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BACK Effective methods of treating osteochondrosis of the cervical spine.

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

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Causes of cervical osteochondrosis

As a result of the action of the factors listed below, an increase in the load on the cervical spine occurs, the neck muscles try to compensate for the excess load, their spasm occurs, blood circulation in this area is disturbed, which causes degenerative changes.Due to a number of factors, changes occur in the intervertebral discs of the cervical spine, their structure changes, their nutrition is disturbed, changes occur in the small joints between the vertebrae, bone growths 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 contributing to the development of osteochondrosis of the cervical spine:

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

Degree of development of cervical osteochondrosis

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

First degree

clinical manifestations are minimal, the patient may complain of low-intensity pain in the cervical spine, which may intensify 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 greater, the pain can radiate to the shoulder or arm.This occurs due to a decrease in the height of the intervertebral disc and compression of the nerve roots.The pain intensifies when bending and turning the head.The patient may notice decreased performance, weakness and headache.

Third degree

the symptoms of cervical osteochondrosis intensify, the pain becomes constant, radiating to the arm or shoulder.Numbness or weakness appears in the arm muscles as intervertebral disc herniations form (see lumbar hernia symptoms).I'm worried about weakness and dizziness.On examination, limited mobility in the cervical spine and pain on palpation of the cervical spine are revealed.

Fourth degree

The intervertebral disc is completely destroyed and replaced by connective tissue.Dizziness increases, tinnitus appears and coordination is impaired, as the vertebral artery that irrigates the cerebellum and occipital lobe of the brain is involved in the process.

Symptoms depending on the damaged vertebra

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

  • C1: causes numbness and loss of sensitivity in the back of the neck;
  • C2: pain in the parietal region and neck;
  • C3: impaired speech, tongue sensitivity, pain and decreased sensitivity on the side where the spinal nerve is pinched;
  • C4: pain in the heart, left hypochondrium, shoulder, scapula, respiratory disorders, decreased muscle tone in the neck;
  • C5: pain in the external region of the shoulder;
  • C6: pain radiating from the forearm to the thumb, as well as from the neck to the scapula;
  • C7: pain in the posterior region of the shoulder, from the neck to the scapula, radiating to the forearm up to 2 to 4 fingers;
  • C8: pain from the neck to the shoulder, from the forearm to the little finger.

Diagnosis of cervical osteochondrosis

Basic diagnostic methods:

  • Radiograph of the cervical spine.It is an uninformative method, especially in the more advanced 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 due to spinal hernia).
  • Magnetic resonance imaging.The most informative method.Not only bone structures are clearly visible, but also intervertebral discs, hernias, their size and the direction of their growth.
  • If there is a suspicion of a violation of blood flow in the vertebral arteries, duplex ultrasound is used.This method allows you to accurately determine whether there is a decrease in blood flow velocity or whether there are obstacles to normal blood flow.

Radiographic stages of cervical osteochondrosis.

  • Stage 1 – minimal changes in the configuration of the vertebrae, softening of cervical lordosis (curvature).
  • Stage 2 – instability between the vertebrae, possible displacement of one vertebra in relation to another, torsion (rotation around the axis of the spine), slight decrease in the height of the intervertebral disc.
  • Stage 3 – reduction in the height of the intervertebral disc by ¼ in relation to the disc located above it, changes in the intervertebral joints, posterior osteophytes (bone protuberances), narrowing of the intervertebral foramina 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 foramina and significant narrowing of the spinal canal with the formation of myelopathy.

Symptoms

Damage to the upper spine can manifest itself in a variety of symptoms, depending on the location and severity of the dystrophic process, as well as the severity of the impact of the root structures of the cervical spine.Often, patients' complaints boil down to symptoms that at first glance are unrelated, which can complicate the diagnosis and subsequent treatment of the disease.In general, the clinical picture of cervical osteochondrosis consists of the following series of syndromes:

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

How to treat cervical osteochondrosis?

Osteochondrosis of the cervical segment develops gradually and patients generally seek treatment at the stage of clinical manifestations that interfere with quality of life, during periods of exacerbation.The treatment of osteochondrosis of the cervical spine is decided only by the doctor after adequate diagnosis;self-medication in this case is unacceptable.Treatment of cervical osteochondrosis is aimed at eliminating pain, inflammation, partial or complete restoration of affected tissue structures and prevention of complications.Treatment must be predominantly outpatient;any procedures at home can only be carried out in conjunction with medical prescriptions, after instrumental and laboratory diagnosis.In advanced cases, in severe stages of development of neurological lesions and concomitant pathologies, hospital treatment of cervical osteochondrosis with the possibility of surgical intervention may be indicated.

Drug treatment of cervical osteochondrosis

It consists of prescribing medications that relieve symptoms of pain and inflammation.In the acute period, injectable medications are indicated;after some pain disappears, the patient takes pills, local action agents in the form of ointments, 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 different pharmaceutical forms.Reduce swelling of soft tissues, thus reducing pain;local agents have a warming effect, which improves blood flow in the affected cervical area.These medications are used for 5 to 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 tablet form of administration.It is worth remembering that prolonged treatment with NSAIDs negatively affects the mucosa of the gastrointestinal tract, therefore 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, most often an injection of dexamethasone or hydrocortisone into the affected area or tablets.Medicines in this group are prescribed to patients with cervical radicular syndrome to relieve nerve fiber swelling.
  • Anesthetics.They are prescribed in the form of local neuromuscular blockades, which eliminates severe pain symptoms.The block can be intradermal, subcutaneous, muscular, perineural or radicular, depending on where the injection is administered.To prolong the analgesic effect, anesthetics are administered together with hormones.Treatment of cervical osteochondrosis is carried out every other day, a total of 5 to 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 medications that improve microcirculation in the cervical region and collar.To treat muscle tension in the affected area, nicotinic acid and others may be prescribed.By relieving neck muscle spasms and improving blood flow, blood flow in the diseased area is stimulated and symptoms of cervical osteochondrosis and inflammation are alleviated.During the period of exacerbation, diuretics are also taken to reduce vascular spasm and thus improve microcirculation in the affected area.
  • Sedatives, such as valerian tincture, peony and herbal teas, are recommended for prolonged pain and to reduce the risk of developing neuroticism in the patient, which contributes to the effectiveness of treatment of cervical osteochondrosis.
  • Local irritants.These are local ointments, gels and rubs that have a warming, irritating and disturbing effect.They are not used in the treatment of the acute phase.They contain biologically active substances of plant and animal origin, for example, bee or snake venom.If you are hypersensitive to the components of the medicine and their irritating effect is high, it is better not to use them, so as not to provoke even greater swelling.
  • Vitamins.During the period of further treatment and rehabilitation, it is recommended to use multivitamin complexes.Usually these are a group of B vitamins, whose representatives are involved in ensuring normal nerve conduction, as well as vitamins A and C, to strengthen the walls of blood vessels and improve blood flow.Taking vitamins reduces vestibular disorders - motion sickness syndrome, dizziness, hearing loss.
  • Chondroprotectors.These are substances that promote the restoration of the cartilaginous tissue of the vertebral discs of the cervical segment.Treatment of cervical osteochondrosis with chondroprotectors is carried out over a long period of time, from 6 to 12 months.

Orthopedic treatment methods

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 consulting a doctor, as it has several varieties.The collar is a dense framed roller that attaches to the neck and fixes the vertebrae in the desired position.The neck, therefore, does not bend and the head does not turn to the side, which guarantees immobilization of the diseased area, which is important in acute periods.The Shants collar can also be made in the form of two rolls with an inflatable layer, into which air is pumped using a rubber bulb.Inflating the layer between the rollers lengthens the spine, which makes it possible to increase the interarticular spaces of the cervical spine.The degree of stretching is determined by the doctor;It is not recommended to solve this problem alone, to avoid damage to the neurovascular bundles in the neck.During the recovery period, a fully inflatable collar is used, which preserves some mobility of the neck and head.

The collar can be used at home for a maximum of 3 hours a day, the total usage time is about a month.The final rules of use are determined by the doctor depending on the severity of the disease and existing symptoms.