Osteochondrosis refers to degenerative-dystrophic changes in the intervertebral discs and adjacent vertebral bodies, most commonly in the cervical and lumbar spine. It reflects complex interactions between mechanical load, disc nutrition, genetic predisposition and ageing processes.

Intervertebral Disc Degeneration

The intervertebral disc consists of a gelatinous nucleus pulposus and a fibrous annulus fibrosus. With age and chronic overload:

• Proteoglycan and water content in the nucleus decrease, reducing its ability to distribute load.
• Collagen organization in the annulus is disrupted; fissures and tears may form.
• Disc height decreases, приводя к изменению биомеханики сегмента.

These changes can lead to disc bulging or herniation, facet joint overload and narrowing of intervertebral foramina.

Vertebral and Joint Changes

As discs lose height and elasticity, нагрузка перераспределяется на фасеточные суставы и замыкательные пластинки тел позвонков. Compensatory reactions include:

• Formation of osteophytes (bony spurs) along vertebral margins.
• Hypertrophy and sclerosis of facet joints.
• Thickening of ligaments (e.g. ligamentum flavum), which can contribute to spinal canal or foraminal narrowing.

These structural changes are part of spondylosis and contribute to mechanical pain and possible nerve compression.

Pain Mechanisms

Pain in osteochondrosis has multiple sources:

• Discogenic pain from innervated outer layers of the annulus and adjacent vertebral endplates.
• Facet joint pain due to synovial inflammation and capsular strain.
• Myofascial pain from secondary muscle spasm and trigger points.
• In some cases, radicular pain when nerve roots are compressed or inflamed in narrowed foramina.

Chronic nociceptive input may lead to central sensitization, lowering the threshold for perceived pain.

Risk Factors and Modifiers

• Prolonged static postures, repetitive loading and improper lifting techniques.
• Obesity and low physical activity, reducing muscular support for the spine.
• Smoking and vascular factors, potentially impairing disc nutrition.
• Genetic influences on collagen structure and disc metabolism.

Management Principles

• Non-pharmacologic: targeted exercise therapy, posture training, ergonomic adjustments, weight management.
• Pharmacologic: analgesics, NSAIDs and muscle relaxants as appropriate for acute flares.
• Interventional and surgical approaches are reserved for selected cases with persistent pain or significant neurological compromise.

Osteochondrosis thus reflects age- and load-related remodeling of spinal motion segments. Understanding disc and joint changes helps design realistic strategies to reduce symptoms and preserve function.