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BACK Effective methods of treating osteochondrosis of the cervical spine.

In the modern world, almost everyone over the age of 25 has 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 see why this disease occurs, how it manifests itself, how to treat cervical osteochondrosis, what drugs are effective in treating it, non-drug methods that exist, and also find out the answers to the most common questions from patients with the same diagnosis.Osteochondrosis of the cervical spine is a degenerative-dystrophic (progressive) lesion of the intervertebral disc in the cervical spine.

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Causes of cervical osteochondrosis

As a result of the action of the factors listed below, there is an increased load on the cervical spine, the neck muscles try to compensate for the excessive load, their spasms occur, blood circulation in this area is disturbed, which causes degenerative changes.Due to several 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, bone growth of the vertebral bodies appears due to increased loads on the changed intervertebral discs.Click to enlarge - exercise therapy for osteochondrosis of any part of the spine.Factors that contribute to the development of osteochondrosis of the cervical spine:

  • Poor posture and scoliosis
  • Excess body weight
  • Physical inactivity, sedentary work
  • Previous spinal injury
  • Metabolic disorders
  • Great physical activity
  • Constant stress and nervous tension
  • Low level of physical fitness
  • Hereditary tendency
  • Incorrect body positioning habits, such as holding the telephone receiver with your shoulder
  • Constant strain on the back and neck due to the nature of work (strained condition in sitting position) among drivers and office workers.
  • Developmental anomalies in the cervical spine

Stages 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 stage of osteochondrosis.The stages will be discussed below.

First degree

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

second degree

The patient is worried about the pain in the cervical spine, the intensity is much greater, the pain can radiate to the shoulder or arm.This occurs due to a decrease in the height of the intervertebral disc and pinching of the nerve roots.The pain increases when tilting and turning the head.Patients may notice decreased performance, weakness, and headaches.

third degree

the symptoms of cervical osteochondrosis intensify, the pain becomes constant, radiating to the arm or shoulder.Numbness or weakness appears in the arm muscles, when a herniated intervertebral disc is formed (see symptoms of lumbar herniation).I am worried about weakness and dizziness.After examination, limited movement of the cervical spine and pain on palpation of the cervical spine were revealed.

Fourth grade

The intervertebral disc is completely destroyed and replaced by connective tissue.Dizziness increases, tinnitus appears, and coordination is impaired, because the vertebral artery that supplies the cerebellum and the occipital lobe of the brain is involved in the process.

Symptoms depend on which vertebra is damaged

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: leads to numbness and loss of sensitivity in the back of the head;
  • C2: pain in the parietal and back of the head;
  • C3: impaired speech, tongue sensitivity, pain and reduced sensitivity in the side where the spinal nerve is pinched;
  • C4: pain in the heart, left hypochondrium, shoulder, scapula, respiratory disorders, decreased neck muscle tone;
  • C5: shoulder pain in the outer region;
  • C6: pain radiating 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 up to 2-4 fingers;
  • C8: pain from neck to shoulder, from arm to little finger.

Diagnosis of cervical osteochondrosis

Basic diagnostic methods:

  • X-ray of the cervical spine.It is a low-informative method, especially in the late 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 hernia, as well as the presence of disc-medullary conflict (compression by the herniated spinal cord).
  • Magnetic resonance imaging.The most informative method.Not only the bone structure is clearly visible, but also intervertebral discs, hernias, their size, and the direction of their growth.
  • If a violation of blood flow in the vertebral artery is suspected, a duplex ultrasound scan is used.This method allows you to accurately determine whether there is a decrease in the speed of blood flow or whether there is an obstacle to normal blood flow.

X-ray stage of cervical osteochondrosis.

  • Stage 1 - minimal changes in the configuration of the vertebrae, smoothing 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), 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 on it, changes in the intervertebral joints, posterior osteophytes (bone growth), narrowing of the intervertebral foramina and narrowing of the spinal canal where the spinal cord with its membrane is located.
  • Stage 4 - a significant reduction in the height of the intervertebral disc, significant changes in the intervertebral joints, large posterior osteophytes, significant narrowing of the intervertebral foramina and significant narrowing of the spinal canal with the formation of myelopathy.

symptoms

Damage to the upper spine can manifest itself in various symptoms, depending on the location and severity of the dystrophic process, as well as how seriously the radicular structure of the cervical spine is affected.Often, patients' complaints are reduced to seemingly unrelated symptoms, 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:

  • Vertebral, characterized by various types of pain in the back of the head and neck.
  • The spine, where symptoms of motor and sensory disturbances are observed, in addition, the affected trophism of the cervical zone causes gradual atrophy of the muscles of the shoulder girdle and arms.
  • Radicular, expressed in pain symptoms in the peritoneal region and chest organs, which requires additional comprehensive diagnostics to differentiate osteochondrosis and diseases of internal organs.
  • Vertebral artery syndrome with cervical osteochondrosis is a vestibular disorder manifested by headache, hearing impairment, dizziness, even loss of consciousness.This phenomenon occurs as a result of cerebral ischemia due to the violation of the vertebral artery and the weakness 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 interfere with the quality of life, during the exacerbation period.How to treat osteochondrosis of the cervical spine is decided only by a doctor after an appropriate diagnosis;self-medication in this case is unacceptable.Neck osteochondrosis treatment aims to eliminate pain, inflammation, partial or complete recovery of the affected tissue structure and prevent complications.Treatment should be mostly outpatient;any procedure at home can only be carried out together with a medical prescription, after instrumental and laboratory diagnostics.In advanced cases, at severe stages of the development of neurological lesions and concomitant pathology, treatment of patients with cervical osteochondrosis with the possibility of surgical intervention may be indicated.

Drug treatment of cervical osteochondrosis

It consists of prescribing a course of drugs that relieve the symptoms of pain and inflammation.In the acute period, drugs in the form of injections are indicated;after some pain subsides, the patient takes a tablet, a local acting agent in the form of an ointment, 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 different dosage forms.They reduce soft tissue swelling, thereby reducing pain;Local agents have a warming effect, which increases blood flow in the affected cervical area.This medicine is 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 switched to the tablet form of administration.It should be remembered that long-term treatment with NSAIDs has a negative effect on the mucous membrane of the gastrointestinal tract, therefore the course of treatment usually does not exceed 10 days.
  • Hormones.If NSAIDs are not effective, the patient may be given a paravertebral anesthetic block in the cervical spine with glucocorticosteroids as treatment for pain, often dexamethasone or hydrocortisone injections into the affected area or tablets.Drugs of this group are prescribed to patients with cervical radicular syndrome to relieve swelling of nerve fibers.
  • Anesthetic.They are prescribed in the form of local neuromuscular blockade, which eliminates severe pain symptoms.Blockages can be intradermal, subcutaneous, muscular, perineural, or radicular, depending on where the injection is given.To prolong the analgesic effect, anesthetics are given together with hormones.Neck osteochondrosis treatment is carried out daily, a total of 5-7 such procedures are prescribed.Anesthetics can also be administered by injection into 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.To treat muscle tension in the affected area, nicotinic acid and others may be prescribed.By relieving neck muscle spasm and increasing blood flow, blood flow in the diseased area is stimulated, and the symptoms of cervical osteochondrosis and inflammation are relieved.During the exacerbation period, diuretics are also taken to reduce vascular spasm and thus improve microcirculation in the affected area.
  • Sedatives, such as tincture of valerian, peony, and herbal tea are recommended for prolonged pain and to reduce the risk of developing neuroticism in patients, which contributes to the effectiveness of the treatment of cervical osteochondrosis.
  • Local irritants.These are ointments, gels, local rubs that have a warming, irritating and irritating effect.They are not used in acute stage treatment.It contains biologically active substances derived from plants and animals, for example, bee or snake venom.If you have hypersensitivity to the components of the drug and if the irritating effect is high, it is better not to use it, so as not to cause greater swelling.
  • Vitamins.During the further treatment and recovery period, a multivitamin complex is recommended for use.Usually this is a group of B vitamins, 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 flow.Taking vitamins reduces vestibular disorders - hangover syndrome, dizziness, hearing loss.
  • Chondroprotectors.This is a substance that promotes the recovery of the cartilage tissue of the cervical segment vertebral disc.Treatment of cervical osteochondrosis with chondroprotectors is carried out over a long period of time, 6-12 months.

Orthopedic treatment methods

Unpleasant symptoms of the cervical spine are often provoked and aggravated by incorrect body positions during sleep, prolonged exposure to forced positions, or injuries.Therefore, when treating diseases, methods such as cervical collars, or Shants collars, are often used.It is prescribed individually for each patient, after medical consultation, because it comes in several types.The collar is a compact roller frame that is tied around the neck and fixes the vertebrae in the required position.Therefore, the neck is not bent and the head is not turned to the side, which ensures immobilization of the diseased area, which is important during the acute period.Shants neck collar can also be made in the form of two rollers with an inflatable layer, where air is pumped with a rubber bulb.Inflating the layer between the rollers stretches the spine, which makes it possible to increase the interarticular gap in the cervical spine.The degree of stretching is determined by the doctor;it is not recommended to solve this problem yourself, to avoid damage to the neurovascular bundle of the neck.During the recovery period, a fully inflatable collar is used, which preserves some movement of the neck and head.

The collar can be worn at home, no more than 3 hours a day, the total amount of wear is about a month.The final application rules are determined by the doctor, depending on the severity of the condition and existing symptoms.