Cervical osteochondrosis is a disease that affects the vertebrae and intervertebral discs.Cervical osteochondrosis refers to deforming dorsopathies.Involutional changes in the discs are observed from the age of 20.At the same time, they become more sensitive to stress, less elastic and lose lubricating fluid.
Most often, the pathology occurs in older people, but currently there is a significant increase in the incidence among children and young people.Neurologists identify cervical osteochondrosis using the latest diagnostic tests.After clarifying the diagnosis, complex therapy is carried out with the most effective medications, physiotherapeutic procedures and innovative methods of physical rehabilitation.
The name of the disease is composed 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 and decreases in size, leading to convergence of the vertebral bodies and pinching of nerve roots and blood vessels.The vertebrae receive nutrients from surrounding tissues, which harms the body.Compression of nerves and blood vessels leads to a protective muscle spasm, which, as the disease progresses, becomes a cause of pain.
Which doctor treats this disease?
The treatment of osteochondrosis is the field of activity of neurologists.However, if symptoms of neck osteochondrosis appear, you can contact a general practitioner.A neurologist will select drugs for cervical osteochondrosis that have the least burden on the body, which is important during drug treatment.
To determine the presence of a pathological process in the cartilage tissue and cervico-brachial osteochondrosis, the patient is sent for a comprehensive examination.Tactics on how to treat cervical osteochondrosis are being developed in accordance with research results.
Interdisciplinary collaboration also makes it possible to treat the patient's comorbidities.In addition, the patient receives comprehensive information support: a treatment plan, an extract on the cost of services, information on consultations with specialists and diagnostic measures.
Reasons
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 load on the spine.A high load on the spine is observed when wearing incorrect shoes, flat feet, obesity and prolonged sitting;
- Metabolic disorders.Deficiency of vitamins, minerals and disorders of calcium metabolism can cause degenerative processes in the vertebrae;
- Congenital and acquired anomalies of the development of the spine and the ligamentous apparatus (thickening of the ligaments, lumbarization, sacralization);
- Pathologies of the gastrointestinal tract leading to insufficient absorption of nutrients;
- Infections, poisonings;
- Injuries, bruises, fractures of the spine, leading to disruption of the blood supply and innervation of the spine, which causes their degenerative disorders;
- Stress;
- Wear heels;
- Pregnancy, especially multiple pregnancy;
- Autoimmune connective tissue damage, pathological structure of collagen types 1 and 2;
- Occupational risks (lifting heavy loads, prolonged vibrations, working in a seated position with constant head tilt);
- Atherosclerosis and other changes in the vertebral arteries;
- Curvature of the spine (kyphosis, scoliosis, kyphoscoliosis).
Family history is an important risk factor for the development of cervical osteochondrosis.This fact proves the presence of osteochondrosis in children when the spine is not yet overloaded.
Degrees
Thanks to the particular structure of the spine, it is able to perform its functions.The main structural unit is considered to be the spinal movement segment (SMS).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, then in the vertebra.When a vertebra is damaged, its functions are carried out by the adjacent vertebrae.This leads to increased load and loss of mobility of the affected segment.
Doctors distinguish several stages in the development of cervical osteochondrosis:
- First degree of cervical osteochondrosis.Since the intervertebral disc is deprived of its own blood supply and receives nutrients from surrounding tissues, it is susceptible to degenerative changes.Osteochondrosis at the 1st stage of development is characterized by the destruction of the nucleus pulposus and cracks in the annulus fibrosus.Clinically, this manifests as acute or persistent local pain in the neck (cervicalgia) and stiffness;
- Second degree osteochondrosis of the cervical spine.At this stage, the destruction of the annulus fibrosus continues, pathological mobility and instability of the vertebrae appear.Patients complain of neck pain, aggravated by physical activity, tilting the head or in a certain position;
- The third stage of the disease is characterized by the complete destruction of the annulus fibrosus.The nucleus pulposus is not fixed.Intervertebral hernias can occur, causing severe pain.At this stage, due to poor fixation of the SMS, a spinal curvature may form;
- In the fourth stage of the disease, the intervertebral disc is replaced by connective tissue and other adjacent segments are affected.Spondyloarthrosis and arachnoiditis develop.The joints become completely immobile and ankylosis develops.Bone tissue grows around the affected area – an osteon forms.With the fourth degree of cervical osteochondrosis, clear symptoms are observed: severe pain that radiates to the arm, sternum, to the area between the shoulder blades and sensitivity disorders.
Symptoms and signs
Signs of cervical osteochondrosis in the early stages can be nonspecific: dizziness, headache, weakness, crunching when moving the head.As the disease progresses, the following symptoms appear:
- Severe pain in neck and shoulders;
- Numbness of 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 back muscles and cervical spine:
- Cervical migraine syndrome.
- Vertebral artery syndrome.
- Hypertension syndrome.
- Cardiac syndrome.
- Radicular syndrome.
They occur when nerve endings are injured, 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 disruption of blood flow in the artery supplying the brain and spinal cord.The patient's hearing decreases, vision decreases, and constant dizziness develops.The patient may lose consciousness when moving due to sudden disruption of blood flow.
As a result of compression of the nerves responsible for the innervation of the muscles of the chest and diaphragm, pain appears in the heart region, not associated with heart disease, but tachycardia, arrhythmia and hypotension may develop at the same time.Compression of the veins leads to the development of hypertensive liquor syndrome.Intracranial pressure increases, nausea, vomiting and severe headache appear due to impaired blood flow from the brain.
As a result of neck compression, 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 feels severe pain in the back of the head, 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), and arm pain on one or both sides.Reflex pain, unlike radicular pain, is not accompanied by sensory disturbances.Neck pain can be dull and painful.Acute “flares” of pain are called cervicago.There are muscle spasms and pain, pain in the paravertebral points.Signs of cervical osteochondrosis intensify in an uncomfortable position, when tilting the head, coughing or physical activity.Signs of epicondylosis, glenohumeral periarthrosis and shoulder-hand syndrome appear due to nerve impulses from the annulus fibrosus of the affected segment, which causes compensatory muscle spasms.
Radicular syndromes are accompanied by impaired motor activity and sensitivity.In this case, nerves and blood vessels are violated, venous and lymphatic outflow in the pathological focus is disrupted due to a decrease in the intervertebral canal.The pain associated with radicular syndrome is sharp and intense.A common cause of pinched spinal nerves is the formation of a herniation.In the area of the pathological focus, muscle tone decreases.With radiculoischemia, in addition to nerves, blood vessels are compressed.
If the phrenic nerve is involved in the pathological process, cardiac syndrome occurs.It manifests as burning, sharp pain in the left half of the chest with radiotherapy in the arm and interscapular 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 during angina is that it is relieved after taking nitroglycerin, can occur at rest and is accompanied by interruptions in the heart rhythm (tachycardia, arrhythmia).
Signs of cervical osteochondrosis depend on the localization of the pathological process.When the upper cervical vertebrae are affected, blood supply to the brain is disrupted due to compression of the cerebral arteries.This leads to headaches (especially in the occipital region), dizziness, fainting, and high blood pressure.Dizziness related to cervical osteochondrosis is caused by decreased blood flow to the inner ear.Patients also experience nausea and vestibular and ocular symptoms.
With combined lesions of the vertebrae, we speak of cervicothoracic osteochondrosis.The disease manifests itself by the following symptoms:
- Dizziness;
- Neck and arm pain;
- Sensation of tingling and tingling in the upper limb;
- Intercostal neuralgia.
Diagnosis
Cervical osteochondrosis is a chronic disease that can lead to the formation of hernias and compression of the spinal cord.Therefore, it is important to make an accurate diagnosis in a timely manner and 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 any special preparation.An x-ray of the spine allows its anatomical and functional characteristics to be assessed.In the photo, attention is paid to the structure of the vertebrae, their relationships with each other, the distance between them, the lumen of the spinal canal;
- Computed tomography - provides information primarily on the state of bone tissue, allows you to identify narrowing of the spinal canal and herniated disc;
- Magnetic resonance imaging - allows you to determine changes in soft tissues.The MRI image clearly shows changes in the intervertebral discs and spinal cord.
Drug treatment
Treatment of osteochondrosis of the cervical spine includes drug and non-drug treatment.Even after complete recovery, neurologists take preventive measures to exclude relapses of the disease.In the acute period, for the treatment of cervical osteochondrosis, doctors prescribe drugs to patients belonging to the following pharmacological groups:
- Non-narcotic analgesics.They are taken orally or administered intramuscularly to quickly achieve an effect;
- Non-steroidal anti-inflammatory drugs;
- B vitamins in high doses.
To reduce fluid retention in the spinal root and surrounding tissues, diuretics are used.Antihistamines potentiate the effect of analgesics.Muscle spasms are eliminated by muscle relaxants.In case of intense and prolonged pain, neurologists perform a nerve block.
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.
Anti-dizziness pills
Patients often suffer from dizziness related to cervical osteochondrosis.To reduce them, doctors prescribe nonsteroidal anti-inflammatory drugs.NSAIDs belonging to different groups differ in their mechanism of action and effect, so only a qualified specialist can determine the appropriate drug.
It is important to remember that medications for cervical osteochondrosis cannot be taken without a doctor's prescription.Nonsteroidal anti-inflammatory drugs have side effects, so before prescribing them, the neurologist determines the presence of contraindications in the patient and the required dosage.Medications for dizziness related to cervical osteochondrosis can improve the patient's quality of life.
Injections for osteochondrosis
Injections for osteochondrosis of the cervical spine help relieve pain during exacerbation.With this method of administering the drug, the effect occurs quickly.Neurologists use various injections.
Nurses administer drug solutions subcutaneously, intramuscularly or intravenously.During the period of exacerbation of the disease, drugs administered by injection for cervical osteochondrosis have an exclusively symptomatic effect.
Headache treatment
Headache is a symptom that occurs in various disorders.However, cervical osteochondrosis is characterized by attacks of intense headaches.Head movements increase the symptoms, so to eliminate them, doctors prescribe analgesic tablets and nonsteroidal anti-inflammatory drugs.
Non-drug therapies
Complex non-drug treatment of cervical osteochondrosis of the spine includes:
- Protection mode - if the roots are pinched, patients lie on a hard surface,
- Massage;
- Physiotherapy;
- Spinal traction;
- Physiotherapeutic procedures.
Massage for cervical osteochondrosis is used to reduce pain and swelling, improve peripheral blood supply and eliminate muscle spasms.A contraindication to this procedure is the presence of acute pain.Massage the neck and back in the direction of lymphatic flow.Particular attention is paid to the interscapular and paravertebral areas.
Therapeutic exercises for osteochondrosis of the cervical spine are aimed at eliminating muscle spasms and strengthening the muscle structure.Since instability of the vertebrae often occurs in the cervical spine, the exercise therapy instructor conducts individual classes in which he teaches the patient how to perform exercises safely.Some authors recommend conducting physiotherapy classes with a Shants collar.
To improve the mobility of the cervical vertebrae, rehabilitation experts recommend performing the following exercises:
- Neck flexion and extension.Lean your head toward your sternum without pulling your shoulders forward and then back.Hold the incline for 3 seconds, repeat each exercise 8-10 times;
- The neck turns.Turn your neck first to the left to the stop, then to the right, without changing the position of your shoulders and the level of your chin;
- Lower your head completely.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 neck muscles:
- Place your hand on the back of your head.Tilt your head back, leaning on your hand;
- Place your hand in the temporal region.Bowing your head, resist with your hand;
- Place your hand on your forehead, resisting, tilt your head forward;
- With your right hand, tilt your head to the side, your left hand should be behind your back.Repeat the exercise on the other side.
Autogravity therapy is the correct name for the spinal 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 swelling and eliminate pain, the following physiotherapeutic procedures are used:
- Diadynamic currents.During this procedure, low-frequency currents are applied using a special device, which stimulate the muscles, relieve spasms and pain.They have a positive effect by improving tissue trophism;
- Ultraviolet irradiation.Under the influence of UV rays, vitamin D metabolism improves, calcium content increases and bone tissue becomes stronger;
- Ultrasound exposure - used to accelerate blood flow, antispasmodic and restorative effects.Ultrasound is capable of penetrating deep into tissue;sometimes it is used for better absorption of medicinal substances;
- Amplipulse Therapy – allows you to relieve pain by blocking nerve impulses from the source of the pain.
In the acute period of the disease, which lasts 4-7 days, analgesics, antispasmodics and irritants are used to reduce pain.The patient benefits from rest.Immobilization of the cervical spine is carried out using a Shants collar.Exercise therapy and massage are contraindicated.Ultraviolet radiation is used.
The duration of the subacute period is 29 days.After complete recovery, the patient must 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 relaxants, chondroprotectors, B vitamins, and for pain - analgesics, NSAIDs.Physiotherapy classes and massages are provided.The patient receives physiotherapeutic procedures (amplipulse, exposure to alternating current) and spinal traction is performed.
Food
Proper nutrition for osteochondrosis is an important condition for achieving remission.The progression of cervicothoracic osteochondrosis stops with compliance with the diet and therapeutic measures.Neurologists know how to treat osteochondrosis of the cervical spine.So they create a set of treatment measures, including procedures, exercise therapy, proper nutrition and lifestyle changes.
Many patients turn to neurologists to find out how to treat osteochondrosis of the cervical spine and whether there are any dietary restrictions.Specialists create individual nutritional programs that take into account the patient's preferences.The diet for osteochondrosis is based on balanced foods that are low in fat and rich in nutrients.The patient's daily diet 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 provokes the further development of the disease, so it is best to avoid sleeping in this position.The most optimal positions are on your back and side.
Cervical osteochondrosis progresses while 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 cervicothoracic osteochondrosis, experienced specialists will tell you which bedding is safe for sleeping.
Prevention
To prevent the onset or progression of cervical osteochondrosis, doctors recommend:
- Maintain correct posture;
- Lead an active lifestyle, take breaks from work;
- Do physiotherapy exercises regularly;
- Sleeping on a hard, flat surface, 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 with one hand, this will cause curvature of the spine;
- Lead a healthy lifestyle, eat well, eat plenty of fruits and vegetables;
- Do not sit for a long time with your head down;
- Go swimming.
In order to improve blood circulation, you should regularly undergo therapeutic massages.