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BACK Effective methods of treating osteochondrosis of the cervical spine.

In the modern world, almost all people over 25 years old have this disease.Cervical osteochondrosis occurs much more often than in other parts of the spine.The relevance of this topic is difficult to overestimate.In this article we will look at why this disease occurs, how it manifests itself, how to treat cervical osteochondrosis, what medications are effective in treating it, what non-drug methods exist, and also find out the answers to the most common questions from patients with a similar diagnosis.Osteochondrosis of the cervical spine is a degenerative-dystrophic lesion (progressive) of the intervertebral discs 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 increase in the load on the cervical spine, the neck muscles try to compensate for the excess load, their spasm occurs, blood circulation in this area is disrupted, 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 disrupted, changes occur in small joints between the vertebrae, bone growths of the vertebral bodies appear due to the increased load on the altered 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:

  • Poor posture and scoliosis
  • Overweight
  • Physical inactivity, sedentary work
  • Previous spinal injuries
  • Metabolic disorder
  • Great physical activity
  • Stress and constant nervous tension
  • Low level of physical fitness
  • Hereditary predisposition
  • Habitual incorrect body positions, such as holding a telephone receiver with your shoulder
  • Constant tension in the back and neck due to the nature of work (tense state in a 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 patient 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 slight tension in the neck muscles.

Second degree

The patient is concerned about pain in the cervical spine, its 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 intensifies when tilting and turning the head.The patient may notice decreased performance, weakness, and headache.

Third degree

the symptoms of cervical osteochondrosis intensify, the pain becomes constant, radiating to the arm or shoulder.Numbness or weakness appears in the muscles of the arm, as herniated intervertebral discs form (see symptoms of lumbar herniation).I am worried about weakness and dizziness.Upon examination, limited mobility in the cervical spine and pain on palpation of the cervical spine are revealed.

Fourth degree

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

Symptoms depending on the damaged vertebra

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 region and the back of the head;
  • C3: impaired speech, sensitivity of the tongue, pain and decreased 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 area;
  • 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 forearm 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 later 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 hernias, as well as the presence of disc-medullary conflict (compression by a herniated spinal cord).
  • Magnetic resonance imaging.The most informative method.Not only bone structures are clearly visible, but also intervertebral discs, hernias, their size, and the direction of their growth.
  • If a violation of blood flow in the vertebral arteries is suspected, ultrasound duplex scanning is used.This method allows you to accurately determine whether there is a decrease in blood flow speed 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, possible displacement of one vertebra relative to another, torsion (rotation around the axis of the spinal column), slight decrease in the height of the intervertebral disc.
  • Stage 3 – reduction in the height of the intervertebral disc by ¼ relative to the disc located above it, changes in the intervertebral joints, posterior osteophytes (bone outgrowths), narrowing of the intervertebral foramina and narrowing of the spinal canal in which the spinal cord with its membranes is 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 foramina and significant narrowing of the spinal canal with the formation of myelopathy.

Symptoms

Damage to the upper spine can manifest itself in a variety of symptoms, depending on the location and severity of the dystrophic process, as well as on how seriously the radicular structures of the cervical spine are affected.Often, patient complaints are reduced to symptoms that at first glance are unrelated, 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.
  • Spinal, in which symptoms of impaired motor and sensory innervation are observed, in addition, impaired trophism of the cervical zone causes gradual atrophy of the muscles of the shoulder girdle and arms.
  • Radicular, expressed in pain symptoms in the area of the peritoneal and chest organs, which requires additional thorough diagnostics to differentiate osteochondrosis and diseases of the internal organs.
  • Vertebral artery syndrome with cervical osteochondrosis is a vestibular disorder manifested by headaches, hearing impairment, dizziness, even loss of consciousness.These phenomena occur due to cerebral ischemia due to infringement 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 already at the stage of clinical manifestations that interfere with the quality of life, during periods of exacerbation.How to treat osteochondrosis of the cervical spine is decided only by a doctor after appropriate diagnosis; self-medication in this case is unacceptable.Treatment of neck osteochondrosis is aimed at eliminating pain, inflammation, partial or complete restoration of affected tissue structures and preventing complications.Treatment should be predominantly outpatient; any procedures at home can only be carried out in conjunction with medical prescriptions, after instrumental and laboratory diagnostics.In advanced cases, at severe stages of development of neurological lesions and concomitant 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 medications that relieve symptoms of pain and inflammation.In the acute period, drugs in injection form are indicated; after some pain subsides, the patient takes tablets, locally acting agents in the form of ointments, 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 different 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 area.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 switches to the tablet form of administration.It is worth remembering that long-term treatment with NSAIDs negatively affects the mucous membrane of the gastrointestinal tract, for this reason the course of treatment usually does not exceed 10 days.
  • Hormones.If NSAIDs are ineffective, the patient may be prescribed paravertebral anesthetic blockades in the cervical spine with glucocorticosteroids as a treatment for pain, most often an injection of dexamethasone or hydrocortisone into the affected area or tablets.Drugs of this group are prescribed to patients with cervical radicular syndrome to relieve swelling of the nerve fiber.
  • Anesthetics.They are prescribed in the form of local neuromuscular blockades, which eliminates severe pain symptoms.The blockade 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.Treatment of neck osteochondrosis is carried out every other day, 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 medications 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 spasms and improving blood flow, blood flow in the diseased area is stimulated, and the symptoms of cervical osteochondrosis and inflammation are relieved.During the period of exacerbation, diuretics are also taken to reduce vascular spasm and thereby improve microcirculation in the affected area.
  • Sedatives, such as tincture of valerian, peony, and herbal teas are recommended for prolonged pain and to reduce the risk of developing neuroticism in the patient, which contributes to the effectiveness of treatment of cervical osteochondrosis.
  • Local irritants.These are locally acting ointments, gels, rubbings that have a warming, irritating and distracting effect.They are not used in the treatment of 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.During the period of treatment and further rehabilitation, multivitamin complexes are recommended for use.Typically this is a group of vitamins B, 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 - motion sickness syndrome, dizziness, hearing loss.
  • Chondroprotectors.These are substances that promote the restoration of cartilage tissue of the vertebral discs of the cervical segment.Treatment of cervical osteochondrosis with chondroprotectors is carried out over a long period of 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.It is prescribed individually for each patient, after medical consultation, as it comes in several varieties.The collar is a framed dense roller that fastens around the neck and fixes the vertebrae in the required position.The neck, therefore, does not bend and the head does not turn to the side, which ensures immobilization of the diseased area, which is important during acute periods.Shants' neck collar can also be made in the form of two rollers with an inflatable layer, into which air is pumped with a rubber bulb.Inflating the layer between the rollers stretches the spine, which makes it possible to increase the interarticular gaps in 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 preserves some mobility of the neck and head.

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