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BACK Effective methods of treatment of osteochondrosis of the cervical spine.

In the modern world, almost all people over the age of 25 suffer from this disease.Cervical osteochondrosis occurs more often than other parts of the spine.It is difficult to overestimate the relevance of this topic.In this article, we will consider why this disease occurs, how it manifests itself, how to treat cervical osteochondrosis, which drugs are effective in its treatment, which non-drug methods are available, and at the same time we will find 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 in the cervical spine.

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Causes of cervical osteochondrosis

As a result of the influence of the factors listed below, there is an increase in the load on the cervical spine, 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 cervical intervertebral discs of the spine, their structure changes, their nutrition is disturbed, changes occur in the small joints between the vertebrae, as a result of increased loading on the changed intervertebral discs, bone growths of the vertebral bodies appear.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
  • Excess weight
  • Physical inactivity, sedentary work
  • Previous spinal injuries
  • Metabolic disorder
  • Great physical activity
  • Stress and constant nervous tension
  • Low level of physical fitness
  • Hereditary predisposition
  • Common incorrect body positions, such as holding the telephone receiver over your shoulder
  • Constant strain on the back and neck due to the nature of the work (stressful sitting position) among drivers and office workers.
  • Developmental anomalies of the cervical spine

The degree of development of cervical osteochondrosis

The degree of osteochondrosis is determined by the clinical picture and the patient's complaints.The concept of degree 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 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 the pain in the cervical region, its intensity is greater, the pain can spread to the shoulder or arm.This occurs 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 feel a decrease in performance, weakness and headache.

Third degree

symptoms of cervical osteochondrosis intensify, the pain becomes constant, spreads to the arm or shoulder.Numbness or weakness appears in the muscles of the arm because of the ruptured intervertebral discs (see symptoms of a herniated disc).I am worried about weakness and dizziness.During the examination, limited mobility in the cervical spine and pain during palpation of the spine are revealed.

Fourth degree

The intervertebral disc is completely destroyed and replaced by connective tissue.Since the vertebral artery, which supplies the cerebellum and the occipital part of the brain, is involved in the process, dizziness increases, tinnitus appears, and coordination is impaired.

Symptoms depending on the damaged vertebra

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

  • C1: leads to numbness and loss of sensation in the back of the head;
  • C2: pain in the parietal region and the back of the head;
  • C3: speech disorder, sensitivity of the tongue, pain and decreased sensitivity on the side where the spinal nerve is compressed;
  • C4: pain in the heart, left hypochondrium, shoulder, scapula, respiratory disorders, decreased neck muscle tone;
  • C5: shoulder pain in the outer area;
  • C6: pain radiating from the forearm to the thumb, as well as from the neck to the shoulder blade;
  • C7: pain behind the shoulder, from the neck to the shoulder blade, spreading to the forearm up to 2-4 fingers;
  • C8: pain from neck to shoulder, arm to little finger.

Diagnosis of cervical osteochondrosis

Main diagnostic methods:

  • X-ray of the cervical spine.It is a little-known 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 intervertebral hernias, as well as the presence of a disc-medullary conflict (compression with a herniated spinal cord).
  • Magnetic resonance imaging.The most informative method.Not only bone structures, but also intervertebral discs, hernias, their size and direction of growth are clearly visible.
  • If you suspect a violation of blood flow in the vertebral arteries, 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 vertebrae, smoothing of the cervical lordosis (curvature).
  • Stage 2 – instability between the vertebrae, displacement of one vertebra relative to another, torsion (rotation around the axis of the spine), 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 located above, changes in the intervertebral joints, posterior osteophytes (bone protrusions), narrowing of the intervertebral foramina and narrowing of the spinal canal, which is located by the membranes of the spinal cord.
  • Stage 4 - significant narrowing of the spinal canal with a significant decrease in the height of the intervertebral disc, significant changes in the intervertebral joints, giant posterior osteophytes, significant narrowing of the intervertebral foramina and myelopathy.

Symptoms

Damage to the upper part of the spine can manifest itself with different 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 the diagnosis and subsequent treatment of the disease.In general, the clinical picture of cervical osteochondrosis consists of the following series of syndromes:

  • Vertebral is characterized by various types of pain in the back of the head and neck.
  • The spine, where signs of damaged motor and sensory innervation are observed, in addition, the violation of trophism of the cervical zone causes gradual atrophy of the muscles of the shoulder girdle and arms.
  • It is expressed by symptoms of pain in the radicular, peritoneal and chest organs, which require additional comprehensive diagnostics to distinguish between osteochondrosis and diseases of internal organs.
  • Vertebral artery syndrome with cervical osteochondrosis is a vestibular disease manifested by headache, hearing impairment, dizziness, even fainting.These events occur due to cerebral ischemia due to disruption of 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 at the stage of clinical manifestations, which interfere with the quality of life, during the exacerbation period.How to treat osteochondrosis of the cervical spine is decided by a doctor only after an appropriate diagnosis;In this case, self-treatment is unacceptable.Treatment of neck osteochondrosis is aimed at eliminating pain, inflammation, partial or complete restoration of affected tissue structures, and prevention of complications.Treatment should be mainly outpatient;any procedure at home can be carried out only after instrumental and laboratory diagnostics together with medical prescriptions.In advanced cases, in severe stages of the 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

It consists of prescribing courses of drugs that eliminate pain and inflammation symptoms.In the acute period, drugs in the form of injections are indicated;after the pain subsides a little, the patient takes pills with a local effect in the form of an ointment and continues to receive injections.

  • Non-steroidal anti-inflammatory drugs.They are considered the drugs of choice in 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 that 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, NSAIDs are prescribed in the form of injections;after a few days, the patient is transferred to the form of tablet administration.It should be remembered that long-term treatment with NSAIDs 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 NSAIDs are ineffective, the patient may be prescribed paravertebral anesthetic blocks in the cervical spine with glucocorticosteroids as pain management, most commonly injection of dexamethasone or hydrocortisone into the affected area or tablets.Medicines of this group are prescribed to patients with cervical radicular syndrome to eliminate swelling of the nerve fiber.
  • Anesthetics.They are prescribed in the form of local neuromuscular blockades that relieve severe pain symptoms.Depending on the site of injection, the blockade can be intradermal, subcutaneous, muscular, perineural or radicular.Anesthetics are given together with hormones to prolong the analgesic effect.Treatment of neck osteochondrosis is carried out every day, only 5-7 such procedures are prescribed.Anesthetics can also be injected into specific biologically active points;this treatment method 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 eliminating spasms of neck muscles and improving blood flow, blood flow is stimulated in the diseased area, symptoms of cervical osteochondrosis and inflammation are eliminated.During exacerbation, diuretics are also taken to reduce spasm of blood vessels and thereby improve microcirculation in the affected area.
  • Sedatives such as tincture of valerian, peony and herbal teas are recommended for long-lasting 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 topical ointments, gels, rubbing, irritating and distracting.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 sensitive to the components of the drug and its irritating effect is high, it is better not to use them in order not to cause further swelling.
  • Vitamins.It is recommended to use multivitamin complexes during treatment and subsequent rehabilitation.Typically, it is a group of B vitamins, as well as vitamins A and C, whose representatives are involved in ensuring normal nerve conduction, 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 regeneration of the cartilage tissue of the vertebral discs of the cervical segment.Treatment of cervical osteochondrosis with chondroprotectors is carried out for a long time, 6-12 months.

Orthopedic treatment methods

Unpleasant symptoms in the cervical spine are often provoked and aggravated by incorrect body position during sleep, prolonged exposure to a forced position, or injury.Therefore, when treating the disease, a method such as a cervical collar or Shants collar is often used.Since there are several types, it is prescribed individually for each patient after consulting a doctor.The collar is a tight roll with a frame that is tied around the neck and fixes the vertebrae in the right position.The neck, therefore, does not bend and the head does not turn to the side, which provides immobilization of the disease area, which is important in acute periods.The neck collar of Shants can also be made in the form of two rolls with an inflatable layer in which air is pumped with a rubber bulb.The inflation of the layer between the cylinders ensures the stretching of the spine, which makes it possible to increase the inter-articular spaces in the cervical spine.The degree of traction is determined by the doctor;it is not recommended to solve this problem yourself in order not to damage the neurovascular bundles of 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 worn at home, no more than 3 hours a day, the total wearing course is about a month.The final dressing rules are determined by the doctor depending on the severity of the condition and the existing symptoms.