Cervical osteochondrosis is a disease in which the vertebrae and intervertebral discs are affected. Cervical osteochondrosis refers to dorsopathies deformans. Involutive disc changes have already been observed at the age of 20 years. At the same time, they become more sensitive to loads, less elastic and lose lubricating fluid.
Most often, the pathology occurs in the elderly, but currently there is a significant increase in the incidence in children and adolescents. Neurologists identify cervical osteochondrosis using the latest diagnostic studies. After clarifying the diagnosis, complex therapy is carried out with the most effective drugs, physiotherapy procedures and innovative methods of physical rehabilitation.
The name of the disease consists of two Greek terms "osteon" (bone) and "chondros" (cartilage). Cervical osteochondrosis begins with changes in the central part of the disc. The intervertebral disc loses moisture, its size decreases, which leads to the convergence of the vertebral bodies and the violation of the nerve roots with the vessels. The vertebrae receive nutrients from the surrounding tissues, which is harmful to the body. Compression of nerves and blood vessels results in a protective muscle spasm which, as the disease progresses, becomes the cause of the pain.
Which doctor treats this disease
The treatment of osteochondrosis is the field of activity of neurologists. However, when symptoms of osteochondrosis of the neck appear, it is possible to see a general practitioner. A neurologist will select the drugs for cervical osteochondrosis that put the least stress on the body, which is important for drug treatment.
To determine the presence of a pathological process in the cartilage tissue and cervicobrachial osteochondrosis, the patient is referred for a comprehensive examination. Cervical osteochondrosis treatment tactics are under development in accordance with research results.
Interdisciplinary collaboration also allows the treatment of comorbidities presented by the patient. In addition, the patient benefits from comprehensive information support: a treatment plan, an extract on the cost of services, information on specialist consultations and diagnostic measures.
Causes
Cervical osteochondrosis develops under the influence of various provoking factors. No specific cause of cervical osteochondrosis has been identified. The disease is often associated with metabolic disorders and aging of the vertebrae.
Researchers suggest that cervical osteochondrosis develops for the following reasons:
- Excessive stress on the spine. A high load on the spine is observed when wearing the wrong shoes, flat feet, obesity, prolonged sitting;
- Metabolic disorders. A deficiency in vitamins, minerals, disorders of the metabolism of calcium can be at the origin of degenerative processes in the vertebrae;
- Congenital and acquired anomalies of the spine and the ligamentous apparatus (thickening of ligaments, lumbarization, sacralization);
- Pathologies of the gastrointestinal tract, resulting in insufficient absorption of nutrients;
- Infection, intoxication;
- Injuries, bruises, fractures of the spine, as a result of which the blood supply and innervation of the spine are disturbed, which provokes their dystrophic disorders;
- Stress;
- Wear heeled shoes;
- Pregnancy, especially multiple pregnancies;
- Autoimmune connective tissue damage, abnormal collagen structure types 1 and 2;
- Occupational hazards (lifting heavy loads, prolonged vibrations, working in a sitting position with a constant tilt of the head);
- Atherosclerotic and other changes in vertebral arteries;
- Curvature of the spine (kyphosis, scoliosis, kyphoscoliosis).
An important risk factor for the development of cervical osteochondrosis is heredity overwhelmed. This fact proves the presence of osteochondrosis in children, when the spine is not yet overloaded.
Degrees
Due to the special structure of the spine, it is able to perform its functions. The main structural unit is considered the spinal motion segment (VMS). It consists of two adjacent vertebrae, an intervertebral disc and a musculo-ligamentous apparatus. Osteochondrosis leads to dystrophic-degenerative processes, first in the intervertebral disc, and then in the vertebra. With the defeat of a vertebra, the performance of its functions is provided by adjacent ones. This leads to increased load and loss of mobility of the affected segment.
In the development of cervical osteochondrosis, doctors distinguish several stages:
- The first degree of cervical osteochondrosis. Since the intervertebral disc is deprived of its own blood supply and receives nutrients from surrounding tissues, it is prone to degenerative changes. Osteochondrosis in the 1st stage of development is characterized by the destruction of the nucleus pulposus and cracks in the annulus fibrosus. Clinically, this is manifested by acute or persistent local pain in the neck (neck pain) and stiffness;
- Second degree osteochondrosis of the cervical spine. At this stage, the destruction of the fibrous ring continues, pathological mobility and instability of the vertebrae appear. Patients complain of neck pain, aggravated by physical exertion, tilting the head or in a certain position;
- The third stage of the disease is characterized by complete destruction of the fibrous ring. The gelatinous nucleus is not fixed. Herniated discs can occur and cause severe pain. At this stage, due to poor fixation of the SMS, a curvature of the spine may form;
- In the fourth stage of the disease, the intervertebral disc is replaced by connective tissue, other adjacent segments are affected. Spondylarthrosis, arachnoiditis develops. The joints become completely still - ankylosis develops. Bone tissue grows around the affected area - an osteon is formed. With the fourth degree of cervical osteochondrosis, sharp symptoms are observed: severe pain that radiates to the arm, sternum, to the area between the shoulder blades, disturbances in sensitivity.
Symptoms and signs
Signs of cervical osteochondrosis in the initial stages may be nonspecific: dizziness, headache, weakness, crackles when moving the head. As the disease progresses, the following symptoms develop:
- Severe pain in the neck and shoulders;
- Numbness of the hand;
- Dizziness;
- Increased blood pressure;
- Impaired coordination of movements;
- Increased sweating.
There are several syndromes that appear with the development of a pathological condition of the muscles of the back and cervical spine:
- Cervical migraine syndrome.
- Vertebral artery syndrome.
- Hypertensive syndrome.
- Cardiac syndrome.
- Radicular syndrome.
They occur when nerve endings are damaged, arteries and veins are compressed during the development of the disease. The most dangerous complication is considered to be vertebral artery syndrome. There is a violation of blood flow in the artery that supplies the brain and spinal cord. The patient's hearing decreases, vision decreases, constant dizziness develops. The patient may pass out while driving due to a sudden violation of blood flow.
As a result of the compression of the nerves responsible for the innervation of the muscles of the chest and diaphragm, pain in the region of the heart appears, which is not associated with heart disease, but at the same time with tachycardia, arrhythmia and hypotension may develop. Compression of the veins leads to the development of CSF hypertensive syndrome. Intracranial pressure rises, nausea, vomiting and severe headache appear due to impaired blood flow to the brain.
As a result of compression of the neck, radicular syndrome develops - severe pain appears in the neck, shoulders, shoulder blades and back of the head. With this syndrome, the arms and neck become numb. With cervical migraine syndrome, the patient worries about severe pain in the occiput, which is often accompanied by nausea and vomiting.
Reflex syndromes occur when the spinal roots are not yet affected. Patients complain of pain in the neck, head (especially the back of the head), arms on one or both sides. Reflex pain, unlike radicular pain, is not accompanied by disturbances of sensitivity. Neck pain can be dull, painful. The sharp pain of "lumbago" is called cervicago. There is a muscle spasm and pain, pain in the paravertebral points. Signs of cervical osteochondrosis intensify in an uncomfortable position, with tilting of the head, coughing, physical exertion. Signs of epicondylosis, humeroscapular periarthrosis, and shoulder-hand syndrome appear due to nerve impulses from the fibrous annulus of the affected segment, which causes compensatory muscle spasm.
Radicular syndromes are accompanied by impaired motor activity and sensitivity. At the same time, nerves, blood vessels are impaired, venous and lymphatic outflow in the pathological focus is disturbed due to a decrease in the intervertebral canal. The pain in radicular syndrome is sharp, intense. A common cause of spinal nerve compression is the formation of a hernia. In the area of the pathological focus, muscle tone decreases. With radiculoischemia, in addition to the nerves, the vessels are compressed.
If the phrenic nerve is involved in the pathological process, cardiac syndrome occurs. It manifests as a sharp, burning pain on the left side of the chest with irradiation to the arm, the interduloid region. The name of the syndrome is due to the fact that the nature of the pain is similar to an attack of angina pectoris. The main difference between pain in angina is that it is relieved after taking nitroglycerin, it can occur while resting, and is accompanied by interruptions in the heartbeat (tachycardia, arrhythmia).
Signs of cervical osteochondrosis depend on the location of the pathological process. In the event of damage to the upper cervical vertebrae, the blood supply to the brain is disturbed due to the compression of the cerebral arteries. This leads to headache (especially in the occipital region), dizziness, fainting, high blood pressure. Dizziness with cervical osteochondrosis is caused by decreased blood flow to the inner ear. Patients are also concerned about the occurrence of nausea, vestibular and ocular symptoms.
With a combined lesion of the vertebrae, they speak of cervicothoracic osteochondrosis. The disease is manifested by the following symptoms:
- Dizziness;
- Pain in the neck and arm;
- Tingling and crawling sensation on the upper limb;
- Intercostal neuralgia.
Diagnostic
Cervical osteochondrosis is a chronic disease that can lead to herniation and compression of the spinal cord. Therefore, it is important to make an accurate diagnosis in a timely manner and to start treatment. To identify cervical osteochondrosis, the following types of instrumental diagnostics are used:
- Spondylography or x-ray of the spine. This research method is painless, very informative and does not require special training. An x-ray of the spine allows its anatomical and functional characteristics to be assessed. In the photo, special attention is paid to the structure of the vertebrae, their relationship to each other, the distance between them, the lumen of the spinal canal;
- Computed tomography - provides information mainly on the condition of bone tissue, allows you to identify a narrowing of the spinal canal and a herniated disc;
- Magnetic Resonance Imaging - allows you to determine changes in soft tissue. The MRI image clearly shows changes in the intervertebral discs and the spinal cord.
Medical treatment
Treatment of osteochondrosis of the cervical spine consists of drug and non-drug therapy. Even after a complete recovery, neurologists take preventive measures to exclude relapses of the disease. In the acute period, for the treatment of osteochondrosis of the cervical spine, doctors prescribe drugs of the following pharmacological groups to patients:
- Non-narcotic pain relievers. They are taken orally or injected intramuscularly to quickly achieve the effect;
- Nonsteroidal anti-inflammatory drugs;
- B vitamins in high doses.
Diuretics are used to reduce water retention in the spinal root and surrounding tissues. Antihistamines potentiate the action of analgesics. Muscle spasms are eliminated by muscle relaxants. With prolonged severe pain syndrome, neurologists perform a nerve blockage.
To improve metabolic processes in the intervertebral disc, chondroprotectors are used. These drugs increase the content of glycosaminoglycans, increase the firmness, elasticity and shock absorption of the intervertebral discs.
Vertigo pills
Patients often suffer from dizziness with cervical osteochondrosis. To reduce them, doctors prescribe nonsteroidal anti-inflammatory drugs. NSAIDs belonging to different groups differ in their mechanism of action and effect. Therefore, only a qualified specialist can determine the appropriate drug.
It is important to remember that drugs for osteochondrosis of the cervical spine cannot be taken without the appointment of a doctor. Nonsteroidal anti-inflammatory drugs have side effects. Therefore, before prescribing them, the neurologist determines the presence of contraindications in the patient and the required dosage. Drugs for dizziness in cervical osteochondrosis can improve the quality of life of the patient.
Injections for osteochondrosis
Injections for osteochondrosis of the cervical spine help relieve pain during an exacerbation. With this method of administering the drug, the effect occurs quickly. Neurologists use a variety of injections.
Nurses inject drug solutions subcutaneously, intramuscularly or intravenously. During the period of exacerbation of the disease, drugs administered by injection, with cervical osteochondrosis, have an exclusively symptomatic effect.
Treatment of headaches
Headache is a symptom that occurs with various disorders. However, cervical osteochondrosis is characterized by bouts of intense headaches. Movements of the head increase the symptoms, therefore, to eliminate it, doctors prescribe pain tablets and nonsteroidal anti-inflammatory drugs.
Non-drug therapy methods
Complex non-drug treatment for cervical osteochondrosis of the spine includes:
- Protective mode - when the roots are pinched, patients lie on a hard surface,
- Massage;
- Physiotherapy exercises;
- Vertebral traction;
- Physiotherapy procedures.
Massage for cervical osteochondrosis is used to reduce pain and swelling, improve peripheral blood supply, and eliminate muscle spasms. A contraindication to performing this procedure is the presence of sharp pain. Massage the neck and back in the direction of lymphatic flow. Particular attention is paid to the interscapular and paravertebral areas.
Therapeutic gymnastics for osteochondrosis of the cervical spine is aimed at eliminating muscle spasms and strengthening muscle structure. Since instability of the vertebrae often occurs in the cervical spine, the exercise therapy instructor conducts one-to-one lessons during which he teaches the patient how to perform the exercises safely. Some authors recommend to hold physiotherapy courses in the Shants pass.
To improve the mobility of the cervical vertebrae, rehabilitation therapists recommend performing the following exercises:
- Neck flexion and extension. Tilt your head forward towards your breastbone, without pulling your shoulders forward, then back. Hold the slope for 3 seconds, repeat each exercise 8-10 times;
- Neck loops. Turn your neck first to the left until it stops, then to the right, without changing the position of the shoulders and the level of the chin;
- Lower your head until it stops. Then tilt your head back without changing the level of your shoulders. Hold the position for 5 seconds.
The following exercises have been developed to strengthen the muscles of the neck:
- Place your hand on the back of your head. Tilt your head back, leaning on your hand;
- Place your hand in the temporal region. As you bow your head, resist with your hand;
- Put your hand on your forehead, resist, tilt your head forward;
- Tilt your head to the side with your right hand, with your left hand behind your back. Repeat the other exercise.
Autogravity therapy is the correct name for the spine traction procedure. It is carried out using special devices. The goal of therapy is to reduce muscle spasms and restore the correct position of the vertebrae. To avoid complications, spinal traction is performed by a doctor.
To improve blood supply to the pathological focus, relieve puffiness and eliminate pain, the following physiotherapeutic procedures are used:
- Diadynamic currents. During this procedure, with the help of a special device, low-frequency currents are applied, which stimulate the muscles, relieve spasms and pain. Have a positive effect, improving tissue trophism;
- Ultraviolet irradiation. Under the influence of UV rays, vitamin D metabolism improves, calcium content increases, bone tissue becomes stronger;
- Ultrasound exposure - used to accelerate blood flow, antispasmodic and restorative action. Ultrasound is able to penetrate deep into the tissues, sometimes it is used for better absorption of medicinal substances;
- Amplipulse therapy - allows you to relieve pain by blocking nerve impulses from the painful focus.
In the acute period of the disease, which lasts 4-7 days, analgesics, antispasmodics and irritants are used to reduce pain. The patient is at peace. The immobilization of the cervical spine is carried out using the Shants collar. Exercise therapy and massage are contraindicated. Apply ultraviolet radiation.
The duration of the subacute period is 29 days. After full recovery, the patient should rest for several days. Then you can start a course of rehabilitation therapy. During the chronic course of the disease, the patient is prescribed muscle relaxers, chondroprotectors, B vitamins, for pain - analgesics, NSAIDs. Physiotherapy exercises, massages are provided. The patient is released from physiotherapeutic procedures (amplipulse, exposure to alternating current), spinal traction is performed.
Food
Good nutrition for osteochondrosis is an important condition for achieving remission. The progression of cervicothoracic osteochondrosis stops with diet and treatment. Neurologists know how to treat osteochondrosis of the cervical spine. Therefore, they constitute a set of therapeutic measures, including procedures, exercise therapy, good nutrition and lifestyle changes.
Many patients turn to neurologists for advice on how to treat osteochondrosis of the cervical spine and if there are any dietary restrictions. Specialists create individual nutrition programs that take into account the preferences of the patient. The diet for osteochondrosis is based on balanced foods that are low in fat and rich in nutrients. The daily diet of the patient includes foods rich in calcium.
How to sleep with cervical osteochondrosis
For patients with diseases of the musculoskeletal system, the question of how to sleep well with cervical osteochondrosis is relevant. Sleeping on your stomach causes further development of the disease, so it is better to avoid sleeping in this position. The most optimal positions are on the back and on the side.
Cervical osteochondrosis progresses when resting on a bed with a soft mattress. Therefore, experts recommend giving preference to elastic mattresses, as well as moderately soft pillows. If a patient is diagnosed with cervical-thoracic osteochondrosis, experienced specialists will tell you which bedding is safe to sleep on.
Prophylaxis
To prevent the onset or progression of cervical osteochondrosis, doctors recommend:
- Maintain correct posture;
- Lead an active lifestyle, take breaks at work;
- Do physiotherapy exercises regularly;
- Sleep on a firm, level surface with an orthopedic mattress and pillow;
- Get rid of bad habits, especially smoking;
- Choose shoes taking into account the physiological structure of the foot;
- Do not carry bags in one hand, this leads to bending of the spine;
- Lead a healthy lifestyle, eat well, eat lots of fruits and vegetables;
- Do not sit for a long time with your head bowed;
- To go swimming.
In order to improve blood circulation, massage therapy should be performed regularly.