The first signs of osteochondrosis

4 December 2024

Osteochondrosis is an outdated name for degenerative spine disease. The old term is often used in our country, but does not reflect the essence of the disease, which is based on age-related degeneration - destruction of 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 spinal column. It includes the following structures:

Vertebrae consisting 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 behind
Ligamentum flavum - connects the arches of adjacent vertebrae
Supraspinous ligaments and interspinous ligaments - connect the spinous processes
The spinal cord, which is located in the spinal canal, along with the nerve roots extending from it. They are processes of nerve cells. 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 with 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 the discs do not have blood vessels. Nutrients and oxygen penetrate into them from the vertebrae and other surrounding structures by diffusion.

Intervertebral discs make up a 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 core "dries out, " and the height of the intervertebral disc decreases
The fibrous ring, which is located outside the nucleus and consists of 15-25 layers of collagen fibers. Collagen in the annulus fibrosus is type I. It is denser than in the core and is needed to hold the inside of the disk 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 the immobility of spinal structures in a healthy person - doctors call this condition spinal stability. In people with degenerative disease, the annulus fibrosus cracks, so instability may develop: adjacent vertebrae may move anteriorly or posteriorly relative to each other. This is dangerous due to pinching 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 discs. They contain blood vessels that supply the disc. In degenerative disease, calcium is deposited in the end plates, causing the blood supply to be impaired.

Stages of development of osteochondrosis

The development of spinal osteochondrosis occurs gradually:

Initial degeneration. The intervertebral disc does not receive sufficient nutrition, wears out, its height decreases, and it cracks. The nucleus pulposus protrudes through microdamages of the annulus fibrosus, irritating the posterior longitudinal ligament and leading to pain and reflex spasm of the back muscles
Bulging of the intervertebral disc. The fibers of the annulus fibrosus are destroyed, the nucleus pulposus protrudes more strongly, forming a hernia. It can compress the spinal nerve roots, leading to the development of paresis or paralysis of the muscles of the limb and a decrease in skin sensitivity. One of the complications of a hernia is its sequestration - separation of the protrusion of the disc from its main part.
Progression of degeneration of the protrusion and other structures of the spine. 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, disrupting their function and causing pain. Unlike a hernia, bone spurs do not dissolve.

Complications of osteochondrosis, in addition to compression of the 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 area of the ligamentum flavum cause its thickening. This is dangerous because the yellow ligament 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 down 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 the perineum, urinary and fecal incontinence.

Causes of osteochondrosis of the back

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

In most people, these changes are minor and do not cause symptoms: they are sometimes discovered incidentally 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, bulge and put pressure on the spinal nerves and even the spinal cord itself.

It is impossible to accurately predict how severe degenerative changes will be in a particular 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 would show personal risk. There are certain factors that increase the risk of developing osteochondrosis. It is they who are targeted by measures to prevent osteochondrosis.

Risk factors for osteochondrosis include:

Excessive load on the spine: professional sports, heavy lifting, regular hard physical labor
Staying in a static, incorrect position for a long time: sitting, slouching, cross-legged, on 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 into tissues, including intervertebral discs
Alcohol intake - Regular consumption leads to the fact that calcium is 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 more slowly 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 spasm of the back muscles. The localization of symptoms depends on which part of the spine the problem occurs in:

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

If the pain radiates from the back to the limb, they speak of 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 that are localized in a specific area supplied by the damaged nerve. Such manifestations may include:

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

Signs of spinal osteochondrosis in women and men generally 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 labor and develop from an earlier age, but gradually.

Not all back pain is caused by spinal osteochondrosis. Our specialists can conduct a full examination and decide whether you need an MRI.

Osteochondrosis of the spine at a young age

It is generally accepted that osteochondrosis is a disease of older people. Degenerative spinal disease is indeed common among patients over 60 years of age, but it is becoming increasingly common in people in their 30s and even 20s. Usually the cause is genetic predisposition, excess weight, sedentary lifestyle or back injuries. Both one-time severe injuries, for example, from 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 their occurrence is damage to the end plates, which cannot withstand intradiscal pressure. This is how protrusions are formed into the body of the above or underlying vertebra, called Schmorl's hernias. They do not cause compression of the nerve roots and are usually not dangerous. In rare cases, they can grow and lead to back pain, but more often they are discovered by chance during an MRI. Intervertebral hernias that protrude posteriorly are usually accompanied by pain and may require treatment.

Osteochondrosis of the spine: treatment

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

Surgery is only indicated if serious complications threaten, 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 does not relieve pain and further progression of the disease, therefore, after the operation, a special rehabilitation program is prescribed.
Uncomplicated hernias in many cases 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 relapse of the disease in the future. Existing physiotherapeutic techniques and special exercises help:

speed up the resorption of the hernia
improve disk power
normalize the biomechanics of movements and load distribution
avoid the need for surgery in the future

For pain, medications from the groups of nonsteroidal 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 lymphatic vessels, improving lymphatic drainage
Acupuncture - this method relieves pain, swelling and inflammation due to the body’s reflex response to stimulation of biologically active points on the body with special needles
Magnetotherapy method stimulates blood flow, normalizing the diffusion of nutrients and removing toxins from the thickness of the intervertebral discs, accelerating recovery processes
Therapeutic physical education - special sets of exercises help strengthen the muscles of the torso, learn how to correctly distribute the load on the back, maintain the correct posture, and relieve muscle spasms. To monitor performance, it is better 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 completed on an outpatient basis in the clinic. It has all the necessary equipment and a team of professionals specializing in non-surgical hernia treatment. It is not recommended to go to hospitals where they use methods without scientific basis and not approved by the world medical community - this can be dangerous to health. In a modern clinic, you can get advice at an affordable price and choose a further course of action together with your doctor.