Osteochondroma is a common, benign bone tumour that often occurs in children and adolescents. While it’s non-cancerous, it can cause pain or discomfort, particularly if it compresses surrounding tissues or nerves. Osteochondromas develop on the surface of bones, typically near growth plates, and can affect any bone in the body, though they are most commonly found on long bones like the femur, tibia, and humerus. Here’s a closer look at the causes, symptoms, and treatment options for osteochondromas.
What is Osteochondroma?
An osteochondroma is an overgrowth of cartilage and bone that typically appears on the end of long bones near the growth plate. These growths are characterised by a bony stalk capped with cartilage. Osteochondromas are usually solitary, but some individuals may have multiple growths, especially if they have a condition called multiple hereditary exostoses (MHE).
Osteochondromas are benign and don’t usually become cancerous, though a very small percentage may develop into chondrosarcoma, a malignant cartilage tumour.
Causes of Osteochondroma
The exact cause of osteochondromas is not well understood, but there are a few recognised contributing factors:
- Genetic Factors: Osteochondromas may be hereditary, particularly in cases involving multiple growths. MHE is a genetic condition that causes multiple osteochondromas and is inherited in an autosomal dominant pattern.
- Growth Plate Abnormalities: Osteochondromas occur near growth plates, and it’s thought that an abnormality in the growth plate development may lead to the formation of these benign tumours.
- Trauma or Injury: In rare cases, a prior injury near a growth plate may trigger an osteochondroma.
Symptoms of Osteochondroma
Many people with osteochondromas don’t experience symptoms, particularly if the tumour is small and located away from major nerves or blood vessels. However, larger, or strategically positioned osteochondromas can cause a variety of symptoms:
Pain or Discomfort: Pain is usually due to the osteochondroma pressing on nearby muscles, tendons, or nerves, particularly if it is large or located near a joint.
Restricted Movement: Tumours near a joint can limit range of motion or cause stiffness.
Swelling or Visible Lump: A bony lump may be visible under the skin, especially on long bones.
Nerve Compression Symptoms: If the osteochondroma compresses a nerve, symptoms such as numbness, tingling, or muscle weakness may occur in the affected limb.
Growth Deformities: In cases of MHE, multiple osteochondromas can cause bone deformities, limb length discrepancies, or growth abnormalities in children.
Diagnosing Osteochondroma
An osteochondroma is usually identified during an examination or imaging test for other symptoms. The diagnostic process typically includes:
- Physical Examination: A healthcare provider will assess for visible lumps, swelling, or restricted movement.
- Imaging Tests: X-rays are often used to confirm the presence of an osteochondroma, as the bony growth is visible on an X-ray. MRI or CT scans may also be used for more detailed imaging, especially to assess cartilage or nerve involvement.
- Biopsy: In rare cases, if there is concern about malignancy, a biopsy may be performed to rule out cancerous changes.
Treatment Options for Osteochondroma
Treatment for osteochondroma depends on factors such as size, location, and symptoms. Many osteochondromas do not require treatment, particularly if they are asymptomatic. However, for symptomatic cases, various treatment options are available:
Observation and Monitoring
For asymptomatic or small osteochondromas, regular monitoring is often recommended. Annual imaging, such as X-rays, may be done to ensure that the tumour isn’t growing or affecting surrounding structures.
Surgical Removal
Surgical excision is the most common treatment for symptomatic osteochondromas. Surgery is recommended if the tumour causes pain, restricts movement, or compresses nerves or blood vessels. During the procedure, the surgeon removes the bony growth along with the cartilage cap to prevent regrowth. Surgery is typically successful, and recurrence is rare after complete removal.
Physiotherapy
Physiotherapy can play a role in managing symptoms, especially if surgery is not immediately necessary. A physiotherapist can develop exercises to improve range of motion, strengthen surrounding muscles, and relieve pressure on affected areas. Physiotherapy is also valuable in post-surgical rehabilitation, helping patients regain strength, flexibility, and function in the affected limb.
Acupuncture
Acupuncture may be used as an adjunct therapy to relieve pain associated with osteochondroma, especially if the tumour is pressing on nerves or soft tissue. This form of therapy may help reduce pain and improve local circulation, which can aid in symptom management.
Osteopathy
Osteopathy can help relieve discomfort caused by an osteochondroma through manual techniques that improve joint mobility and muscle relaxation. Osteopathic treatment may focus on reducing muscle tension and improving overall alignment to alleviate strain on the area affected by the tumour.
Sports and Exercise Medicine (SEM) Doctor Consultation
An SEM doctor specialises in musculoskeletal conditions and can provide expert guidance on managing osteochondroma symptoms, including recommendations on appropriate exercises and modifications to reduce stress on the affected area.
Custom Orthotics
For osteochondromas that cause limb length discrepancy or affect foot alignment, custom orthotics may be beneficial. Orthotics can help compensate for any imbalances and reduce pressure on the lower extremities, improving comfort and stability.
Preventing Complications from Osteochondroma
While it isn’t possible to prevent osteochondroma, certain strategies can help manage and reduce the impact of symptoms:
- Regular Monitoring: For individuals with osteochondromas, regular check-ups and imaging can help detect changes in the tumour size or symptoms early, reducing the risk of complications.
- Activity Modification: Avoiding high-impact activities or movements that cause pain can help prevent aggravation of symptoms. Low-impact exercises, such as swimming, may be preferable for maintaining fitness without stressing the affected area.
- Stretching and Strengthening Exercises: Engaging in regular stretching and strengthening exercises, particularly if advised by a physiotherapist, can improve flexibility and help prevent stiffness around the affected joint.
- Post-Surgical Rehabilitation: For those who undergo surgical removal of an osteochondroma, adhering to a structured rehabilitation plan can optimise recovery and prevent muscle weakness or joint stiffness.
Conclusion
Osteochondromas are benign bone growths that can cause discomfort, restricted movement, and, in rare cases, complications. At Freedom Clinics, we offer a variety of treatments, including physiotherapy, osteopathy, acupuncture, and orthotics, to help manage symptoms and support recovery. With the right approach to treatment, most individuals can manage their symptoms effectively and lead an active, pain-free lifestyle.
