek help and prevention should be as early as possible.

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Treatment minimizes the risk of new hernias in other segments, as well as hernia recurrence.

Reasons for the formation of osteophytes

Normally, the vertebrae are connected by means of discs that act as shock absorbers and provide flexibility and mobility of the spine. But with their degeneration, the distance between the bone structures decreases, and the edges change their structure and spikes form on them. Depending on the location, they are:

posterior, often cause severe suffering;
anterolateral, appear in those departments that are most exposed to stress and pressure;
front, of all types, they cause the least inconvenience and discomfort;
posterolateral, more common in the cervical region, their growth is complicated by damage to the spinal cord.

Post-traumatic and dystrophic osteophytes of the spine are isolated due to the formation. And in case of inflammation of the periosteum, periosteal formations appear. Most often there are single spiny processes, but with a tumor process of bones or marble disease (osteosclerosis), they can be multiple and massive.

Factors provoking the formation of osteophytes are infectious diseases affecting the joints and spine (arthritis, spondylarthrosis, osteochondrosis). In addition, a significant role is played by:

constant loads;
uncomfortable shoes;
deformities of the spinal column;
bad habits and sedentary lifestyle;
obesity;
hereditary predisposition with impaired bone growth;
bruises, blows and other traumatic injuries;
disruption of the internal secretion organs.

Symptoms

There are no signs of ostephitis in the spine at an early stage. They are often discovered during x-rays or MRIs for another condition. Features of the manifestation of pathology also depend on the localization of bone growths:

The cervical region, due to its structure, reacts very strongly to any changes. The appearance of spiny formations is accompanied by compression of the nerve bundle and blood vessels. As a result, a person begins to feel dizzy, pain when turning the neck, radiating them to the shoulder and arm. Hearing and visual acuity are often reduced.
In the thoracic region, the vertebrae are inactive, and very often the occurrence of osteophytes in this area is not accompanied by special disorders of the condition. Only when they reach a large size, symptoms may appear, resembling an intervertebral hernia.
The lumbar region always experiences the maximum load. Therefore, the appearance of osteophytes is accompanied by vivid symptoms. The patient has pain in the lower part of the spine, which is aggravated by walking or standing for a long time. A decreases with forward bending, when direct contact with the nerve stops. With its prolonged squeezing, a change in sensitivity in the legs begins, there is a “crawling crawl”. A severe form of pathology is accompanied by a violation of the functioning of the pelvic organs.

Often the presence of an osteophyte is observed as an obstacle when turning, when it becomes impossible to complete the movement. Soreness with such a violation occurs at the time of injury by a sharp spike of a muscle fiber or tendon with secondary inflammation, irritation of the nerve bundle or pressure on the spinal cord.

Suffering is aggravated both by physical exertion and by staying in the same position for a long time. Late stages of the disease are accompanied by severe neurological symptoms, decreased reflexes, and atrophy of the muscles of the extremities.

Diagnosis of osteophytes in the spine

After questioning and studying the history of the disease, the doctor refers the patient for additional examinations. This is necessary for differential diagnosis and determination of the cause of bone spikes. A neglected picture can be seen on the x-ray when the osteophytes reach large sizes.

MRI provides more detailed information. This technique allows you to determine the level of damage, the number and size of growths, the condition of the tissues of the vertebrae and discs. It also helps assess the extent of nerve root damage and spinal cord problems (if any).

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Hospital treatment

Even the highest quality conservative therapy in an ordinary medical institution cannot completely rid the patient of osteophytes. All methods are directed to the relief of symptoms. Treatment begins with the use of medicines:

analgesics;
myotropic antispasmodics;
non-steroidal anti-inflammatory drugs.

All of these drugs help relieve acute symptoms, but do not get rid of the cause of the disease. With severe pain, epidural administration of corticosteroids, novocaine blockades are used. It is recommended to comply with bed rest, the complete elimination of any physical activity. In addition, injections and tablets with B vitamins, complex preparations with potassium, magnesium, and calcium are used.

The patient is prescribed a regular massage, but only after the pain syndrome has been eliminated. Physiotherapy and balneotherapy help to fix the result. But these methods cannot stop the progression of the disease for a long time, and a person is forced to seek help several times a year and even more often.

Official medicine stops the exacerbation for a while and takes a wait-and-see attitude. If during the next examination it becomes obvious that the condition worsens and the conservative therapy is ineffective, then surgical removal of osteophytes is usually recommended. But in the event that the syndrome of compression of the nerve roots continues for a long time, then even after the operation, the patient may be disturbed by pain in the area of infringement.

Treatment at Dr. Length’s Clinic

Upon admission of a patient to Doctor’s Length Clinic, an initial consultation and examination is provided free of charge. This allows you to assess the functional state of each segment of the spine, determine the cause of pain and infringement of the roots. For the patient, his own program of care is drawn up, and this approach allows you to get a high degree of efficiency.

The doctors of the clinic have many methods in their arsenal that will help to significantly alleviate the condition and prolong remission for a long time. For the treatment of osteophytes of the spine is used:

Di-Tazin therapy;
manual therapy;
osteopathy;
acupuncture;
paravertebral blocks for severe pain;
electrophoresis;
physiotherapy exercises.

The unique technique of the founder of the clinic Dr. Length, called Di-Tazin therapy. It consists of three simultaneous ways, each of which potentiates the action of the other. This allows you to get a positive result, eliminate the acute manifestations of the disease after 2-3 sessions. Gentle manual therapy techniques help relieve pressure on the nerve roots.

Electrophoresis with drugs relieves swelling and inflammation at the local level, without affecting other organs and systems. Photodynamic laser treatment improves recovery processes. This technique has no contraindications, is used for people of any gender and age.

Acupuncture relieves pain, triggers central mechanisms to normalize metabolic processes. An important part of the treatment are special exercises that help restore range of motion and prevent the progression of osteophyte growth.

All methods of helping each admitted patient are aimed at obtaining a positive result, and not at the usual relief of the symptoms of the disease. An integrated approach to therapy and individual selection of techniques helps in more than 90% of cases to restore maximum mobility of the spine and improve the quality of life. At the same time, the clinic does not practice surgical methods for solving the problem, believing that the progression of the disease can be stopped. And with the help of a number of ways, some processes are reversed.

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Mikhailov Valery Borisovich

Manual therapist, vertebrologist, neurologist

Work experience – 25 years

Video testimonials of patients

Articular block in the neck 90 005 Hernias in the lower back and neck

I came to Dr. Length’s clinic with spinal problems. With two intervertebral lower hernias and two intervertebral hernias in the neck. I was assigned a comprehensive 10 step program. For 4 months, my lower vertebrae completely disappeared and crunches in my neck disappeared …

Lumbo-sacral hernia

“After the first time, my back stopped hurting. I felt relieved. Now 7 sessions have already passed and the back really does not hurt. I began to forget about it. And at first it hurt a lot.”

Inflammation of the sciatic nerve

“For 4 months I suffered from severe inflammation of the sciatic nerve on the right side. After the first visit, relief came immediately within six hours. After 6 courses, the pain was almost gone.

Pain in the lower back and leg

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I want to express my deep gratitude for the fact that I was put on my feet in the truest sense of the word. I came to the clinic a month and a half ago with severe pain in the lower back and leg. These complaints were long enough and the treatment that I used in the past was ineffective. Fortunately, I ended up in the clinic of Dr. Length and his team of super professionals!

Osteochondrosis of the cervical spine

“I applied 2 months ago with osteochondrosis of the cervical spine. I have a sedentary job and my neck muscles were very cramped. It was impossible to work. Before that, I went to other doctors, but this did not solve my problem. For 2 months I have a fairly positive dynamics. Every week it gets better and better.”

Bechterew’s disease

“I have had Bechterew’s disease for 10 years. The vertebrae began to move out, I began to slouch. I turned to other chiropractors, very famous, media ones. In the end, I didn’t get any results. After 2 sessions I felt much better. Now I don’t have any pain.”

Pain in the spine

“I came in with problems in my back, cervical, thoracic and lumbar spine. I was prescribed procedures, had a massage, and was assigned to do physical education at home. This made it much easier for me. I’m already turning my head. I have no pain.”

Shoulder shoulder periarthrosis

I came to the clinic with severe pain in my shoulder. My hand did not rise, I could not sleep at night, I woke up from pain. After the first treatment session, I felt much better. Somewhere in the middle of the course, my hand began to rise, I began to sleep at night.

Osteoarthritis of the knee joint, 2nd degree

Came with a very serious illness. I could not walk, I have arthrosis of the 2nd degree of the knee joint. I went through a course of treatment at the Clinic and now I am going 100%.

Herniated disc

“I came to the clinic after I had back pain and it turned out to be a herniated disc. I went to other places, but they only relieved attacks of pain. Hope for a return to normal life was given only by Sergei Vladimirovich, his golden hands!

Scoliosis

“Since I was a teenager, I have suffered from scoliosis in the thoracic region. I felt a feeling of discomfort, tension, periodic pain in the spine. I turned to various specialists, a massage therapist, an osteopath, but I did not feel a strong effect. After treatment, Length S.V. I almost have a straight spine. Currently, I do not feel any problems and discomfort.”

Intervertebral hernia

“At the 5th-6th session there was an improvement. I felt much better. The pain is gone. Improvement progressed more and more each time. Lesson 10 today. I feel great.”

Pain in the lumbar and cervical region

“I am 21 years old. I went to the clinic with discomfort in the lumbar and cervical region. I also sometimes had sharp pains. After undergoing therapy, I felt a significant improvement in my back. I have no pain. The condition as a whole has improved.”

Back pain

“At the beginning of the healing process, my back hurt very badly. I could no longer walk. I take 5 steps and stop. My entire journey consisted of such stops. In the very first procedure, I left the office with no pain in my spine.”

Cervical hernia

“I came in with a problem in my neck and my right arm was very sore. The neck did not turn, the hand did not rise. After the 3rd session, I felt better. After the 5th, all this pain began to decrease. It turns out I have 2 hernias in my cervical vertebrae. After the sessions, I did an MRI and one hernia decreased. Now he began to move, his hand earned.

Pain in the neck

“I went to Dr. Long because I had a very bad pain in my neck on the right side. I fell on a snowboard 5 years ago, even went to an osteopath, but somehow it didn’t really help. Now everything is fine, there are some consequences left, the muscles were spasmodic. When I came, I had steel muscles, now my neck is very soft.”

Pain in the thoracic region

“I went to the clinic with back pain, namely in the thoracic region. After 10 sessions of treatment, I could already calmly go about my usual business, stay at work until lunch, without howling in pain. Now I’ve come back for an adjustment after 2 months. I’m fine, my back doesn’t hurt.”

Hernia and protrusion

“I came to the clinic with L4-L5 hernia and L5-S1 protrusion. Today the course of treatment has ended. Lower back hurt, it was difficult to bend down. After completing the course and receiving instructions in the form of physical exercises, it became much easier. After a month of treatment, I do not feel any stiffness of movements. ”

Pain in the lower back and hip joint

“From a young age I was troubled by back pain. When they became unbearable, I went to Dr. Length’s clinic.

Osteophytes in Osteoarthritis: A Comprehensive Analysis of Bone Spurs

Understanding Osteophytes in Osteoarthritis

Classifying Osteophyte Types in Osteoarthritis

Type I Osteophytes

Type II Osteophytes

Type III Osteophytes

Implications of Osteophyte Classification

Factors Influencing Osteophyte Formation

Clinical Relevance of Osteophytes

Future Directions in Osteophyte Research

Differentiation of osteophyte types in osteoarthritis – proposal of a histological classification

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Osteophyte – Physiopedia

Contents

Osteophytes of the spine – treatment, symptoms, causes, diagnosis

Causes

Symptoms

Diagnosis

Treatment

Osteophytes of the spine: causes and methods of treatment

Reasons for the formation of osteophytes

Symptoms

Diagnosis of osteophytes in the spine

Free medical consultation and diagnostics

Hospital treatment

Treatment at Dr. Length’s Clinic

Video testimonials of patients

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