The diagnosis of "cervical osteochondrosis" is usually made if a person complains of neck pain. Some also attribute dizziness, memory loss, numbness in the hands and other unpleasant symptoms. It is mistakenly believed that the disease is associated with wear and age-related deformation of intervertebral discs and other elements of the spine.
How does the cervical spine work?
The cervical region consists of 7 vertebrae. Among 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 surfaces of the vertebral processes, covered with cartilage, protrude. Joints are connected by ligaments and back muscles.
Why does neck pain occur?
Typically, neck pain occurs in response to strange movements, injuries, or due to inflammation of any of the structures in the cervical spine. Also, the cause of pain can be excessive stretching 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 articular processes. "Nerve entrapment", or cervical radiculopathy, specific processes (metastases, tumors of the vertebrae, spinal cord membranes in the cervical region) are relatively rare.
26% of men and 40% of women over the age of 30 have experienced neck pain in the last month, and 5% of men and 7% of women experience it all the time.
Acute neck pain usually goes away on its own within 1 to 2 weeks. Chronic pain, in most cases, arises due to a lack of physical activity or, on the contrary, very intense exercise.
However, people often mistakenly call unexplained pain and discomfort in the neck cervical osteochondrosis and associate its development with age-related wear and tear and deformation of the intervertebral discs and other elements of the spine. But this 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 disruption of the normal development and growth of bones. As a rule, osteochondrosis begins in childhood and is serious: part of the joint or bone becomes deformed and sometimes even dies. With this disease, most often it is not the cervical spine that is affected, but the thoracic spine (lower thoracic vertebrae). Hence the main clinical manifestation of osteochondrosis is a pronounced curvature of the thoracic spine, the so-called thoracic kyphosis.
Symptoms associated with damage to the thoracic spine:
- dyspnea,
- constant weakness
- inability to breathe fully,
- pain and burning behind the sternum,
- rapid heartbeat attacks.
Conditions accompanied by neck pain
Cervical spondylosis
In people over 50, neck pain is often caused by cervical spondylosis, age-related wear and tear on the vertebrae and related structures. With this disease, the intervertebral discs become dehydrated and flattened, worsening depreciation in the cervical region and many movements are accompanied by pain.
But changes in the spine as we age are normal. Thus, their structures begin to wear out from the age of 30, on average, and by the age of 60, 9 out of 10 people already have cervical spondylosis. However, in most people it is asymptomatic.
Other reasons
Less commonly, neck pain occurs due to hypothermia or severe stress, due to herniated discs or abnormalities in the cervical vertebrae - bony growths (spurs) that compress the nerves extending 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.
Furthermore, the muscles of the cervical spine are closely connected to the aponeurosis - a broad tendinous plate that surrounds the head. The muscular elements of the aponeurosis in the occipital, temporal and frontal regions connect with the muscles in the cervical region, so neck pain is often accompanied by a headache. So, pain in the neck, which appears after prolonged sedentary work or sleep in an uncomfortable position and is combined with a headache, in most cases is associated with a lack of physical activity and incorrect posture and is not dangerous to health.
The phenomenon of tech neck, the so-called techno-neck or neck of the Internet era, is associated with pain resulting from an uncomfortable posture. Techneck is the result of constant use of computers and smartphones, which forces the person to bend their neck. The fact is that the relative mass of the head increases with forward tilt. Thus, 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, the neck muscles become overloaded, microtraumas, inflammation, fibrosis (excessive growth of connective tissue) and, consequently, pain can occur.
Reasons contributing to the development of degenerative changes in the cervical spine
The occurrence of pain in the cervical spine is facilitated by birth or any other injuries of the spine, anomalies in its development, postural disorders, muscular 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 verticalization, when the load on them increases, they become excessively tense. Pain occurs.
- 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 cause neck pain.
Stages of degenerative changes in the cervical spine
There are 4 main stages of degeneration (destruction) of the cervical spine:
- Stage I: the intervertebral discs become thinner, slight discomfort appears in the neck area;
- Stage II: intervertebral discs are deformed, the distance between the vertebrae is reduced. The pain increases with movements of the cervical spine;
- Stage III: the cartilage and vertebrae rub against each other, the pain in the neck becomes constant and movement becomes limited. With very severe deformities of the cervical spine, vertebral artery syndrome with visual and vestibular disorders, headache may occur;
- Stage IV: degenerative changes are pronounced, movements of 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 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;
- pain radiates to the shoulder or arm;
- numbness, tingling and weakness in the arms and hands;
- clicking or creaking in the neck (especially when turning the head);
- headache;
- dizziness attacks;
- impaired coordination of movements;
- loss of bladder or bowel control.
If such symptoms appear, you should 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, or syndromes: vertebral, radicular and vertebral artery syndrome.
Symptoms of vertebral (spinal) syndrome:
- clicking in the neck when moving;
- Limited mobility;
- violation of the location of the vertebrae relative to each other in the neck;
- smoothing of the natural cervical lordosis or lateral curvature of the cervical spine (can only be seen on x-ray, MRI or CT scan).
Symptoms of radicular syndrome:
- numbness of the fingers on one or both hands;
- sharp, burning pain in the neck, radiating to the arm or both arms;
- dystrophy of the muscles of the neck and arms.
Symptoms of Vertebral Artery Syndrome:
- paroxysmal dizziness, up to loss of consciousness;
- sudden jumps in blood pressure;
- noise in the ears;
- blurred vision or spots in the eyes;
- loss of balance and bouts of nausea when moving the head;
- headache (severe pain on one side or both sides).
Diagnosis of degenerative changes in the cervical spine
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 need to conduct 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 medical history and carry out an examination: he will check reflexes, muscle strength, sensitivity and the condition of the vestibular apparatus.
In "cervical osteochondrosis", visible areas of muscle atrophy (muscle wasting), decreased or increased muscle tone of the long back muscles and static disorders in the cervical region in the neck region 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, causing dizziness or headache.
In addition, patients may experience movement disorders in the hands (weakness), vision and hearing problems.
The doctor may also ask the patient to walk, stand on one leg with their eyes closed, or touch their nose. This way, the specialist will be able to assess whether the coordination of movements is impaired and whether there are problems with gross and fine motor coordination.
Laboratory diagnosis
To assess the general condition of bones, patients with suspected cervical osteochondrosis are given blood tests for total and ionized calcium, as well as markers of growth and destruction of bone tissue - osteocalcin and osteoprotegerin, alkaline phosphatase.
With progressive cervical osteochondrosis, the joints are destroyed, the calcium content may decrease, and osteocalcin and osteoprotegerin, on the contrary, increase.
Total creatine kinase is also considered a marker of muscle tissue destruction in cervical muscle myositis.
Additionally, the doctor may need to assess blood levels of microelements involved in regulating muscle tone: magnesium, potassium, sodium.
Instrumental diagnostics
To establish the cause of neck pain and associated disorders, imaging studies are necessary: x-ray of the cervical spine, computed tomography and magnetic resonance imaging, electroneuromyography.
- Radiography.Using X-rays, you can identify bone deformations, malignant tumors and degenerative changes in the joints.
- Magnetic and computerized resonance imagingcarried out if pathology of the spine, spinal cord or brain is suspected. Computed tomography shows hemangiomas of the vertebral bodies and gross deformities of the cervical spine. MRI is more informative for visualizing muscles, roots and spinal cord.
- Electroneuromyography- a method for studying the efficiency of impulse transmission along a nerve fiber using low-intensity electrical 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 the 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 to relieve pain, prevent compression of the nerves in the neck, and restore cervical mobility.
Depending on the severity of the condition, your doctor may prescribe medication, physical therapy, or massage. Surgery may be necessary if nerves are compressed or joints become deformed.
Drug treatment of degenerative changes in the cervical spine
Neck pain can be relieved with medication.
Medicines to relieve neck pain and stiffness:
- local anesthetic ointments, gels and patches;
- nonsteroidal anti-inflammatory drugs;
- hormonal medications in the form of tablets or injections into the affected joint area;
- muscle relaxants to relieve muscle spasms;
- antidepressants to relieve chronic pain.
Non-drug treatment of cervical osteochondrosis
Along with drug therapy, it is important for patients with cervical osteochondrosis to do neck exercises. To do so, the person is referred for consultation with a physiotherapist. Teaches you how to properly stretch and strengthen your neck and shoulder muscles.
Your doctor may recommend mats or rollers with metal or plastic needles. They are used 15 to 30 minutes before bed to relax muscles.
Using a Shantz splint (neck brace) is a passive exercise therapy for the deep muscles of the cervical region, which are difficult to influence with exercise. When a person puts on a splint, the muscles relax and when they remove it, they become tense. If you wear a splint for 15 to 20 minutes several times a day, you can train and strengthen it.
It only makes sense to wear it for 2 to 3 hours if you have serious neck injuries. Furthermore, you shouldn't lie on it, much less sleep.
Surgical treatment of degenerative changes in the cervical spine
As a rule, surgery is necessary for patients with severe spinal deformity who have a pinched nerve.
During the operation, the surgeon removes pathological elements (hernial protrusions, formations, etc. ) or part of the vertebra. After this treatment, a long period of rehabilitation is necessary: use of a Shants splint or rigid splint for the cervical spine, 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:
- intractable pain syndrome in the head, neck, chest;
- cramps, movement disorders and numbness in the hands;
- frequent dizziness, impaired coordination of movements, fine and gross motor skills.
Prevention of degenerative changes in the cervical spine ("cervical osteochondrosis")
There is no specific prevention of true cervical osteochondrosis, because it is a hereditary disease.
To avoid the appearance of non-specific pain in the neck, mistakenly associated with cervical osteochondrosis, it is important to ensure correct posture and be physically active: the more the person moves, the better the condition of the muscles, bones, ligaments and joints.
To maintain physical activity, adults need 150 minutes of moderate-intensity aerobic activity per week. Brisk walking, swimming, cycling, tennis, dancing or rollerblading are suitable. Pilates and yoga will help strengthen your muscles.
In addition, gymnastics helps to avoid excessive strain on the neck muscles and the appearance of pain: tilting the head forward, backward, alternately to each shoulder and rotating it, as well as sleeping on an orthopedic pillow.
Injuries to the cervical spine must be avoided: do not jump into the water upside down, wear a seat belt in the car (prevention of cervical injuries in the event of an accident).
Sleeping position for back pain
Neck and back pain, often attributed to osteochondrosis, can be the result of an uncomfortable sleeping position.
During sleep, the head and spine should be at approximately the same level. This position minimizes additional pressure on the neck area.
If the person sleeps mainly on their back, the height of the pillow should be an average of 6 to 11 cm. For side sleepers, the pillow should be thicker: 9 to 13 cm. This way, the desired angle will be maintained between the shoulder and the head, the cervical spine will not sag and the muscles will tense to compensate for the inconvenience.
Furthermore, the greater the person's weight, 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 give under the weight of your body and the higher the pillow should be. In addition, it is better not to always sleep on one side - this leads to muscle imbalance.
If a person prefers to sleep on their stomach, they may suffer more frequently from back and neck pain. The fact is that in this position it is difficult to maintain a neutral spine. To relieve back tension, you can place a pillow under your pelvis and lower abdomen and choose a flat pillow under your head, or even sleep without it.
Additionally, you can use a special orthopedic pillow.
Common questions
- Where can the pain of "cervical osteochondrosis" radiate?
Pain caused by degenerative changes in the cervical spine can radiate to the shoulder or arm and also intensify with movement or standing.
- How to relieve a dizziness attack with "cervical osteochondrosis"?
To alleviate a dizziness attack, you should assume a comfortable position in which the likelihood of falling is minimal (sitting on a chair with a back or lying down) and ask for help. After 5-7 minutes, you can try to turn your head: most likely, the dizziness attack will pass during this time. If dizziness persists or worsens, nausea, vomiting or other neurological symptoms appear (disorders of speech, vision, movement, swallowing, sensitivity), call an ambulance as soon as possible.
- How to sleep well with "cervical osteochondrosis"?
During sleep, the head and spine should be at approximately the same level. This position minimizes additional pressure on the neck area.
- How long does an exacerbation of "osteochondrosis" of the cervical spine last?
On average, exacerbation of symptoms due to degenerative changes in the cervical spine ("cervical osteochondrosis") lasts 4 to 7 days. Nonsteroidal anti-inflammatory drugs and muscle relaxants are used to reduce pain. During this time, it is best for the person to remain calm and wear a neck brace.
- Which doctor treats "osteochondrosis" of the cervical spine?
The diagnosis and treatment of pain in the cervical region is carried out by a neurologist, neurosurgeon, orthopedist and general practitioner.