The first signs of osteochondrosis

4 December 2024

Osteochondrosis is an outdated name for degenerative spine disease. The old term is widely used in our country, but it does not reflect the essence of the disease, which is based on age-related degeneration - destruction of the tissue structure. In this article we will consider the first signs of osteochondrosis, patterns of its development and treatment options.

What is osteochondrosis

To understand the processes occurring during osteochondrosis, you need to understand the anatomy of the spine. Includes the following structures:

Vertebrae made up of bodies, arches, processes. Between the arches of adjacent vertebrae there are joints called facets.
Intervertebral discs located between the bodies of adjacent vertebrae
Spinal ligaments
Posterior and anterior longitudinal 一 pass along the bodies of all vertebrae in front and back
Yellow ligament - connects the arches of adjacent vertebrae
Supraspinous ligaments and interspinous ligaments – connect the spinous processes
The spinal cord, located in the spinal canal, along with the nerve roots that extend from it. They are nerve cell processes. Through these processes, the brain receives information about the state of tissues and, in response, sends signals that regulate their functioning: muscle contractions, changes in the diameter of blood vessels and much more.

Degeneration begins in the intervertebral discs and, as the changes progress, all of the above structures are involved in the process. This is partly due to the fact that discs do not have blood vessels. Nutrients and oxygen enter them from the vertebrae and other surrounding structures by diffusion.

The intervertebral discs make up one-third of the length of the spine and serve as shock absorbers, protecting the vertebrae from overload during heavy lifting, prolonged standing or sitting, bending and twisting. Each disk consists of:

The nucleus pulposus, which is located inside, in the center, contains a lot of hyaluronic acid, type II collagen, which retains water. This gives the normal core a jelly-like consistency for effective cushioning. As degeneration progresses, the composition of the inner part of the disc changes, its water content decreases, the nucleus "dries out" and the height of the intervertebral disc decreases.
The fibrous ring, located outside the nucleus and consists of 15 to 25 layers of collagen fibers. The collagen in the fibrous ring is type I. It is denser than the nucleus and is needed to hold the inside of the disc together and protect it from damage. The fibers of the ring are intertwined along the periphery with the posterior longitudinal ligament of the spine. This ensures immobility of the spinal structures in a healthy person - doctors call this condition spinal stability. In people with degenerative disease, the fibrous ring cracks, and instability may occur: adjacent vertebrae may move anteriorly or posteriorly in relation to each other. This is dangerous due to compression of the nerve root between them

It is also important to mention the end plates. These are thin cartilages located between the vertebral bodies and the discs. They contain blood vessels that supply the disc. In degenerative disease, calcium is deposited in the endplates, impairing blood supply.

Stages of development of osteochondrosis

The development of spinal osteochondrosis occurs gradually:

Initial degeneration. The intervertebral disc does not receive enough nutrition, it wears out, its height decreases and it cracks. The nucleus pulposus protrudes through microdamages in the fibrous ring, irritating the posterior longitudinal ligament and causing pain and reflex spasm of the back muscles.
Bulging of the intervertebral disc. The fibers of the fibrous ring are destroyed, the nucleus pulposus protrudes more strongly, forming a hernia. It can compress spinal nerve roots, leading to the development of paresis or paralysis of the limb muscles and decreased skin sensitivity. One of the complications of a hernia is its sequestration - separation of the disc protrusion from its main part.
Progression of degeneration of the ridge and other spinal structures. The disc becomes even more compact and the body tries to compensate for the excessive mobility of the spine by forming pathological bone growths of the vertebral bodies - osteophytes. They, like the hernia itself, can affect nerves and ligaments, impairing their function and causing pain. Unlike a hernia, bone spurs do not dissolve.

Complications of osteochondrosis, in addition to compression of herniated spinal nerve roots:

Spondyloarthrosis. Decreased intervertebral disc height places greater stress on the facet joints. They can develop inflammation and malnutrition, causing them to become "dry" and cause pain.
Spondylolisthesis 一 displacement of the vertebral bodies relative to each other due to damage to the ligaments
Degenerative processes in the yellow ligament area cause its thickening. This is dangerous because the ligamentum flavum is adjacent to the spinal canal and can narrow it, compressing the spinal cord.
At the level of the 1st-2nd lumbar vertebrae, it extends downward from the spinal cord "ponytail" - a bundle of nerve roots responsible for the innervation of the lower extremities and pelvic organs: bladder, rectum, external genitalia. Cauda equina syndrome is one of the most dangerous complications of osteochondrosis, manifested by severe pain, muscle weakness in the legs, numbness of theperineum, urinary and fecal incontinence.

Causes of back osteochondrosis

There is still no consensus on what degree of degenerative changes in the spine should be considered normal. Sooner or later, spinal aging begins in everyone.

In most people, these changes are small and do not cause symptoms: sometimes they are discovered accidentally during a magnetic resonance imaging (MRI) scan of the spine. The progression of degeneration leads to significant changes in the structure of the spine. Intervertebral discs can be so destroyed that they cease to perform a shock-absorbing function, swell and put pressure on spinal nerves and even the spinal cord itself.

It is impossible to accurately predict the severity of degenerative changes in a given person and whether they will lead to complications. There is a genetic predisposition to osteochondrosis, but the specific genetic mutations responsible for the course of the disease have not been identified. Therefore, there is no accurate genetic test that demonstrates personal risk. There are certain factors that increase the risk of developing osteochondrosis. They are the targets of osteochondrosis prevention measures.

Risk factors for osteochondrosis include:

Excessive load on the spine: professional sports, weightlifting, regular heavy physical work
Remaining in a static and incorrect position for a long time: sitting, bent over, cross-legged, in a chair without lumbar support, working in a vertical position with an inclination
Sedentary lifestyleleading to weakness of the trunk muscles that cannot effectively support the spine
Overweight 一 obesity creates additional stress on the back and joints
Smoking - nicotine and other components of cigarettes disrupt the diffusion of nutrients from blood vessels to tissues, including intervertebral discs
Alcohol intake - Regular consumption causes calcium to be poorly absorbed from food. Lack of calcium causes vertebrae to lose density
Back injuries with damage to the structure of the vertebrae or discs, due to which the recovery process occurs much slower than the degeneration process

Osteochondrosis of the spine in adults: symptoms

In the early stages of a degenerative disease, a person usually does not experience any symptoms. They occur suddenly or gradually as the disease progresses. The main manifestations are back pain and reflex spasms of the back muscles. The location of the symptoms depends on which part of the spine the problem occurs:

Degeneration in the cervical spine leads to muscle stiffness, neck pain that radiates to the shoulder and arm or back of the head and worsens with head movements
Changes in the thoracic spine appear extremely rarely, as it is the most static. If a hernia occurs, pain appears between the shoulder blades
Hernias in the lumbar region occur more frequently than others and are manifested by pain in the lumbar region or sacrum, radiating to the gluteal region, to the leg. Stiffness in the lower back is also noted. The pain worsens when sitting, standing for long periods and bending over.

If the pain radiates from the back to the limb, they talk about radiculopathy - damage to the nerve root. This is compression by a herniated spinal nerve. Radiculopathy, in addition to pain, is also accompanied by other symptoms located in a specific area supplied by the injured nerve. Such manifestations may include:

weakness of limb muscles, up to paralysis
disturbances in the sensitivity of the skin of the extremity
bladder and rectal dysfunction with lumbar radiculopathy

Signs of spinal osteochondrosis in women and men usually do not differ, but in women symptomatic degeneration develops more quickly after menopause, when bone density decreases. In men, degenerative processes are more often caused by physical work and develop from an earlier age, but gradually.

Not all back pain is caused by spinal osteochondrosis. Our experts can perform a complete exam and decide if you need an MRI.

Osteochondrosis of the spine at a young age

It is generally accepted that osteochondrosis is a disease of the elderly. Degenerative spinal disease is indeed common among patients over 60 years of age, but is becoming increasingly common in people in their 30s and even 20s. The cause is usually genetic predisposition, excess weight, sedentary lifestyle or back injuries. Both one-off serious injuries, for example caused by a fall, and regular minor injuries, for example when playing professional sports, are important. The disease most often occurs in the lumbar region as the most mobile. Intervertebral hernias, including Schmorl's nodes, can form here. The main mechanism of its occurrence is damage to the endplates, which cannot withstand intradiscal pressure. This is how protrusions form on the body of the above or underlying vertebra, called Schmorl's hernias. They do not cause nerve root compression and are generally not dangerous. In rare cases, they can grow and cause back pain, but more often they are discovered by chance during an MRI. Intervertebral hernias that project posteriorly are usually accompanied by pain and may require treatment.

Osteochondrosis of the spine: treatment

Up to 90% of cases of degenerative diseases can be treated with conservative methods.

Surgery is only indicated if there is a threat of serious complications, such as progressive loss of bladder control or weakness in the lower extremities. Surgical treatment allows you to save a person from paralysis, but in itself it does not alleviate pain and the progression of the disease, therefore, after the operation, a special rehabilitation program is prescribed.
In many cases, uncomplicated hernias resolve on their own. The resorption process may be accompanied by the formation of excess connective tissue and calcifications in the spine, which increases the likelihood of disease recurrence in the future. Existing physiotherapeutic techniques and special exercises help:

accelerate hernia resorption
improve disc power
normalize the biomechanics of movements and load distribution
avoid the need for surgery in the future

For pain, medications from the groups of non-steroidal anti-inflammatory drugs, glucocorticoids and muscle relaxants are also used, but the use of medications is limited to the acute period of the disease and does not improve the condition of the spine in the long term. You can reduce the intensity of degeneration by:

MLS laser therapy - the laser radiation used has an anti-inflammatory effect, dilates the lymphatic vessels, improving lymphatic drainage
Acupuncture - this method relieves pain, swelling and inflammation due to the body's reflex response to the stimulation of biologically active points on the body with special needles
Magnetotherapy - a method that stimulates blood flow, normalizing the diffusion of nutrients and removing toxins from the thickness of the intervertebral discs, accelerates recovery processes
Therapeutic physical education - special series of exercises help to strengthen the muscles of the trunk, learn how to correctly distribute the load on the back, maintain correct posture and relieve muscle spasms. To monitor performance, it is best to start working with an instructor and then continue the exercises yourself according to the recommendations

Depending on the manifestations of the disease and the characteristics of the patient, different combinations of the above methods can be used.

Both conservative treatment of spinal hernias and rehabilitation after surgery can be carried out on an outpatient basis in the clinic. It has all the necessary equipment and a team of professionals specialized in the non-surgical treatment of hernias. It is not recommended to go to hospitals where methods that have no scientific basis and are not approved by the global medical community are used - this can be dangerous to your health. In a modern clinic, you can get advice at an affordable price and choose another course of action together with your doctor.