Osteochondrosis is a lesion of the intervertebral discs of a degenerative-dystrophic nature, and the cervical region is the most vulnerable part of the spinal column, which has an anatomically different structure of very close adjacent vertebrae 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 squeezing the holes by overgrown osteophytes is fraught with very serious consequences.
What is this?
Osteochondrosis of the cervical spine is a polyetiologic progressive disease that is manifested by degeneration of the intervertebral discs and dystrophy of the ligamentous apparatus of the spine.
The main causes and prerequisites for the occurrence of osteochondrosis of the cervical vertebra are:
- Curvature of the spine, 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, uncomfortable body position during sleep (for example, uncomfortable pillow).
- Congenital problems or the presence of hereditary diseases of the cervical spine.
- Poor posture in young people and adolescence.
- Overweight, obesity of 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.
- Work related to physical labor, which can provoke diseases of the spine in its various parts.
- Inactive lifestyle, sedentary work, improper exercise.
For successful treatment of cervical osteochondrosis, it is first necessary to establish the cause of the occurrence, the prerequisites that provoked its development and eliminate them. Until recently, the disease occurred only in people over the age of 45. Now young people are exposed to it, the age range is 18-25 years old.
Cervical spine features
Let's consider how the cervical spine differs from the rest of the spine, and that during the development of osteochondrosis is a prerequisite for the development of these syndromes.
- In the cervical region are located important ganglia (nodes) of the autonomic nervous system.
- In the transverse processes of the vertebrae there are holes that form a canal through which the vertebral artery passes, which supplies oxygen and nutrients to the brain, cerebellum, hearing organs, and also the vertebral nerve. These are prerequisites for frequent clamping of the artery and nerve.
- The cervical spine is the most mobile. He is characterized by all types of movements in full. These are preconditions for frequent infringements and subluxations.
- The intervertebral foramen of the lower three vertebrae are not round, but triangular. These are prerequisites for the pinching of the nerve roots by bone growths that are formed in osteochondrosis.
- The intervertebral discs are not located between the vertebral bodies along their entire length. In the front part, instead of them, there are protruding edges of the vertebrae, which are connected by joints. These are prerequisites for the occurrence of joint subluxation.
The degree of osteochondrosis is determined by the clinical picture and the patient's complaints. The concept of degree should not be confused with the stages of osteochondrosis. The stages are discussed below.
- First degree. Clinical manifestations are minimal, the patient may complain of low-intensity cervical spine pain, which may worsen when turning the head. Physical examination may show slight muscle tension in the neck.
- Second degree. The patient is worried about pain in the cervical spine, its intensity is much greater, there may be irradiation to the shoulder, to the arm. This occurs due to a decrease in the height of the intervertebral disc and pinching of the nerve roots. Painful sensations increase when tilting and turning the head. The patient may notice decreased performance, weakness, headache.
- Third degree. Symptoms of cervical osteochondrosis intensify, the pain becomes constant with irradiation to the arm or shoulder. Numbness or weakness appears in the muscles of the arm, as herniated intervertebral discs form. Worried about weakness, dizziness. Examination reveals limited mobility in the cervical spine, pain on palpation of the cervical spine.
- The fourth degree. There is a complete destruction of the intervertebral disc and its replacement with connective tissue. Dizziness increases, tinnitus appears, impaired coordination, since the process involves the vertebral artery that feeds the cerebellum and the occipital lobe of the brain.
The severity of the symptoms of cervical osteochondrosis depends on the degree of destruction of the vertebral structures. 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 into the spinal canal).
The first signs of the disease are periodic headache in the occiput, soreness in the neck, crunching and clicks in the vertebrae when turning the head, sometimes a slight tingling sensation 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 either dull, constant, or sharp with lumbago below the occiput when turning the head. The entire cervical region or the projection area of the modified vertebra, as well as the clavicle, shoulder, scapula, and heart area, may hurt. Irradiation of pain in the lower jaw, teeth, arm, ear, 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 lesion - immediately there is a lumbago in the shoulder or neck. Restriction of head movements due to pain often occurs in the morning after sleeping in an uncomfortable position.
The disease leads to compression of the roots of the peripheral nerves (radicular syndrome) and causes pain along the course of these nerves. Perhaps numbness of the hands or fingers, impaired sensitivity of certain skin areas innervated by the pinched 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 half of the neck where the spinal nerve was infringed, possibly impaired sensitivity of the tongue, impaired speech due to loss of control over the tongue;
- C4 - impaired sensitivity and pain in the shoulder-scapular region, decreased tone of the muscles of the head and neck, possible respiratory disorders, pain in the liver and heart;
- C5 - pain and sensory disturbance in the outer surface of the shoulder;
- C6 - pain extending from the neck to the shoulder blade, forearm, outer surface of the shoulder, radial surface of the forearm to the thumb;
- C7 - pain extending from the neck to the scapula, back of the shoulder, forearm to fingers II – IV of the hand, impaired sensitivity in this area.
- C8 - pain and sensory disturbances spread from the neck to the shoulder, forearm to the little finger.
Cervical osteochondrosis is always accompanied by a headache. Severe, persistent pain is aggravated by turning the neck or sudden movements. Some patients complain of heaviness in the head. Compression of the vertebral artery leads to bouts of dizziness, nausea. There is noise, ringing in the ears, flickering of black dots before the eyes. Deterioration of cerebral circulation provokes a progressive decrease in hearing and visual acuity, numbness of the tongue, and a change in taste.
Clicks or crunching during neck movements almost always accompany cervical osteochondrosis, observed in every patient. The crunch appears during a sharp turn of the head or throwing it back.
Syndromes due to cervical osteochondrosis
Symptoms of cervical osteochondrosis are grouped into specific groups called syndromes. Their presence and severity may indicate a pathology in the cervical spine with a specified localization.
A group of common syndromes:
- Vegetative-dystonic syndrome. Subluxation of the first cervical vertebra with displacement can lead to the development of vegetative-vascular dystonia. VSD is not a definite diagnosis, since it does not have pronounced symptoms. There may be neurological signs, symptoms of impaired cerebral blood flow, surges in intracranial pressure, muscle spasms. As a result, the patient's complaints are reduced to dizziness, decreased visual acuity, loss of consciousness, headaches, nausea.
- Irritative - reflexive. Burning and sharp pain in the back of the head and neck, sometimes with a return to the chest and shoulder, arising at the time of a change in the position of the head and neck, with sneezing and a sharp turn of the head.
- Radicular. Otherwise called cervical radiculitis, it combines symptoms associated with infringement of the nerve roots of the cervical vertebrae. Characterized by "chills" in the affected area, tingling in the fingers, forearms, pasty skin, spreading to certain fingers.
- Cardiac. Almost the same picture with angina pectoris often leads to incorrect diagnosis and treatment. The syndrome appears due to irritation of the phrenic nerve receptors, partly involving the pericardium and pectoralis major muscle. Thus, spasms in the heart area are more reflexive, like a response to irritation of the cervical nerves.
- Vertebral artery syndrome. It develops directly both with compression of the artery itself, and with irritation of the sympathetic nerve plexus, which is located around it. The pain in this pathology is burning or throbbing in the occipital region with spread to the temples, superciliary arches, crown. Occurs both on one and both sides. Patients usually 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.
As with any diagnosis in medicine, the diagnosis of osteochondrosis is established on the basis of the patient's complaints, medical history, clinical examination and auxiliary research methods. Radiography of the cervical spine is performed in frontal and lateral projections, if necessary in special positions (with an open mouth). At the same time, specialists are interested in the height of the intervertebral discs, the presence of osteophytes.
Of modern research methods, NMR and CT studies are used, which allow the most accurate verification of the diagnosis. In addition to the listed methods of additional research, consultations of related specialists (cardiologist, ophthalmologist, neurosurgeon) may be needed, and examination by a neurologist is simply vital. A neurologist is engaged in the treatment of osteochondrosis, therefore, after examining the patient, he, at his discretion, will prescribe the necessary minimum examination.
How to treat osteochondrosis of the cervical spine?
Complex treatment of cervical osteochondrosis may 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 localizations of this disease:
- First you need to relieve 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 medicines and drugs for the treatment of cervical osteochondrosis at home is very extensive:
- Anti-inflammatory (steroid). These are hormonal drugs that relieve inflammation and, thereby, eliminate pain;
- Analgesics (non-steroidal drugs that relieve pain). They are usually prescribed as tablets 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 to relieve pain. These drugs are administered parenterally and are therefore always under medical supervision. There is an extensive list of contraindications;
- Chondroprotectors are drugs containing substances that replace components of cartilage tissue. To achieve a lasting positive effect, such medicines must be taken for a very long time;
- Ointments and gels for external use. This is the most accessible group of drugs for use at home. They are divided into relieving inflammation, warming and pain relievers. Such funds are often advertised. With cervical osteochondrosis, not all ointments are effective, in addition, due to their availability, they are sometimes used unreasonably and without taking into account the peculiarities of pathogenesis.
- Vitamins. With 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 both painkillers and vitamin components have become more often prescribed.
Only a team of good specialists can select the most suitable therapy, which includes a neurologist, physiotherapist, massage therapist, surgeon, and vertebral neurologist.
Exercise therapy for cervical osteochondrosis should be carried out outside of acute exacerbation. The greatest efficiency of this technique is during the recovery period. There should be no discomfort and pain during the execution of the complex!
- Exercise # 1. Lying on your stomach, put your hands on the floor, raise your head and torso, your back should be straight. Remain 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 6-7 times in each direction.
- Exercise # 3. In a sitting position, while inhaling, bend forward, and try to touch your chest with your head, then exhaling, bend back and tilt your head back. Repeat 10-15 times.
- Exercise # 4. While sitting, put 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. Slowly rotate your head first in one direction, then in the other direction. 10 rotations in each direction. Watch for dizziness. When it appears, the exercise stops.
Massage can be performed at home, but very carefully so as not to aggravate and harm the patient. The patient should take a prone position, put the forehead on the hands and stretch the chin towards the chest. The neck muscles must be completely relaxed.
- Stroking. It is necessary to start the massage with these movements: stroking the neck area in the direction of the lymph to the axillary and supraclavicular nodes. Then flat and comb strokes are applied.
- Pushups. To perform push-therapist puts his hand across the neck (the thumb and fingers at the same time have to be together), and moves down the spine. Push-ups can also be performed with the edge of the palm up to the shoulder joints.
- Rubbing. Rubbing is done to warm up the muscles, relax them, and improve blood flow to the area. Massage should be started from the base of the skull, performing circular and rectilinear movements with your fingers. You can also perform sawing movements with palms parallel to the ribs.
- Kneading. The neck should be kneaded in a circular motion.
- Vibration. Finish the massage strokes and vibration, which is performed by means of shaking and tapping.
Massage is necessary to strengthen muscle tone and relieve pain. Depending on the stage at which osteochondrosis is, a massage technique is selected. However, doing a neck massage, specialists apply all the techniques of classical massage: rubbing, stroking, kneading, etc. In cases where the patient has pain on only one side, massage begins in a healthy part of the neck, gradually moving to the part of the neck area, where there are painful sensations.
Manual therapy helps to cope with both acute and chronic pain, it also increases range of motion and improves posture well. The main methods of manual therapy for osteochondrosis of the cervical spine:
- Relaxing and segmental massage. It is used to warm up muscles and relieve tension.
- Mobilization. Influences aimed at the restoration of joint function by traction.
- Manipulation. A sharp push aimed at the pathological areas of the patient. The procedure is accompanied by a characteristic crunch (return of the joint to its normal position).
The practitioner of chiropractic should be fluent in these techniques. Otherwise, any mistake could result in injury.
Orthopedic sleep 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 ensures a uniform horizontal position of a person during sleep and, thus, guarantees a physiologically adequate blood supply to the brain.
When choosing a pillow, one should take into account the individual anatomical features of a person and correlate them with the volume and characteristics of the filler. A properly selected pillow brings tangible benefits to a patient with osteochondrosis of the cervical spine.
Physiotherapy procedures for osteochondrosis of the cervical spine:
- Electrophoresis. It should be used with pain relievers (anesthetics), which are injected under the skin by means of electronic pulses.
- Ultrasound. It has a beneficial effect on metabolic processes in the tissues of the cervical spine, due to which swelling is removed, pain goes away.
- Magnetotherapy. A safe method of treatment, which consists in exposing damaged cells to a low-frequency magnetic field. It has an 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, combined treatment helps get rid of the symptoms of the disease. The procedures are carried out in a hospital or specialized rooms at polyclinics. Before starting the course, you must consult a doctor, determine the duration of physiotherapy, types. It is strictly forbidden to pass it during an exacerbation.
Shants collar is a soft and comfortable device, fastened with Velcro at the back and is used for cervical osteochondrosis. But not for treatment, but for temporary relaxation and relieve fatigue. It cannot be worn without taking it off, otherwise the neck muscles will stop working and soon atrophy. If the collar of Shants is chosen correctly, the patient feels comfortable and protected.
The collar is selected strictly according to the size in the pharmacy or orthopedic store. Better in a store, because the people who work there, as a rule, know their business and the characteristics of the product quite well, which means they can help in each specific case.
If the pain from osteochondrosis of the spine becomes unbearable and regular, then you will agree to anything to stop it, and here traditional complex treatment will successfully complement traditional methods.
- insist 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 tsp. honey and 1 tablet of mummy. We heat the components in a water bath, spread on a cloth and apply to the cervical region, that is, the neck, at night;
- in case of acute pain, horseradish growing in the country helps me. I just wash his leaf, pour it over with boiling water, cool it a little, apply it to the 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 to a boil (for 500 ml of oil you need 30 grams of a plant), rub into the sore areas;
- honey-potato compress also helps, for this, the root vegetable needs to be grated and mixed with honey in the same amount, applied to a sore neck at night, used regularly, at least once a week.
As usual, proper prophylaxis will help to avoid cervical osteochondrosis, but, of course, all physical exercises must be used regularly, otherwise there will be little benefit from "periodic" exercises.
It remains to remember simple rules:
- Eat plenty of calcium and magnesium foods. These are fish, peas, legumes, nuts, cheese, herbs, but it is better to abstain from sugar, flour, smoked, spicy.
- to exercise regularly, especially swimming, water aerobics, gymnastics for stretching and flexibility of the vertebrae is also suitable for preventing osteochondrosis, which can be practiced at home.
- when sedentary, perform a special set of exercises at least a couple of times a day.
- choose a good orthopedic mattress and a pillow that is ideal for the neck, supporting the head in the correct anatomical position during sleep (yes, your favorite huge down pillows won't go away with spinal problems! )
If you already have such a diagnosis, then the patient should spare his spine, namely:
- Be very careful with lifting and carrying weights, it is better to go to the store twice than to pull heavy bags in both hands, incredibly straining your neck and shoulder girdle;
- Do not overcool, avoid drafts and the flow of cold air from the air conditioner (some people like to cool down on a hot day, standing with their back to the fan);
- When bending the trunk forward - remember about osteochondrosis;
- Avoid local overheating of the muscles, which can happen in excessively hot baths;
- Do not forget to periodically break away from the monitor, change body position, do not sit for hours, or even days;
- Rest your neck by purchasing a Shants collar;
- If possible, if the state of the cardiovascular system allows, take a steam bath.
In conclusion, I would like to say that a child who is at risk of osteochondrosis (the father and mother already have it) and an adult who acquired the disease in the course of life are simply obliged to take preventive measures so as not to become disabled and not end up on the operating table, After all, this operation is rather complicated and requires long-term rehabilitation. In addition, it is not always possible, because there are inoperable cases, so it is better to protect your health from a young age, as long as the discs are intact and unnecessary growths do not squeeze blood vessels.