Cervical osteochondrosis is a disease in which the vertebrae and intervertebral discs are affected. Cervical osteochondrosis refers to the deformation of dorsopathies. Involutional changes in the discs have already been observed by the age of 20 years. 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 today there is 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 carried out 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 the infringement of the nerve roots with the vessels. The vertebrae receive nutrients from the surrounding tissues, which is harmful to the body. Compression of nerves and blood vessels leads to a protective muscle spasm which, as the disease progresses, becomes the cause of pain.
What 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 GP. 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 the cartilage tissue and cervicobrachial osteochondrosis, the patient is referred for a comprehensive examination. The tactics of how to treat cervical osteochondrosis are being developed according to the results of research.
Interdisciplinary collaboration also allows the treatment of comorbidities that the patient has. In addition, the patient receives comprehensive information support: a treatment plan, an extract on the cost of services, provision of information on specialized 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 large load on the spine is observed when wearing the wrong shoes, flat feet, obesity, prolonged sitting position;
- Metabolic disordersDeficiency of vitamins, minerals, calcium metabolism disorders can serve as causes of degenerative processes in the vertebrae;
- Congenital and acquired anomalies of the spine and the ligamentous apparatus (thickening of the ligaments, lumbarization, sacralization);
- Pathologies of the gastrointestinal tract, which lead to insufficient absorption of nutrients;
- Infection, poisoning;
- Injuries, bruises, fractures of the spine, as a result of which the blood supply and innervation of the spine is disrupted, causing its dystrophic disorders;
- Stress;
- Wearing shoes with heels;
- Pregnancy, especially multiple pregnancies;
- Autoimmune connective tissue lesions, abnormal structure of type 1 and 2 collagen;
- Occupational hazards (lifting heavy loads, prolonged vibration, working seated with a 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 laden heredity. This fact proves the presence of osteochondrosis in children, when the spine is not yet overloaded.
Degrees
Due to the special structure of the spine, it can 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-ligamentous apparatus. Osteochondrosis leads to dystrophic-degenerative processes, first in the intervertebral disc, and then in the vertebra. With the defeat of one vertebra, the adjacent ones provide the performance of its functions. This leads to increased 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 the surrounding tissues, it is subject to degenerative changes. Osteochondrosis in the first stage of development is characterized by the destruction of the nucleus pulposus and cracks in the fibrous annulus. Clinically, this is manifested by acute or persistent local pain in the neck (neck pain) and stiffness;
- Osteochondrosis of the second degree 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, 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 gelatinous nucleus 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 can form;
- In 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 osteon is formed. With the fourth degree of cervical osteochondrosis, vivid symptoms are observed: severe pain radiating to the arm, sternum, to the area between the shoulder blades, sensitivity disorders.
Signs and symptoms
Signs of cervical osteochondrosis in the initial stages can be nonspecific: dizziness, headaches, weakness, creaking 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 perspiration.
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
- Heart syndrome
- Root syndrome.
They occur when nerve endings are injured, arteries and veins tighten during the development of the disease. The most dangerous complication is considered to be vertebral artery syndrome. There is a violation of 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 strong violation 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 region of the heart, which is not associated with heart disease, but at the same time, tachycardia, arrhythmia and hypotension may appear. develop. Compression of the veins leads to the development of hypertensive CSF syndrome. Intracranial pressure increases, nausea, vomiting and severe headache appear due to impaired blood flow to the brain.
As a result of squeezing the neck, root syndrome develops - severe pain appears in the neck, shoulders, shoulder blades, and the back of the head. With this syndrome, the arm and neck area becomes 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), in the arms on one or both sides. Reflex pain, unlike radicular pain, is not combined with sensitivity disorders. Neck pain can be dull and painful. Sharp, sharp "lumbago" 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 epicondilosis, humeroscapular periarthrosis, and shoulder-hand syndrome appear due to nerve impulses from the annulus fibrosus of the affected segment, causing compensatory muscle spasm.
Root syndromes are accompanied by alterations in motor activity and sensation. At the same time, the nerves, blood vessels deteriorate, the venous and lymphatic outflow in the pathological focus is disturbed as a result of a decrease in the intervertebral canal. The pain in radicular syndrome is sharp and intense. A common cause of spinal nerve entrapment is hernia formation. 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, the cardiac syndrome occurs. It manifests as burning, sharp pain in the left side of the chest with radiation 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 interruptions (tachycardia, arrhythmia).
Signs of cervical osteochondrosis depend on the location of the pathological process. With damage to the upper cervical vertebrae, the blood supply to the brain is disrupted due to compression of the cerebral arteries. This leads to headaches (especially in the occipital region), dizziness, fainting, high blood pressure. Dizziness with cervical osteochondrosis is caused by decreased blood flow to the inner ear. Patients are also concerned about nausea, vestibular and eye symptoms occur.
With a combined injury of the vertebrae, they speak of cervicothoracic osteochondrosis. The disease is manifested by the following symptoms:
- Dizziness;
- Pain in the neck and arm;
- 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 start therapy. To identify cervical osteochondrosis, the following types of instrumental diagnostics are used:
- Spondylography or spinal radiography. This research method is painless, highly informative, and requires no special training. An X-ray of the spine allows you to evaluate 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 - provides information mainly on the state of bone tissue, allows you to identify a narrowing of the spinal canal and a herniated disc;
- Magnetic Resonance Imaging - Allows you to determine soft tissue changes. 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 a complete cure, neurologists carry out preventive measures to exclude relapses of the disease. In the acute period, for the treatment of osteochondrosis of the cervical spine, doctors prescribe drugs of the following pharmacological groups to patients:
- Non-narcotic pain relievers. They are taken orally or injected intramuscularly to quickly achieve effect;
- Non-steroidal anti-inflammatory drugs;
- B vitamins in large doses.
Diuretics are used to reduce fluid retention in the spinal root and surrounding tissues. Antihistamines enhance the action of pain relievers. Muscle relaxants eliminate muscle spasms. 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, therefore 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. Nonsteroidal anti-inflammatory drugs have side effects, therefore, before prescribing them, the neurologist determines the presence of contraindications in the patient and the required dose. Medications for motion sickness 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 delivery, 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 occurs with various disorders. However, cervical osteochondrosis is characterized by episodes of severe headache. Head movements increase symptoms, therefore, to eliminate them, doctors prescribe pain reliever tablets and non-steroidal anti-inflammatory drugs.
Non-drug therapy methods
Complex non-drug therapy of cervical osteochondrosis of the spine includes:
- Protection mode: when the roots are pinched, patients lie on a hard surface,
- Massage;
- Physiotherapy exercises;
- 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 outflow. Special attention is paid to the interscapular and paravertebral zones.
Therapeutic gymnastics for osteochondrosis of the cervical spine is aimed at eliminating muscle spasm and strengthening the muscle structure. Since the instability of the vertebrae often occurs in the cervical spine, the exercise therapy instructor conducts individual lessons, during which she teaches the patient to safely perform the exercises. Some authors recommend taking physical therapy classes in the Shants collar.
To improve mobility of the cervical vertebrae, rehabilitation therapists recommend performing the following exercises:
- Flexion and extension of the neck. Tilt your head towards your sternum, without pulling your shoulders forward and then back. Hold the incline for 3 seconds, repeat each exercise 8 to 10 times;
- Neck twists. 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 level of your shoulders. Hold the position for 5 seconds.
The following exercises have been developed to strengthen the neck muscles:
- Place your hand on the back of your head. Tilt your head back, resting on your hand;
- Place your hand in the temporal region. While tilting 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 with the other hand.
Autogravity therapy is the exact name of the spinal traction procedure. It is carried out by special devices. The goal of therapy is to reduce muscle spasms and restore the correct position of the vertebrae. To avoid complications, spinal traction is done by a doctor.
To improve the 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. It has a positive effect, improving the trophism of the tissues;
- UV irradiation. Under the influence of UV radiation, vitamin D metabolism improves, calcium content increases, bone tissue is strengthened;
- Exposure to ultrasound: it is used to accelerate blood flow, antispasmodic and restorative action. Ultrasound can penetrate deep into the tissues, sometimes it is used for better absorption of medicinal substances;
- Amplipulse therapy - Allows you to relieve pain by blocking nerve impulses from the pain focus.
In the acute period of the disease, which lasts 4-7 days, analgesics, antispasmodics, and irritants are used to reduce pain. The patient is given peace. Immobilization of the cervical spine is done using the Shants collar. Exercise therapy and massage are contraindicated. Apply ultraviolet radiation.
The duration of the subacute period is 29 days. After full 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, for pain - analgesics, NSAIDs. Physiotherapy exercises, massages are provided. The patient is freed from physiotherapeutic procedures (pulse amplification, exposure to alternating current), spinal traction is performed.
Food
Proper nutrition for osteochondrosis is an important condition for achieving remission. The progression of cervicothoracic osteochondrosis is stopped with diet and treatment. Neurologists know how to treat osteochondrosis of the cervical spine, therefore, they compose a complex of therapeutic measures, including procedures, exercise therapy, proper nutrition, and lifestyle changes.
Many patients come 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 balanced foods, low in fat and rich in nutrients. The daily diet of the patient 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 better to avoid sleeping in this position. The most optimal positions are the back and the 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 cervicothoracic osteochondrosis, experienced specialists will tell him what type of bed is safe to sleep on.
Prophylaxis
To prevent the onset or progression of cervical osteochondrosis, doctors recommend:
- Maintain a correct posture;
- Lead an active lifestyle, take breaks from work;
- Do physical therapy exercises regularly;
- Sleep on a firm, level 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 in one hand, this leads to a flexion of the spine;
- Live a healthy lifestyle, eat well, eat lots of fruits and vegetables;
- Do not sit for a long time with your head bowed;
- Go swimming.
To improve blood circulation, massage therapy should be done regularly.