Cervical osteochondrosis is a disease in which the vertebrae and intervertebral discs are affected. Cervical osteochondrosis refers to deforming dorsopathies. Involutive changes in discs were observed as early as 20 years of age. At the same time, they become more sensitive to loads, less elastic and lose lubricating fluid.
Most of the time, the pathology occurs in the elderly, but currently there is a significant increase in its incidence among children and adolescents. Neurologists identify cervical osteochondrosis using the most recent diagnostic studies. Once the diagnosis is clarified, a complex therapy is carried out with the most effective medications, physiotherapeutic procedures and innovative methods of physical rehabilitation.
The name of the disease consists of two Greek terms "osteon" (bone) and "chondros" (cartilage). Cervical osteochondrosis starts with changes in the central part of the disc. The intervertebral disc loses moisture, shrinks in size, which leads to the convergence of the vertebral bodies and the violation of the nerve roots with the vessels. The vertebrae receive nutrients from the surrounding tissues, which are harmful to the body. The compression of 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 area of expertise of neurologists. However, when symptoms of osteochondrosis of the neck appear, it is possible to consult a general practitioner. A neurologist will select cervical osteochondrosis medications that put less stress on the body, which is important for drug therapy.
To determine the presence of a pathological process in cartilage tissue and cervicobrachial osteochondrosis, the patient is referred for a complete examination. Treatment tactics for cervical osteochondrosis are being developed based on research findings.
Interdisciplinary collaboration also allows for the treatment of comorbidities that the patient has. In addition, the patient receives all informational support: treatment plan, statement 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 triggering factors. No definite cause of cervical osteochondrosis has been identified. The disease is usually associated with metabolic disorders and aging of the vertebrae.
Researchers suggest that cervical osteochondrosis develops for the following reasons:
- Excessive stress on the spine. There is a high load on the spine when wearing the wrong shoes, flat feet, obesity, prolonged sitting position;
- Metabolic disorders. Deficiency of vitamins, minerals, disturbances in calcium metabolism can serve as causes of degenerative processes in the vertebrae;
- Congenital and acquired anomalies of the spine and ligament apparatus (ligament thickening, lumbarization, sacralization);
- Pathologies of the gastrointestinal tract, leading to insufficient absorption of nutrients;
- Infection, intoxication;
- Injuries, bruises, fractures of the spine, as a result of which the blood supply and innervation of the spine are interrupted, which causes its dystrophic disorders;
- Stress;
- Wear shoes with heels;
- Pregnancy, especially multiple pregnancies;
- Autoimmune connective tissue lesions, abnormal structure of collagen types 1 and 2;
- Occupational hazards (lifting heavy loads, prolonged vibration, working seated with constant head tilt);
- Atherosclerotic and other changes in vertebral arteries;
- Spine curvature (kyphosis, scoliosis, kyphoscoliosis).
An important risk factor for the development of cervical osteochondrosis is overloaded 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 is able to perform its functions. The main structural unit is considered the spinal movement segment (VMS). It consists of two adjacent vertebrae, an intervertebral disc and a muscle-ligament apparatus. Osteochondrosis leads to dystrophic-degenerative processes, first in the intervertebral disc, then in the vertebra. With the defeat of a vertebra, the performance of its functions is ensured by the adjacent ones. This leads to an increase in load and loss of mobility in the affected segment.
In the development of cervical osteochondrosis, doctors distinguish several stages:
Symptoms and Signs
Signs of cervical osteochondrosis in the early stages may be nonspecific: dizziness, headaches, weakness, crushing during head movements. As the disease progresses, the following symptoms develop:
- Severe pain in neck and shoulders;
- Numbness of the hand;
- Dizziness;
- Increased blood pressure;
- Impaired movement coordination;
- 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.
- Hypertensive syndrome.
- Cardiac syndrome.
- Root syndrome.
They occur when nerve endings are injured, arteries and veins are compressed during disease development. The most dangerous complication is considered 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 appears. The patient may lose consciousness while driving due to an abrupt violation of blood flow.
As a result of compression of the nerves responsible for innervating the chest and diaphragm muscles, pain arises in the heart region, which is 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 CSF hypertensive syndrome. Increases in intracranial pressure, nausea, vomiting and severe headache appear due to impaired blood flow to the brain.
As a result of neck compression, radicular syndrome develops - severe pain appears in the neck, shoulders, shoulder blades and the back of the head. With this syndrome, the arms and neck region go 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 still unaffected. Patients complain of pain in the neck, head (especially the back of the neck), arms on one or both sides. Reflex pain, unlike radicular pain, is not combined with sensitivity disturbances. Neck pain can be dull and painful. Sharp, sharp pain of the "lumbago" type is called cervicago. There is a spasm and muscle pain, pain in the paravertebral points. The signs of cervical osteochondrosis intensify in an uncomfortable position, with head tilt, cough, physical exertion. Signs of epicondylosis, humeroscapular periarthrosis, and shoulder-hand syndrome appear due to nerve impulses from the fibrous ring of the affected segment, which causes compensatory muscle spasm.
Root syndromes are accompanied by impaired motor activity and sensitivity. At the same time, nerves, blood vessels are damaged, the venous and lymphatic flow in the pathological focus is disturbed as a result of a decrease in the intervertebral canal. Pain in radicular syndrome is acute, intense. A common cause of spinal nerve compression is hernia formation. In the area of pathological focus, muscle tone decreases. In radiculo-ischemia, in addition to the nerves, the vessels are compressed.
If the phrenic nerve is involved in the pathological process, cardiac syndrome occurs. It manifests as burning, sharp pain on the left side of the chest, radiating to the arm, 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 ingestion of nitroglycerin, can occur at rest, and is associated with interruptions in heart rhythm (tachycardia, arrhythmia).
The 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 cut off due to compression of the cerebral arteries. This causes headaches (especially in the occipital region), dizziness, fainting, high blood pressure. Dizziness with cervical osteochondrosis is caused by a decrease in blood flow to the inner ear. Patients are also concerned about the occurrence of nausea, vestibular and ocular symptoms.
With a combined injury to the vertebrae, they speak of cervicothoracic osteochondrosis. The disease is manifested by the following symptoms:
- Dizziness;
- Neck and arm pain;
- Tingling and crawling sensation in the upper limb;
- Intercostal neuralgia.
Diagnosis
Cervical osteochondrosis is a chronic disease that can lead to hernia formation and spinal cord compression. Therefore, it is important to timely establish an accurate diagnosis and initiate therapy. To identify cervical osteochondrosis, the following types of instrumental diagnoses are used:
- Spondylogram or X-ray of the spine. This research method is painless, highly informative, and requires no special training. An X-ray of the spine allows you to assess 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 state of the bone tissue, allows the identification of a narrowing of the spinal canal and a herniated disc;
- Magnetic resonance imaging - allows you to determine changes in soft tissue. The MRI image clearly shows the changes in the intervertebral discs and spinal cord.
drug treatment
The treatment of osteochondrosis of the cervical spine consists of drug and non-drug therapy. Even after 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 medications from the following pharmacological groups to patients:
- Non-narcotic analgesics. They are taken orally or injected intramuscularly to quickly achieve the 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 potentiate the action of analgesics. Muscle spasms are eliminated by muscle relaxants. With prolonged severe pain syndrome, neurologists perform a nerve block.
To improve metabolic processes in the intervertebral disc, chondroprotectors are used. These medications increase the content of glycosaminoglycans, increase the firmness, elasticity and shock absorption of the intervertebral discs.
Pills for dizziness
Patients often experience dizziness with cervical osteochondrosis. To reduce them, doctors prescribe nonsteroidal anti-inflammatory drugs. NSAIDs belonging to different groups differ in mechanism of action and effect, so only a qualified specialist can determine the appropriate drug.
It is important to remember that medications for osteochondrosis of the cervical spine cannot be taken without a doctor's consultation. Nonsteroidal anti-inflammatory drugs have side effects, therefore, before prescribing them, the neurologist determines the presence of contraindications in the patient and the necessary dosage. Drugs for dizziness in cervical osteochondrosis can improve the patient's quality of life.
Injections for Osteochondrosis
Cervical spine osteochondrosis injections help relieve pain during an exacerbation. With this method of administering medications, the effect occurs quickly. Neurologists use a variety of injections.
Nurses inject drug solutions subcutaneously, intramuscularly, or intravenously. During the period of disease exacerbation, injectable drugs, with cervical osteochondrosis, have an exclusively symptomatic effect.
Headache Treatment
Headache is a symptom that occurs with many disorders. However, cervical osteochondrosis is characterized by severe headache attacks. Head movements increase symptoms, so to eliminate them, doctors prescribe painkillers and nonsteroidal anti-inflammatory pills.
Non-drug therapy methods
Complex non-drug therapy for cervical osteochondrosis of the spine includes:
- Protection mode - when roots are clamped, patients are 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 spasm. A contraindication for performing this procedure is the presence of acute pain. Massage the neck and back in the direction of the lymph exit. Special attention is given to the interscapular and paravertebral zones.
Therapeutic gymnastics for osteochondrosis of the cervical spine aims to eliminate muscle spasm and strengthen the muscle structure. Since vertebral instability often occurs in the cervical spine, the exercise therapy instructor gives one-on-one lessons, during which he teaches the patient how to safely perform the exercises. Some authors recommend performing physiotherapy classes on 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 forward toward your sternum without pulling your shoulders forward and then back. Hold the incline for 3 seconds, repeat each exercise 8-10 times;
- Neck twists. 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 until it stops. Then tilt your head back without changing the level of your shoulders. Keep the position for 5 seconds.
The following exercises are designed to strengthen your neck muscles:
- Put your hand on the back of your neck. Tilt your head back, leaning on your hand;
- Place your hand in the temporal region. While bowing your head, resist with your hand;
- Put your hand on your forehead, resisting, lean your head forward;
- Tilt your head to the side with your right and left hands 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 through special devices. The goal of therapy is to reduce muscle spasm and restore the vertebrae to the correct position. To avoid complications, spinal traction is performed by a doctor.
To improve the blood supply in the pathological focus, relieve swelling and eliminate pain, the following physical therapy procedures are used:
- Diadynamic currents. During this procedure, through a special apparatus, low frequency currents are applied, which stimulate the muscles, relieve spasms and pain. They have a positive effect, improving tissue trophism;
- Ultraviolet irradiation. Under the influence of ultraviolet radiation, vitamin D metabolism improves, calcium content increases, bone tissue becomes stronger;
- Ultrasound exposure - used to accelerate blood flow, antispasmodic and restorative action. Ultrasound is capable of penetrating deeply into tissues, it is sometimes used for better absorption of medicinal substances;
- Amplipulse Therapy - Allows you to relieve pain by blocking nerve impulses from the painful focus.
In the acute period of the illness, which lasts from 4 to 7 days, analgesics, antispasmodics and irritants are used to reduce pain. The patient is at peace. Immobilization of the cervical spine is performed with the Shants collar. Exercise therapy and massage are contraindicated. Apply ultraviolet radiation.
The duration of the sub-acute 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, muscle relaxants, chondroprotectors, B vitamins are prescribed for the patient - analgesics, NSAIDs. Physiotherapy exercises and massages are provided. The patient is released from physical therapy procedures (amplitude, exposure to alternating current), spinal traction is performed.
food
Adequate 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, so they constitute a complex of therapeutic measures, including procedures, exercise therapy, proper nutrition, and lifestyle changes.
Many patients go to neurologists to find out how to treat osteochondrosis of the cervical spine and if there are any dietary restrictions. Experts create individual nutrition programs that take patient preferences into account. The osteochondrosis diet is based on balanced, low-fat, nutrient-rich foods. The patient's daily diet includes calcium-rich foods.
How to sleep with cervical osteochondrosis
For patients with musculoskeletal system disorders, the question of how to sleep well with cervical osteochondrosis is relevant. Sleeping on your back causes the disease to develop, so it is best to avoid sleeping in this position. The most ideal positions are at the back and side.
Cervical osteochondrosis progresses at rest 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 you which bedding is safe to sleep on.
Prophylaxis
To prevent the onset or progression of cervical osteochondrosis, doctors recommend:
- Maintain correct posture;
- Lead an active lifestyle, take breaks from work;
- Do physical therapy exercises regularly;
- Sleeping on a firm, level surface, mattress and orthopedic pillow;
- Get rid of bad habits, especially smoking;
- Choose the shoe taking into account the physiological structure of the foot;
- Do not carry bags in one hand, as this causes a bending of the spine;
- Lead a healthy lifestyle, eat right, eat lots of fruits and vegetables;
- He doesn't sit for long with his head bowed;
- Go for a swim.
In order to improve blood circulation, massage therapy should be performed regularly.