Cervical osteochondrosis is a disease that affects the vertebrae and intervertebral discs.Cervical osteochondrosis refers to deforming dorsopathies.The involutional changes in the discs can already be observed at the age of 20.At the same time, they become more sensitive to stress, less flexible and lose their lubricating fluid.
Most often, the pathology occurs in the elderly, but currently the incidence has increased significantly among children and young people.Neurologists use the latest diagnostic tests to identify cervical osteochondrosis.After clarifying the diagnosis, complex therapy is carried out with the most effective drugs, physiotherapy 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 leads to convergence of the vertebral bodies, pinching of nerve roots and blood vessels.The vertebrae receive nutrients from the surrounding tissue, which damages 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?
The treatment of osteochondrosis is the field of activity of neurologists.However, if symptoms of cervical osteochondrosis appear, consult a family doctor.The neurologist selects drugs 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 cartilage tissue and cervicobrachial osteochondrosis, the patient is sent for a comprehensive examination.The tactics of treatment of cervical osteochondrosis are developed in accordance with the research results.
Interdisciplinary cooperation also enables the treatment of the patient's comorbidities.In addition, the patient receives complete information: a treatment plan, a summary of the costs of the services, information about the specialist consultation and diagnostic measures.
Reasons
Cervical osteochondrosis develops as a result of various provoking factors.The specific cause of cervical osteochondrosis has not been identified.The disease is often associated with metabolic disorders and aging of the vertebrae.
According to researchers, cervical osteochondrosis develops for the following reasons:
- Excessive load on the spine.A high load on the spine can be observed when wearing the wrong shoes, flat feet, obesity and prolonged sitting;
- Metabolic disorders.Lack of vitamins and minerals and disturbances in 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 lead to insufficient absorption of nutrients;
- Infections, poisoning;
- Injuries, bruises, spinal fractures, as a result of which the blood supply and innervation of the spinal column are disturbed, which causes their degenerative disorders;
- Tension;
- Wearing heels;
- Pregnancy, especially multiple pregnancy;
- Autoimmune connective tissue changes, pathological structure of type 1 and type 2 collagen;
- Occupational hazards (lifting heavy loads, prolonged vibration, work in a sitting position with constant head tilt);
- Atherosclerotic and other changes in the vertebral arteries;
- Curvature of the spine (kyphosis, scoliosis, kyphoscoliosis).
Family history is an important risk factor for the development of cervical osteochondrosis.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 the spinal motion segment (SMS).It consists of two adjacent vertebrae, an intervertebral disc and a musculo-ligamentous apparatus.Osteochondrosis leads to dystrophic-degenerative processes, first in the intervertebral disc and then in the vertebra.If one of the vertebrae is damaged, its functions are performed by the adjacent vertebrae.This leads to increased load on the affected segment and loss of mobility.
Doctors distinguish several stages of the development of cervical osteochondrosis:
- The first stage 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 first stage of development, osteochondrosis is characterized by the destruction of the nucleus pulposus and cracks in the fibrous ring.Clinically, this manifests as acute or persistent local pain in the neck (cervicalgia) and stiffness;
- Second-degree osteochondrosis of the cervical spine.In this stage, the destruction of the fibrous ring continues, pathological mobility and instability of the vertebrae appear.Patients complain of neck pain, which is aggravated by physical activity, tilting 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 fixed.Intervertebral hernias can occur, causing severe pain.At this stage, due to poor fixation of the SMS, a curvature of the spine may develop;
- 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 that radiates to the arm, sternum, to the area between the shoulder blades, and sensitivity disorders.
Symptoms and signs
Signs of cervical osteochondrosis in the initial stage may be non-specific: dizziness, headache, weakness, crunching when moving the head.As the disease progresses, the following symptoms appear:
- Severe pain in the neck and shoulders;
- Numbness of the hand;
- Dizziness;
- Increased blood pressure;
- Disturbance of coordination of movements;
- Increased sweating.
Several syndromes occur with the development of pathological conditions of the muscles of the back and cervical spine:
- Cervical migraine syndrome.
- Vertebral artery syndrome.
- Hypertensive syndrome.
- Cardiac syndrome.
- Radicular syndrome.
They occur when, during the development of the disease, nerve endings are damaged, arteries and veins are compressed.The most dangerous complication is vertebral artery syndrome.Blood flow through the artery supplying the brain and spinal cord is interrupted.The patient's hearing and vision decrease, constant dizziness develops.The patient may lose consciousness while moving due to a sudden disruption of blood flow.
As a result of compression of the nerves responsible for innervating the muscles of the chest and diaphragm, pain unrelated to heart disease occurs in the area of the heart, and at the same time tachycardia, arrhythmia, and hypotension may develop.Compression of the veins leads to the development of hypertensive liquor syndrome.Intracranial pressure increases, nausea, vomiting and severe headache occur due to disruption of cerebral blood flow.
As a result of compression of the neck, radicular syndrome develops - severe pain occurs in the neck, shoulders, shoulder blades and back of the head.With this syndrome, the arms and neck area become numb.In the case of cervical migraine syndrome, the patient feels severe pain in the back of the head, which is often accompanied by nausea and vomiting.
Reflex syndromes occur when the roots of the spine 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.Unlike radicular pain, reflex pain is not associated with sensory disturbances.Cervicalgia can be dull and painful.Acute sharp "shoots" of pain are called cervicago.Muscle spasm and pain, pain in paravertebral points.The signs of cervical osteochondrosis intensify in an uncomfortable position, when tilting the head, when coughing or during physical activity.Signs of epicondylosis, glenohumeral periarthrosis, and shoulder-hand syndrome occur as a result of nerve impulses from the annulus fibrosus of the affected segment causing compensatory muscle spasm.
Radicular syndromes are accompanied by impaired motor activity and sensitivity.In this case, the nerves and blood vessels are damaged, the venous and lymphatic outflow in the pathological focus is interrupted due to the reduction of the intervertebral canal.The pain associated with radicular syndrome is acute 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 the case of radiculoischaemia, the blood vessels are compressed next to the nerves.
If the phrenic nerve is involved in the pathological process, a cardiac syndrome occurs.It manifests itself as a burning, acute pain in the left side of the chest, with radiation to the arm and the 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 the pain during angina pectoris is that it is relieved after taking nitroglycerin, it can also occur at rest, and it is combined with interruption of the heart rhythm (tachycardia, arrhythmia).
Signs of cervical osteochondrosis depend on the location of the pathological process.In the case of involvement of the upper cervical vertebrae, 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 high blood pressure.Dizziness associated with cervical osteochondrosis is caused by a decrease in blood flow to the inner ear.Patients also experience nausea and vestibular and ophthalmic symptoms.
With the combined damage of the vertebrae, they speak of cervicothoracic osteochondrosis.The disease is manifested by 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 lead to herniation and compression of the spinal cord.Therefore, it is important to make an accurate diagnosis in time 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, extremely informative and does not require special preparation.X-rays of the spine allow the assessment of its anatomical and functional characteristics.In the picture, 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 - primarily provides information on the state of the bone tissue, enables the identification of spinal canal narrowing and disc herniation;
- Magnetic resonance imaging - makes it possible to determine changes in soft tissues.The MRI image clearly shows the lesions of 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 relapse of the disease.In the acute period, for the treatment of cervical osteochondrosis, doctors prescribe drugs for patients belonging to the following pharmacological groups:
- Non-narcotic pain relievers.It is administered orally or intramuscularly to achieve a rapid effect;
- Nonsteroidal anti-inflammatory drugs;
- B vitamins in large doses.
Diuretics are used to reduce fluid retention in the spinal root and surrounding tissues.Antihistamines increase the effect of pain relievers.Myalgia is eliminated by muscle relaxants.In case of prolonged severe pain, neurologists perform a nerve block.
To improve the metabolic processes of the intervertebral disc, chondroprotectors are used.These drugs increase the content of glycosaminoglycans, increase the tension, elasticity and shock-absorbing capacity of the intervertebral discs.
Anti-vertigo pills
Patients often experience dizziness in cervical osteochondrosis.To reduce these, 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 determine the appropriate drug.
It is important to remember that drugs for the treatment of 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 dose.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 exacerbation.With this method of drug administration, the effect appears quickly.Neurologists use various injections.
The nurses administer the drug solutions subcutaneously, intramuscularly or intravenously.In the period of exacerbation of the disease, drugs administered by injection for the treatment of cervical osteochondrosis have only a symptomatic effect.
Headache treatment
Headache is a symptom of various disorders.However, attacks of intense headache are characteristic of cervical osteochondrosis.Head movements increase the symptoms, so doctors prescribe painkillers and non-steroidal anti-inflammatory drugs to relieve them.
Non-drug therapies
Complex non-drug therapy for cervical osteochondrosis of the spine includes:
- Protective mode - if the roots are trapped, patients lie on a hard surface,
- Massage;
- Physiotherapy;
- Traction of spine;
- Physiotherapy procedures.
Massage of cervical osteochondrosis is used to reduce pain and swelling, improve peripheral blood supply and eliminate muscle spasms.A contraindication to the procedure is the presence of acute pain.Massage the neck and back in the direction of the outflow of lymph.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 muscular skeleton.Because vertebral instability often occurs in the cervical spine, the physical therapy instructor holds individual lessons to teach the patient how to perform the exercises safely.Some authors recommend that physical therapy classes be held in a Shants collar.
In order to improve the mobility of the cervical vertebrae, rehabilitation experts recommend performing the following exercises:
- Flexion and extension of the neck.Bend your head forward toward your sternum without pulling your shoulders forward and back.Hold the slope 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 your shoulders and the level of your 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 hands on the back of your head.Tilt your head back, lean on your hands;
- Place your hand in the temporal region.As you tilt your head, resist with your hands;
- Put your hand on your forehead, resist it, tilt your head forward;
- Tilt your head to the side with your right hand, your left hand should be behind your back.On the other hand, repeat the exercise.
Autogravity therapy is the exact name of the spine traction procedure.This is done with special tools.The aim of the therapy is to reduce muscle spasm and restore the correct position of the vertebrae.To avoid complications, spinal traction is performed by a doctor.
In order to improve blood supply to the pathological focus, relieve swelling and eliminate pain, the following physiotherapy procedures are used:
- Diadynamic currents.During the procedure, low-frequency currents are applied with a special device, which stimulate the muscles, relieve spasms and pain.They have a positive effect by improving tissue trophism;
- Ultraviolet radiation.as a result of UV radiation, vitamin D metabolism improves, calcium content increases, and bone tissue becomes stronger;
- Exposure to ultrasound - to accelerate blood flow, antispasmodic and restorative effects.Ultrasound can penetrate deep 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.
In the acute period of the disease, which lasts 4-7 days, painkillers, antispasmodics, irritants are used to reduce pain.The patient provides rest.The cervical spine is immobilized 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 several days.Then you can start rehabilitation therapy.During the chronic course of the disease, the patient is prescribed muscle relaxants, chondroprotectors, B vitamins and pain relievers, NSAIDs.Physiotherapy classes and massages are also available.The patient is subjected to physiotherapy procedures (amplipulse, alternating current exposure) and spinal traction is performed.
Food
Proper nutrition in osteochondrosis is an important condition for achieving remission.The progression of cervicothoracic osteochondrosis is stopped by following the diet and therapeutic measures.Neurologists know how to treat osteochondrosis of the cervical spine, so they create complex treatment 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 dietary restrictions.Specialists create individual nutrition programs that take into account the patient's preferences.The diet for osteochondrosis is based on balanced, low-fat, nutrient-rich foods.The patient's daily diet includes foods with a high calcium content.
How to sleep with cervical osteochondrosis
For patients with musculoskeletal diseases, the question of how to sleep properly in cervical osteochondrosis is important.Sleeping on the 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 side.
Cervical osteochondrosis progresses while resting 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 cervical thoracic osteochondrosis, experienced specialists will tell you which bedding is safe for sleeping.
Prevention
In order to prevent the occurrence or progression of cervical osteochondrosis, doctors recommend:
- Maintain correct posture;
- Lead an active lifestyle, take a break from work;
- Do physical therapy exercises regularly;
- Sleep on a hard and smooth 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 a bag on one hand, this leads to curvature of the spine;
- Lead a healthy lifestyle, eat right, eat lots of fruits and vegetables;
- Do not sit with your head down for a long time;
- Go swimming.
In order to improve blood circulation, a therapeutic massage should be performed regularly.