Signs of Osteochondrosis: Where It Hurts and How an Exacerbation Manifests

Back or neck pain is often attributed to osteochondrosis. But this term is understood to mean different things, and pain may have causes other than "spinal" ones. Let's look at what happens in the spine, where it hurts in osteochondrosis, and how to recognize an exacerbation.

What osteochondrosis is and what happens in the spine with it

Spinal osteochondrosis is a term widely used in Russia since the 1960s to denote degenerative changes of the intervertebral disc and segmental instability of the lower part of the spinal column. In developed countries, medical classifications do not include such a nosological entity among degenerative-dystrophic diseases. Doctor of Medical Sciences Professor Pavel Zharkov and Academician of the Russian Academy of Medical Sciences Alexander Skoromets assert that osteochondrosis is not a disease but a sign of aging — just like gray hair. Due to heavy loads, age-related changes, and impaired microcirculation, the cartilage between the vertebrae dries out, loses elasticity, becomes denser, and subsequently — brittle.

Main signs of osteochondrosis: where it hurts

The predominance of the "osteochondrosis" paradigm in Russian neurology leads to the fact that almost any pain in the back area is recognized as its symptom. Back pain can be caused by a wide variety of reasons, including oncological diseases, tuberculosis, spinal osteomyelitis, epidural abscess, ankylosing spondylitis and other spondyloarthritides, traumatic and osteoporotic vertebral fracture, compression of the spinal nerve root, diseases of the organs of the thoracic and abdominal cavities and the pelvis. In many patients, back pain is not associated with either visceral diseases or serious pathology of the spine, spinal cord, and its roots (nonspecific back pain). Many foreign authors emphasize the absence of correlation between radiological signs of degenerative spinal damage and the presence of back pain, as well as its intensity. It is known that only 1 in 10 patients with radiological signs of degenerative spinal damage has clinical signs of the disease, such as back pain.

Neuropathic pain in osteochondrosis

Compression of the spinal nerve root is among the causes of back pain. In the clinical classification of spinal osteochondrosis syndromes proposed by Ya. Yu. Popelyansky, compression, reflex, and myoadaptive syndromes are distinguished.

Exacerbation and attack of osteochondrosis

Acute back pain begins suddenly and usually lasts from several days to several weeks. The causes of cartilage change are cited as heavy loads, age-related changes, and impaired microcirculation; there are no separate data on triggers of exacerbation.

How the diagnosis is confirmed and when a doctor is needed

The diagnosis of "spinal osteochondrosis" is often made on the basis of radiography, since in any patient over 30 years of age, radiographs can reveal certain signs of degenerative-dystrophic changes. However, patients with nonspecific back pain do not need mandatory spinal radiography and mandatory consultation with a neurologist, and should be treated by a therapist or general practitioner. The doctor assesses the nature of the pain, neurological status, and, if necessary, prescribes radiography. You should see a doctor if the pain does not go away within several weeks.

• Back pain that does not go away within several weeks.
• Pain that interferes with performing usual tasks.
• Unexplained weight loss, a tumor, or a change in the shape of the back.
• Pain does not go away after rest or worsens at night; worsens with coughing, sneezing, defecation.
• Pain in the upper back (between the shoulder blades), rather than in the lower back.

The mere presence of osteochondrosis is not a reason to call an ambulance; 103/112 — if, with back pain, the following appear: pain, tingling, weakness, or numbness in both legs; loss of sensation in the genital or anal area; urinary or fecal disorders (retention or incontinence); changes in genital sensation, problems with erection or orgasm; chest pain; pain occurred after a serious accident.

This material is for reference and does not replace consultation with a doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer