"Cervical osteochondrosis" is often diagnosed if a person complains of neck pain. Some also attribute it to dizziness, memory loss, numbness in hands and other unpleasant symptoms. It is mistakenly believed that the disease is related to wear and tear of the intervertebral discs and other elements of the spinal column and age-related deformation.
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 jelly-like center that act as shock absorbers. There are two joints on the right and left of each vertebra, between which the surfaces of the vertebral processes, covered with cartilage, protrude. The joints are connected by spinal ligaments and muscles.
Why does neck pain occur?
As a rule, neck pain appears in response to an awkward movement, trauma, or inflammation of some structure of the cervical spine. In addition, the cause of pain can be stretching of muscles or ligaments, for example, when lifting weights, turning the head unsuccessfully, or in the background of arthrosis of the joints between the joint processes. "Nerve entrapment", i. e. cervical radiculopathy, specific processes (metastases, spinal tumors, spinal cord sheaths in the cervical region) are relatively rare.
26% of men over 30 and 40% of women over 30 have had neck pain in the past month, and 5% of men and 7% of women feel it all the time.
Acute neck pain usually goes away on its own within 1-2 weeks. In most cases, chronic pain appears due to lack of physical activity or, on the contrary, too intense training.
However, people often mistakenly call unexplained pain and discomfort in the neck cervical osteochondrosis and associate its development with wear and age-related deformation of the intervertebral discs and other elements of the spinal column. But such pain, as a rule, has nothing to do with true osteochondrosis.
Cervical osteochondrosis
According to the International Classification of Diseases (ICD), osteochondrosis (osteochondropathy) is a group of rare hereditary diseases associated with disturbances in the normal development and growth of bones. As a rule, osteochondrosis begins in childhood and progresses severely: part of the joint or bone is deformed, sometimes it even dies. With this disease, not the cervical spine is most often affected, but the thoracic spine (lower thoracic vertebrae). Therefore, the main clinical manifestation of osteochondrosis is pronounced curvature of the thoracic spine, i. e. yearKyphosis of the chest.
Symptoms associated with damage to the thoracic spine:
- shortness of breath
- constant weakness
- complete inability to breathe
- pain and burning behind the breast,
- Rapid heartbeat attacks.
Conditions that accompany neck pain
Cervical spondylosis
Neck pain in people over 50 is usually caused by cervical spondylosis, age-related wear and tear on the vertebrae and related structures. In this disease, the intervertebral discs become dehydrated and flattened, causing wear and tear in the cervical region and pain with many movements.
But with age, changes in the spine are normal. So, its structures begin to wear out after an average of 30 years, and by the age of 60, 9 out of 10 people already have cervical spondylosis. However, it is asymptomatic in most people.
other reasons
Less often, neck pain occurs due to hypothermia or severe stress, due to herniated discs or anomalies of the cervical spine - bony growths (spurs) that suffocate the nerves that extend from the spinal cord.
The most common source of pain in the cervical spine and shoulder girdle is excessive muscle tension (defense): trapezius, long back muscles of the cervical spine.
In addition, the muscles of the cervical spine are closely connected to the aponeurosis - a broad tendon plate that surrounds the head. Muscular elements of the aponeurosis in the occipital, temporal and frontal regions are connected to the muscles of the cervical region, so neck pain is often accompanied by a headache. Thus, neck pain, which appears after long sitting work or sleeping in an uncomfortable position and is combined with a headache, is in most cases associated with a lack of physical activity and incorrect posture and is not dangerous to health.
The phenomenon of technical neck, the so-called techno-neck or neck of the Internet age, is related to pain caused by an uncomfortable posture. Neck strain is the result of constant use of computers and smartphones, due to which a person is forced to bend his neck. It is a fact that the relative mass of the head increases with forward inclination. Thus, the average weight of an adult's head in the "correct" position is 5 kg. If you tilt your head forward by 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, neck muscles are overloaded, microtraumas, inflammation, fibrosis (excessive growth of connective tissue) and, consequently, pain can occur.
Causes that contribute to the development of degenerative changes in the cervical spine
Birth or other spine injuries, developmental anomalies, postural disorders, muscle dystonia, as well as long-term immobilization, obesity and some autoimmune diseases contribute to pain in the cervical spine.
- Long-term immobilization is a condition in which a person is forced to lie down for more than a month due to an underlying disease. As a result, the muscles become weak - and during verticalization, when the load on them increases, they are overstretched. There is pain.
- 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 of the cervical spine
There are 4 main stages of degeneration (destruction) of the cervical spine:
- Stage I: intervertebral discs become thinner, mild discomfort appears in the neck area;
- II stage: The intervertebral discs are deformed, the distance between the vertebrae decreases. The pain intensifies with the movement of the cervical spine;
- III stage: Cartilages and vertebrae interfere with each other, neck pain becomes constant and movements are limited. In case of very severe deformations of the cervical spine, vertebral artery syndrome may occur with vision and vestibular disorders, headache;
- IV stage: Degenerative changes are expressed, movements of the cervical spine are very limited and painful. The neck area can be immobilized almost completely.
Symptoms of degenerative changes in the cervical spine
Most people with cervical osteochondrosis experience chronic aching pain and neck stiffness. As the disease progresses, other symptoms may appear (especially if the spinal roots, spinal artery, and surrounding nerve plexuses are compressed).
Symptoms of degenerative changes in the cervical spine:
- neck pain that worsens with movement or standing;
- pain spreads to the shoulder or arm;
- Numbness, tingling and weakness in hands and arms;
- Clicking or grinding in the neck (especially when turning the head);
- headache;
- dizziness attacks;
- Violation of coordination of movements;
- Loss of bladder or bowel control.
If such symptoms appear, you should consult a neurologist as soon as possible.
Types of "cervical osteochondrosis" symptoms
All symptoms of "cervical osteochondrosis" can be conditionally divided into 3 groups or syndromes: vertebral, radicular and vertebral artery syndrome.
Symptoms of vertebral (back) syndrome:
- Cramping of the neck when moving;
- limited mobility;
- Disturbance of the relative position of the vertebrae in the neck;
- Reduction of cervical lordosis or lateral curvature in the cervical spine (can only be seen on X-ray, MRI or CT).
Symptoms of radicular syndrome:
- Numbness of fingers on one or both hands;
- Shooting, burning pain in neck, radiating down arm or both arms;
- Muscular dystrophy of the neck and arms.
Symptoms of vertebral artery syndrome:
- Paroxysmal dizziness, before loss of consciousness;
- sudden jump in blood pressure;
- noise in the ears;
- blurred vision or spots in the eyes;
- loss of balance and nausea attacks 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 to make a diagnosis of "degenerative changes of the cervical spine" (commonly called cervical osteochondrosis), the doctor must conduct an examination, study the medical history, evaluate the results of laboratory tests and instrumental examinations. .
Cervical osteochondrosis is diagnosed and treated by a neurologist.
It is checked
During the examination, the doctor will listen to the patient's complaints, clarify the details of the medical history and conduct an examination: he will check reflexes, muscle strength, sensitivity and the condition of the vestibular apparatus.
During "cervical osteochondrosis", visible areas of muscle atrophy (muscle loss), decreased or increased muscle tone of the long back muscles, and static disorders in the cervical area can be observed in the neck area. When palpating the muscles, a person complains of pain, and when bending the head, pain may spread to the head or arms, dizziness or headache.
In addition, patients may have motor disturbances in the hands (weakness), vision and hearing problems.
The doctor may also ask the patient to walk, stand on one leg with the eyes closed, or touch the nose. In this way, the specialist will be able to assess whether the coordination of movements is disturbed, whether there are problems with gross and fine motor skills.
Laboratory diagnostics
To assess the general state of the bones, patients suspected of cervical osteochondrosis are prescribed a blood test for total and ionized calcium, as well as markers of bone tissue growth and destruction - osteocalcin and osteoprotegerin, alkaline phosphatase.
With progressive cervical osteochondrosis, the joints are destroyed, calcium content may decrease, and on the contrary, osteocalcin and osteoprotegerin may increase.
Total creatine kinase is also considered a marker of muscle tissue destruction in cervical muscle myositis.
In addition, the doctor may need to assess the level of trace elements in the blood, which are involved in the regulation of muscle tone: magnesium, potassium, sodium.
Instrumental diagnostics
To determine the cause of neck pain and related 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 deformities, malignant tumors and degenerative joint changes.
- Computer and magnetic resonance imagingPerformed if pathology of the spine, spine or brain is suspected. Computed tomography shows hemangiomas of the vertebral bodies and gross deformation of the cervical spine. Magnetic resonance imaging is more informative for imaging the muscles, roots, and spinal cord.
- Electromyography- the method of studying the effectiveness of impulse transmission along the nerve fiber using low intensity electric current. The test may be slightly uncomfortable. The study helps to clarify the conduction of impulses from roots, nerves and nerves to muscles, to confirm damage to nerves or muscles, and to clarify the nature and level of damage.
Treatment of degenerative changes of the cervical spine
The main goals of treating degenerative changes in the cervical spine are pain relief, prevention of neck nerve compression, and restoration of cervical mobility.
Depending on the severity of the condition, the doctor may prescribe medication, physical therapy or massage. Surgery may be necessary if nerves are pinched or joints are 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;
- non-steroidal anti-inflammatory drugs;
- Hormonal drugs in the form of tablets or injections in the area of the affected joint;
- muscle relaxants to relieve muscle spasms;
- Antidepressants for chronic pain relief.
Non-narcotic treatment of cervical osteochondrosis
Along with drug therapy, neck exercises are important for patients with cervical osteochondrosis. For this purpose, the person is referred for consultation with a physiotherapist. It teaches us 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 exercise therapy for the deep muscles of the cervical region, which are difficult to influence during exercise. When a person wears a splint, the muscles relax, and when it is removed, it tenses. If you spend 15-20 minutes several times a day doing slime, you can train and strengthen.
It only makes sense to wear it for 2-3 hours if you have a serious neck injury. In addition, you should not lie in it, let alone sleep.
Surgical treatment of degenerative changes of the cervical spine
As a rule, surgery is required for patients with severe spinal deformity who have a pinched nerve.
During the operation, the surgeon will remove the pathological elements (hernia protrusion, formations, etc. ) or part of the spine. After such treatment, a long period of rehabilitation is required: wearing a Shantz skeleton or a rigid brace for the cervical spine, physical therapy, regular walking, painkillers.
Complications and consequences of degenerative changes of the cervical spine
Without treatment, the intervertebral discs gradually wear out and the vertebrae "dry up".
Common complications of degenerative changes in the cervical spine:
- incurable pain syndrome in the head, neck, chest;
- convulsions, movement disorders and numbness of 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 non-specific neck pain, which is mistakenly associated with cervical osteochondrosis, it is important to have the right posture and to be physically active: the more a person moves, the better the condition of muscles, bones, ligaments and joints.
Adults need 150 minutes of moderate-intensity aerobic activity per week to maintain physical activity. Suitable for brisk walking, swimming, cycling, tennis, dancing or rollerblading. Pilates and yoga can help you strengthen your muscles.
In addition, gymnastics helps prevent neck muscle overload and pain: tilting the head forward, backward, alternately on each shoulder and turning it, as well as sleeping on an orthopedic pillow.
Cervical spine injuries should be avoided: do not jump into the water upside down, wear seat belts in the car (to avoid whiplash injuries in an accident).
Sleeping position for back pain
Pain in the neck and back, often attributed to osteochondrosis, may be the result of an uncomfortable sleeping position.
During sleep, the head and spine should be approximately at the same level. This position reduces additional pressure on the neck.
If a person mainly sleeps on his back, the height of the pillow should be on average 6-11 cm, for those who sleep on the side, the pillow should be thicker: from 9 to 13 cm. This way it will be the desired angle. Maintained between the shoulder and the head, the cervical spine does not descend and the muscles tighten to compensate for the discomfort.
Moreover, the greater the person's weight, the higher the pillow should be. You should also pay attention to the firmness of the mattress. The softer it is, the more it bends under the weight of the body and the higher the pillow should be. In addition, it is better not to always sleep on only one side - this leads to muscle imbalance.
If a person prefers to sleep on his stomach, he may suffer from back and neck pain more often. The fact is that it is difficult to keep the spine in a neutral position in this position. To relieve tension from your back, you can put a pillow under your pelvis and lower abdomen and choose a flat pillow under your head, or even sleep without one.
In addition, you can use a special orthopedic pillow.
FAQ
- Where can pain from "cervical osteochondrosis" spread?
As a result of degenerative changes in the cervical spine, the pain can spread to the shoulder or arm and also worsen with movement or standing.
- How to relieve an attack of dizziness with "cervical osteochondrosis"?
To relieve a vertigo attack, you should take a comfortable position in which the probability of falling is minimal (sit in a chair with the back or lie down) and call for help. After 5-7 minutes, you can try to turn your head: most likely, the vertigo attack will pass at this time. If dizziness persists or worsens, nausea, vomiting or other neurological symptoms (impaired speech, vision, movement, swallowing, sensitivity) appear, you should call an ambulance as soon as possible.
- How to sleep properly "cervical osteochondrosis"?
During sleep, the head and spine should be approximately at the same level. This position reduces additional pressure on the neck.
- How long does the exacerbation of "osteochondrosis" of the cervical spine last?
On average, the exacerbation of symptoms due to degenerative changes in the cervical spine ("cervical osteochondrosis") lasts from 4 to 7 days. Nonsteroidal anti-inflammatory drugs and muscle relaxants are used to reduce pain. At this time, it is better for a person to keep calm and wear a neck brace.
- Which doctor treats "osteochondrosis" of the cervical spine?
Cervical pain is diagnosed and treated by a neurologist, neurosurgeon, orthopedist and general practitioner.