A diagnosis of "cervical osteochondrosis" is often made if a person complains of neck pain. Some also associate dizziness, memory loss, hand numbness and other unpleasant symptoms. It is mistaken to believe that the disease is associated with age-related wear and deformation of the intervertebral disc and other elements of the spinal column.
How does the cervical spine work?
The cervical region consists of 7 vertebrae. Among them is the intervertebral disc - a semi-rigid structure with a dense ring along the periphery and a jelly-like center, which acts as a shock absorber. On the right and left side of each vertebra there are two joints, between which the surface of the vertebral process protrudes, covered with cartilage. The joints are connected by ligaments and back muscles.
Why does neck pain occur?
Usually, neck pain occurs in response to awkward movements, injuries, or due to inflammation of any cervical spine structure. In addition, the cause of pain can be too many muscles or ligaments, for example, when lifting weights, unsuccessfully turning the head, or against the background of arthrosis of the joints that are very between the articular processes. "Nerve entrapment", or cervical radiculopathy, certain processes (metastases, vertebral tumors, spinal cord membranes in the cervical region) are quite rare.
26% of men 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. Chronic pain in most cases appears due to a lack of physical activity or, on the contrary, too intense exercise.
However, people often mistakenly call unexplained pain and discomfort cervical osteochondrosis of the neck and associate its development with age-related wear and deformation of the intervertebral disc and other elements of the spinal column. But such pain, as a rule, 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 disorders of normal development and bone growth. As a rule, osteochondrosis begins in childhood and is severe: part of the joint or bone is deformed, and sometimes death. With this disease, it is often not the cervical spine that is affected, but the thoracic spine (lower thoracic vertebrae). Therefore, the main clinical manifestation of osteochondrosis is a pronounced curvature of the thoracic spine, which is called thoracic kyphosis.
Symptoms associated with damage to the thoracic spine:
- breathing difficulties,
- persistent weakness
- inability to breathe fully,
- pain and burning behind the sternum,
- fast heart attack
A condition accompanied by neck pain
Cervical spondylosis
In people over the age of 50, neck pain is usually caused by cervical spondylosis, age-related wear and tear of the vertebrae and related structures. With this disease, the intervertebral disc becomes dehydrated and flattened, causing the depreciation in the cervical region to worsen, and many movements are accompanied by pain.
But changes in the spine as we age are normal. So, the structure begins to wear out after an average of 30 years, and at the age of 60, 9 out of 10 people already have cervical spondylosis. However, in most people it is asymptomatic.
Another reason
Less commonly, neck pain occurs as a result of hypothermia or severe stress, caused by a herniated disc or abnormality of the cervical vertebrae - bony growths (spurs) that compress nerves that extend from the spinal cord.
The most common source 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 related to the aponeurosis - a wide tendon plate that envelops the head. The elements of the aponeurosis muscles in the occipital, temporal and frontal areas connect to the muscles of the cervical area, so neck pain is often accompanied by headaches. Therefore, neck pain, which appears after prolonged sedentary work or sleeping in an uncomfortable position and is combined with a headache, in most cases is associated with a lack of physical activity and incorrect posture and is not harmful to health.
The technology neck phenomenon, called techno-neck or Internet-era neck, is associated with pain arising from uncomfortable posture. Techneck is the result of the constant use of computers and smartphones, which causes a person to bend his neck. The fact is that the relative mass of the head increases with forward tilt. Therefore, in the "straight" position, the average weight of an adult's head 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. As a result of constant overload, the neck muscles are overstretched, microtraumas, inflammation, fibrosis (overgrowth of connective tissue) and, thus, pain can occur.
Reasons that contribute to the development of degenerative changes in the cervical spine
The occurrence of pain in the cervical spine is facilitated by birth or any other injury to the spine, its developmental anomalies, postural disorders, muscle dystonia, as well as prolonged immobilization, obesity, and some autoimmune diseases.
- Long-term immobilization is a condition in which a person, due to an underlying disease, is forced to lie down for more than a month. As a result, the muscles become weak - and during standing, when the load on them increases, they become too tense. Pain occurs.
- Obesity: Excess body weight increases pressure on the spinal structure 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: the intervertebral disc becomes thinner, mild discomfort appears in the neck area;
- Stage II: intervertebral discs are deformed, the distance between the vertebrae is reduced. Pain increases with movement in the cervical spine;
- Stage III: cartilage and vertebrae rub against each other, neck pain becomes constant, and movement becomes limited. With very severe cervical spine deformities, vertebral artery syndrome may occur with visual and vestibular disorders, headaches;
- Stage IV: pronounced degenerative changes, movement in the cervical spine is very limited and painful. The neck area can be almost completely immobile.
Symptoms of degenerative changes in the cervical spine
Most people with cervical osteochondrosis experience chronic pain and neck stiffness. As the disease progresses, other symptoms may appear (especially if the spinal roots, vertebral arteries and adjacent nerve plexus are compressed).
Symptoms of degenerative changes in the cervical spine:
- neck pain that gets worse with movement or standing;
- pain radiating to the shoulder or arm;
- numbness, tingling, and weakness in arms and hands;
- clicking or grinding in the neck (especially when turning the head);
- Headache;
- dizziness attacks;
- impaired movement coordination;
- loss of bladder or bowel control.
If such symptoms appear, you should see a neurologist as soon as possible.
Types of symptoms of "cervical osteochondrosis"
All symptoms of "cervical osteochondrosis" can be conditionally classified into 3 groups, or syndromes: vertebral, radicular and vertebral artery syndromes.
Symptoms of vertebral (spine) syndrome:
- dryness in the neck when moving;
- limited mobility;
- violation of the location of the vertebrae relative to each other in the neck;
- smoothing the natural cervical lordosis or lateral curvature in the cervical spine (only visible on x-ray, MRI or CT).
Symptoms of radicular syndrome:
- numbness of fingers on one or both hands;
- shooting, burning pain in the neck, radiating to the arm or both arms;
- muscular dystrophy of the neck and arms.
Symptoms of vertebral artery syndrome:
- paroxysmal dizziness, until loss of consciousness;
- sudden jump 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" (usually called cervical osteochondrosis), the doctor needs to conduct an examination, review the medical history, evaluate the results of laboratory tests and instrumental examinations.
Diagnosis and treatment of cervical osteochondrosis is carried out by neurologists.
Inspection
During the examination, the doctor will listen to the patient's complaints, explain the details of the medical history and conduct an examination: checking reflexes, muscle strength, sensitivity, and the condition of the vestibular apparatus.
With "cervical osteochondrosis, " areas of visible muscle atrophy (muscle loss), decreased or increased muscle tone of the long back muscles, and static disturbances in the cervical region may be observed in the neck region. When palpating the muscles, a person complains of pain, and when tilting the head, the pain may radiate to the head or arm, and dizziness or headache may occur.
In addition, patients may experience motor impairment in the hands (weakness), vision and hearing problems.
Doctors may also ask patients to walk, stand on one leg with their eyes closed, or touch their nose. In this way, the specialist will be able to assess whether movement coordination is affected, 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.
With progressive cervical osteochondrosis, joints are destroyed, calcium content can be reduced, and osteocalcin and osteoprotegerin, on the contrary, increase.
Total creatine kinase is also considered a marker of muscle tissue destruction in cervical muscle myositis.
In addition, the doctor may need to evaluate the blood level of microelements 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: radiography of the cervical spine, computed tomography and magnetic resonance imaging, electroneuromyography.
- Radiography.Using X-rays, you can identify bone deformities, malignant tumors, and degenerative changes in the joints.
- Computed and magnetic resonance imagingperformed if pathology of the spine, spinal cord or brain is suspected. Computed tomography showed a hemangioma of the vertebral body and a gross malformation of the cervical spine. Magnetic resonance imaging is more informative to visualize the muscles, roots, and spinal cord.
- Electroneuromyography- a method to study the efficiency of impulse transmission along nerve fibers using low-intensity electric currents. The test may be a little uncomfortable. The study helps explain the conduction of impulses along roots, nerves and from nerves to muscles, confirms damage to nerves or muscles and explains the nature and extent of damage.
Treatment of degenerative changes in the cervical spine
The main goal of treating degenerative changes in the cervical spine is to relieve pain, prevent nerve compression in the neck, and restore cervical mobility.
Depending on the severity of the condition, the doctor may prescribe medication, physical therapy, or massage. Surgery may be needed if the nerve is pinched or the joint is deformed.
Drug treatment of degenerative changes in the cervical spine
Neck pain can be relieved with medication.
Remedies 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 into the affected joint area;
- muscle relaxant to relieve muscle spasms;
- antidepressants to relieve chronic pain.
Non-drug treatment of cervical osteochondrosis
Along with drug therapy, it is important for patients with cervical osteochondrosis to do neck exercises. For this purpose, the person is referred to a physiotherapist for consultation. It teaches how to properly stretch and strengthen the neck and shoulder muscles.
Your doctor may recommend a mat or roller with metal or plastic needles. They are used for 15-30 minutes before going to bed to relax the muscles.
Wearing a Shantz splint (neck brace) is passive exercise therapy for muscles in the cervical region, which are difficult to influence with exercise. When a person wears a bandage, their muscles relax, and when they take it off, they tense up. If you wear a splint for 15-20 minutes several times a day, you can train and strengthen it.
It only makes sense to wear it for 2-3 hours if you have a serious neck injury. In addition, you should not lie down in it, let alone sleep.
Surgical treatment of degenerative changes in the cervical spine
As a rule, surgery is required for patients with severe deformities of the spine that have pinched nerves.
During the operation, the surgeon removes pathological elements (hernia protrusions, formations, etc. ) or part of the vertebra. After such treatment, a long recovery period is required: wearing a Shants splint or a rigid splint for the cervical spine, physiotherapy, normal walking, painkillers.
Complications and consequences of degenerative changes in the cervical spine
Without treatment, the intervertebral disc gradually wears out and the vertebrae are "erased. "
Common complications of degenerative changes in the cervical spine:
- uncontrollable pain syndrome in the head, neck, chest;
- cramps, movement disorders and hand numbness;
- frequent dizziness, impaired movement coordination, fine and gross motor skills.
Prevention of degenerative changes in the cervical spine ("cervical osteochondrosis")
There is no specific prevention for true cervical osteochondrosis, as it is a hereditary disease.
To avoid the appearance of non-specific neck pain, which is mistakenly associated with cervical osteochondrosis, it is important to ensure 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. Brisk walking, swimming, cycling, tennis, dancing or rollerblading are ideal. Pilates and yoga will help strengthen your muscles.
In addition, gymnastics helps to avoid straining the neck muscles and the appearance of pain: tilting the head forward, backward, alternately to each shoulder and twisting it, as well as sleeping on an orthopedic pillow.
You should avoid injuries to the cervical spine: do not jump into the water upside down, wear a seat belt in the car (prevention of whiplash injuries in an accident).
Sleeping position for back pain
Pain in the neck and back, which is often associated with osteochondrosis, may be caused by an uncomfortable sleeping position.
While sleeping, the head and spine should be at the same level. This position minimizes additional pressure on the neck area.
If a person sleeps mainly on his back, the height of the pillow should be on average 6-11 cm For those who sleep on their side, the pillow should be thicker: from 9 to 13 cm In this way, the desired angle will be maintained between the shoulders and the head, the spinethe cervix will not sag, and the muscles tighten to compensate for the discomfort.
Moreover, the greater the weight of a person, the higher the pillow. You also need to pay attention to the hardness of the mattress. The softer it is, the more it will sag under body weight and the higher the pillow should be. In addition, it is better not to always sleep on one side - this leads to muscle imbalance.
If a person prefers to sleep on his stomach, he may experience back and neck pain more often. The fact is that in this position it is difficult to maintain the spine in a neutral position. To relieve tension from your back, you can place a pillow under your pelvis and lower abdomen, and choose a flat pillow under your head, or sleep without a pillow.
In addition, you can use a special orthopedic pillow.
Frequently asked questions
- Where can pain radiate from "cervical osteochondrosis"?
Pain due to degenerative changes in the cervical spine can radiate to the shoulder or arm, and also worsen with movement or standing.
- How to relieve dizziness with "cervical osteochondrosis"?
To relieve dizziness, you should take a comfortable position where the possibility of falling is minimal (sitting in a chair with back support or lying down) and call for help. After 5-7 minutes, you can try to turn your head: most likely, the dizziness will pass during 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 with "cervical osteochondrosis"?
While sleeping, the head and spine should be at the same level. This position minimizes additional pressure on the neck area.
- How long does the exacerbation of "osteochondrosis" of the cervical spine last?
On average, the worsening 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 best for a person to keep calm and wear a neck brace.
- Which doctor treats "osteochondrosis" of the cervical spine?
Diagnosis and treatment of pain in the cervical region is carried out by neurologists, neurosurgeons, orthopedists and general practitioners.