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The first signs of osteochondrosis

Osteochondrosis is an outdated name for a degenerative disease of the spine. 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 - the 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

how the spine works

To understand the processes that occur during osteochondrosis, you need to understand the anatomy of the spine. It includes the following structures:

  • Vertebrae consisting of bodies, arcs, processes. Between the arches of adjacent vertebrae are joints called facets
  • Intervertebral discs located between the bodies of adjacent vertebrae
  • Spinal ligaments
  • Posterior and anterior longitudinals 一 pass along the body 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, located in the spinal canal, as well as the nerve roots that arise from it. These are nerve cell processes. Thanks to 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 changes progress, all of the above structures are involved in the process. This is partly because the discs do not have blood vessels. Nutrients and oxygen enter by diffusion from the vertebrae and other surrounding structures.

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, located inside, in the center, contains a lot of hyaluronic acid, type II collagen, which retains water. This gives the normal core a gel-like consistency for effective cushioning. As degeneration progresses, the composition of the inner part of the disc changes, its water content decreases, the core "drys out" and the height of the intervertebral disc decreases.
  • The annulus fibrosus, located outside the nucleus and made up of 15 to 25 layers of collagen fibers. The collagen in the annulus fibrosus is type I. It is denser than the nucleus and is necessary to hold the interior 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 a degenerative disease, the annulus fibrosus cracks, which can lead to instability: adjacent vertebrae may move forward or backward 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 the discs. They contain blood vessels that supply the disc. In degenerative diseases, calcium is deposited in the end plates, leading to impaired blood supply.

Stages of development of osteochondrosis

The development of spinal osteochondrosis occurs gradually:

  • Initial degeneration. The intervertebral disc is not sufficiently nourished, wears out, decreases in height and cracks. The nucleus pulposus protrudes through microdamage of the annulus fibrosus, irritating the posterior longitudinal ligament and leading to pain and reflex spasms of the back muscles.
  • Bulge of the intervertebral disc. The fibers of the annulus fibrosus 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 muscles of the limb and decreased skin sensitivity. One of the complications of a herniation is its sequestration - separation of the disc protrusion 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 excessive mobility of the spine by forming pathological bony outgrowths of the vertebral bodies - osteophytes. Like the hernia itself, they 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 herniated spinal nerve roots:

  • Spondyloarthrosis. The decrease in the height of the intervertebral disc places greater pressure on the facet joints. They can develop inflammation and malnutrition, making them "dry" and causing pain.
  • Spondylolisthesis 一 displacement of the vertebral bodies relative to each other due to ligament damage
  • Degenerative processes in the ligamentum flavum 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 vertebra, it descends from the spinal cord"ponytail» - a bundle of nerve roots responsible for the innervation of the lower limbs 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 of 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, spinal aging begins in every person.

In most people, these changes are minor and do not cause symptoms: they are sometimes 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. The intervertebral discs can be so destroyed that they cease to perform their shock-absorbing function, bulge and put pressure on the spinal nerves and even the spinal cord itself.

It is impossible to accurately predict the severity of degenerative changes 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 progression of the disease have not been identified. Therefore, there is no precise genetic test to demonstrate personal risk. Certain factors 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, heavy and regular physical work
  • Staying in a static and incorrect position for a long time:  sitting, slumped, cross-legged, in a chair without lumbar support, working in an upright position with tilt
  • Sedentary lifestyleleading to weak core 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 consumption - Regular consumption leads to the fact that calcium is poorly absorbed from food. Lack of calcium leads to loss of vertebrae 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 has no symptoms. They appear 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 the part of the spine in which the problem occurs:

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

If the pain radiates from the back to the limb, it is called radiculopathy - damage to the nerve root. This is compression caused by a herniation of the spinal nerve. Radiculopathy, in addition to pain, is also accompanied by other symptoms localized in a specific area supplied by the damaged nerve. Such manifestations may include:

  • weakness of the muscles of the limbs, which can lead to paralysis
  • skin sensitivity disorders of the limb
  • bladder and rectal dysfunction with lumbar radiculopathy

Signs of osteochondrosis of the spine 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 provoked by physical labor and develop from an early age, but gradually.

Not all back pain is caused by osteochondrosis of the spine. Our specialists can perform a complete 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 that affects older people. Degenerative diseases of the spinespinal are indeed common in patients over 60, but they are becoming more and more common in people in their 30s and even 20s. The cause is usually a genetic predisposition, excess weight, a sedentary lifestyle or back injuries. One-off serious injuries, for example following a fall, and regular minor injuries, for example when playing professional sport, are important. The disease most often occurs in the lumbar region, as it is the most mobile. Intervertebral hernias, including Schmorl's lymph 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 form in the body of the upper 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 larger and cause back pain, but more often they are discovered incidentally during an MRI. Intervertebral hernias that protrude backward 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 serious complications threaten, such as progressive loss of bladder control or lower extremity weakness. Surgical treatment allows you to save a person from paralysis, but in itself does not relieve pain or the progression of the disease. Therefore, after the operation, a special rehabilitation program is prescribed.
In many cases, simple hernias go away on their own. The resorption process may be accompanied by the formation of excess connective tissue and calcifications in the spine, which increases the risk of relapse of the disease in the future. Existing physiotherapeutic techniques and special exercises help to:

  • accelerate hernia resorption
  • improve disk power
  • normalize the biomechanics of movements and load distribution
  • avoid needing surgery in the future

For pain, drugs from the group of nonsteroidal anti-inflammatory drugs, glucocorticoids and muscle relaxants are also used, but the use of drugs is limited to the acute period of the disease and does not improve the condition of thespine 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 and improves 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
  • The magnetotherapy method stimulates blood flow, normalizing the diffusion of nutrients and removing toxins from the thickness of the intervertebral discs, thereby accelerating recovery processes
  • Therapeutic physical education - special sets of exercises help to strengthen the muscles of the torso, learn to correctly distribute the load on the back, maintain the correct posture and relieve muscle spasms. To track 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.

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 without scientific basis and not approved by the world medical community are used - this can be dangerous for health. In a modern clinic you can get advice at an affordable price and decide with your doctor what course of action to take.