The diagnosis of "cervical osteochondrosis" is often made when a person complains of neck pain. Some also attribute dizziness, memory loss, numbness in the hands and other unpleasant symptoms to it. It is erroneously believed that the disease is associated with wear and age-related deformation of the intervertebral discsand other elements of the spine.
How does the cervical spine work?
The neck area consists of 7 vertebrae. Between them are intervertebral discs - semi-rigid structures with a dense ring along the periphery and a jelly-like center that act as shock absorbers. To the right and left of each vertebra there are two joints, between which the cartilage-covered surfaces of the vertebral processes protrude. The joints are connected by ligaments and back muscles.
Why does neck pain occur?
Typically, neck pain occurs in response to awkward movements, injuries, or due to inflammation of one of the structures of the cervical spine. In addition, the cause of pain can be overstretching of muscles or ligaments, for example, when lifting weights, unsuccessfully turning the head, or against the background of arthrosis of the joints between the articular processes. "Nerve entrapment" or cervical radiculopathies, specific processes (metastases, tumors of the vertebrae, spinal cord membranes in the neck area) are relatively rare.
26% of men and 40% of women over 30 have experienced neck pain in the last month, and 5% of men and 7% of women feel it constantly.
Acute neck pain usually goes away on its own within 1-2 weeks. In most cases, chronic pain arises from a lack of physical activity or, on the contrary, from too intense physical activity.
However, people often mistakenly refer to unexplained pain and discomfort in the neck as cervical osteochondrosis, associating its development with wear and age-related deformation of the intervertebral discs and other elements of the spine. But such pain usually 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 normal development and growth of bones. As a rule, osteochondrosis begins in childhood and is severe: part of the joint or bone becomes deformed and sometimes even dies. This disease usually affects not the cervical spine, but the thoracic spine (lower thoracic vertebrae). Therefore, the main clinical manifestation of osteochondrosis is a pronounced curvature of the thoracic spine, the so-called thoracic kyphosis.
Symptoms associated with thoracic spine damage:
- dyspnea,
- constant weakness
- inability to breathe fully,
- pain and burning behind the breastbone,
- Attacks of palpitations.
Diseases associated with neck pain
Cervical spondylosis
In people over 50, neck pain is most often caused by cervical spondylosis, age-related wear and tear of the vertebrae and related structures. This disease causes the intervertebral discs to dry out and flatten, which worsens the wear and tear in the neck area and makes many movements painful.
But changes in the spine as we age are normal. The structures begin to wear out after an average of 30 years and by the age of 60, 9 out of 10 people already suffer from cervical spondylosis. However, in most people it is asymptomatic.
Different reasons
Less commonly, neck pain occurs due to hypothermia or severe stress, due to herniated discs or anomalies of the cervical vertebrae - bone growths (spurs) that compress the nerves coming from the spinal cord.
The most common cause of pain in the cervical spine and shoulder girdle is excessive tension (defense) of the muscles: trapezius, long back muscles of the cervical spine.
In addition, the muscles of the cervical spine are closely connected to the aponeurosis - a wide tendon plate that envelops the head. The muscular elements of the aponeurosis in the back of the head, temples and forehead area connect with the muscles of the cervical spine, so neck pain is often accompanied by headaches. Neck pain that occurs after prolonged sitting or when sleeping in an uncomfortable position and is accompanied by headaches is in most cases associated with a lack of physical activity and poor posture and does not pose a health risk.
The phenomenon of tech neck, the so-called techno neck or neck of the Internet age, is associated with pain caused by uncomfortable posture. Techneck is the result of constant use of a computer and smartphone, forcing a person to bend their neck. The fact is that the relative mass of the head increases with forward tilt. So, the average head weight of an adult in the "straight" position is 5 kg. If you tilt your head forward at least 15°, the load on the neck muscles is 13 kg, at 30° - 20 kg, at 60° - 30 kg. ThroughConstant overloading leads to overloading of the neck muscles, which can lead to microtrauma, inflammation, fibrosis (connective tissue overgrowth) and thus pain.
Reasons that contribute to the development of degenerative changes in the cervical spine
The occurrence of pain in the cervical spine is favored by childbirth or other injuries to 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 is forced to lie down for more than a month due to an underlying medical condition. As a result, the muscles become weaker - and during verticalization, excessive tension occurs as the load increases. Pain occurs.
- Obesity: Being overweight increases stress on spinal structures and can cause pain.
- Autoimmune diseases in which cartilage tissue is destroyed (autoimmune arthritis, polychondritis) also lead to neck pain.
Stages of degenerative changes in the cervical spine
There are 4 main stages of degeneration (destruction) of the cervical spine:
- Stage I: Intervertebral discs become thinner, slight discomfort occurs in the neck area;
- Stage II: Intervertebral discs are deformed and the distance between the vertebrae decreases. The pain increases with movements in the cervical spine;
- Stage III: Cartilage and vertebrae rub against each other, neck pain becomes permanent and movements are restricted. With very severe deformations of the cervical spine, vertebral artery syndrome can occur with visual and vestibular disorders, headaches;
- IV stage: degenerative changes are pronounced, movements in 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, additional symptoms may occur (particularly 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;
- the pain radiates to the shoulder or arm;
- numbness, tingling and weakness in arms and hands;
- Clicking or crunching in the neck (especially when turning the head);
- Headache;
- attacks of dizziness;
- impaired coordination of movements;
- Loss of bladder or bowel control.
If such symptoms occur, you should see a neurologist as soon as possible.
Types of symptoms of "cervical osteochondrosis"
All symptoms of "cervical osteochondrosis" can be conditionally divided into three groups or syndromes: vertebral, radicular and vertebral artery syndrome.
Symptoms of vertebral (spinal) syndrome:
- Crunch in the neck when moving;
- limited mobility;
- Violation of the position of the vertebrae relative to each other in the neck;
- Smoothing of the natural cervical lordosis or lateral curvature of the cervical spine (only visible on X-rays, MRI or CT).
Symptoms of radicular syndrome:
- Numbness of the fingers on one or both hands;
- stabbing, burning pain in the neck that radiates to the arm or both arms;
- Dystrophy of the neck and arm muscles.
Symptoms of Vertebral Artery Syndrome:
- paroxysmal dizziness up to unconsciousness;
- sudden jumps in blood pressure;
- noise in the ears;
- blurred vision or spots in the eyes;
- Loss of balance and attacks of nausea when moving the head;
- Headache (severe pain on one 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 must conduct an examination, study the medical history and 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 listens to the patient's complaints, clarifies the details of the medical history and conducts an examination: checking reflexes, muscle strength, sensitivity and the condition of the vestibular apparatus.
In "cervical osteochondrosis" visible muscle atrophies (muscle loss), reduced or increased muscle tone of the long back muscles, as well as static disorders in the neck area can be observed in the neck area. When palpating the muscles, a person complains of pain, and when tilting the head, the pain can be on the heador radiate to the arms and dizziness or headaches may occur.
In addition, patients may experience motor problems in the hands (weakness) as well as vision and hearing problems.
The doctor may also ask the patient to walk, stand on one leg with his eyes closed, or touch his nose. In this way, the specialist can assess whether movement coordination is impaired and whether there are problems with gross and fine motor skills.
Laboratory diagnostics
To assess the general condition of the bones, patients with suspected cervical osteochondrosis are prescribed blood tests for total and ionized calcium, as well as markers of bone tissue growth and destruction - osteocalcin and osteoprotegerin, alkaline phosphatase.
As cervical osteochondrosis progresses, the joints are destroyed, the calcium content may be reduced, but osteocalcin and osteoprotegerin are increased.
Total creatine kinase is also considered a marker of muscle tissue destruction in myositis of the neck muscles.
In addition, the doctor may need to determine the blood levels of microelements involved in the regulation of muscle tone: magnesium, potassium, sodium.
Instrumental diagnostics
To determine the cause of neck pain and associated disorders, imaging studies are required: radiography of the cervical spine, computed tomography and magnetic resonance imaging, electroneuromyography.
- Radiography.Using X-rays, you can detect bone deformations, malignant tumors and degenerative changes in the joints.
- Computed and magnetic resonance imagingCarried out when there is suspicion of pathology of the spine, spinal cord or brain. Computed tomography shows hemangiomas of the vertebral bodies and gross deformities of the cervical spine. Magnetic resonance imaging 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 electric current. The test can be somewhat uncomfortable. The study helps to clarify the conduction of impulses along the roots, nerves and from nerves to muscles, confirm damage to nerves or muscles and clarify the nature and extent 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 mobility to the cervical spine.
Depending on the severity of the disease, the doctor may prescribe medication, physical therapy or massage. If nerves become pinched or joints become deformed, surgery may be necessary.
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 plasters;
- Non-steroidal anti-inflammatory drugs;
- hormonal drugs in the form of tablets or injections into the area of the affected joint;
- muscle relaxants to relieve muscle spasms;
- Antidepressants to relieve chronic pain.
Non-drug treatment of cervical osteochondrosis
In addition to drug therapy, it is important for patients with cervical osteochondrosis to perform neck exercises. For this purpose, the person is referred to a physiotherapist for advice. It teaches how to properly stretch and strengthen the neck and shoulder muscles.
Your doctor may recommend mats or rollers with metal or plastic needles. They are used 15-30 minutes before bedtime to relax the muscles.
Wearing a Shantz splint (neck brace) is a passive movement therapy for the deep muscles of the cervical spine that are difficult to influence through movement. When a splint is put on, the muscles relax; when it is removed, the muscles become tense. Wearing a splint for 15-20 minutes several times a day can help exercise and strengthen it.
It only makes sense to wear it for 2-3 hours if you have a serious neck injury. In addition, you shouldn't lie in it, let alone sleep.
Surgical treatment of degenerative changes in the cervical spine
As a rule, surgery is required for patients with severe spinal deformity and a pinched nerve.
During the operation, the surgeon removes pathological elements (hernia protrusions, formations, etc. ) or parts of the vertebra. After such treatment, a long rehabilitation period is required: wearing a shants splint or a 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:
- persistent pain syndrome in the head, neck, chest;
- Cramps, movement disorders and numbness of the hands;
- frequent feeling of 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, as it is a hereditary disease.
To avoid the occurrence of nonspecific neck pain, which is mistakenly associated with cervical osteochondrosis, it is important to maintain correct posture and be physically active: the more a 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. Fast walking, swimming, cycling, tennis, dancing or inline skating are suitable. Pilates and yoga strengthen your muscles.
In addition, gymnastics helps to avoid overstrain of the neck muscles and the occurrence of pain: tilting and turning the head forward, back, alternately to each shoulder, as well as sleeping on an orthopedic pillow.
You should avoid injuries to the cervical spine: do not jump headfirst into the water, wear a seatbelt in the car (preventing whiplash 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.
When you sleep, your head and spine should be at approximately the same height. This position minimizes additional pressure on the neck area.
If someone sleeps primarily on their back, the height of the pillow should be an average of 6-11 cm. For side sleepers, the pillow should be thicker: 9 to 13 cm. In this way, the desired angle is achieved between the shoulder and the head is maintained, the cervical spine will not sag and the muscles will be tense to compensate for the discomfort.
In addition, the greater the person's weight, the higher the pillow should be. You also need to pay attention to the firmness of the mattress. The softer it is, the more it will sag under your body weight and the higher the pillow should be. It is also better not to always sleep on one side - this leads to an imbalance in the muscles.
If someone prefers to sleep on their stomach, they may experience more back and neck pain. The fact is that in this position it is difficult to keep the spine in a neutral position. To relieve tension in your back, you can place a pillow under your pelvis and lower abdomen, choose a flat pillow under your head, or even sleep without it.
In addition, you can use a special orthopedic pillow.
FAQ
- Where can pain in "cervical osteochondrosis" radiate?
Pain caused by degenerative changes in the cervical spine can radiate to the shoulder or arm and can also increase when moving or standing.
- How to relieve an attack of dizziness with "cervical osteochondrosis"?
To relieve an attack of dizziness, you should take a comfortable position in which the risk of falling is minimal (sitting on a chair with a back or lying down) and call 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 (impaired speech, vision, movement, swallowing, sensitivity) occur, you should call an ambulance as soon as possible.
- How do you sleep properly if you have "cervical osteochondrosis"?
When you sleep, your head and spine should be at approximately the same height. This position minimizes additional pressure on the neck area.
- How long does "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 relieve pain. During this period, it is better to remain calm and wear a cervical collar.
- Which doctor treats "osteochondrosis" of the cervical spine?
The diagnosis and treatment of pain in the neck area is carried out by a neurologist, neurosurgeon, orthopedist and general practitioner.