Cervical osteochondrosis is a disease that affects the vertebrae and intervertebral discs. Cervical osteochondrosis refers to deforming dorsopathies. Involuntary changes in the discs are observed as early as 20 years of age. At the same time, they become more sensitive to loads, less elastic and lose lubricating fluid.
The pathology is most common in the elderly, but there is currently a significant increase in incidence among children and adolescents. Neurologists identify cervical osteochondrosis using the latest diagnostic tests. After clarifying the diagnosis, complex therapy is performed 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, decreases in size, this leads to the convergence of the vertebral bodies and disruption of the nerve roots with the vessels. The vertebrae receive nutrients from the surrounding tissues, which is harmful to the body. Compression of the nerves and blood vessels leads to protective muscle spasm, which as the disease progresses causes 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 consult a general practitioner. A neurologist will choose medications for cervical osteochondrosis that have the least stress on the body, which is important for drug therapy.
To determine the presence of a pathological process in the cartilage tissue and cervicobrachial osteochondrosis, the patient is referred for a comprehensive examination. Tactics for the treatment of cervical osteochondrosis are being developed in accordance with the results of research.
Interdisciplinary collaboration also allows for the treatment of comorbidities that the patient has. In addition, the patient receives full information support: treatment plan, service cost statement, provision of information for specialist consultations and diagnostic measures.
Reasons
Cervical osteochondrosis develops under the influence of various provoking factors. No definite cause of cervical osteochondrosis has been identified. The disease is often associated with metabolic disorders and aging of the vertebrae.
The researchers suggest that cervical osteochondrosis develops for the following reasons:
- Excessive stress on the spine. High load on the spine is observed when wearing the wrong shoes, flat feet, obesity, prolonged sitting;
- Metabolic disorders. Deficiency of vitamins, minerals, disorders of calcium metabolism can serve as causes of degenerative processes in the vertebrae;
- Congenital and acquired anomalies of the spine and ligament apparatus (thickening of the ligaments, lumbarization, sacralization);
- Pathologies of the gastrointestinal tract, leading to 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 is disrupted, causing their dystrophic disorders;
- Stress;
- Wearing shoes with heels;
- Pregnancy, especially multiple pregnancy;
- Autoimmune connective tissue lesions, abnormal collagen structure types 1 and 2;
- Occupational hazards (lifting heavy loads, prolonged vibration, working in a sitting position with a constant tilt of the head);
- 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 the burden of heredity. This fact proves the presence of osteochondrosis in children when the spine is not yet congested.
Degrees
Thanks to the special structure of the spine, it is able to perform its functions. The basic structural unit is considered to be a segment of the spine (VMS). It consists of two adjacent vertebrae, the intervertebral disc and the musculoskeletal system. Osteochondrosis leads to dystrophic-degenerative processes, first in the intervertebral disc, then in the vertebrae. With the defeat of a vertebra, the performance of its functions is ensured by neighboring ones. This leads to an increase in 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. Because the intervertebral disc is deprived of its own blood supply and receives nutrients from the surrounding tissues, it is subject to degenerative changes. Osteochondrosis in the 1st stage of development is characterized by destruction of the pulpal nucleus and cracks in the fibrous ring. Clinically, this is manifested by acute or persistent local pain in the neck (cervicalgia) and stiffness;
- Second-degree osteochondrosis of the cervical spine. At this stage, the destruction of annular fibrosis continues, pathological mobility and instability of the vertebrae appear. Patients complain of neck pain, aggravated by exercise, tilting the head or in a certain position;
- The third stage of the disease is characterized by complete destruction of annular fibrosis. The gelatin core is not fixed. Disc herniations can occur and cause severe pain. At this stage, due to poor SMS fixation, 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. Develops spondyloarthritis, arachnoiditis. The joints become completely immobile - ankylosis develops. Bone tissue grows around the affected area - osteon is formed. In the fourth degree of cervical osteochondrosis there are bright symptoms: severe pain that radiates to the arm, sternum, in the area between the shoulder blades, sensitivity disorders.
Symptoms and signs
Signs of cervical osteochondrosis in the initial stages may be nonspecific: dizziness, headache, weakness, crunch during head movements. As the disease progresses, the following symptoms develop:
- Severe pain in the neck and shoulders;
- Numbness in the hand;
- Dizziness;
- High blood pressure;
- Impaired coordination of movements;
- Increased sweating.
There are several syndromes that occur with the development of a pathological condition of the muscles of the back and cervical spine:
- Cervical migraine syndrome.
- Vertebral artery syndrome.
- Hypertensive syndrome.
- Heart 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 spinal artery syndrome. There is a disturbance in blood flow through the artery that feeds the brain and spinal cord. The patient's hearing decreases, vision decreases, constant dizziness develops. The patient may lose consciousness while driving due to a sharp disturbance of blood flow.
As a result of compression of the nerves responsible for the innervation of the muscles of the chest and diaphragm, there is pain in the heart, which is not associated with heart disease, but at the same time tachycardia, arrhythmia and hypotension may develop. Vein compression leads to the development of hypertensive CSF syndrome. The intracranial pressure increases, nausea, vomiting and severe headache appear due to impaired blood flow from the brain.
As a result of compression of the neck, radicular syndrome develops - severe pain appears in the neck, shoulders, shoulders and back of the head. In this syndrome, the area of the arms and neck tingles. In cervical migraine syndrome, the patient is bothered by severe pain in the back of the head, 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), in the hands on one or both sides. Reflex pain, unlike radicular pain, is not combined with sensitivity disorders. Cervical pain can be dull, painful. Acute acute "lumbago" pain is called cervicago. There is spasm and muscle pain, soreness of the paravertebral points. Signs of cervical osteochondrosis are exacerbated in an awkward position, with tilting of the head, cough, exercise. Signs of epicondylosis, humeroscapular periarthrosis and shoulder-arm syndrome appear due to nerve impulses from the annular fibrosis of the affected segment, which causes compensatory muscle spasm.
Radical syndromes are accompanied by impaired motor activity and sensitivity. At the same time the nerves, blood vessels are disturbed, venous and lymphatic outflow in the pathological focus is disturbed as a result of reduction of the intervertebral canal. The pain in radicular syndrome is sharp, intense. A common cause of spinal nerve retention is hernia formation. In the area of pathological focus, muscle tone decreases. In radiculoischemia, in addition to the nerves, the vessels are also compressed.
If the phrenic nerve is involved in the pathological process, cardiac syndrome occurs. Manifested as burning, sharp pain in the left side of the chest with radiation in the arm, interduloid area. 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 the pain of angina pectoris is that it is relieved after taking nitroglycerin, can occur at rest and be combined with interruptions in heart rhythm (tachycardia, arrhythmia).
The signs of cervical osteochondrosis depend on the location of the pathological process. When the upper cervical vertebrae are damaged, the blood supply to the brain is disrupted due to 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 a decrease in blood flow to the inner ear. Patients also experience nausea, vestibular and ocular symptoms.
With a combined vertebral lesion, they speak of cervicothoracic osteochondrosis. The disease manifests itself with the following symptoms:
- Dizziness;
- Pain in the neck and arm;
- Numbness, creeping sensation in the upper limb;
- Intercostal neuralgia.
Diagnosis
Cervical osteochondrosis is a chronic disease that can lead to the formation of a hernia and compression of the spinal cord. That is why it is important to make an accurate diagnosis and start therapy in a timely manner. The following types of instrumental diagnostics are used to identify cervical osteochondrosis:
- Spondylography or X-ray of the spine. This method of examination is painless, highly informative and does not require special training. Spinal radiography allows you to assess its anatomical and functional characteristics. The photo pays attention to the structure of the vertebrae, their connection with each other, the distance between them, the lumen of the spinal canal;
- Computed tomography - provides information mainly about the condition of bone tissue, allows to identify narrowing of the spinal canal and disc herniation;
- Magnetic resonance imaging - allows to determine changes in soft tissues. Magnetic resonance imaging clearly shows changes in the intervertebral discs and spinal cord.
Medication treatment
The treatment of osteochondrosis of the cervical spine consists of drug and non-drug therapy. Even after complete recovery, neurologists take preventive measures to rule out recurrence of the disease. In the acute period for the treatment of osteochondrosis of the cervical spine, doctors prescribe to patients drugs from the following pharmacological groups:
- Non-narcotic analgesics. They are taken orally or injected intramuscularly to quickly achieve the effect;
- Non-steroidal anti-inflammatory drugs;
- B vitamins in large doses.
Diuretics are used to reduce fluid retention in the spinal cord and surrounding tissues. Antihistamines increase the action of analgesics. Muscle spasms are eliminated by muscle relaxants. In the syndrome of prolonged severe pain, neurologists perform a nerve block.
Chondroprotectors are used to improve metabolic processes in the intervertebral disc. These drugs increase the content of glycosaminoglycans, increase the hardness, elasticity and shock absorption of the intervertebral discs.
Dizziness pills
Patients often experience dizziness in cervical osteochondrosis. To reduce them, doctors prescribe nonsteroidal anti-inflammatory drugs. NSAIDs belonging to different groups differ in the mechanism of action and effect, so only a qualified specialist can determine the appropriate drug.
It is important to remember that medications for osteochondrosis of the cervical spine cannot be taken without a doctor's appointment. Non-steroidal anti-inflammatory drugs have side effects, so before prescribing them, the neurologist determines the presence of contraindications in the patient and the required dose. 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 exacerbations. With this method of drug administration, the effect occurs rapidly. Neurologists use different injections.
Nurses inject medicinal solutions subcutaneously, intramuscularly or intravenously. During the exacerbation of the disease, drugs administered by injection with cervical osteochondrosis have an extremely symptomatic effect.
Headache treatment
Headache is a symptom that manifests itself in various disorders. However, cervical osteochondrosis is characterized by attacks of intense headache. Head movements increase symptoms, so doctors prescribe analgesic pills and nonsteroidal anti-inflammatory drugs to eliminate it.
Methods for non-drug therapy
Complex non-drug therapy of cervical osteochondrosis of the spine includes:
- Protective regime - when the roots are pressed, patients lie on a hard surface,
- Massage;
- Physiotherapy exercises;
- Spinal traction;
- Physiotherapeutic procedures.
Massage for cervical osteochondrosis is used to reduce pain and swelling, improve peripheral blood supply and eliminate muscle spasm. Contraindication to this procedure is the presence of acute pain. Massage the neck and back in the direction of lymph flow. Particular attention is paid to the interscapular and paravertebral areas.
Therapeutic gymnastics for osteochondrosis of the cervical spine is aimed at eliminating muscle spasm and strengthening the muscular framework. Because vertebral instability often occurs in the cervical spine, the exercise instructor conducts individual lessons during which he trains the patient to perform the exercises safely. Some authors recommend conducting physical therapy lessons in the Shants collar.
To improve the mobility of the cervical spine, rehabilitation therapists recommend performing the following exercises:
- Flexion and neck extension. Tilt your head forward toward the sternum without pulling your shoulders forward, then back. Hold the slope for 3 seconds, repeat each exercise 8-10 times;
- He turns on his neck. 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;
- Bend your head down until it stops. Then tilt your head back without changing the level of your shoulders. Hold the position for 5 seconds.
The following exercises are designed to strengthen the neck muscles:
- Put your hand on the back of your head. Tilt your head back, leaning on your arm;
- Place your hand in the temporary area. As you tilt your head, resist with your hand;
- Put your hand on your forehead, resisting it, tilt your head forward;
- Tilt your head to the side with your right hand, with your left hand behind your back. Repeat the exercise on the other side.
Autogravity therapy is the exact name of the procedure for traction of the spine. It is performed with the help of special devices. The goal 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.
The following physiotherapeutic procedures are used to improve the blood supply in the pathological focus, relieve swelling and eliminate pain:
- Diadynamic currents. During this procedure, using a special device, low-frequency currents are applied, which stimulate the muscles, relieve spasms and pain. They have a positive effect, improving tissue trophism;
- Ultraviolet radiation. Under the influence of UV radiation, the metabolism of vitamin D improves, the calcium content increases, bone tissue becomes stronger;
- Ultrasound exposure - used to accelerate blood flow, antispasmodic and reparative action. Ultrasound is able to penetrate deep into tissues, sometimes used for better absorption of drugs;
- 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, painkillers, antispasmodics, irritants are used to reduce pain. The patient is provided with peace of mind. Immobilization of the cervical spine is performed using the Shanz collar. Exercise therapy and massage are contraindicated. Apply ultraviolet radiation.
The duration of the subacute period is 29 days. After complete recovery, the patient should rest for a few days. You can then begin a course of rehabilitation therapy. In the chronic course of the disease the patient is prescribed muscle relaxants, chondroprotectors, B vitamins, for pain - analgesics, NSAIDs. Physiotherapy exercises, massage are provided. The patient is discharged from physiotherapy procedures (amplipulse, alternating current exposure), spinal traction is performed.
Food
Proper nutrition in 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, so they make up a set of therapeutic measures, including procedures, exercise, 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 nutrition programs that take into account the patient's preferences. The diet for osteochondrosis is based on a balanced, low-fat diet rich in nutrients. The patient's daily diet includes foods high in calcium.
How to sleep with cervical osteochondrosis
For patients with diseases of the musculoskeletal system, the question of how to sleep properly with cervical osteochondrosis is relevant. Sleeping on your stomach provokes further development of the disease, so it is better to avoid sleeping in this position. The most optimal positions are on the back and sides.
Cervical osteochondrosis progresses while resting in bed with a soft mattress. Therefore, experts recommend giving preference to elastic mattresses, as well as moderately soft pillows. If the patient is diagnosed with cervicothoracic osteochondrosis, experienced specialists will tell you which bed linen is safe for sleep.
Prevention
To prevent the onset or progression of cervical osteochondrosis, doctors recommend:
- Maintain a proper posture;
- Lead an active lifestyle, take breaks from work;
- Do regular physiotherapy exercises;
- Sleep on a hard and 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 leads to bending of the spine;
- Live a healthy lifestyle, eat right, eat lots of fruits and vegetables;
- He does not sit for a long time with his head bowed;
- I'm going to swim.
In order to improve blood circulation, massage therapy should be performed regularly.