Osteochondrosis of the cervical spine

26 August 2020

Osteochondrosis is a degenerative-dystrophic intervertebral disc lesion, the cervical region being the most vulnerable part of the spine, which has an anatomically distinct vertebrae structure very close to each other and a weak muscle corset. Therefore, even with small additional loads on the neck, displacement of the vertebrae can occur, leading to compression of blood vessels and nerves.

And since the vertebral arteries that are involved in the blood supply to the brain pass through the holes in the transverse processes of the vertebrae in this section, pinching the vertebrae in this section or tightening the holes by overgrown osteophytes is fraught with very serious consequences.

What's that?

Osteochondrosis of the cervical spine is a progressive polyethiological disease, manifested by degeneration of the intervertebral discs and degeneration of the ligamentous apparatus of the spine.

Reasons for

The main causes and prerequisites for the occurrence of osteochondrosis of the cervical vertebra are:

Spine curvature, scoliosis.
Stress, nervous tension negatively affect the general condition of the body, can cause cervical osteochondrosis.
Past infectious diseases often become the root cause.
Incorrect and uncomfortable body position while sleeping (for example, uncomfortable pillow).
Congenital problems or presence of hereditary diseases of the cervical spine.
Bad posture in youth and adolescence.
Overweight, obesity in varying degrees. Extra pounds increase the load on the vertebrae and discs, which leads to degenerative processes.
Back injuries that may have occurred during childhood or adolescence.
Disruption of metabolic processes.
Works related to physical work, which can cause diseases of the spine in its various parts.
Inactive lifestyle, sedentary work, inadequate exercise.

For the successful treatment of cervical osteochondrosis, it is necessary to first establish the cause of the occurrence, the prerequisites that caused its development and eliminate them. Until recently, the disease occurred only in people over 45 years old. Now that young people are exposed to it, the age group is 18 to 25 years old.

Characteristics of the cervical spine

We will consider how the cervical spine differs from the rest of the spine, and that in the process of developing osteochondrosis is a prerequisite for the development of these syndromes.

In the cervical region are important ganglia (nodules) of the autonomic nervous system.
In the transverse processes of the vertebrae, there are holes that form a channel through which the vertebral artery passes, which supplies oxygen and nutrients to the brain, cerebellum, auditory organs and also to the vertebral nerve. These are prerequisites for frequent clamping of the artery and nerve.
The cervical spine is the most mobile. It is characterized by all types of movements in full. These are preconditions for frequent infractions and subluxations.
The intervertebral foramen of the three lower vertebrae is not round, but triangular. These are prerequisites for the clamping of nerve roots by bone growth that are formed in osteochondrosis.
The intervertebral discs are not located between the vertebral bodies along their entire length. At the front, instead of them, there are protruding edges of the vertebrae, which are connected by joints. These are prerequisites for the occurrence of joint subluxation.

Stages of development

The degree of osteochondrosis is determined by the patient's clinical condition and complaints. The concept of degree should not be confused with the stages of osteochondrosis. The steps are discussed below.

First degree. The clinical manifestations are minimal, the patient may complain of low intensity cervical spine pain, which can get worse when the head is turned. Physical examination may show mild muscle tension in the neck.
Second degree. The patient is concerned about pain in the cervical spine, its intensity is much greater, there may be irradiation to the shoulder, to the arm. This is due to a decrease in the height of the intervertebral disc and clamping of nerve roots. Painful sensations increase when you tilt and turn your head. The patient may notice decreased performance, weakness, headache.
Third degree. The symptoms of cervical osteochondrosis intensify, the pain becomes constant with radiation to the arm or shoulder. Numbness or weakness appears in the muscles of the arm as the herniated intervertebral discs form. Worried about weakness, dizziness. The examination reveals limited mobility in the cervical spine, pain on palpation of the cervical spine.
The fourth degree. Complete destruction of the intervertebral disc occurs and its replacement by connective tissue. Dizziness increases, tinnitus arises, impaired coordination, as the process involves the vertebral artery that feeds the cerebellum and the occipital lobe of the brain.

Symptoms

The severity of the symptoms of cervical osteochondrosis depends on the degree of destruction of the vertebral structures. The symptoms are aggravated by the growth of bone tissue with the formation of osteophytes, radicular syndrome (radicular pain when a nerve is pinched), intervertebral hernia (protrusion of the disc in the spinal canal).

The first signs of the disease are recurrent headaches in the occiput, pain in the neck, crackles and pops in the vertebrae when turning the head and, sometimes, a slight tingling in the shoulders. Over time, the symptoms increase and the intensity of the pain increases.

Pain syndrome is the main manifestation of osteochondrosis. Neck pain is deaf, constant or acute, with lumbago below the occiput when turning the head. The entire cervical region or the projected area of the modified vertebra, as well as the clavicle, shoulder, scapula and heart area can hurt. The irradiation of pain in the jaw, teeth, arm, ear and eye area is not excluded. The muscles of the neck and shoulders are tense, painful on palpation. Difficulty raising the arm from the side of the injury - immediately there is lumbago in the shoulder or neck. The restriction of head movements due to pain usually occurs in the morning, after sleeping in an uncomfortable position.

The disease leads to compression of the peripheral nerve roots (radicular syndrome) and causes pain along the course of these nerves. Perhaps numbness in the hands or fingers, impaired sensitivity of certain areas of the skin innervated by the compressed nerve.

Some characteristic symptoms suggest which vertebrae are affected:

C1 - impaired sensitivity in the occipital region;
C2 - pain in the occipital and parietal regions;
C3 - decreased sensitivity and pain in the middle of the neck where the spinal nerve was violated, possibly impaired tongue sensitivity, impaired speech due to loss of control over the tongue;
C4 - decreased sensitivity and pain in the shoulder-scapular region, decreased tone of the head and neck muscles, possible respiratory disorders, pain in the liver and heart;
C5 - pain and sensory disturbance on the external surface of the shoulder;
C6 - pain that extends from the neck to the shoulder blade, forearm, external surface of the shoulder, radial surface from the forearm to the thumb;
C7 - pain that extends from the neck to the scapula, back of the shoulder, forearm to the fingers II - IV of the hand, impaired sensitivity in this area.
C8 - pain and sensory disorders spread from neck to shoulder, from forearm to little finger.

Cervical osteochondrosis is always accompanied by a headache. The intense and persistent pain is aggravated by the rotation of the neck or by sudden movements. Some patients complain of a feeling of heaviness in the head. Compression of the vertebral artery leads to bouts of dizziness, nausea. Noise is heard, ringing in the ears, flicker of black dots before the eyes. The deterioration of cerebral circulation causes a progressive decrease in hearing and visual acuity, numbness of the tongue and altered taste.

Clicks or crushing during neck movements almost always accompany cervical osteochondrosis, seen in all patients. Crunching occurs during a sudden turn of the head or when it is thrown back.

Syndromes due to cervical osteochondrosis

The symptoms of cervical osteochondrosis are grouped into specific groups called syndromes. Its presence and severity may indicate a pathology in the cervical spine with a specific location.

A group of common syndromes:

Vegetative-dystonic syndrome. The subluxation of the first cervical vertebra with displacement can lead to the development of vegetative-vascular dystonia. VSD is not a definitive diagnosis, as it does not show pronounced symptoms. There may be neurological signs, symptoms of decreased cerebral blood flow, spikes in intracranial pressure, muscle spasms. As a result, the patient's complaints are reduced to dizziness, decreased visual acuity, loss of consciousness, headache, nausea.
Irritating - reflective. Burning and sharp pain in the neck and neck, sometimes returning to the chest and shoulders, arising at the time of a change in the position of the head and neck, with sneezing and a sudden turn of the head.
Root. Also called cervical radiculitis, it combines symptoms associated with the violation of the nerve roots of the cervical vertebrae. Characterized by "chills" in the affected area, tingling in the fingers, forearms, pasty skin, spreading to some fingers.
Cardiac. Almost the same picture with angina pectoris often leads to an incorrect diagnosis and treatment. The syndrome appears due to irritation of phrenic nerve receptors, partially involving the pericardium and the pectoralis major muscle. Thus, spasms in the heart area are more reflexive, as a response to irritation of the cervical nerves.
Vertebral artery syndrome. It develops directly with the compression of the artery itself and with the irritation of the sympathetic nervous plexus, which is located around it. The pain in this pathology is burning or throbbing in the occipital region, spreading to the temples, superciliary arches, crown. It occurs on one and on both sides. Patients generally associate exacerbation with the state after sleeping in a non-physiological position, traveling in transport, walking. With severe symptoms, hearing loss, dizziness, tinnitus, nausea, vomiting, loss of consciousness, increased blood pressure are possible.

Diagnosis

Like any medical diagnosis, the diagnosis of osteochondrosis is established based on the patient's complaints, medical history, clinical examination and auxiliary research methods. X-ray of the cervical spine is performed in frontal and lateral projections, if necessary in special positions (with the mouth open). At the same time, experts are interested in the height of the intervertebral discs, in the presence of osteophytes.

Of the modern research methods, NMR and CT studies are used, which allow more accurate verification of the diagnosis. In addition to the listed methods of further research, you may need to consult related specialists (cardiologist, ophthalmologist, neurosurgeon), and examination by a neurologist is simply vital. The neurologist is involved in the treatment of osteochondrosis, therefore, after examining the patient, he, at his discretion, will prescribe the minimum necessary exam.

How to treat cervical spine osteochondrosis?

The complex treatment of cervical osteochondrosis can include the following traditional and non-traditional methods: drug treatment, massage, acupressure, manual therapy, physiotherapy, acupuncture, homeopathy, folk remedies, etc.

The main treatment regimen for osteochondrosis is the same for all locations of this disease:

First you need to relieve the pain.
Then the swelling is relieved.
At this stage, it is necessary to normalize blood circulation.
Strengthening the muscular corset.
Improving tissue nutrition and regeneration.

The list of medications and drugs for the treatment of cervical osteochondrosis at home is very long:

Anti-inflammatory (steroid). These are hormonal drugs that relieve inflammation and thus eliminate pain;
Analgesics (non-steroidal drugs that relieve pain). They are usually prescribed as pills or capsules. It should be remembered that most of these drugs cause irritation of the mucous membrane of the digestive tract;
Muscle relaxants are drugs that relax muscle tone. They are used in surgery and orthopedics as aids in pain relief. These drugs are administered parenterally and, therefore, are always under medical supervision. There is an extensive list of contraindications;

Chondroprotectors are drugs that contain substances that replace components of cartilage tissue. In order to have a lasting positive effect, these drugs must be taken for a very long period;
Ointments and gels for external use. This is the most affordable group of medicines for home use. They are divided into pain relievers for inflammation, heating and pain. These funds are frequently announced. In the case of cervical osteochondrosis, not all ointments are effective, in addition, due to their availability, they are sometimes used irrationally and without taking into account the peculiarities of the pathogenesis.
Vitamins. In osteochondrosis, vitamins are prescribed, which have a beneficial effect on the peripheral nervous system and improve conductivity. Water-soluble vitamins: B1, B6, B12, fat-soluble vitamins: A, C, D, E. In recent years, combined preparations containing analgesics and vitamin components have come to be prescribed more frequently.

Only a team of good specialists can choose the most appropriate therapy, which includes a neurologist, physiotherapist, massage therapist, surgeon, vertebral neurologist.

Physiotherapy

Exercise therapy for cervical osteochondrosis should be performed outside of acute exacerbation. The greatest efficiency of this technique is during the recovery period. There should be no discomfort and pain when running the complex!

Exercise # 1. Lying on your stomach, place your hands on the floor, lift your head and torso, your back should be straight. Stay in this position for 1-2 minutes. Slowly lower yourself to the floor. Repeat 2-3 times.
Exercise # 2. Lying on your stomach, stretch your arms along your body, turn your head to the left, try to touch the floor with your ear, then turn your head to the right. Repeat 6 to 7 times in each direction.
Exercise # 3. In a sitting position, as you inhale, lean forward and try to touch your chest with your head; then exhale, lean back and tilt your head back. Repeat 10-15 times.
Exercise # 4. While sitting, place your palms on your forehead, apply pressure with your palms on your forehead and your forehead on your palms. Continue this exercise for 30 seconds. Repeat 2-3 times.
Exercise # 5. Rotate your head slowly, first in one direction, then the other. 10 rotations in each direction. Watch out for dizziness. When it appears, the exercise stops.

Therapeutic massage

The massage can be performed at home, but with great care not to aggravate and harm the patient. The patient should be in prone position, place the forehead on the hands and stretch the chin towards the chest. The neck muscles should be completely relaxed.

Stroking. It is necessary to start the massage with these movements: stroking the collar area towards the lymph towards the supraclavicular and axillary nodules. Then, the flat and comb strokes are applied.
Push-ups. To perform push-ups, the masseuse places his hand on the neck (the index finger and thumb must be together) and goes down the spine. Push-ups can also be performed from the edge of the palm to the shoulder joints.

Therapeutic massage for cervical chondrosis

Rub. The friction is done to warm up the muscles, relax them and improve blood flow to the area. The massage should be initiated by the base of the skull, making circular and rectilinear movements with the fingers. You can also perform sawing movements with your palms parallel to your ribs.
Knead. The neck should be kneaded in a circular motion.
Vibration. The massage ends with strokes and vibration, which is performed with agitation and strokes.

Massage is necessary to strengthen muscle tone and relieve pain. Depending on the stage of osteochondrosis, a massage technique is selected. However, when doing neck massage, specialists use all the techniques of classical massage: rub, caress, knead, etc. In cases where the patient has pain on only one side, the massage begins on the healthy part of the neck, gradually moving to that part of the collar area where the painful sensations appear.

Manual therapy

Manual therapy helps to deal with acute and chronic pain, it also increases range of motion and improves posture. The main methods of manual therapy for osteochondrosis of the cervical spine:

Relaxing and segmental massage. It is used to warm up the muscles and relieve tension.
Mobilization. Influences aimed at restoring joint function by traction.
Manipulation. A strong push towards the patient's pathological areas. The procedure is accompanied by a characteristic shredding (return of the joint to its normal position).

The chiropractic practitioner must be fluent in these techniques. Otherwise, any error can result in injury.

Orthopedic pillows

Orthopedic sleeping pillows are an effective prevention tool. In many cases, osteochondrosis is aggravated by additional compression of the cervical artery and nerve roots while sleeping on an uncomfortable pillow. The orthopedic product guarantees a uniform horizontal position of the person during sleep and, thus, guarantees a physiologically adequate blood supply to the brain.

When choosing a pillow, one must take into account the individual anatomical characteristics of a person and correlate them with the volume and characteristics of the filling. A properly selected pillow brings tangible benefits to a patient with osteochondrosis of the cervical spine.

Physiotherapy

Physiotherapy procedures for osteochondrosis of the cervical spine:

Electrophoresis. It must be used with analgesics (anesthetics), which are injected under the skin using electronic pulses.
Ultrasound. It has a beneficial effect on the metabolic processes in the tissues of the cervical spine, due to which the swelling is removed, the pain passes.
Magnetotherapy. A safe method of treatment, which consists of exposing the damaged cells to a low frequency magnetic field. It has analgesic effect, acts as an anti-inflammatory agent.
Laser therapy. Improves blood circulation in the affected area, relieves tissue swelling, pain.

Physiotherapy procedures have a beneficial effect on discs and vertebrae in cervical osteochondrosis. In combination with taking medications, the combined treatment helps to eliminate the symptoms of the disease. The procedures are performed in a hospital or specialized polyclinic rooms. Before starting the course, it is necessary to consult a doctor, determine the duration of physical therapy, types. It is strictly prohibited to transmit it during an exacerbation.

Trench necklace

The Shants collar is a soft and comfortable device, fastened with velcro on the back and is used for cervical osteochondrosis. But not for treatment, but for temporary relaxation and fatigue relief. It cannot be used without removing it, otherwise the neck muscles will stop working and will soon atrophy. If the Shants collar is chosen correctly, the patient feels comfortable and protected.

The collar is selected strictly according to the size at the pharmacy or orthopedic store. Better in the store, because the people who work there, as a rule, know their business and the product's characteristics very well, which means they can help in each specific case.

Folk remedies

If the pain of osteochondrosis of the spine becomes unbearable and regular, you will agree to anything to stop it, and here the traditional complex treatment will be successfully complemented by alternative methods.

We insist on celery root (5 grams per 1 liter of boiling water) for 4 hours, drink a tablespoon before each meal;
honey compress, for which we take 2 teaspoons. honey and 1 mummy tablet. We heat the components in a water bath, spread on a cloth and apply to the cervical region, that is, neck, at night;
in case of acute pain, the cultivation of horseradish in the country helps me. I just wash his leaf, pour it with boiling water, cool it a little, apply it to my neck and wrap it with a thin scarf for the night - in the morning you can already live and work;
We insist chamomile flowers in vegetable oil for two days, preheat until boiling (for 500 ml of oil you need 30 grams of a plant), rub on painful areas;The potato compress with honey
also helps, for this, the tuber needs to be grated and mixed with honey in the same amount, applied to the sore neck at night, used regularly, at least once a week.

Prevention

As usual, adequate prophylaxis will help prevent cervical osteochondrosis, but, of course, all physical exercises should be used regularly, otherwise there will be little benefit from "periodic" exercises.

It remains to remember simple rules:

Eat plenty of foods with calcium and magnesium. These are fish, peas, vegetables, nuts, cheese, herbs, but it is better to abstain from sugar, flour, smoked, spicy.
exercising regularly, especially swimming, water aerobics, gymnastics for stretching and flexibility of the vertebrae is also indicated for the prevention of osteochondrosis, which can be practiced at home.
when sedentary, perform a special series of exercises at least a few times a day.
choose a good mattress and orthopedic pillow ideal for your neck, supporting your head in the correct anatomical position while sleeping (yes, your favorite huge feather pillows will not go away with spine problems! )

If you already have this diagnosis, then the patient should spare the spine, namely:

Be very careful when lifting and carrying weights, it is better to go to the store twice than to pull heavy bags with both hands, incredibly forcing the neck and shoulder girdle;
Don't over-cool, avoid drafts and cold air flow from the air conditioner (some people like to cool off on hot days, with their backs to the fan);
When tilting the trunk forward - remember osteochondrosis;
Avoid local overheating of the muscles, which can happen in excessively hot baths;
Don't forget to periodically move away from the monitor, change your body position, don't sit for hours, or even days;
Rest your neck by buying a Shants collar;
If possible, if the state of the cardiovascular system allows, take a steam bath.

To conclude, I would like to say that a child at risk of osteochondrosis (father and mother already have) and an adult who has acquired the disease throughout their lives are simply obliged to take preventive measures so that they do not become disabled and do not end up at the tableAfter all, this operation is quite complicated and requires long-term rehabilitation. In addition, it is not always possible, as there are inoperable cases, so it is better to protect health early, as long as the discs are intact and unnecessary growth does not compress the blood vessels.