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 as early as 20 years of age.At the same time, they become more sensitive to stress, less elastic and lose lubricating fluid.
Most often, the pathology occurs in the elderly, but currently there is a significant increase in incidence among children and young people.Neurologists identify cervical osteochondrosis using the latest diagnostic tests.After clarifying the diagnosis, complex therapy is carried out using the most effective medications, physiotherapeutic 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 and decreases in size, which leads to convergence of the vertebral bodies and compression of the nerve roots and blood vessels.The vertebrae receive nutrients from the surrounding tissues, which causes damage to the body.Compression of nerves and blood vessels leads to protective muscle spasm which, as the disease progresses, becomes the cause of pain.
Which doctor treats this disease?
The treatment of osteochondrosis is the area of activity of neurologists.However, if symptoms of cervical osteochondrosis appear, you can contact a general practitioner.A neurologist will select medications for cervical osteochondrosis that have the least burden on the body, which is important during drug therapy.
To determine the presence of a pathological process in the cartilaginous tissue and cervicobrachial osteochondrosis, the patient is sent for a complete examination.Tactics on how to treat cervical osteochondrosis are being developed in accordance with research results.
Interdisciplinary collaboration also makes it possible to treat patient comorbidities.In addition, the patient receives full informational support: treatment plan, statement of the cost of services, information about 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.Often the disease is associated with metabolic disorders and aging of the vertebrae.
Researchers suggest that cervical osteochondrosis develops for the following reasons:
- Excessive load on the spine.There is a high load on the spine with the use of incorrect shoes, flat feet, obesity and prolonged sitting;
- Metabolic disorders.Deficiency of vitamins, minerals and calcium metabolism disorders 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 that lead to insufficient absorption of nutrients;
- Infections, intoxication;
- Injuries, bruises, fractures of the spine, as a result of which the blood supply and innervation of the spine is interrupted, which causes its degenerative disorders;
- Stress;
- Wear shoes with heels;
- Pregnancy, especially multiple pregnancies;
- Autoimmune lesions of connective tissue, pathological structure of collagen types 1 and 2;
- Occupational risks (lifting heavy loads, prolonged vibration, working while sitting with constant head tilt);
- Atherosclerotic and other changes in the vertebral arteries;
- Curvature of the spine (kyphosis, scoliosis, kyphoscoliosis).
An important risk factor for the development of cervical osteochondrosis is family history.This fact proves the presence of osteochondrosis in children when the spine is not yet overloaded.
Degrees
Thanks to the special structure of the spine, it is able to perform its functions.The main structural unit is considered the spinal movement segment (SMS).It consists of two adjacent vertebrae, an intervertebral disc and a musculoligamentous apparatus.Osteochondrosis leads to dystrophic-degenerative processes, first in the intervertebral disc, then in the vertebra.When a vertebra is damaged, its functions are provided by adjacent ones.This leads to increased load and loss of mobility in the affected segment.
Doctors distinguish several stages in the development of cervical osteochondrosis:
- First degree of cervical osteochondrosis.Because 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 fibrous ring.Clinically, it 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 fibrous ring 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 complete destruction of the fibrous ring.The nucleus pulposus is not fixed.Intervertebral hernias can occur, which cause severe pain.At this stage, due to poor fixation of the SMS, curvature of the spine may occur;
- 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 - ankylosis develops.Bone tissue grows around the affected area - osteon is formed.In the fourth degree of cervical osteochondrosis, clear symptoms are observed: intense pain that radiates to the arm, sternum, the area between the shoulder blades and sensitivity disorders.
Symptoms and signs
Signs of cervical osteochondrosis in the early stages can be nonspecific: dizziness, headaches, weakness, clicking sounds 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.
- 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 an interruption of blood flow through the artery that supplies the brain and spinal cord.The patient's hearing decreases, vision decreases and constant dizziness appears.The patient may lose consciousness while moving due to a sudden interruption in blood flow.
As a result of compression of the nerves responsible for innervating the muscles of the chest and diaphragm, pain appears in the region of the heart, not associated with heart disease, but at the same time tachycardia, arrhythmia and hypotension can develop.Compression of the veins leads to the development of hypertensive liquor syndrome.Increases in intracranial pressure, 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 area become numb.In cervical migraine syndrome, the patient feels severe pain in the back of the head, which is usually accompanied by nausea and vomiting.
Reflex syndromes occur when the spinal roots have not yet been affected.Patients complain of pain in the neck, head (especially the back of the head) and arms on one or both sides.Reflex pain, unlike radicular pain, is not combined with sensory disturbances.Neck pain can be uncomfortable and painful.The sharp “shoots” of pain are called cervicago.There is muscle spasm and pain, pain in the paravertebral points.Signs of cervical osteochondrosis intensify in an uncomfortable position, when tilting the head, coughing or performing physical activity.Signs of epicondylosis, glenohumeral periarthrosis and shoulder-hand syndrome appear due to nerve impulses from the fibrous ring of the affected segment, which causes compensatory muscle spasm.
Radicular syndromes are accompanied by impaired motor activity and sensitivity.In this case, the nerves and blood vessels are violated, the venous and lymphatic flow in the pathological focus is disrupted as a result of the narrowing of the intervertebral canal.The pain in radicular syndrome is sharp and intense.A common cause of pinched spinal nerves is the formation of a hernia.In the area of the pathological focus, muscle tone decreases.In 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 sharp, burning pain in the left half of the chest, radiating to 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 angina attack.The main difference between pain during angina pectoris is that it is relieved after taking nitroglycerin, can occur at rest and is combined with interruptions in the heart rhythm (tachycardia, arrhythmia).
Signs of cervical osteochondrosis depend on the location of the pathological process.When the upper cervical vertebrae are affected, the blood supply to the brain is interrupted due to compression of the cerebral arteries.This causes headaches (especially in the occipital region), dizziness, fainting and high blood pressure.Dizziness in cervical osteochondrosis is caused by a decrease in blood flow to the inner ear.Patients also present with nausea and vestibular and ocular symptoms.
With combined damage to the vertebrae, one speaks of cervicothoracic osteochondrosis.The disease is manifested by the following symptoms:
- Dizziness;
- Neck and arm pain;
- Tingling and crawling sensation 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 timely establish an accurate diagnosis and begin therapy.To identify cervical osteochondrosis, the following types of instrumental diagnostics are used:
- Spondylography or x-ray of the spine.This research method is painless, highly informative and does not require special preparation.An x-ray of the spine allows you to evaluate its anatomical and functional characteristics.In the photo, 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 about 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 consists of drug and non-drug therapy.Even after complete recovery, neurologists carry out preventive measures to exclude relapses of the disease.In the acute period, for the treatment of cervical osteochondrosis, doctors prescribe patients medications from the following pharmacological groups:
- Non-narcotic analgesics.They are taken orally or intramuscularly to take effect quickly;
- Nonsteroidal anti-inflammatory drugs;
- B vitamins in large doses.
To reduce fluid retention in the spinal root region and surrounding tissues, diuretics are used.Antihistamines enhance the effect of analgesics.Muscle spasms are eliminated by muscle relaxants.For prolonged severe 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 intervertebral discs.
Anti-dizziness pills
Patients often experience 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 medicine.
It is important to remember that medications for cervical osteochondrosis cannot be taken without a prescription.Non-steroidal anti-inflammatory drugs have side effects, therefore, before prescribing them, the neurologist determines the presence of contraindications in the patient and the necessary dosage.Medications for dizziness in cervical osteochondrosis can improve the patient's quality of life.
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 several injections.
Nurses administer medication solutions subcutaneously, intramuscularly, or intravenously.During the period of exacerbation of the disease, injectable medications for cervical osteochondrosis have an exclusively symptomatic effect.
Headache treatment
Headache is a symptom that occurs with several disorders.However, cervical osteochondrosis is characterized by attacks of severe headaches.Head movements increase symptoms, so to eliminate them, doctors prescribe analgesic tablets and non-steroidal anti-inflammatory drugs.
Non-drug therapies
Complex non-drug therapy for cervical osteochondrosis of the spine includes:
- Protection mode - if the roots are pinched, patients lie down 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 for carrying out this procedure is the presence of acute pain.Massage the neck and back in the direction of the lymph exit.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 muscular structure.Since instability of the vertebrae in the cervical spine often occurs, the physical therapy instructor teaches individual classes, during which he teaches the patient how to perform the exercises safely.Some authors recommend carrying out physiotherapy classes using a Shants collar.
To improve the mobility of the cervical vertebrae, rehabilitation experts recommend performing the following exercises:
- Flexion and extension of the neck.Tilt your head forward toward your sternum without pulling your shoulders forward and then back.Hold the incline for 3 seconds, repeat each exercise 8 to 10 times;
- Neck turns.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 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, supporting yourself with your hand;
- Place your hand on the temporal region.When tilting 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 exact name of the spinal traction procedure.It is carried out using special devices.The aim of therapy is to reduce muscle spasm and restore the correct position of the vertebrae.To avoid complications, spinal traction is performed by a doctor.
To improve the 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 through a special device, which stimulates the muscles, relieves spasms and pain.They have a positive effect by improving tissue trophism;
- Ultraviolet irradiation.Under the influence of UV radiation, vitamin D metabolism improves, calcium content increases, bone tissue becomes stronger;
- Ultrasound exposure - used to accelerate blood flow, antispasmodic and reparative effects.Ultrasound is capable of penetrating deep into tissues;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 pain.
In the acute period of the disease, which lasts 4 to 7 days, analgesics, antispasmodics and irritants are used to reduce pain.The patient receives rest.Immobilization of the cervical spine is performed 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.In 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, therefore they create a complex of treatment measures, including procedures, exercise therapy, proper nutrition and lifestyle changes.
Many patients turn to neurologists with the question of 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, 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 causes the disease to develop further, so it is best to avoid sleeping in this position.The most ideal positions are on the back and sides.
Cervical osteochondrosis progresses while you rest 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 bed is safe to sleep on.
Prevention
To prevent the occurrence or progression of cervical osteochondrosis, doctors recommend:
- Maintain correct posture;
- Lead an active lifestyle, take breaks from work;
- Do physical therapy exercises regularly;
- Sleep on a hard, flat surface, mattress and orthopedic pillow;
- Get rid of bad habits, especially smoking;
- Choose footwear taking into account the physiological structure of the foot;
- Do not carry bags in one hand, as this causes curvature in the spine;
- Lead a healthy lifestyle, eat well, eat lots of fruits and vegetables;
- Don't sit for a long time with your head down;
- Go swimming.
To improve blood circulation, you should have therapeutic massages regularly.