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Effective methods of treatment of cervical spine osteochondrosis.

In the modern world, almost all people over the age of 25 have this disease.Cervical osteochondrosis occurs more often than in other parts of the spine.The relevance of this topic is difficult to overestimate.In this article, we will discuss why this disease occurs, how it is manifested, how to treat cervical osteochondrosis, what drugs are effective in its treatment, what non-drug methods are available, and we will also find out the answers to the most common questions of patients with a similar diagnosis.Osteochondrosis of the cervical spine is a degenerative-dystrophic damage (progressive) of the intervertebral discs of the cervical spine.

pain

Causes of cervical osteochondrosis

As a result of the action of the factors listed below, the load on the cervical spine increases, the neck muscles try to compensate for the excess load, their spasm appears, the 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, bony growth of the vertebral bodies occurs 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 injuries of the spine
  • metabolic disorder
  • A lot of physical activity
  • Stress and constant nervous tension
  • Low level of physical fitness
  • Hereditary tendency
  • Common incorrect body positions, such as holding the telephone receiver with your shoulders
  • Constant strain on the back and neck due to the nature of work (strained 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 the patient's complaints.The concept of quality should not be confused with the stages of osteochondrosis.The stages will be discussed below.

first degree

Clinical manifestations are minimal, the patient may complain of low-intensity pain in the cervical region, which may intensify when turning the head.Physical examination may reveal slight tension in the neck muscles.

second degree

The patient suffers from pain in the area of the cervical spine, its intensity is much greater, the pain can spread to the shoulder or arm.This happens due to a decrease in the height of the intervertebral disc and compression of the nerve roots.Pain intensifies when bending and turning the head.The patient may notice a decrease in performance, weakness and headache.

third degree

Cervical osteochondrosis symptoms intensify, the pain becomes constant, spreads to the arm or shoulder.Numbness or weakness occurs in the arm muscles as herniated intervertebral discs (see Lumbar Herniated Symptoms).I suffer from weakness and dizziness.During the examination, limited mobility of 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 disturbed, since the vertebral artery, which supplies the cerebellum and the occipital lobe of the brain, is involved in the process.

Symptoms depend on the affected vertebra

Separately, we can distinguish radicular syndromes that cause certain sensory and motor disorders.They differ depending on which vertebra is compressed at the root of the spine:

  • C1: causes numbness and loss of sensation in the back of the head;
  • C2: pain in the parietal region and the back of the head;
  • C3: Slurred speech, tongue sensitivity, pain and numbness on the side where the spinal nerve is pinched;
  • C4: pain in the heart, left hypochondrium, shoulder, scapula, breathing disorders, decreased neck muscle tone;
  • C5: shoulder pain in the outer area;
  • C6: pain that radiates from the forearm to the thumb, as well as from the neck to the shoulder blade;
  • C7: pain in the back of the shoulder, from the neck to the shoulder blade, radiating to the forearm 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.This is a low-informative method, especially in the later stages of the disease.
  • Computed tomography.It better shows changes in the vertebrae, but it is difficult to determine the size and presence of an intervertebral hernia, as well as the presence of a disc-medullary conflict (compression of the hernia by the spinal cord).
  • Magnetic resonance imaging.The most informative method.Not only bone structures are clearly visible, but also intervertebral discs, hernias, their size and direction of growth.
  • If a blood flow disorder in the vertebral arteries is suspected, an ultrasound duplex scan is used.This method allows you to accurately determine whether there is a decrease in the speed of blood flow or whether there are obstacles to normal blood flow.

X-ray stages of cervical osteochondrosis.

  • Stage 1 - minimal changes in the configuration of the spine, smoothing of the cervical lordosis (curve).
  • Stage 2 - instability between the vertebrae, possible displacement of one vertebra in relation to another, rotation (rotation around the axis of the spinal column), a slight decrease in the height of the intervertebral disc.
  • Stage 3 - reduction of the height of the intervertebral disc by ¼ compared to the disc above it, changes in the intervertebral joints, posterior osteophytes (bone spurs), narrowing of the intervertebral foramen and narrowing of the spinal canal in which the spinal cord and its sheaths 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 foramen and significant narrowing of the spinal canal with the formation of myelopathy.

symptoms

Damage to the upper spine can be manifested in various symptoms, depending on the location and severity of the dystrophic process, as well as how seriously the radicular structures of the cervical spine are affected.Often, patients' complaints are reduced to seemingly unrelated symptoms, which can complicate disease diagnosis and further treatment.In general, the clinical picture of cervical osteochondrosis consists of the following syndromes:

  • Vertebral, characterized by various types of pain in the back of the head and neck.
  • Spinal, in which there are symptoms of motor and sensory innervation disorders, in addition, cervical trophism disorders cause gradual atrophy of the muscles of the shoulder girdle and arms.
  • Radical, with pronounced pain symptoms in the area of peritoneum and chest organs, which requires additional thorough diagnosis to differentiate between osteochondrosis and diseases of internal organs.
  • Vertebral artery syndrome with cervical osteochondrosis is a vestibular disorder manifested by headache, hearing loss, dizziness, even loss of consciousness.These events occur due to cerebral ischemia due to disruption of the vertebral artery and weakening of blood supply.

How to treat cervical osteochondrosis?

Osteochondrosis of the cervical segment develops gradually, and patients usually apply for treatment already at the stage of clinical manifestations that disturb the quality of life, during periods of exacerbation.Treatment of osteochondrosis of the cervical spine is decided only by a doctor after the appropriate diagnosis;Self-medication in this case is unacceptable.Treatment of osteochondrosis of the neck is aimed at eliminating pain, inflammation, partial or complete restoration of affected tissue structures and prevention of complications.Treatment should be predominantly outpatient;Any procedure at home can be performed only with medical prescriptions, after instrumental and laboratory diagnostics.In advanced cases, in the severe stages of the development of neurological injuries and accompanying pathologies, inpatient treatment of cervical osteochondrosis with the possibility of surgical intervention may be indicated.

Medical treatment of cervical osteochondrosis

It includes prescribing courses of medications that relieve pain and inflammation.In the acute period, drugs are prescribed in an injectable form;After some pain relief, the patient takes tablets, locally acting means in the form of ointments and continues to receive injections.

  • Nonsteroidal anti-inflammatory drugs.They are considered the drugs of choice for the treatment of cervical osteochondrosis to relieve pain and inflammation.Available in various dosage forms.They reduce swelling of soft tissues, thereby reducing pain;Local agents have a warming effect, which improves blood flow in the affected cervical region.These drugs are used for 5-10 days, sometimes up to 2 weeks.In the acute period, nonsteroidal anti-inflammatory drugs are prescribed as injections;After a few days, the patient switches to the tablet form.It should be remembered that long-term treatment with non-steroidal anti-inflammatory drugs has a negative effect on the mucous membrane of the gastrointestinal tract, so the course of treatment usually does not exceed 10 days.
  • hormones.If nonsteroidal anti-inflammatory drugs are ineffective, the patient may be prescribed a paravertebral anesthetic block with glucocorticosteroids to treat pain, most commonly dexamethasone or hydrocortisone injected into the affected area or tablets.Drugs of this group are prescribed to patients with cervical radicular syndrome to relieve swelling of nerve fibers.
  • anesthetics.They are prescribed in the form of local neuromuscular blockades, which eliminate severe pain symptoms.The block can be intradermal, subcutaneous, intramuscular, perineural, or radicular, depending on where the injection is made.Anesthetics are given together with hormones to prolong the pain-relieving effect.Treatment of osteochondrosis of the neck is carried out every other day, a total of 5-7 such procedures are prescribed.Anesthetics can also be administered by injection in special biologically active points;This treatment technique is a type of acupuncture and is called pharmacopuncture.
  • Antispasmodics and drugs that improve microcirculation in the cervical and collar areas.Nicotinic acid and others may be prescribed to treat muscle tension in the affected area.By removing the spasm of the neck muscles and improving blood flow, it stimulates blood circulation in the diseased area, and the symptoms of cervical osteochondrosis and inflammation are relieved.During the exacerbation period, diuretics are also taken to reduce vascular spasm and thereby improve microcirculation in the affected area.
  • Sedatives such as valerian, peony tincture and herbal tea are recommended for long-term pain and to reduce the risk of neuroticism in the patient, which contributes to the effectiveness of the treatment of cervical osteochondrosis.
  • local irritants.These are local ointments, gels, creams 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, for example, bee or snake venom.If you have hypersensitivity to the components of the drug and if its irritating effect is high, it is better not to use them, so as not to provoke even greater swelling.
  • vitamins.It is recommended to use multivitamin complexes during treatment and subsequent rehabilitation.As a rule, it is a group of B vitamins, representatives of which participate 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 contribute to the restoration of the cartilage tissue of the spinal discs of the cervical segment.Treatment of cervical osteochondrosis with chondroprotectors is carried out for a long period of time, 6-12 months.

Orthopedic treatment methods

Unpleasant symptoms in the cervical spine are often provoked and aggravated by the incorrect position of the body during sleep, long exposure to forced posture or injury.Therefore, in the treatment of the disease, such a method as cervical collar or Schanzi collar is often used.It is prescribed for each patient individually, after medical consultation, as it comes in several types.The collar is a dense roller in the frame, which holds the neck and fixes the vertebrae in the required position.Accordingly, the neck does not bend and the head does not tilt to the side, which ensures immobilization of the affected area, which is important in the acute period.The collar of the neck of the trench can also be made with an inflatable layer in the form of two shafts, in which air is pumped with a rubber bulb.Inflating the layer between the rollers stretches the spine, which makes it possible to increase the inter-articular gaps of the cervical spine.The degree of stretching is determined by the doctor;It is not recommended to solve this issue 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, which maintains some mobility of the neck and head.

The collar can be worn at home, no more than 3 hours a day, the total wearing course is about one month.The doctor will determine the final rules of wearing according to the severity of the condition and the existing symptoms.