Cervical osteochondrosis is a disease that affects the vertebrae and intervertebral discs.Cervical osteochondrosis refers to deforming back pathologies.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.
Very often the pathology occurs in the elderly, 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 drugs, 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, this leads to convergence of the vertebral bodies and pinching of the nerve roots and blood vessels.The vertebrae receive nutrients from surrounding tissues, which cause damage to the body.Compression of the 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?
Treatment of osteochondrosis is the field of activity of neurologists.However, if symptoms of osteochondrosis of the neck appear, you can contact a family doctor.A neurologist will select drugs for cervical osteochondrosis that have the least load 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 comprehensive examination.Tactics on how to treat cervical osteochondrosis are developed in accordance with research findings.
Interdisciplinary collaboration also allows the patient's comorbidities to be treated.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.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.A high load on the spine is observed when wearing the wrong shoes, flat feet, obesity and prolonged sitting;
- Metabolic disorders.Deficiencies of vitamins, minerals and calcium metabolism disorders can cause degenerative processes in the vertebrae;
- Congenital and acquired anomalies of the development of the spinal column and the ligament system (thickening of the ligaments, lumbarization, sacralization);
- Pathologies of the gastrointestinal tract that lead to insufficient absorption of nutrients;
- Infections, intoxication;
- Injuries, bruises, spinal fractures, as a result of which the blood supply and innervation of the spine are disrupted, causing their degenerative disorders;
- Stress;
- Wear high-heeled shoes;
- Pregnancy, especially multiple pregnancy;
- Autoimmune lesions of connective tissue, pathological structure of collagen types 1 and 2;
- Occupational risks (lifting heavy loads, prolonged vibrations, working in a sitting position with constant head inclination);
- 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 demonstrates the presence of osteochondrosis in children when the spine is not yet overloaded.
Degrees
Thanks to the special structure of the spinal column, it is able to perform its functions.The main structural unit is considered the spinal motion 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 ensured by those adjacent to it.This leads to an increase in load and loss of mobility of 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 blood supply and receives nutrients from surrounding tissues, it is susceptible to degenerative changes.Osteochondrosis at the 1st stage of development is characterized by destruction of the nucleus pulposus and cracks in the fibrous ring.Clinically it manifests itself with acute or persistent local pain in the neck (cervicalgia) and stiffness;
- Second degree osteochondrosis of the cervical spine.In this phase, 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 being 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 fixed.Intervertebral hernias can occur and cause severe pain.At this stage, due to poor fixation of the SMS, a spinal curvature may form;
- At 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.With the fourth degree of cervical osteochondrosis, clear symptoms are observed: severe pain radiating to the arm, sternum, the area between the shoulder blades and sensitivity disorders.
Symptoms and signs
Signs of cervical osteochondrosis in the initial stages may be nonspecific: dizziness, headache, weakness, crunching when moving the head.As the disease progresses, the following symptoms develop:
- Severe pain in the neck and shoulders;
- Hand numbness;
- 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 damaged, arteries and veins are compressed during the development of the disease.The most dangerous complication is considered 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 develops.The patient may lose consciousness while moving due to a sudden interruption 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 area, not associated with heart disease, but at the same time tachycardia, arrhythmia and hypotension may 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 violation of blood flow from 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.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 arms on one or both sides.Reflex pain, unlike radicular pain, is not associated with sensory disturbances.Neck pain can be dull and painful.Sharp, 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 doing physical activity.Signs of epicondylosis, glenohumeral periarthrosis and shoulder-hand syndrome appear due to nerve impulses coming from the annulus fibrosus of the affected segment, which cause a compensatory muscle spasm.
Radicular syndromes are accompanied by reduced motor activity and sensitivity.In this case, the nerves and blood vessels are violated, the venous and lymphatic outflow in the pathological focus is disrupted due to a decrease in the intervertebral canal.The pain with radicular syndrome is sharp and intense.A common cause of spinal nerve pinching is hernia formation.In the area of the pathological focus, muscle tone decreases.With radiculoischemia, in addition to the nerves, the blood vessels are compressed.
If the phrenic nerve is involved in the pathological process, cardiac syndrome occurs.It manifests itself as a sharp, burning pain in the left half of the chest with radiation 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 disruptions of 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 leads to headaches (especially in the occipital region), dizziness, fainting and hypertension.Dizziness with cervical osteochondrosis is caused by a decrease in blood flow to the inner ear.Patients also experience nausea and vestibular and ocular symptoms.
With combined damage to the vertebrae, they talk about cervicothoracic osteochondrosis.The disease manifests itself with the following symptoms:
- Dizziness;
- Neck and arm pain;
- Tingling and tingling sensation in 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 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 on the condition 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.
Pharmacological treatment
Treatment of osteochondrosis of the cervical spine consists of pharmacological and non-pharmacological 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 to patients from the following pharmacological groups:
- Non-narcotic analgesics.They are taken orally or administered intramuscularly to quickly obtain an effect;
- Non-steroidal anti-inflammatory drugs;
- B vitamins in large doses.
To reduce fluid retention in the spinal root area and surrounding tissues, diuretics are used.Antihistamines enhance the effect of analgesics.Muscle spasms are eliminated by muscle relaxants.In cases 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.
Pills against dizziness
Patients often feel dizziness with 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 drugs 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.Drugs 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 drug administration, 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 with various disorders.However, cervical osteochondrosis is characterized by attacks of intense headache.Head movements increase symptoms, so to eliminate them, doctors prescribe analgesic tablets and nonsteroidal anti-inflammatory drugs.
Non-pharmacological therapies
Complex non-drug therapy for cervical osteochondrosis of the spine includes:
- Protective mode: if the roots are pinched, patients lie on a hard surface,
- Massage;
- Physical therapy;
- Spinal traction;
- Physiotherapy procedures.
Massage for cervical osteochondrosis is used to reduce pain and swelling, improve peripheral blood supply and eliminate 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.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 physical therapy instructor conducts individual lessons, during 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.Bend your head forward towards 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 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 were developed to strengthen the neck muscles:
- Place your hand on the back of your head.Tilt your head back, resting it on your hand;
- Place your hand in the temporal region.As you tilt your head, resist with your hand;
- Place your hand on your forehead, holding on, 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 hand.
Self-gravity therapy is the exact name of the spinal 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 to the pathological focus, relieve swelling and eliminate pain, the following physiotherapeutic procedures are used:
- Diadynamic currents.During this procedure, using a special device, low-frequency currents are applied that stimulate the muscles, relieve spasms and pain.They act positively by improving tissue trophism;
- Ultraviolet irradiation.Under the influence of UV rays, vitamin D metabolism improves, calcium content increases, bone tissue becomes stronger;
- Ultrasound exposure - used to accelerate blood flow, antispasmodic and restorative effects.Ultrasound is able to penetrate deep into tissues;sometimes it is used for better absorption of medicinal substances;
- Amplipulse therapy: allows you to relieve pain by blocking nerve impulses coming from the source of the pain.
In the acute period of the disease, which lasts 4-7 days, painkillers, antispasmodics and irritants are used to reduce pain.The patient is given rest.Immobilization of the cervical spine is carried out using a Shants collar.Physical 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 analgesics, NSAIDs.Physiotherapy and massage courses are provided.The patient is subjected to 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 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 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 correctly with cervical osteochondrosis is relevant.Sleeping on your stomach causes 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 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 bed 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 at work;
- Do physiotherapy exercises regularly;
- Sleep 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 on one hand, this leads to curvature of the spine;
- Lead a healthy lifestyle, eat well, eat lots of fruit and vegetables;
- Don't sit for a long time with your head bowed;
- Go swimming.
To improve blood circulation, you should regularly undergo therapeutic massage.