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BACK Effective methods of treating osteochondrosis of the cervical spine.

In the modern world, almost all people over 25 years old suffer from this disease.Cervical osteochondrosis is much more common than in other parts of the spine.The relevance of this topic can hardly be overestimated.In this article we will examine why this disease occurs, how it manifests itself, how to treat cervical osteochondrosis, what drugs are effective in treatment, what non-drug methods exist, and also find answers to the most common questions of patients with a similar diagnosis.Osteochondrosis of the cervical spine is a degenerative-dystrophic (progressive) damage to the intervertebral discs in the cervical spine.

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Causes of cervical osteochondrosis

Due to the action of the factors listed below, there is an increased load on the cervical spine, the neck muscles try to compensate for the overload, cramps occur, blood circulation in this area is disrupted, which leads to degenerative changes.Due to a number of factors, changes occur in the intervertebral discs of the cervical spine, changes in their structure, disturbances in their nutrition, changes in small joints between the vertebrae, bone proliferation of the vertebral bodies 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:

  • Poor posture and scoliosis
  • Overweight
  • Physical inactivity, sedentary work
  • Previous spinal injuries
  • Metabolic disorder
  • Great physical activity
  • Stress and constant nervous tension
  • Low physical fitness
  • Hereditary predisposition
  • Habitual incorrect postures, e.g.E.g. holding a telephone receiver with your shoulder
  • Work-related constant tension in the back and neck area (tension when sitting) in drivers and office workers.
  • Developmental anomalies of the cervical spine

Degree of development of cervical osteochondrosis

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

First degree

The clinical manifestations are minimal.The patient may complain of low-intensity pain in the cervical spine, which may increase when turning the head.A physical examination may reveal slight tension in the neck muscles.

Second degree

The patient is worried about pain in the cervical spine, the intensity of which is much greater, the pain can radiate to the shoulder or arm.This happens due to a decrease in the height of the intervertebral disc and pinching of the nerve roots.The pain increases when you tilt and turn your head.The patient may notice reduced performance, weakness and headaches.

Third degree

Symptoms of cervical osteochondrosis intensify, the pain becomes constant and radiates to the arm or shoulder.Numbness or weakness occurs in the arm muscles when herniated discs form (see symptoms of a lumbar herniated vertebra).I'm worried about weakness and dizziness.The examination reveals limited mobility of the cervical spine and pain when palpating the cervical spine.

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 supplies the cerebellum and occipital lobe of the brain is involved in the process.

Symptoms depend 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 head;
  • C2: Pain in the vertex and back of the head;
  • C3: Speech disturbances, tongue tenderness, pain and decreased sensitivity on the side where the spinal nerve is pinched;
  • C4: Pain in the heart, left hypochondrium, shoulder, scapula, respiratory disease, decreased neck muscle tone;
  • C5: External shoulder pain;
  • C6: Pain radiating from the forearm to the thumb and from the neck to the shoulder blade;
  • C7: Pain in the back of the shoulder, from the neck to the shoulder blade, radiating into the forearm up to 2-4 fingers;
  • C8: Pain from neck to shoulder, from forearm to little finger.

Diagnosis of cervical osteochondrosis

Basic diagnostic methods:

  • X-ray of the cervical spine.It is a less informative method, especially in later stages of the disease.
  • Computed tomography.It shows changes in the vertebrae better, but it is difficult to determine the size and presence of intervertebral hernias, as well as the presence of intervertebral disc-medullary conflict (compression caused by a spinal cord herniation).
  • 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 a circulatory disorder in the vertebral arteries is suspected, an ultrasound duplex examination is used.This method allows you to accurately determine whether the blood flow speed is decreasing or whether there are obstacles to normal blood flow.

X-ray stages of cervical osteochondrosis.

  • Stage 1 – minimal changes in the configuration of the vertebrae, smoothing of the cervical lordosis (curvature).
  • Stage 2 – instability between vertebrae, possible displacement of one vertebra relative 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 a quarter compared to the intervertebral disc above it, changes in the intervertebral joints, posterior osteophytes (bone outgrowths), narrowing of the intervertebral foramina and narrowing of the spinal canal in which the spinal cord and its membranes are 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 development of myelopathy.

Symptoms

Damage to the upper spine can manifest itself in different symptoms depending on the location and severity of the dystrophic process, as well as the severity of the impairment of the radicular structures of the cervical spine.Patient complaints are often reduced to symptoms that, at first glance, have nothing to do with each other, which can complicate the diagnosis and further treatment of the disease.In general, the clinical picture of cervical osteochondrosis consists of the following series of syndromes:

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

How to treat cervical osteochondrosis?

Osteochondrosis of the cervical segment develops gradually, and patients usually seek treatment already at the stage of clinical manifestations that affect the quality of life, during periods of exacerbation.Only a doctor will decide on the treatment of osteochondrosis of the cervical spine after an appropriate diagnosis;Self-medication in this case is unacceptable.Treatment of neck osteochondrosis is aimed at eliminating pain and inflammation, partially or completely restoring the affected tissue structures and preventing complications.Treatment should primarily take place on an outpatient basis;any procedures at home can only be carried out in conjunction with a doctor's prescription, after instrumental and laboratory diagnostics.In advanced cases, in severe stages of development of neurological lesions and accompanying pathologies, inpatient treatment of cervical osteochondrosis with the possibility of surgical intervention may be indicated.

Drug treatment of cervical osteochondrosis

This involves prescribing medication that relieves symptoms of pain and inflammation.In the acute phase, medications in injection form are indicated;After some pain has subsided, the patient takes tablets, locally acting agents in the form of ointments, and continues to receive injections.

  • Nonsteroidal anti-inflammatory drugs.They are considered the drug of choice in the treatment of cervical osteochondrosis to relieve pain and inflammation.Available in various dosage forms.They reduce soft tissue swelling and thereby relieve pain;Local active ingredients have a warming effect that improves blood circulation in the affected neck area.These medications are taken for 5-10 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 tablet form.It is worth remembering that long-term treatment with NSAIDs negatively affects the mucous membrane of the gastrointestinal tract, which is why the duration 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 to treat pain, most often an injection of dexamethasone or hydrocortisone into the affected area or tablets.Drugs in this group are prescribed to patients with cervical root syndrome to relieve swelling of nerve fibers.
  • Anesthetics.They are prescribed in the form of local neuromuscular blocks, eliminating severe pain symptoms.The blockage may be intradermal, subcutaneous, muscular, perineural, or radicular, depending on where the injection occurs.To prolong the pain-relieving effect, anesthetics are administered together with hormones.Treatment of neck osteochondrosis is carried out every other day, a total of 5-7 such procedures are prescribed.Anesthetics can also be administered by injection to specific biologically active points;This treatment technique is a type of acupuncture and is called pharmacopuncture.
  • Antispasmodics and drugs that improve microcirculation in the neck and collar area.To treat muscle tension in the affected area, nicotinic acid and others may be prescribed.By relieving neck muscle spasms and improving blood circulation, it stimulates blood circulation in the diseased area and relieves the symptoms of cervical osteochondrosis and inflammation.During the exacerbation phase, diuretics are also taken to reduce vascular spasm and thereby improve microcirculation in the affected area.
  • Sedatives such as valerian, peony and herbal teas are recommended for persistent pain and to reduce the risk of developing neuroticism in the patient, which contributes to the effectiveness of the treatment of cervical osteochondrosis.
  • Local irritants.These are locally acting ointments, gels and rubs that have a warming, irritating and distracting effect.They are not used to treat the acute stage.They contain biologically active substances of plant and animal origin, such as bee or snake venom.If you are hypersensitive to the components of the drug and the irritating effect is severe, it is better not to use it so as not to provoke even greater swelling.
  • Vitamins.During treatment and further rehabilitation, the use of multivitamin complexes is recommended.Typically, this is a group of vitamin B, 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 circulation.Taking vitamins reduces balance disorders – motion sickness syndrome, dizziness, hearing loss.
  • Chondroprotectors.These are substances that promote the restoration of the cartilage tissue of the intervertebral discs of the cervical segment.Treatment of cervical osteochondrosis with chondroprotectors is carried out over a long period of 6-12 months.

Orthopedic treatment methods

Unpleasant discomfort in the cervical spine is often caused and exacerbated by incorrect posture while sleeping, prolonged forced postures or injuries.Therefore, in the treatment of the disease, a method such as a neck brace or shants collar is often used.It is prescribed individually for each patient after medical advice, as it is available in several variants.The collar is a framed, dense roll that attaches around the neck and fixes the vertebrae in the desired position.Therefore, the neck does not bend and the head does not turn to the side, which ensures immobilization of the diseased area, which is important in acute phases.Shants' neck collar can also be made in the form of two rolls with an inflatable layer into which air is pumped using a rubber ball.Inflating the layer between the rollers stretches the spine, which can increase the interarticular gaps in the cervical spine.The degree of stretching is determined by the doctor;It is not recommended to solve this problem on your own in order to avoid damage to the neurovascular bundles of the neck.During the recovery period, a fully inflatable collar is used to maintain some neck and head mobility.

The collar can be worn at home for no more than 3 hours a day, the total wearing time is about a month.The final wearing rules are determined by the doctor depending on the severity of the disease and existing complaints.