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BACK Effective methods of treating osteochondrosis of the cervical spine.

In the modern world, almost all people over the age of 25 have this disease.Cervical osteochondrosis occurs much more often than in other parts of the spine.The relevance of this topic is hard to overestimate.In this article, we will look at why this disease appears, how it manifests itself, how to treat cervical osteochondrosis, which drugs are effective in treatment, which non-drug methods exist, and we will also find out the answers to the most common questions of patients with a similar diagnosis.Osteochondrosis of the cervical spine is a degenerative-dystrophic lesion (progressive) of the intervertebral discs in the cervical spine.

pain

Causes of cervical osteochondrosis

As a result of the action of the factors mentioned below, there is an increase in the load on the cervical spine, the neck muscles try to compensate for the excess load, they spasm, the blood circulation in this area is disturbed, which causes degenerative changes.As a result of a number of factors, changes occur on the intervertebral discs of the cervical spine, their structure changes, nutrition is disturbed, changes occur in the small joints between the vertebrae, bony outgrowths of the vertebral bodies appear due to the increased load on the changed intervertebral discs.Click to enlarge - exercise therapy for osteochondrosis of any part of the spine.Factors that contribute to the development of osteochondrosis of the cervical spine:

  • Poor posture and scoliosis
  • Excessive weight
  • Physical inactivity, sedentary work
  • Previous spinal injuries
  • Metabolic disorder
  • Great physical activity
  • Stress and constant nervous tension
  • Low level of physical fitness
  • Hereditary predisposition
  • Common incorrect body positions, such as holding the telephone receiver with your shoulder
  • Constant tension in the back and neck due to the nature of work (tense sitting position) in drivers and office workers.
  • Developmental anomalies of the cervical spine

The degree of development of cervical osteochondrosis

The degree of osteochondrosis is determined by the clinical picture and complaints of patients.The concept of degree should not be confused with the stages of osteochondrosis.The stages will be discussed below.

First degree

clinical manifestations are minimal, the patient may complain of low-intensity pain in the cervical spine, which may increase when turning the head.Physical examination may reveal mild tension in the neck muscles.

Second degree

The patient is worried about pain in the cervical spine, its intensity is much higher, the pain can radiate to the shoulder or arm.This happens due to a decrease in the height of the intervertebral disc and pinching of the nerve roots.The pain intensifies when leaning and turning the head.The patient may notice a decrease in performance, weakness and headache.

Third degree

the symptoms of cervical osteochondrosis intensify, the pain becomes constant, spreads to the arm or shoulder.Numbness or weakness appears in the arm muscles as herniated intervertebral discs form (see symptoms of lumbar herniation).I am worried about weakness and dizziness.Examination reveals limited mobility of the cervical spine and pain on palpation of the cervical spine.

Fourth degree

The intervertebral disc is completely destroyed and replaced by connective tissue.Dizziness increases, ringing in the ears appears, and coordination is disturbed, because the vertebral artery that supplies the cerebellum and the occipital lobe of the brain is involved in the process.

Symptoms depending on the damaged vertebra

We can separately distinguish radicular syndromes that lead to certain sensory and motor disorders.They differ depending on which vertebra compresses the spinal root:

  • C1: leads to stiffness and loss of sensitivity in the back of the head;
  • C2: pain in the parietal region and the back of the head;
  • C3: impaired speech, sensitivity of the tongue, pain and reduced sensitivity on the side where the spinal nerve is pinched;
  • C4: pain in the heart, left hypochondrium, shoulder, scapula, respiratory disorders, reduced neck muscle tone;
  • C5: shoulder pain in the outer area;
  • C6: pain that spreads from the forearm to the thumb, as well as from the neck to the shoulder blade;
  • C7: pain in the back of the shoulder, from the neck to the scapula, spreading into the forearm to 2-4 fingers;
  • C8: pain from neck to shoulder, from forearm to little finger.

Diagnosis of cervical osteochondrosis

Basic diagnostic methods:

  • X-ray of the cervical spine.It is a low informative method, especially in the later stages of the disease.
  • Computed tomography.It better shows changes in the vertebrae, but it is difficult to determine the size and presence of intervertebral hernias, as well as the presence of disc-medullary conflict (compression by a herniated spinal cord).
  • Magnetic resonance.The most informative method.Not only bone structures, but also intervertebral discs, hernias, their size and the direction of their growth are clearly visible.
  • If a violation of the blood flow in the vertebral arteries is suspected, an ultrasound duplex scan is used.This method allows you to accurately determine whether there is a decrease in the speed of blood flow or whether there are obstacles to normal blood flow.

X-ray stages of cervical osteochondrosis.

  • Phase 1 – minimal changes in the configuration of the vertebrae, smoothing of the cervical lordosis (curvature).
  • Stage 2 – instability between the vertebrae, possible movement of one vertebra in relation to the other, torsion (rotation around the axis of the spinal column), a slight decrease in the height of the intervertebral disc.
  • Stage 3 - reduction of the height of the intervertebral disc by ¼ compared to the disc located above it, changes in the intervertebral joints, posterior osteophytes (bone growths), narrowing of the intervertebral openings and narrowing of the spinal canal in which the spinal cord with its membranes is located.
  • Stage 4 - significant reduction in the height of the intervertebral disc, significant changes in the intervertebral joints, huge posterior osteophytes, significant narrowing of the intervertebral openings and significant narrowing of the spinal canal with the formation of myelopathy.

Symptoms

Damage to the upper part of the spine can be manifested by different symptoms, depending on the location and severity of the dystrophic process, as well as how seriously the radicular structures of the cervical spine are affected.Often, patients' complaints are reduced to symptoms that are not related at first glance, which can make diagnosis and further treatment of the disease difficult.In general, the clinical picture of cervical osteochondrosis consists of the following series of syndromes:

  • Vertebral, characterized by different types of pain in the back of the head and neck.
  • Spinal, in which symptoms of disturbed motor and sensory innervation are observed, in addition, disturbed trophism of the cervical zone causes gradual atrophy of the muscles of the shoulder girdle and arms.
  • Radicular, expressed in symptoms of pain in the area of peritoneal and chest organs, which requires additional detailed diagnostics to distinguish between osteochondrosis and diseases of internal organs.
  • Vertebral artery syndrome with cervical osteochondrosis is a vestibular disorder manifested by headaches, hearing loss, dizziness, and even loss of consciousness.These phenomena occur due to cerebral ischemia due to injury of the vertebral artery and weakening of the blood supply.

How to treat cervical osteochondrosis?

Osteochondrosis of the cervical segment develops gradually, and patients most often seek treatment already at the stage of clinical manifestations that disturb the quality of life, in periods of exacerbation.How to treat osteochondrosis of the cervical spine is decided only by a doctor after a proper diagnosis;self-medication in this case is unacceptable.Treatment of osteochondrosis of the neck is aimed at removing pain, inflammation, partial or complete restoration of affected tissue structures and prevention of complications.Treatment should be predominantly outpatient;any procedure at home can only be performed with a doctor's prescription, after instrumental and laboratory diagnostics.In advanced cases, in severe stages of development of neurological lesions and accompanying pathologies, hospital treatment of cervical osteochondrosis with the possibility of surgical intervention may be indicated.

Drug treatment of cervical osteochondrosis

It consists of prescribing courses of drugs that relieve symptoms of pain and inflammation.In the acute period, drugs in the form of injections are indicated;after a small cessation of pain, the patient takes tablets, means of local action in the form of ointment, and continues to receive injections.

  • Nonsteroidal anti-inflammatory drugs.They are considered the drugs of choice in the treatment of cervical osteochondrosis to relieve pain and inflammation.Available in various dosage forms.They reduce the swelling of soft tissues, which reduces pain;local agents have a warming effect, which improves blood flow in the affected area of the cervix.These drugs are used for 5-10 days, sometimes up to 2 weeks.In the acute period, NSAIDs are prescribed in the form of injections;after a few days, the patient switches to the form of tablets.It is worth remembering that long-term treatment with NSAIDs negatively affects the mucosa of the gastrointestinal tract, which is why the course of treatment usually does not exceed 10 days.
  • Hormones.If NSAIDs are ineffective, the patient may be prescribed paravertebral anesthetic blocks in the cervical spine with glucocorticosteroids as a treatment for pain, usually injection of dexamethasone or hydrocortisone into the affected area or tablets.Medicines of this group are prescribed to patients with cervical radicular syndrome to alleviate the swelling of the nerve fiber.
  • Anesthetics.They are prescribed in the form of local neuromuscular blockades, which eliminate strong pain symptoms.The block can be intradermal, subcutaneous, muscular, perineural or radicular, depending on where the injection is given.To prolong the analgesic effect, anesthetics are given together with hormones.Treatment of osteochondrosis of the neck is carried out every other day, a total of 5-7 such procedures are prescribed.Anesthetics can also be administered by injection into special biologically active points;this treatment technique is a type of acupuncture and is called pharmacopuncture.
  • Antispasmodics and drugs that improve microcirculation in the cervical and neck area.Nicotinic acid and others can be prescribed to treat muscle tension in the affected area.By removing spasms of the neck muscles and improving blood flow, blood flow in the affected area is stimulated, and the symptoms of cervical osteochondrosis and inflammation are alleviated.In the period of exacerbation, diuretics are also taken in order to reduce vascular spasm and thereby improve microcirculation in the affected area.
  • Sedatives, such as tincture of valerian, peony and herbal teas, are recommended for prolonged pain and to reduce the risk of developing neuroticism in patients, which contributes to the effectiveness of the treatment of cervical osteochondrosis.
  • Local irritants.We are talking about ointments, gels, rubs with local effect that have a warming, irritating and distracting effect.They are not used in the treatment of the acute stage.They contain biologically active substances of plant and animal origin, for example, bee or snake venom.If you have hypersensitivity to the components of the drug and if its irritating effect is high, it is better not to use them in order not to cause even greater swelling.
  • Vitamins.In the period of treatment and further rehabilitation, multivitamin complexes are recommended for use.Usually it is a group of B vitamins, whose representatives are involved in ensuring normal nerve conduction, as well as vitamins A and C, for strengthening the walls of blood vessels and improving blood flow.Taking vitamins reduces vestibular disorders - motion sickness syndrome, dizziness, hearing loss.
  • Chondroprotectors.These are substances that stimulate the renewal of the cartilage tissue of the vertebral discs of the cervical segment.Treatment of cervical osteochondrosis with chondroprotectors is carried out over a longer period of time, 6-12 months.

Orthopedic methods of treatment

Unpleasant symptoms in the cervical spine are often caused and aggravated by incorrect body position during sleep, prolonged exposure to a forced position or injury.Therefore, in the treatment of the disease, a method such as a cervical collar or Shants collar is often used.It is prescribed individually for each patient, after a doctor's consultation, because it comes in several variants.The collar is a framed dense roller that is attached around the neck and fixes the vertebrae in the desired position.Therefore, the neck does not bend and the head does not turn to the side, which ensures immobilization of the affected area, which is important in acute periods.The shunt neck collar can also be made in the form of two rollers with an inflatable layer, into which air is pumped with a rubber bulb.Inflating the layer between the rollers stretches the spine, which makes it possible to increase the inter-articular gaps in the cervical spine.The degree of stretching is determined by the doctor;it is not recommended to solve this problem independently in order to avoid damage to the neurovascular bundles of the neck.During the recovery period, a fully inflatable collar is used, which maintains some mobility of the neck and head.

The necklace can be worn at home, no more than 3 hours a day, the total course of wearing is about a month.Final wear regulations are determined by the doctor depending on the severity of the condition and existing symptoms.