Cervical osteochondrosis is a disease that affects the vertebrae and intervertebral discs.Cervical osteochondrosis refers to deforming dorsopathies.Involutional changes in discs are observed even at the age of 20.At the same time, they become more sensitive to stress, become less flexible and lose their lubrication.
Most often, the pathology occurs in the elderly, but now 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 drugs, physiotherapeutic procedures and innovative methods of physical rehabilitation.
The name of the disease consists of two Greek words "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 causes the vertebral bodies to converge and compress the nerve roots and blood vessels.Vertebrates take nutrients from the surrounding tissues, which causes damage to the body.Compression of nerves and blood vessels leads to protective muscle spasm, which causes pain as the disease progresses.
Which doctor treats this disease?
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 choose drugs for cervical osteochondrosis with the least burden on the body, which is important during drug treatment.
The patient is sent for a comprehensive examination to determine the presence of a pathological process in cartilage tissue and cervicobrachial osteochondrosis.According to the results of the research, tactics are being developed on how to treat osteochondrosis of the neck.
Interdisciplinary cooperation also allows treating the patient's comorbidities.In addition, the patient receives full information support: a treatment plan, an extract about the cost of services, consultations with specialists and information about diagnostic measures.
Reasons
Cervical osteochondrosis develops under the influence of various provoking factors.The specific cause of cervical osteochondrosis has not been determined.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.Incorrect shoes, flat feet, obesity and sitting for a long time cause a high load on the spine;
- Metabolic disorders.Deficiency of vitamins, minerals and disturbance of calcium metabolism can cause degenerative processes in the vertebrae;
- Congenital and acquired anomalies of the development of the spine and ligaments (thickening of ligaments, lumbarization, sacralization);
- pathologies of the gastrointestinal tract that cause insufficient absorption of nutrients;
- Infections, intoxication;
- Injuries, bruises, fractures of the spine, as a result, the blood supply and innervation of the spine are disrupted, which causes their degenerative disorders;
- Stress;
- Wearing heels;
- Pregnancy, especially multiple pregnancy;
- Autoimmune connective tissue lesions, pathological structure of type 1 and 2 collagen;
- Occupational hazards (lifting heavy loads, long-term vibration, working in a sitting position with constant tilting 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 family history.This fact proves the presence of osteochondrosis in children who have not yet overloaded the spine.
Degrees
Thanks to the special structure of the spine, it can perform its functions.The basic structural unit is considered to be the motion segment of the spine (SMS).It consists of two adjacent vertebrae, an intervertebral disc and a musculo-ligamentous apparatus.Osteochondrosis first leads to dystrophic-degenerative processes in the intervertebral disc, and then in the vertebra.When one vertebra is damaged, its functions are provided by adjacent ones.This leads to increased load and loss of mobility of the affected segment.
Doctors distinguish several stages in the development of cervical osteochondrosis:
- 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 susceptible to degenerative changes.In the 1st stage of development, osteochondrosis is characterized by the destruction of the pulpous nucleus and cracks in the fibrous ring.Clinically, it manifests as acute or persistent local pain (cervicalgia) and stiffness in the neck;
- Secondary osteochondrosis of the cervical spine.At this stage, the destruction of the fibrous ring continues, pathological mobility and instability of the vertebra appear.Patients complain of pain in the neck, aggravated by physical activity, bending the head or in a certain position;
- The third stage of the disease is characterized by the complete destruction of the fibrous ring.The nucleus pulposus is not stable.Intervertebral tears can occur, causing severe pain.At this stage, spinal curvature may occur due to poor fixation of the SMS;
- 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 - an osteon is formed.With the fourth degree of cervical osteochondrosis, clear symptoms are observed: severe pain and sensitivity disorders spreading to the arm, sternum, and the area between the shoulder blades.
Symptoms and signs
In the initial stages, the symptoms of cervical osteochondrosis can be non-specific: dizziness, headaches, weakness, wheezing when moving the head.As the disease progresses, the following symptoms develop:
- Severe pain in the neck and shoulders;
- Numbness of hands;
- dizziness;
- Increased blood pressure;
- Violation of coordination of movements;
- Increased sweating.
There are several syndromes that appear with the development of the pathological condition of the back and cervical spine muscles:
- Cervical migraine syndrome.
- Vertebral artery syndrome.
- Hypertension syndrome.
- Heart syndrome.
- Radicular syndrome.
They occur during the development of the disease when nerve endings are damaged, arteries and veins are compressed.The most dangerous complication is considered vertebral artery syndrome.There is a violation of blood flow through the artery that supplies the brain and spinal cord.The patient's hearing decreases, vision decreases, constant dizziness develops.Due to a sudden disruption of blood flow, the patient may lose consciousness while moving.
As a result of compression of the nerves responsible for the innervation of the muscles of the chest and diaphragm, pains unrelated to heart disease appear in the heart area, and at the same time tachycardia, arrhythmia and hypotension may develop.Compression of blood vessels leads to the development of hypertensive drinking syndrome.Due to disruption of blood flow from the brain, intracranial pressure increases, nausea, vomiting, and severe headache appear.
As a result of neck compression, radicular syndrome develops - severe pain appears in the neck, shoulders, shoulder blades and back of the head.Arms and neck are numb with this syndrome.With cervical migraine syndrome, the patient experiences 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) and arms on one or both sides.Reflex pain, unlike radicular pain, is not combined with sensory disturbances.Cervicalgia can be dull and painful.Sharp sharp "shoots" of pain are called cervicago.There is muscle spasm and pain, pain in paravertebral points.Cervical osteochondrosis symptoms are aggravated in an uncomfortable position, bending over, coughing or physical activity.Symptoms 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 spasm.
Radicular syndromes are accompanied by impaired motor activity and sensitivity.In this case, nerves and blood vessels are disturbed, as a result of the reduction of the intervertebral canal, venous and lymphatic flow is disturbed in the pathological focus.Pain with radicular syndrome is sharp and intense.A common cause of spinal nerve compression is herniation.Muscle tone decreases in the pathological focus area.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 itself as a burning, sharp pain in the left half of the chest with radiation to the arm and interscapular area.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 disappears after taking nitroglycerin, it can occur at rest and is combined with interruptions in the heart rhythm (tachycardia, arrhythmia).
Symptoms 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 disrupted due to compression of the cerebral vessels.This causes headaches (especially in the occipital region), dizziness, fainting, and increased blood pressure.Dizziness with cervical osteochondrosis is associated with a decrease in blood flow to the inner ear.Patients also have nausea, vestibular and eye symptoms.
They talk about cervicothoracic osteochondrosis with combined damage to the vertebrae.The disease manifests itself with the following symptoms:
- dizziness;
- Pain in neck and arm;
- Tingling, creeping sensation in the upper limb;
- Intercostal neuralgia.
Diagnostics
Cervical osteochondrosis is a chronic disease that can cause herniation and compression of the spinal cord.Therefore, it is important to make an accurate diagnosis and start therapy in time.The following types of instrumental diagnostics are used to determine cervical osteochondrosis:
- Spondylography or radiography of the spine.This research method is painless, highly informative and does not require special preparation.X-ray of the spine allows to assess its anatomical and functional features.In the picture, attention is paid to the structure of the vertebrae, their relationship with each other, the distance between them, the lumen of the spinal canal;
- computed tomography - mainly provides information about the condition of bone tissue, allows to determine the narrowing of the spinal canal and disc herniation;
- Magnetic resonance imaging - allows you to identify changes in soft tissues.The MRI image clearly shows changes in the intervertebral discs and the 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 drugs from the following pharmacological groups to patients:
- Non-narcotic analgesics.To achieve a quick effect, it is taken orally or given intramuscularly;
- non-steroidal anti-inflammatory drugs;
- Large doses of B vitamins.
Diuretics are used to reduce fluid retention in the spinal cord and surrounding tissues.Antihistamines enhance the effect of analgesics.Muscle spasms are relieved with muscle relaxants.For long-lasting severe pain, neurologists perform a nerve block.
Chondroprotectors are used to improve metabolic processes in the intervertebral disc.These preparations increase the content of glycosaminoglycans, increase the strength, elasticity and shock absorption of the intervertebral discs.
Anti-vertigo pills
Patients often experience dizziness with cervical osteochondrosis.To reduce them, doctors prescribe non-steroidal anti-inflammatory drugs.NSAIDs belonging to different groups differ in their mechanism of action and effects, so only a qualified specialist can prescribe the appropriate drug.
It is important to remember that drugs for cervical osteochondrosis cannot be taken without a doctor's prescription.Nonsteroidal anti-inflammatory drugs have side effects, therefore, before prescribing them, the neurologist determines the presence of contraindications in the patient and the necessary dosage.Medicines 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 quickly.Neurologists use different injections.
Nurses administer drug solutions subcutaneously, intramuscularly, or intravenously.In the period of exacerbation of the disease, drugs administered by injection for cervical osteochondrosis have only a symptomatic effect.
Headache treatment
Headache is a symptom that appears with various disorders.However, cervical osteochondrosis is characterized by attacks of severe headaches.Head movements increase symptoms, so doctors prescribe analgesic tablets and non-steroidal anti-inflammatory drugs to relieve them.
Non-drug treatment
Complex non-drug therapy of cervical osteochondrosis of the spine includes:
- Protective mode - if the roots are compressed, patients lie on a hard surface,
- Massage;
- Physical therapy;
- Stretching of the spine;
- Physiotherapy procedures.
Massage for cervical osteochondrosis is used to reduce pain and swelling, improve peripheral blood supply and relieve muscle spasms.A contraindication to performing this procedure is the presence of acute pain.Massage the neck and back in the direction of the lymph flow.Special attention is paid to the interscapular and paravertebral zones.
Therapeutic exercises for osteochondrosis of the cervical spine are aimed at eliminating muscle spasms and strengthening the muscle frame.Since spinal instability often occurs in the cervical spine, an exercise therapy instructor conducts private lessons during which the patient is taught how to perform the exercises safely.Some authors recommend conducting physical therapy classes on Shantz collar.
To improve the mobility of the cervical vertebrae, rehabilitation experts recommend the following exercises:
- Neck flexion and extension.Bend your head forward towards the sternum without pulling your shoulders forward and then back.Hold the slope for 3 seconds, repeat each exercise 8-10 times;
- The neck turns.Without changing the position of your shoulders and the level of your chin, turn your neck first to the left, then to the right until it stops;
- 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 behind your head.Tilt your head back and lean on your hand;
- Place your hand on the temporal region.When bending your head, resist with your hand;
- Put your hand on your forehead, resist, bend your head forward;
- Tilt your head to the side with your right hand, and 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 goal of therapy is to reduce muscle spasm and restore the correct position of the vertebra.To prevent complications, the spine is pulled by a doctor.
The following physiotherapeutic procedures are used to improve the blood supply of the pathological focus, remove swelling and relieve pain:
- Diadynamic currents.During this procedure, low-frequency currents are applied using a special device that stimulates muscles, relieves spasm and pain.They have a positive effect by improving tissue trophism;
- Ultraviolet radiation.Under the influence of UV radiation, vitamin D metabolism improves, calcium content increases, bone tissue strengthens;
- Exposure to ultrasound - used to accelerate blood flow, antispasmodic and reparative effects.Ultrasound is able to penetrate deeply into tissues;sometimes used for better absorption of medicinal substances;
- Amplipulse therapy - allows you to relieve pain by blocking nerve impulses from the source of pain.
Painkillers, spasmolytics, irritants are used to reduce pain during the acute period of the disease lasting 4-7 days.The patient is given 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 should rest for a few 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.Physical therapy courses and massages are provided.Physiotherapy procedures (amplipulse, exposure to alternating current) are given to the patient and spinal traction is performed.
Food
Proper nutrition for osteochondrosis is an important condition for achieving remission.The development of cervicothoracic osteochondrosis is stopped by following dietary and therapeutic measures.Neurologists know how to treat osteochondrosis of the cervical spine, so they create a complex of treatment measures, including procedures, exercise therapy, proper nutrition and lifestyle changes.
Many patients turn to neurologists about how to treat osteochondrosis of the cervical spine and whether there are dietary restrictions.Specialists create individual nutrition programs that take into account the patient's preferences.Diet for osteochondrosis is based on balanced, low-fat foods rich in nutrients.The patient's daily diet includes foods rich in calcium.
How to sleep with cervical osteochondrosis
The issue of how to sleep properly with cervical osteochondrosis is relevant for patients with diseases of the musculoskeletal system.Sleeping on the stomach leads to further development of the disease, so it is better to avoid sleeping in this position.The most optimal positions are on the back and side.
Cervical osteochondrosis progresses during bed rest 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 to sleep on.
Prevention
To prevent the occurrence or development of cervical osteochondrosis, doctors recommend:
- Maintain proper posture;
- Leading an active lifestyle, taking breaks at work;
- Do physical therapy exercises regularly;
- Sleeping on a hard and flat surface, on 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 on one side, this leads to curvature of the spine;
- Leading a healthy lifestyle, eating right, eating plenty of fruits and vegetables;
- Do not sit for a long time with your head down;
- Go swimming.
To improve blood circulation, you should regularly undergo therapeutic massage.