Osteochondrosis of the cervical spine.

26 August 2020

Osteochondrosis is a lesion of the intervertebral discs of a degenerative-dystrophic nature, and the cervical region is the most vulnerable part of the spine, which has an anatomically different structure of vertebrae very close to each other and a corsetweak muscle. 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 supply of blood to the brain pass through the holes in the transverse processes of the vertebrae in this section, pinch the vertebrae in this section or squeeze the holes by overgrown osteophytesis fraught with very dire consequences.

What's this?

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

Reasons for

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

Curvature of the spine, scoliosis.
Stress, nervous tension adversely affects the general condition of the body, can cause cervical osteochondrosis.
Past infectious diseases often become the main cause.
Incorrect and uncomfortable body position during sleep (eg uncomfortable pillow).
Congenital problems or presence of hereditary diseases of the cervical spine.
Poor posture in youth and adolescence.
Overweight, obesity to varying degrees. The 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 cause diseases of the spine in its various parts.
Inactive lifestyle, sedentary work, inadequate exercise.

For successful treatment of cervical osteochondrosis, it is first necessary to establish the cause of the appearance, the prerequisites that provoked its development, and eliminate them. Until recently, the disease occurred only in people older than 45 years. Now young people are exposed to it, the age range is 18 to 25 years.

Characteristics of the cervical spine

Let's consider how the cervical spine differs from the rest of the spine, and that during the development of osteochondrosis it is a prerequisite for the development of these syndromes.

Important ganglia (nodes) of the autonomic nervous system are located in the cervical region.
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 performing all kinds of movements in its entirety. 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 pinching of the nerve roots by bony growths that form in osteochondrosis.
The intervertebral discs are not found between the vertebral bodies over their entire length. In the front, instead of them, there are projecting edges of the vertebrae, which are connected by joints. These are prerequisites for the development of joint subluxation.

Stages of development

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

First degree. The 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 grade. The patient is concerned about pain in the cervical spine, its intensity is much higher, there may be radiation 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 a decrease in performance, weakness, headache.
Third grade. Symptoms of cervical osteochondrosis intensify, pain becomes constant with irradiation to the arm or shoulder. Numbness or weakness develops in the arm muscles as the 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 grade. There is a complete destruction of the intervertebral disc and its replacement by connective tissue. Dizziness increases, tinnitus appears, coordination impaired, 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. Symptoms are aggravated by bone tissue growth with osteophyte formation, radicular syndrome (radicular pain when a nerve is pinched), intervertebral hernia (disc protrusion in the spinal canal).

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

Pain syndrome is the main manifestation of osteochondrosis. Neck pain is dull, constant, or sharp with lumbago below occiput when turning the head. It can hurt the entire cervical region or the projection area of the modified vertebra, as well as the clavicle, shoulder, scapula, and heart area. Radiation of pain to the lower jaw, teeth, arm, ear, and eye area is not excluded. The muscles of the neck and shoulders are tight and painful on palpation. Difficulty lifting the arm on the side of the injury: immediately there is 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 peripheral nerve roots (radicular syndrome) and causes pain along the path of these nerves. Perhaps numbness of the hands or fingers, impaired sensation of certain areas of the skin innervated by the pinched nerve.

Some characteristic symptoms suggest which vertebrae are affected:

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

Cervical osteochondrosis is always accompanied by a headache. Severe and persistent pain is aggravated by turning the neck or making sudden movements. Some patients complain of heaviness in the head. Compression of the vertebral artery causes episodes of dizziness, nausea. There is noise, ringing in the ears, flickering 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 a change in taste.

Clicks or crackles during neck movements almost always accompany cervical osteochondrosis, which is seen in all patients. The creak appears during a sharp turn of the head or pulling it 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. 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 have pronounced symptoms. There may be neurological signs, symptoms of impaired cerebral blood flow, sudden increases in intracranial pressure, muscle spasms. As a result, the patient's complaints are reduced to dizziness, decreased visual acuity, loss of consciousness, headaches, nausea.
Irritant - reflective. Sharp, burning pain in the back of the head and neck, sometimes returning to the chest and shoulder, arising at the time of a change in position of the head and neck, with sneezing and a sharp turn of thehead.
Radicular. Also 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 often leads to incorrect diagnosis and treatment. The syndrome appears due to irritation of the receptors of the phrenic nerve, which partly affects the pericardium and the pectoralis major muscle. Therefore, spasms in the heart area are more reflexive, as a response to irritation of the cervical nerves.
Vertebral artery syndrome. It develops directly both with compression of the artery and with irritation of the sympathetic nervous plexus, which is located around it. The pain in this pathology is burning or throbbing in the occipital region with extension to the temples, superciliary arches, crown. It occurs on both one and both sides. Patients often 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 diagnosis in medicine, the diagnosis of osteochondrosis is established on the basis of patient complaints, medical history, clinical examination, and ancillary research methods. Radiography of the cervical spine is performed in frontal and lateral views, if necessary in special positions (with the mouth open). At the same time, specialists are interested in the height of the intervertebral discs, the presence of osteophytes.

Of modern research methods, MRI and CT studies are used, which allow the most accurate verification of the diagnosis. In addition to the listed methods of further investigation, you may need to consult related specialists (cardiologist, ophthalmologist, neurosurgeon), 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 minimum necessary 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, physical therapy, acupuncture, homeopathy, home remedies, etc.

The main treatment regimen for osteochondrosis is the same for all sites 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 of the muscular corset.
Improves nutrition and tissue regeneration.

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

Anti-inflammatory (steroid). These are hormonal drugs that relieve inflammation and thus eliminate pain;
Analgesics (non-steroidal pain relievers). They are usually prescribed in the form of 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 pain relief aids. These drugs are administered parenterally and therefore are always under medical supervision. There is an extensive list of contraindications;

Chondroprotectors are medications that contain substances that replace the components of cartilage tissue. To achieve a lasting positive effect, these drugs must be taken for a long time;
Ointments and gels for external use. This is the most accessible group of drugs to use at home. They are divided into painkillers to relieve inflammation, warm up, and relieve pain. These funds are often advertised. With cervical osteochondrosis, not all ointments are effective, moreover, due to their availability, they are sometimes used unreasonably and without taking into account the peculiarities of the 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, combination preparations containing both painkillers and vitamin components have been prescribed more often.

Only a team of good specialists can select the most suitable therapy, which includes a neurologist, physiotherapist, masseur, surgeon and spinal neurologist.

Physiotherapy

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

Exercise n. ° 1. Lying on your stomach, put your hands on the floor, raise your head and torso, your back should be straight. Stay in this position for 1-2 minutes. Slowly lower yourself to the ground. 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 ground with your ear, and then turn your head to the right. Repeat 6-7 times in each direction.
Exercise n. 3. In a sitting position, while inhaling, lean forward and try to touch your head with your chest, then exhale, bend back and tilt your head back. Repeat 10 to 15 times.
Exercise # 4. While sitting, place the palms of the hands on the forehead, apply pressure with the palms of the hands on the forehead and the forehead on the palms. Continue this exercise for 30 seconds. Repeat 2-3 times.
Exercise n. ° 5. Slowly turn your head first in one direction and then in the other. 10 rotations in each direction. Watch for dizziness. When it appears, the exercise stops.

Massage therapy

The massage can be done at home, but with great care 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 should be completely relaxed.

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

Therapeutic massage for cervical chondrosis.

Rub. It is rubbed to warm up the muscles, relax them, and improve blood flow to the area. The massage should start from the base of the skull, making circular and rectilinear movements with the fingers. You can also perform sawing motions with your palms parallel to the ribs.
Kneading. The neck should be rolled in a circular motion.
Vibration. The massage ends with strokes and vibrations, which is done with shaking and tapping.

Massage is necessary to strengthen muscle tone and relieve pain. Depending on the stage in which the osteochondrosis is, a massage technique is selected. However, when performing the neck massage, specialists use all the classic massage techniques: rubbing, stroking, kneading, etc. In cases where the patient has pain on only one side, the massage begins in the healthy part of the neck, gradually moving towards that part of the neck area where the painful sensations arise.

Manual therapy

Manual therapy helps to cope with 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 the muscles and relieve tension.
Mobilization. Influences aimed at the restoration of joint function by traction.
Manipulation. A strong push directed at the pathological areas of the patient. The procedure is accompanied by a characteristic crunch (return of the joint to its normal position).

The chiropractic practitioner must master these techniques. Otherwise, any errors could lead to injury.

Orthopedic pillows

Orthopedic sleeping pillows are an effective prevention tool. In many cases, osteochondrosis is exacerbated 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, the individual anatomical characteristics of a person should be taken into account and correlated 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 should be used with pain relievers (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 eliminated, the pain disappears.
Magnetotherapy. A safe treatment method, which consists of exposing the damaged cells to a low frequency magnetic field. It has an analgesic effect, acts as an anti-inflammatory agent.
Laser therapy. Improve blood circulation in the affected area, relieve tissue swelling, pain.

Physiotherapy procedures have a beneficial effect on the discs and vertebrae in cervical osteochondrosis. In combination with taking medicines, the combined treatment helps to eliminate the symptoms of the disease. The procedures are carried out in a hospital or specialized wards of polyclinics. Before starting the course, you should consult a doctor, determine the duration of physiotherapy, types. It is strictly forbidden to pass it during an exacerbation.

Trench Collar

The Shants collar is a soft and comfortable device that is attached with velcro at the back and is used for cervical osteochondrosis. But not for treatment, but for temporary relaxation and relief of fatigue. It cannot be used without taking it off, 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 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 that they can help in each specific case.

Folk remedies

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

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 tsp. honey and 1 mummy pill. We heat the components in a water bath, spread them on a cloth and apply them to the cervical region, that is, the neck, at night;
in case of acute pain, horseradish cultivation in the field helps me. I just wash its sheet, pour it 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 until boiling (for 500 ml of oil, 30 grams of a plant are needed), rub in sore areas;
also helps the honey-potato compress, for this, the tuber should 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, proper prophylaxis will help prevent cervical osteochondrosis, but of course all physical exercises should be used regularly, otherwise "regular" exercises will be of little benefit.

It remains to remember simple rules:

Eat lots of foods with calcium and magnesium. These are fish, peas, legumes, nuts, cheese, herbs, but it is better to refrain from sugar, flour, smoked, spicy.
regularly participate in sports, especially swimming, water aerobics and gymnastics for the stretching and flexibility of the vertebrae is also suitable for preventing osteochondrosis, which can be practiced at home.
When you're sedentary, do a special set of exercises at least a couple of times a day.
choose a good orthopedic mattress and pillow that is ideal for your neck, supporting your head in the correct anatomical position during sleep (yes, your favorite large down pillows won't go away with spinal problems! )

If he already has such a diagnosis, then the patient should preserve his spine, namely:

Be very careful lifting and carrying weights, it is better to go twice to the store than to take out heavy bags with both hands, incredibly stretching the neck and shoulder girdle;
Don't get too cold, avoid drafts and cold air flow from the air conditioner (some people like to cool off on a hot day, standing with their back to the fan);
When bending the trunk forward, remember osteochondrosis;
Avoid local overheating of the muscles, which can occur in excessively hot baths;
Do not forget to periodically move away from the monitor, change your body position, do not sit for hours or even days;
Rest your neck by buying a necklace from Shants;
If possible, if the state of the cardiovascular system permits, 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 throughout life are simply obliged to take preventive measures so as not to remaindisabled and not ending up on the operating table. After all, this operation is quite complicated and requires long-term rehabilitation. Also, it is not always possible, because there are inoperable cases, so it is better to protect your health from an early age, as long as the discs are intact and unnecessary growths do not squeeze the blood vessels.