Osteochondrosis of the spine: truth and myths - treatment in Tashkent

Other names: Дегенеративные изменения позвоночника, спондилоартроз, дорсопатия

Osteochondrosis is age-related degenerative changes in the intervertebral discs and joints of the spine. It is important to understand: to one degree or another, almost all people after 30–35 years have them, and in themselves they are not a disease. The problem is that this diagnosis in post-Soviet medicine is used to explain almost any pain - in the back, neck, head, arm, heart. Meanwhile, in most cases, back pain is not associated with “salt deposits”, but with muscles and joints, and responds well to movement, rather than rest and IVs.

🧾 МКБ-10: M42 🏥 Where it is treated: 8 Almost everyone has changesRest is more harmful than movementSnapshot does not equal pain

👨‍⚕️ Which doctor

Neurologist, vertebrologist

🔬 Diagnostics

Inspection; MRI according to indications

💊 Treatment

Movement, exercise therapy, short course of NSAIDs

📈 Prognosis

Favorable

⚠️ At risk

Inactivity, excess weight, smoking

⏱ When to see a doctor

Planned; in case of “red flags” - urgently

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Нарушение мочеиспускания и дефекации, онемение промежности — экстренная ситуация
Нарастающая слабость в ноге или руке
Боль после травмы, особенно при остеопорозе
Боль с температурой, ознобом, ночной потливостью
Потеря веса, онкологическое заболевание в анамнезе
Боль, которая не уменьшается в покое и будит ночью

What the pictures show

This is the key point around which there is the most anxiety. Most people have changes on MRI and X-ray without any pain.

Disc protrusions are found in approximately half of people 30–40 years old who do not experience pain
Disc herniations are found in a significant proportion of healthy people
Reduced disc height and osteophytes are natural age-related changes
The degree of change in the image is weakly related to the severity of pain

Практический вывод: лечат пациента, а не снимок. Обнаруженная на МРТ грыжа при отсутствии неврологического дефицита сама по себе не является поводом ни для операции, ни для паники.

Where does the pain really come from?

Nonspecific back pain - up to 85% of cases: muscles, ligaments, small joints of the spine. Diagnosis is clinical; no imaging is needed
Radiculopathy - compression of the nerve root: pain radiates to the leg or arm, there is numbness and weakness
Spinal stenosis: pain and weakness in the legs when walking, relieved by bending forward and sitting
Specific causes (less than 1%): tumors, infections, fractures, inflammatory diseases - these are identified by “red flags”

What Really Works

The modern approach to back pain has changed radically: the main thing is to stay active, not lie down.

Продолжать повседневную активность. Постельный режим дольше 1–2 дней замедляет выздоровление.
НПВС коротким курсом при выраженной боли; миорелаксанты при мышечном спазме.
Через несколько дней — начать лечебную физкультуру; при хронической боли это метод номер один.
Регулярные упражнения на укрепление мышц спины и брюшного пресса, растяжка.
Плавание, ходьба, при хронической боли — йога и пилатес под контролем специалиста.
Работа со стрессом и нормализация сна: они напрямую влияют на интенсивность хронической боли.

Massage and manual therapy can provide relief for nonspecific pain, but are used after examination by a doctor and do not replace exercise. Spinal traction has no proven effectiveness.

Prevention

Regular physical activity is the most effective way to prevent relapses
Changing position every 45–60 minutes during sedentary work, lumbar support
Correct weight lifting: with a straight back, using your legs, without twisting
Weight control
Quitting smoking: it impairs the nutrition of the intervertebral discs
Comfortable mattress of medium hardness; super-hard surfaces are no healthier

Frequently asked questions: Osteochondrosis of the spine

Is osteochondrosis a disease?+

Rather, age-related changes that almost everyone has after 30–35 years. By themselves, they do not equal pain: many people with pronounced changes in the pictures do not have back pain at all.

Found a protrusion and hernia - is it dangerous?+

Not necessarily. Protrusions and even hernias are found in a significant proportion of people without pain. The symptoms that matter are: pain along the nerve, numbness and weakness. Without them, the finding in the image does not require treatment.

Should you lie down if you have back pain?+

No. Bed rest for more than a day or two slows down recovery. The modern approach is to stay as active as possible and start exercising as early as possible.

Do IVs and chondroprotectors help?+

They have no convincing evidence. Movement, physical therapy, a short course of anti-inflammatory drugs during an exacerbation, and weight control work reliably.

When do you need to see a doctor urgently?+

For problems with urination, numbness of the perineum, increasing weakness in the leg, pain after injury, pain with fever and weight loss. These are signs of conditions that require emergency care.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.