Cervical osteochondrosis is a disease that affects the vertebrae and intervertebral discs.Cervical osteochondrosis refers to deforming dorsopathies.Involutional changes in 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.
Most 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 specifying the diagnosis, complex therapy is carried out with the most effective medications, 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 and shrinks in size, causing the vertebral bodies to come together and pinch the nerve roots and blood vessels.The vertebrae receive nutrients from the surrounding tissues, which causes harm to the body.The compression of the nerves and blood vessels leads to a protective muscle spasm, which, as the disease progresses, becomes the cause of pain.
Which doctor treats this disease?
The treatment of osteochondrosis is the field of activity of neurologists.However, if symptoms of osteochondrosis of the neck appear, you can contact a general practitioner.The neurologist will choose 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.In accordance with the research results, tactics are being developed for the treatment of cervical osteochondrosis.
Interdisciplinary cooperation also enables the treatment of concomitant diseases of the patient.In addition, the patient receives full informational support: a treatment plan, an extract from 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 large load on the spine is observed when wearing incorrect shoes, flat feet, obesity and prolonged sitting;
- Metabolic disorders.Deficiency of vitamins, minerals and disorders of calcium metabolism can cause degenerative processes in the vertebrae;
- Congenital and acquired abnormalities in the development of the spine and ligament apparatus (thickening of the ligaments, lumbarization, sacralization);
- Pathologies of the gastrointestinal tract leading to insufficient absorption of nutrients;
- Infections, intoxication;
- Injuries, bruises, fractures of the spine, as a result of which the blood supply and innervation of the spine are disturbed, which causes their degenerative disorders;
- stress;
- Wearing heels;
- Pregnancy, especially multiple pregnancy;
- Autoimmune lesions of the connective tissue, pathological structure of collagen type 1 and 2;
- Occupational hazards (lifting heavy loads, continuous vibration, working in a sitting position with a constant tilt of the head);
- Atherosclerotic and other changes in the spinal arteries;
- Distortion of the spine (kyphosis, scoliosis, kyphoscoliosis).
An important risk factor for the development of cervical osteochondrosis is the family burden.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 the spinal motor 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, then in the vertebrae.When one vertebra is damaged, its functions are provided by neighboring ones.This leads to increased loading and loss of mobility of the affected segment.
Doctors distinguish several stages in the development of cervical osteochondrosis:
- 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 susceptible to degenerative changes.Osteochondrosis in the first stage of development is characterized by destruction of the pulpous nucleus 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.At this stage, the destruction of the fibrous ring continues, pathological mobility and instability of the vertebrae appear.Patients complain of pain in the neck, aggravated by physical activity, tilting the head or in a certain position;
- The third stage of the disease is characterized by complete destruction of the fibrous ring.The nucleus pulposus is not fixed.The appearance of intervertebral hernias, which cause severe pain, is possible.At this stage, due to the poor fixation of the SMS, spinal curvature may form;
- 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.In the fourth degree of cervical osteochondrosis, clear symptoms are observed: severe pain that spreads to the arm, sternum, in the area between the shoulder blades and sensitivity disorders.
Symptoms and signs
Signs of cervical osteochondrosis in the initial stages can be non-specific: dizziness, headache, weakness, crunching when moving the head.As the disease progresses, the following symptoms develop:
- Severe pain in the neck and shoulders;
- Numbness of the arm;
- vertigo;
- 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 injured, arteries and veins are compressed during the development of the disease.The most dangerous complication is considered vertebral artery syndrome.There is a violation of blood flow through the artery supplying the brain and spinal cord.The patient's hearing decreases, vision decreases, and constant vertigo develops.The patient may lose consciousness during movement 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 occurs in the area of the heart, which is not related to heart disease, but at the same time tachycardia, arrhythmia and hypotension may develop.The compression of the veins leads to the development of hypertensive cerebrospinal fluid syndrome.Intracranial pressure increases, nausea, vomiting and severe headache occur due to impaired blood flow from the brain.
As a result of neck compression, radicular syndrome develops - severe pain occurs in the neck, shoulders, shoulder blades and back of the head.In this syndrome, the hands and the neck area go numb.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 in 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 the paravertebral points.Signs of cervical osteochondrosis increase in an uncomfortable position, when tilting the head, coughing or physical activity.Signs 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, the nerves and blood vessels are disturbed, the venous and lymphatic outflow in the pathological focus is disturbed as a result of the reduction of the intervertebral canal.The pain with radicular syndrome is sharp 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 radiculoischaemia, in addition to nerves, blood vessels are compressed.
If the phrenic nerve is involved in the pathological process, a cardiac syndrome occurs.It manifests itself as a burning, sharp pain in the left half of the chest, radiating 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 pain during 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.When the upper cervical vertebrae are affected, the blood supply to the brain is disrupted due to compression of the cerebral arteries.This leads to headache (especially in the occipital region), dizziness, fainting and high blood pressure.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.
In case of combined damage to the vertebrae, it is called cervico-thoracic osteochondrosis.The disease manifests itself with the following symptoms:
- vertigo;
- Neck and arm pain;
- Sensation of numbness, crawling along the upper limb;
- Intercostal neuralgia.
Diagnosis
Cervical osteochondrosis is a chronic disease that can lead to herniation and compression of the spinal cord.Therefore, it is important to establish an accurate diagnosis in a timely manner and start therapy.The following types of instrumental diagnostics are used to identify 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 you to evaluate its anatomical and functional characteristics.The photo draws attention 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 about the state of bone tissue, allows you to identify narrowing of the spinal canal and disc herniation;
- Magnetic resonance - allows you to determine changes in soft tissues.The MRI image clearly shows changes in the intervertebral discs and 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 to patients from the following pharmacological groups:
- Non-narcotic analgesics.They are taken orally or administered intramuscularly for a quick effect;
- Nonsteroidal anti-inflammatory drugs;
- B vitamins in large doses.
Diuretics are used to reduce fluid retention in the area of the spinal root and surrounding tissues.Antihistamines potentiate the effect of analgesics.Muscle spasms are eliminated with muscle relaxants.In case of prolonged severe pain, neurologists perform a nerve block.
Chondroprotectors are used to improve metabolic processes in the intervertebral disc.These drugs increase the content of glycosaminoglycans, increase the stiffness, elasticity and cushioning of the intervertebral discs.
Anti-vertigo pills
Patients often experience dizziness with cervical osteochondrosis.To reduce them, doctors prescribe nonsteroidal anti-inflammatory drugs.NSAIDs belonging to different groups differ in their 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 necessary dosage.Medicines 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 exacerbations.With this method of drug administration, the effect occurs quickly.Neurologists use different injections.
Nurses administer drug solutions subcutaneously, intramuscularly, or intravenously.During the period of exacerbation of the disease, drugs that are administered by injection in cervical osteochondrosis have an extremely symptomatic effect.
Headache treatment
Headache is a symptom that occurs in various disorders.However, cervical osteochondrosis is characterized by bouts of intense headache.Head movements intensify the symptoms, so to eliminate them, doctors prescribe analgesic tablets and non-steroidal anti-inflammatory drugs.
Non-drug therapies
Complex non-drug therapy for cervical osteochondrosis of the spine includes:
- Protective mode - if the roots are pressed, 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 for performing this procedure is the presence of acute pain.Massage the neck and back in the direction of lymphatic drainage.Special 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 frame.Since vertebral instability often occurs in the cervical spine, the physical therapy instructor conducts one-on-one sessions during which he teaches the patient how to perform exercises safely.Some authors recommend conducting physiotherapy courses in a Shants collar.
To improve the mobility of the cervical vertebrae, rehabilitation specialists recommend performing the following exercises:
- Neck flexion and extension.Bend your head forward toward your sternum without pulling your shoulders forward and then back.Hold the incline for 3 seconds, repeat each exercise 8-10 times;
- Turning the neck.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 all the way.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, leaning on your hand;
- Place your hand in the temporal area.As you tilt your head, resist with your hand;
- Put your hand on your forehead, resisting, tilt your head forward;
- With the right hand, tilt your head to the side, the left hand should be behind the back.Repeat the exercise on the other hand.
Autogravity therapy is the correct name for 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 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, with the help of a special device, low-frequency currents are applied, which stimulate the muscles, relieve spasm and pain.They have a positive effect by improving tissue trophicity;
- Ultraviolet radiation.Under the influence of ultraviolet rays, the metabolism of vitamin D improves, the calcium content increases, bone tissue becomes stronger;
- Exposure to ultrasound - used to accelerate blood flow, spasmolytic and reparative action.Ultrasound is able to 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, pain relievers, antispasmodics and irritants are used to reduce pain.The patient is provided with rest.Immobilization of the cervical spine is performed with 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.After that, you can start a course of rehabilitation therapy.In the chronic course of the disease, the patient is prescribed muscle relaxants, chondroprotectors, vitamins of group B, and for pain - analgesics, NSAIDs.Physiotherapy and massage courses are available.Physiotherapy procedures (amplipulse, alternating current irradiation) are prescribed to the patient, spinal traction is performed.
food
Proper nutrition in osteochondrosis is an important condition for achieving remission.The progression of cervico-thoracic osteochondrosis stops with adherence to diet 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 with the question of how to treat osteochondrosis of the cervical spine and whether there are any dietary restrictions.Specialists create individual nutritional 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 diseases of the musculoskeletal system, the question of how to sleep properly with cervical osteochondrosis is important.Sleeping on your 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 on the side.
Cervical osteochondrosis progresses when resting on a bed with a soft mattress.That is why experts recommend giving preference to elastic mattresses, as well as moderately soft pillows.If the patient is diagnosed with cervicothoracic osteochondrosis, experienced specialists will tell you which bedding is safe to sleep on.
Prevention
To prevent the onset or progression of cervical osteochondrosis, doctors recommend:
- Maintain proper posture;
- Lead an active lifestyle, take breaks at work;
- Do physical therapy exercises regularly;
- Sleeping on a hard 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 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 for a long time with your head down;
- Go swimming.
To improve blood circulation, you should regularly undergo a therapeutic massage.