Cervical osteochondrosis is a disease that affects the vertebral and intervertebral discs.Cervical osteochondrosis refers to deforming dorsopathies.Involutive changes in the discs are observed already at the age of 20 years.At the same time, they become more sensitive to stress, less elastic and lose their lubricating fluid.
Most often, the pathology occurs in the elderly, but currently there is a significant increase in 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 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 and pinching of nerve roots and blood vessels.The vertebrae receive nutrients from the surrounding tissues, which causes damage to the body.Compression of nerves and blood vessels leads to protective muscle spasm, which, as the disease progresses, becomes the cause of pain.
Which doctor treats this disease?
Treatment of osteochondrosis is the field of activity of neurologists.However, if symptoms of cervical osteochondrosis appear, you can consult a general practitioner.The neurologist will choose drugs for cervical osteochondrosis that put the least burden on the body, which is important during drug therapy.
In order to determine the presence of a pathological process in the cartilage tissue and cervicobrachial osteochondrosis, the patient is sent for a comprehensive examination.Treatment tactics for cervical osteochondrosis are developed in accordance with research results.
Interdisciplinary collaboration also enables the treatment of patient comorbidities.In addition, the patient receives full informational support: a treatment plan, a statement on the price 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 established.Often the disease is associated with metabolic disorders and aging of the vertebrae.
Researchers suggest that cervical osteochondrosis develops for the following reasons:
- Excessive strain on the spine.High load on the spine is observed when wearing improper shoes, flat feet, obesity and prolonged sitting;
- Metabolic disorders.Lack of vitamins, minerals and disorders of calcium metabolism can cause degenerative processes in the vertebrae;
- Congenital and acquired anomalies of the development of the spine and ligament apparatus (thickening of ligaments, lumbarization, sacralization);
- Pathologies of the gastrointestinal tract that lead to insufficient absorption of nutrients;
- Infections, intoxications;
- Injuries, bruises, fractures of the spine, due to which the blood supply and innervation of the spinal column are disturbed, which causes their degenerative disorders;
- Stress;
- Wearing heeled shoes;
- Pregnancy, especially multiple pregnancy;
- Autoimmune lesions of connective tissue, pathological structure of collagen type 1 and 2;
- Occupational hazards (lifting heavy loads, prolonged vibrations, working in a sitting position with a constant tilt of the head);
- 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 proves the existence 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 spinal column movement segment (SMS) is considered the main structural unit.It consists of two adjacent vertebrae, an intervertebral disc and a muscular-ligamentous apparatus.Osteochondrosis leads to dystrophic-degenerative processes, first in the intervertebral disc, then in the spine.When one vertebra is damaged, its functions are provided by the adjacent one.This leads to an increased load and loss of mobility of the affected segment.
Doctors distinguish several stages in the development of cervical osteochondrosis:
- 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 1st stage of development is characterized by the destruction of the nucleus pulposus and a crack in the fibrous ring.Clinically, it is manifested by acute or persistent local pain in the neck (cervicalgia) and stiffness;
- Osteochondrosis of the second degree 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 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 the complete destruction of the fibrous ring.Nucleus pulposus is not fixed.Intervertebral hernias may occur, causing severe pain.At this stage, due to poor fixation of the SMS, curvature of the spine may occur;
- In the fourth stage of the disease, the intervertebral disc is replaced by connective tissue, and other adjacent segments are also 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 stage of cervical osteochondrosis, clear symptoms are observed: severe pain radiating to the arm, sternum, to 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, creaking when moving the head.As the disease progresses, the following symptoms develop:
- Severe pain in the neck and shoulders;
- Hand numbness;
- Vertigo;
- High blood pressure;
- Movement coordination disorder;
- Increased sweating.
There are several syndromes that occur 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 are formed 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 disruption 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 disruption 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 heart area, which is not related to heart disease, but at the same time tachycardia, arrhythmia and hypotension may develop.Compression of the veins leads to the development of hypertensive cerebrospinal fluid syndrome.Intracranial pressure increases, nausea, vomiting and severe headache occur due to disturbed 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 neck area become numb.With 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 spinal roots are not yet affected.Patients complain of pain in the neck, head (especially the nape of the neck) and arms on one or both sides.Reflex pain, unlike radicular pain, is not combined with sensory disturbances.Cervicalgia can be dull and painful.Acute sharp "shoots" of pain are called cervicago.There is muscle spasm and pain, pain in paravertebral points.Signs of cervical osteochondrosis intensify in an uncomfortable position, when tilting the head, coughing or physical activity.Signs of epicondylosis, glenohumeral periarthrosis and shoulder-hand syndrome occur due to nerve impulses from the annulus fibrosus of the affected segment, which causes compensatory muscle spasm.
Radicular syndromes are accompanied by impairment of motor activity and sensitivity.In this case, the nerves and blood vessels are injured, the venous and lymphatic outflow in the pathological focus is disturbed as a result of the reduction of the intervertebral canal.Pain with radicular syndrome is acute and intense.A common cause of spinal nerve entrapment is the formation of a hernia.In the area of the pathological focus, muscle tone decreases.In radiculoischemia, in addition to nerves, blood vessels are also compressed.
If the phrenic nerve is involved in the pathological process, a cardiac syndrome occurs.It manifests as burning, acute pain in the left half 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 alleviated after taking nitroglycerin, it 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, blood flow 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.Vertigo in cervical osteochondrosis is caused by a decrease in blood flow in the inner ear.Patients also have nausea and vestibular and ocular symptoms.
With combined damage to the vertebrae, they speak of cervicothoracic osteochondrosis.The disease is manifested by the following symptoms:
- Vertigo;
- Pain in the neck and arm;
- Tingling, crawling sensation on 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 and start therapy in time.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.An X-ray of the spine allows you to assess its anatomical and functional characteristics.In the picture, attention is paid to the structure of the vertebrae, their mutual relationship, 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 the 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 given intramuscularly to achieve a quick effect;
- Nonsteroidal anti-inflammatory drugs;
- B vitamins in large doses.
In order to reduce fluid retention in the area of the spinal root and surrounding tissues, diuretics are used.Antihistamines potentiate the effect of analgesics.Muscle spasms are eliminated with the help of muscle relaxants.In case of long-term 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 strength, elasticity and shock absorption of the intervertebral discs.
Anti-vertigo tablets
Patients often experience dizziness with cervical osteochondrosis.In order to reduce them, doctors prescribe non-steroidal anti-inflammatory drugs.Nonsteroidal anti-inflammatory drugs belonging to different groups differ in their mechanism of action and action, 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.Medicines against 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 appears quickly.Neurologists use various injections.
Nurses administer drug solutions subcutaneously, intramuscularly, or intravenously.In the period of exacerbation of the disease, drugs administered by injection for cervical osteochondrosis have an exclusively symptomatic effect.
Treatment of headache
Headache is a symptom that occurs in various disorders.However, cervical osteochondrosis is characterized by attacks of intense headaches.Head movements increase the symptoms, so in order to eliminate them, doctors prescribe analgesics and non-steroidal anti-inflammatory drugs.
Non-drug therapies
Complex therapy of cervical osteochondrosis of the spine without drugs includes:
- Protective mode of operation - if the roots are tightened, patients lie on a hard surface,
- Massage;
- Physical therapy;
- Traction of the spine;
- Physiotherapy procedures.
Massage in 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 lymph drainage.Special attention is paid to the interscapular and paravertebral zone.
Therapeutic exercises for osteochondrosis of the cervical spine are aimed at removing muscle spasms and strengthening the muscle frame.Since vertebral instability often occurs in the cervical spine, an exercise therapy instructor leads individual classes, during which he teaches the patient how to perform the exercises safely.Some authors recommend performing physical therapy classes in the 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 back.Hold the incline for 3 seconds, repeat each exercise 8-10 times;
- He turns his 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 all the way.Then throw 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:
- Put your hand on the back of your head.Tilt your head back, lean on your hand;
- Place your hand in the temporal region.As you tilt 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, your left hand should be behind your back.Repeat the exercise on the other side.
Autogravity therapy is the correct name for 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.In order to avoid complications, spinal traction is performed by a doctor.
The following physiotherapeutic procedures are used to improve blood supply to the pathological focus, relieve swelling and eliminate pain:
- Diadynamic currents.During this procedure, low-frequency currents are applied using a special device, which stimulate muscles, relieve spasm and pain.They have a positive effect by improving tissue trophism;
- Ultraviolet radiation.Under the influence of UV radiation, the metabolism of vitamin D improves, the calcium content increases, and bone tissue is strengthened;
- Exposure to ultrasound - used to accelerate blood flow, antispasmodic and reparative effects.Ultrasound is capable of penetrating deep into tissues;sometimes used for better absorption of medicinal substances;
- Amplipuls 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 and irritants are used to reduce pain.The patient is allowed to rest.Immobilization of the cervical spine is carried out 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 a course of rehabilitation therapy.In the chronic course of the disease, the patient is prescribed muscle relaxants, chondroprotectors, B vitamins, and pain relievers - analgesics, NSAIDs.Physical therapy and massage classes are provided.Physiotherapy procedures are performed on the patient (amplipulse, alternating current exposure), and spinal traction is performed.
Food
Proper nutrition for osteochondrosis is an important condition for achieving remission.Progression of cervicothoracic osteochondrosis is stopped by 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 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 foods that are 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 properly with cervical osteochondrosis is relevant.Sleeping on the stomach provokes the 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 while lying on a bed with a soft mattress.Therefore, experts recommend giving preference to elastic mattresses, as well as moderately soft pillows.If the patient has been diagnosed with cervicothoracic osteochondrosis, experienced experts will tell you which bedding is safe to sleep on.
Prevention
In order 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 feet;
- Do not carry bags on one arm, this leads to curvature of the spine;
- Lead a healthy lifestyle, eat properly, eat lots of fruits and vegetables;
- Do not sit with your head down for a long time;
- Go swimming.
To improve blood circulation, you regularly undergo therapeutic massage.