The diagnosis of "cervical osteochondrosis" is often made if a person complains of neck pain. Some attribute this to dizziness, memory loss, numbness of hands and other unpleasant symptoms. It is wrongly believed that the disease is related to wear and tear of the intervertebral discs and other elements of the spinal column due to aging.
How does the cervical spine work?
The cervical region consists of 7 vertebrae. Between them are intervertebral discs - semi-rigid structures with a dense ring along the periphery and a gelatinous center, which act as shock absorbers. To the right and left of each vertebra there are two joints, between which the cartilage-covered surfaces of the vertebrae protrude. The joints are connected by ligaments and back muscles.
Why does neck pain occur?
Typically, neck pain occurs in response to an uncomfortable movement, injury, or inflammation of any structure in the cervical spine. In addition, the cause of pain can be overstrain of muscles or ligaments, for example, when lifting weights, unsuccessfully turning the head or against the background of arthrosis of the joints themselves between the joint processes. "Nerve entrapment", or cervical radiculopathy, specific processes (metastases, vertebral tumors, membranes of the spinal cord in the cervical region) are relatively rare.
26% of men and 40% of women over the age of 30 have had neck pain in the last month, and 5% of men and 7% of women feel it constantly.
Acute neck pain usually goes away on its own within 1-2 weeks. Chronic pain in most cases occurs due to lack of physical activity or, on the contrary, too intense exercise.
However, people often mistakenly call unexplained pain and discomfort in the neck cervical osteochondrosis and associate its development with wear and aging deformation of the intervertebral discs and other elements of the spinal column. But such pain, as a rule, has nothing to do with real osteochondrosis.
Cervical osteochondrosis
According to the International Classification of Diseases (ICD), osteochondrosis (osteochondropathy) is a group of rare hereditary diseases associated with a disorder of normal bone development and growth. As a rule, osteochondrosis begins in childhood and is severe: part of the joint or bone is deformed, and sometimes even dies. In this disease, the cervical spine is most often not affected, but the thoracic spine (lower thoracic vertebrae). Therefore, the main clinical manifestation of osteochondrosis is pronounced curvature of the thoracic spine, so-called thoracic kyphosis.
Symptoms associated with damage to the thoracic spine:
- dyspnea,
- constant weakness
- inability to breathe completely,
- pain and burning behind the sternum,
- attacks of rapid heartbeat.
Conditions accompanied by neck pain
Cervical spondylosis
In people over the age of 50, neck pain is usually caused by cervical spondylosis, wear and tear of the vertebrae and related structures caused by aging. In this disease, the intervertebral discs become dehydrated and flattened, which leads to worsening of the depreciation in the cervical region, and many movements are accompanied by pain.
But changes in the spine as we age are normal. Therefore, its structures begin to wear out after an average of 30 years, and at the age of 60, 9 out of 10 people already have cervical spondylosis. However, most people are asymptomatic.
Other reasons
Less often, neck pain occurs due to hypothermia or severe stress, due to herniated discs or abnormalities of the cervical vertebrae - bone growths (spurs) that compress the nerves that extend from the spinal cord.
The most common source of pain in the cervical spine and shoulder girdle is excessive tension (defense) of the muscles: trapezius, long back muscles of the cervical spine.
In addition, the muscles of the cervical spine are closely related to the aponeurosis - a broad tendon plate that wraps around the head. The muscular elements of the aponeurosis in the occipital, temporal and frontal regions connect with the muscles of the cervical region, so neck pain is often accompanied by a headache. Therefore, neck pain, which occurs after prolonged sitting or sleeping in an uncomfortable position and is combined with a headache, is in most cases associated with a lack of physical activity and improper posture and is not dangerous to health.
The phenomenon of tech neck, the so-called techno-neck or neck from the Internet era, is associated with pain caused by an uncomfortable posture. Techneck is the result of constant use of computers and smartphones, due to which a person is forced to bend his neck. It is a fact that the relative mass of the head increases with forward inclination. So, in the "straight" position, the average weight of an adult's head is 5 kg. If you tilt your head forward at least 15°, the load on the neck muscles will be 13 kg, at 30° - 20 kg, at 60° - 30 kg. As a result of constant overload, there is an overload of the neck muscles, microtrauma, inflammation, fibrosis (excessive growth of connective tissue) and, accordingly, pain.
Reasons that contribute to the onset of degenerative changes in the cervical spine
The appearance of pain in the cervical spine is facilitated by childbirth or any other spinal injuries, anomalies of its development, postural disorders, muscle dystonia, as well as prolonged immobilization, obesity and some autoimmune diseases.
- Long-term immobilization is a condition in which a person, due to an underlying illness, is forced to lie down for more than a month. As a result, the muscles weaken - and during the vertical, when the load on them increases, they become excessively tense. There is pain.
- Obesity: Excess body weight increases stress on spinal structures and can cause pain.
- Autoimmune diseases in which cartilage tissue is destroyed (autoimmune arthritis, polychondritis) also lead to neck pain.
Stages of degenerative changes in the cervical spine
There are 4 main stages of degeneration (destruction) of the cervical spine:
- Phase I: intervertebral discs become thinner, mild discomfort occurs in the neck area;
- Phase II: the intervertebral discs are deformed, the distance between the vertebrae is reduced. Pain increases with movements in the cervical spine;
- Phase III: cartilage and vertebrae rub against each other, pain in the neck becomes constant, and movements are limited. In the case of very severe deformities of the cervical spine, vertebral artery syndrome may occur with disturbances of vision and vestibular system, headache;
- IV stage: degenerative changes are pronounced, movements in the cervical spine are very limited and painful. The neck area can be almost completely immobilized.
Symptoms of degenerative changes in the cervical spine
Most people with cervical osteochondrosis experience chronic aching pain and neck stiffness. As the disease progresses, other symptoms may appear (especially if the spinal roots, vertebral artery, and adjacent nerve plexuses are compressed).
Symptoms of degenerative changes in the cervical spine:
- neck pain that worsens with movement or standing;
- the pain spreads to the shoulder or arm;
- numbness, tingling and weakness in the arms and hands;
- clicking or grinding in the neck (especially when turning the head);
- headache;
- attacks of vertigo;
- impaired movement coordination;
- loss of bladder or bowel control.
If such symptoms appear, it is necessary to consult a neurologist as soon as possible.
Types of symptoms of "cervical osteochondrosis"
All symptoms of "cervical osteochondrosis" can be conditionally classified into 3 groups, i. e. syndromes: vertebral, radicular and vertebral arterial syndrome.
Symptoms of vertebral (spinal) syndrome:
- crunching in the neck when moving;
- limited mobility;
- violation of the position of the vertebrae in relation to each other in the neck;
- smoothing out the natural cervical lordosis or lateral curvature in the cervical spine (can only be seen on X-ray, MRI or CT).
Symptoms of radicular syndrome:
- numbness in the fingers of one or both hands;
- shooting, burning pain in the neck, which spreads to the arm or both arms;
- dystrophy of neck and arm muscles.
Symptoms of vertebral artery syndrome:
- paroxysmal dizziness, until loss of consciousness;
- sudden jumps in blood pressure;
- tinnitus;
- blurred vision or spots in the eyes;
- loss of balance and attacks of nausea when moving the head;
- headache (severe pain on one or both sides).
Diagnosis of degenerative changes in the cervical spine
In order to understand the cause of neck pain and make a diagnosis of "degenerative changes in the cervical spine" (commonly called cervical osteochondrosis), the doctor will have to perform an examination, study the medical history, evaluate the results of laboratory tests and instrumental examinations. .
Diagnosis and treatment of cervical osteochondrosis is carried out by a neurologist.
Inspection
During the examination, the doctor will listen to the patient's complaints, clarify the details of the history and perform an examination: check reflexes, muscle strength, sensitivity and the condition of the vestibular apparatus.
In "cervical osteochondrosis", visible areas of muscle atrophy (muscle loss), reduced or increased muscle tone of the long back muscles and static disorders in the cervical region in the neck area can be observed. When palpating the muscles, the person complains of pain, and when tilting the head, the pain may radiate to the head or arms, and dizziness or headache may also occur.
In addition, patients may have motor impairments in the hands (weakness), vision and hearing problems.
The doctor may also ask the patient to walk, stand on one leg with the eyes closed, or touch the nose. In this way, the specialist will be able to assess whether movement coordination is disturbed, whether there are problems with gross and fine motor skills.
Laboratory diagnostics
To assess the general state of the bones, patients with suspected cervical osteochondrosis are prescribed blood tests for total and ionized calcium, as well as markers of growth and destruction of bone tissue - osteocalcin and osteoprotegerin, alkaline phosphatase.
In progressive cervical osteochondrosis, joints are destroyed, calcium content may be reduced, and osteocalcin and osteoprotegerin, on the contrary, increased.
Total creatine kinase is also considered a marker of muscle tissue destruction in cervical muscle myositis.
In addition, the doctor may need to evaluate the blood levels of trace elements involved in the regulation of muscle tone: magnesium, potassium, sodium.
Instrumental diagnostics
To determine the cause of neck pain and accompanying disorders, imaging studies are necessary: radiography of the cervical spine, computed tomography and magnetic resonance, electroneuromyography.
- Radiography.Using X-rays, you can identify bone deformations, malignant tumors and degenerative changes in the joints.
- Computer and magnetic resonance imagingit is performed if pathology of the spinal column, spinal cord or brain is suspected. Computed tomography shows hemangiomas of the vertebral bodies and gross deformities of the cervical spine. Magnetic resonance imaging is more informative for visualization of muscles, roots and spinal cord.
- Electroneuromyography- a method for studying the efficiency of impulse transmission along a nerve fiber using a low-intensity electric current. The test can be a little uncomfortable. The study helps clarify the conduction of impulses along roots, nerves and from nerves to muscles, confirm damage to nerves or muscles, and clarify the nature and level of damage.
Treatment of degenerative changes in the cervical spine
The main goals of treating degenerative changes in the cervical spine are pain relief, prevention of nerve compression in the neck, and restoration of cervical mobility.
Depending on the severity of the condition, the doctor may prescribe medication, physical therapy or massage. Surgery may be required if nerves are pinched or joints are deformed.
Treatment of degenerative changes in the cervical spine with drugs
Neck pain can be relieved with medication.
Medicines to relieve pain and stiffness in the neck:
- local anesthetic ointments, gels and patches;
- non-steroidal anti-inflammatory drugs;
- hormonal drugs in the form of tablets or injections in the area of the affected joint;
- muscle relaxants to relieve muscle spasms;
- antidepressants to relieve chronic pain.
Treatment of cervical osteochondrosis without drugs
In addition to drug therapy, it is important for patients with cervical osteochondrosis to do neck exercises. For this purpose, the person is referred to a physiotherapist for consultation. Learn how to properly stretch and strengthen neck and shoulder muscles.
Your doctor may recommend mats or rollers with metal or plastic needles. They are used 15-30 minutes before going to bed to relax the muscles.
Wearing a Shantz splint (neck brace) is a passive exercise therapy for the deep muscles of the cervical region that are difficult to influence with exercise. When a person puts on a splint, the muscles relax, and when they take it off, they tense. If you wear a splint for 15-20 minutes several times a day, you can train and strengthen them.
It only makes sense to wear it for 2-3 hours if you have serious neck injuries. In addition, you should not lie in it, let alone sleep.
Surgical treatment of degenerative changes in the cervical spine
As a rule, surgery is required for patients with severe deformation of the spinal column who have a pinched nerve.
During the operation, the surgeon removes pathological elements (hernial protrusions, formations, etc. ) or part of the vertebra. After such treatment, a long period of rehabilitation is required: wearing a Shants splint or rigid cervical spine splint, physiotherapy, regular walking, painkillers.
Complications and consequences of degenerative changes in the cervical spine
Without treatment, the intervertebral discs gradually wear out and the vertebrae are "erased".
Common complications of degenerative changes in the cervical spine:
- syndrome of severe pain in the head, neck, chest;
- spasms, movement disorders and numbness of the hands;
- frequent dizziness, impaired movement coordination, fine and gross motor skills.
Prevention of degenerative changes in the cervical spine ("cervical osteochondrosis")
There is no specific prevention of true cervical osteochondrosis, as it is a hereditary disease.
In order to avoid the appearance of non-specific pain in the neck, which is mistakenly associated with cervical osteochondrosis, it is important to ensure proper posture and be physically active: the more a person moves, the better the condition of muscles, bones, ligaments and joints.
To maintain physical activity, adults need 150 minutes of moderate-intensity aerobic activity per week. It is suitable for brisk walking, swimming, cycling, tennis, dancing or rollerblading. Pilates and yoga will help you strengthen your muscles.
In addition, gymnastics helps to avoid overstraining the neck muscles and the appearance of pain: tilting the head forward, back, alternately on each shoulder and rotating, as well as sleeping on an orthopedic pillow.
Injuries to the cervical spine should be avoided: do not jump into the water upside down, fasten seat belts in the car (prevention of whiplash injury in an accident).
Sleeping position for back pain
Neck and back pain, which is often attributed to osteochondrosis, can be the result of an uncomfortable sleeping position.
During sleep, the head and spine should be approximately at the same level. This position minimizes additional pressure on the neck area.
If a person sleeps mostly on his back, the height of the pillow should be on average 6-11 cm. For side sleepers, the pillow should be thicker: from 9 to 13 cm. In this way, the desired angle will be the angle. if it is maintained between the shoulders and the head, the cervical spine will not sag and the muscles will strain to compensate for the discomfort.
Moreover, the heavier the person, the higher the pillow should be. You also need to pay attention to the hardness of the mattress. The softer it is, the more it will sag under the weight of the body and the pillow should be higher. In addition, it is better not to always sleep on one side - this leads to muscle imbalance.
If a person prefers to sleep on his stomach, he may suffer more often from back and neck pain. The fact is that in this position it is difficult to keep the spine in a neutral position. To reduce tension from the back, you can put a pillow under the pelvis and lower abdomen, and choose a flat pillow under the head or even sleep without it.
In addition, you can use a special orthopedic pillow.
FAQ
- Where can pain radiate from "cervical osteochondrosis"?
Pain from degenerative changes in the cervical spine can radiate to the shoulder or arm, and increase when moving or standing.
- How to relieve an attack of vertigo in "cervical osteochondrosis"?
To relieve an attack of vertigo, you should take a comfortable position in which the probability of falling is minimal (sit on a chair with a back support or lie down) and call for help. After 5-7 minutes, you can try to turn your head: most likely, the vertigo attack will pass during this time. If vertigo persists or worsens, nausea, vomiting or other neurological symptoms (disturbances in speech, vision, movement, swallowing, sensitivity) appear, you should call an ambulance as soon as possible.
- How to sleep properly with "cervical osteochondrosis"?
During sleep, the head and spine should be approximately at the same level. This position minimizes additional pressure on the neck area.
- How long does the exacerbation of "osteochondrosis" of the cervical spine last?
On average, worsening of symptoms due to degenerative changes in the cervical spine ("cervical osteochondrosis") lasts from 4 to 7 days. Nonsteroidal anti-inflammatory drugs and muscle relaxants are used to reduce pain. During this time, it is better for the person to remain calm and wear a neck brace.
- Which doctor treats "osteochondrosis" of the cervical spine?
Diagnosis and treatment of pain in the cervical region is carried out by a neurologist, neurosurgeon, orthopedist and general practitioner.