Cervical osteochondrosis is a disease in which the vertebrae and intervertebral discs are affected. Cervical osteochondrosis refers to deforming back diseases. Involutionary changes in the discs have been observed as early as the age of 20. 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 there is currently a significant increase in the incidence among children and adolescents. Neurologists identify cervical osteochondrosis using the latest diagnostic studies. After clarifying the diagnosis, complex therapy is performed with the most effective drugs, 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, decreases in size, this 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 are harmful to the body. Compression of the nerves and blood vessels leads to a protective muscle spasm which, as the disease progresses, becomes the cause of the pain.
Which doctor treats this disease
Treatment of osteochondrosis is the field of activity of neurologists. However, when symptoms of osteochondrosis of the neck appear, a general practitioner can be consulted. A neurologist will select cervical osteochondrosis drugs that have the least stress on the body, which is important for drug therapy.
To determine the presence of a pathological process in cartilage tissue and cervicobrachial osteochondrosis, the patient is referred for a comprehensive examination. Tactics on how to treat cervical osteochondrosis are being developed in accordance with the results of research.
The interdisciplinary collaboration also allows the treatment of the patient's comorbidities. In addition, the patient receives 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 a variety of provoking factors. No definite 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 position;
- Metabolic disorders. Deficiency of vitamins, minerals, disorders of calcium metabolism can serve as the cause 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 are disrupted, causing their dystrophic disorders;
- Fatigue;
- Wear shoes with heels;
- Pregnancy, especially multiple pregnancies;
- Autoimmune lesions of connective tissue, abnormal structure of collagen types 1 and 2;
- Occupational hazards (lifting heavy loads, prolonged vibrations, working in a sitting position 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 burdened heredity. 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 to be the spinal motion segment (VMS). It consists of two adjacent vertebrae, an intervertebral disc and a musculo-ligament apparatus. Osteochondrosis leads to dystrophic-degenerative processes, first in the intervertebral disc, then in the vertebra. With the defeat of one vertebra, the performance of its functions is provided by adjacent 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. 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 fibrous ring. Clinically it 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, head tilt or a certain position
- The third stage of the disease is characterized by complete destruction of the fibrous ring. The gelatinous core 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;
- At the fourth stage of the disease, the intervertebral disc is replaced by connective tissue, other adjacent segments are affected. Spondyloarthrosis, arachnoiditis develops. The joints become completely immobile - ankylosis develops. Bone tissue grows around the affected area - an osteone is formed. With the fourth degree of cervical osteochondrosis, vivid symptoms are observed: severe pain radiating to the arm, sternum, area between the shoulder blades, sensitivity disorders.
Symptoms and signs
Signs of cervical osteochondrosis in the initial stages can be nonspecific: dizziness, headache, weakness, crunching during head movements. 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 injured, arteries and veins are squeezed during the development of the disease. The most dangerous complication is considered to be the 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. The patient may lose consciousness while driving due to a sharp violation of blood flow.
As a result of compression of the nerves responsible for innervation of the muscles of the chest and diaphragm, pain appears in the region of the heart, which is 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 cerebrospinal fluid syndrome. Increases in intracranial pressure, nausea, vomiting and severe headache appear due to impaired outflow of blood from the brain.
As a result of squeezing 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. With cervical migraine syndrome, the patient is concerned 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 root pain, is not combined with sensitivity disorders. Neck pain can be dull, sore. The sharp and acute pain of "low back pain" is called cervicago. There is a spasm and muscle pain, pain of the paravertebral points. Signs of cervical osteochondrosis intensify in an uncomfortable position, with head tilt, cough, physical exertion. Signs of epicondylosis, humeroscapular 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 reduced motor activity and sensitivity. At the same time, the nerves, blood vessels are impaired, the 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 entrapment is the formation of hernias. 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, heart syndrome occurs. It manifests itself as sharp, burning pain in 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 pectoris is that it is relieved after taking nitroglycerin, can occur at rest, and is combined with heart rhythm disruptions (tachycardia, arrhythmia).
Signs of cervical osteochondrosis depend on the localization of the pathological process. With damage to the upper cervical vertebrae, the blood supply to the brain is cut off due to compression of the cerebral arteries. This leads to headaches (especially in the occipital region), dizziness, fainting, hypertension. Dizziness with cervical osteochondrosis is caused by a decrease in blood flow to the inner ear. Patients are also worried about nausea, vestibular and ocular symptoms occur.
With a combined lesion of the vertebrae, they speak of cervicothoracic osteochondrosis. The disease manifests itself with the following symptoms:
- Dizziness;
- Pain in the neck and arm
- Tingling, creeping sensation on the upper limb;
- Intercostal neuralgia.
Diagnostics
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 establish an accurate diagnosis in a timely manner and start 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 specific training. An x-ray of the spinal column allows to evaluate its anatomical and functional characteristics. In the photo, the focus is on 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 the bone tissue, allows you to identify a narrowing of the spinal canal and a herniated disc;
- MRI - allows you to determine changes in soft tissues. The MRI image clearly shows the changes in the intervertebral discs and spinal cord.
Pharmacological treatment
Treatment of osteochondrosis of the cervical spine consists of drug and non-drug therapy. Even after a complete cure, neurologists take preventive measures to rule out relapses of the disease. In the acute period, for the treatment of osteochondrosis of the cervical spine, doctors prescribe to patients drugs of the following pharmacological groups:
- Non-narcotic analgesics. They are taken orally or injected intramuscularly to get the effect quickly;
- Non-steroidal anti-inflammatory drugs;
- Vitamins of group B in large doses.
Diuretics are used to reduce fluid retention in the spinal root and surrounding tissues. Antihistamines enhance the action of analgesics. Muscle spasms are eliminated by muscle relaxants. With prolonged severe pain syndrome, 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.
Dizziness 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 the mechanism of action and effect, so 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. Non-steroidal 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 vertigo 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 drug administration, 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 that are administered by injection, with cervical osteochondrosis, have an exclusively symptomatic effect.
Headache treatment
Headache is a symptom that manifests itself with various ailments. However, cervical osteochondrosis is characterized by bouts of intense headache. Head movements increase the symptoms, therefore, to eliminate it, doctors prescribe analgesic tablets and non-steroidal anti-inflammatory drugs.
Methods of non-drug therapy
Non-drug complex therapy of cervical osteochondrosis of the spine includes:
- Protective mode: when the roots are pinched, patients lie on a hard surface,
- Massage;
- Physiotherapy exercises;
- spinal traction;
- Physiotherapy procedures.
Cervical osteochondrosis massage is used to reduce pain and swelling, improve peripheral blood supply, and eliminate muscle spasm. A contraindication to performing this procedure is the presence of acute pain. Massage the neck and back in the direction of the outflow of the lymph. 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 muscle structure. Since instability of the vertebrae often occurs in the cervical spine, the physical therapy instructor conducts individual classes, during which he teaches the patient to perform the exercises safely. Some authors recommend conducting physical therapy classes in the Shants collar.
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 incline for 3 seconds, repeat each exercise 8-10 times;
- Turns of the neck. Turn the 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 shoulder level. Hold the position for 5 seconds.
The following exercises have been developed to strengthen the neck muscles:
- Put your hand on the back of your neck. Tilt your head back, resting on your hand;
- Put your hand in the temporal region. By tilting your head, resist with your hand;
- Put your hand on your forehead, resisting, 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 spine traction procedure. It is performed using 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.
To improve blood supply in the pathological focus, relieve swelling and eliminate pain, the following physiotherapeutic procedures are used:
- Diadynamic currents. During this procedure, using a special apparatus, low-frequency currents are applied, which stimulate the muscles, relieve spasms and pain. They have a positive effect, improving tissue trophism;
- Ultraviolet irradiation. Under the influence of UV radiation, the metabolism of vitamin D improves, the calcium content increases, the 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: Relieves 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 endowed with peace. Immobilization of the cervical spine is performed using the Shants collar. Physical therapy and massage are contraindicated. Apply ultraviolet radiation.
The duration of the subacute period is 29 days. After complete recovery, the patient must rest for several days. Then you can start a rehabilitation therapy course. In the chronic course of the disease, the patient is prescribed muscle relaxants, chondroprotectors, vitamins of group B, for pain - analgesics, NSAIDs. Physiotherapy exercises, massages are provided. The patient is released physiotherapeutic procedures (amplipulse, exposure to alternating current), spinal traction is performed.
Food
Proper nutrition for osteochondrosis is an important condition for achieving remission. Progression of cervicothoracic osteochondrosis stops with diet and treatment. Neurologists know how to treat osteochondrosis of the cervical spine, therefore, they constitute a complex of therapeutic measures, including procedures, physical 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 dietary restrictions. Specialists create individual nutritional programs that take into account the patient's preferences. The osteochondrosis diet is based on balanced, low-fat and nutrient-rich foods. 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 properly with cervical osteochondrosis is relevant. Sleeping on your stomach causes further development of the disease, so it is best to avoid sleeping in this position. The most optimal positions are on the back and to the side.
Cervical osteochondrosis progresses while resting on a bed with a soft mattress. Therefore, experts recommend giving preference to elastic mattresses and moderately soft pillows. If a patient is diagnosed with cervicothoracic 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 proper posture;
- Lead an active lifestyle, take breaks at work;
- Regularly do physiotherapy exercises;
- Sleeping on a solid 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 a flexion of the spine;
- Lead a healthy lifestyle, eat well, eat lots of fruits and vegetables;
- He does not sit for long with his head tilted;
- Go swimming.
In order to improve blood circulation, massage therapy should be done regularly.