Cervical osteochondrosis, or spondylosis, occurs as a result of changes in the shape and structure of the vertebrae.Although the cervical region is quite short in relation to the total length of the spine, it is perhaps the most important part of the spine.Each pair of adjacent vertebrae forms intervertebral foramina, through which nerve roots emerge and are directed to each muscle and organ in the upper half of the body.The vital vessels providing blood supply to the brain pass through other openings - in the lateral processes of these vertebrae.
Causes of osteochondrosis of the cervical spine
The causes of osteochondrosis are:
- injuries,
- “sedentary” work on a monitor located below eye level,
- physical work associated with transporting heavy loads,
- driving a car for a long time,
- work “on the phone” without using remote devices (in this case, the operator presses the receiver to her ear with her shoulder)
- constitutional features (torticollis, congenital changes in cervical vertebrae, short neck)
Formation of pathological changes in the vertebrae
In osteochondrosis, small sharp points begin to form on the edges of the vertebral bodies, which can damage nearby structures.Most often, this occurs in response to excessive load on the cervical spine and is not just the result of “aging” of the intervertebral joints (recall that osteochondrosis was previously considered a degenerative and natural “age-related” disease, like osteoarthritis).As the disease progresses, the vertebral endplates become denser and the height of the intervertebral discs decreases.These discs normally play the role of shock absorber between the vertebrae and, among other things, prevent damage to the spinal roots.With progressive osteochondrosis, there is a protrusion (hernia) of the nucleus pulposus of the intervertebral disc, on which, during the course of the disease, increasing pressure is exerted while the ligaments that “retain” it on all sides are weakened.This hernia can also compress spinal structures and cause neurological manifestations of the disease.
What are the symptoms of cervical osteochondrosis?
Osteochondrosis of the cervical spine with pain syndrome
Any pain in the neck region makes you suspect a pathology of the cervical spine.According to the increasing intensity of the pain syndrome, they are divided into 4 stages, in the first stage the patient feels numbness, tingling, a sensation of “tightness” in the region of a certain muscle group, in the fourth stage - the most intense - the pain is so intense that it leads to the patient's immobility and loss of performance.
In addition to pain in the cervical and occipital region, the patient notices “referred” (radiated) pain in the upper limb and in the lateral subscapular areas of the chest.
Osteochondrosis of the cervical spine with radicular syndrome
The involvement of nerve roots in the process is indicated when pain, numbness and tingling spreads to the jaw, upper back, forearm and fingers.At the same time, the patient draws attention to the fact that he “appeared to be resting” his hand and was sleeping uncomfortably.There is morning stiffness in the finger joints, lasting no more than 10-15 minutes.With the development of radicular syndromes, upon examination, a decrease in muscle strength in the upper extremities may be noted.
Osteochondrosis of the cervical spine with “vertebral artery syndrome”
The involvement of blood vessels in the process (compression by hernial protrusion or osteophyte) is indicated when the patient complains of frequent attacks of headaches, especially after staying in a certain position for a long time, when throwing the head back (for example, when swimming breaststroke), if there is tinnitus and dizziness.This clinical situation is well identified by ultrasound (with “Doppler mapping mode”).Ultrasound reveals tortuosity of the vertebral arteries and narrowing of their lumen.In this case, we may be talking about surgery, since a pronounced change in blood flow in the vertebral arteries is a risk factor for stroke.
Osteochondrosis of the cervical spine with “cardiac (heart) syndrome”
This syndrome forces the patient to first see a cardiologist, as the main complaints concern pain in the left half of the chest, subscapular region, which weakens or intensifies when performing physical activities or changing the position of the body.After ruling out myocardial infarction and other heart diseases, the patient is hospitalized under the supervision and treatment of a neurologist and orthopedist.
Diagnosis
To clarify the diagnosis, four methods are used: radiography, ultrasound, computed tomography and magnetic resonance imaging.
The most accessible method is still x-ray of the cervical spine;the most informative is the x-ray in lateral projection (“side view”).This method allows, as a first approximation, to determine the presence of injuries and gross structural changes in the vertebrae.
Ultrasound examination (ultrasound) is performed to clarify the condition of the vertebral arteries.Using this method, it is determined whether blood flow is impaired and, if so, to what extent and what type of obstacles have arisen and where they are located.
Computed tomography (CT).It allows you to more accurately assess the condition of bone structures, the degree of density of bone tissue and allows you to see smaller osteophytes (bone protuberances) than is possible with radiography.
Magnetic resonance imaging (MRI).This type of examination is essential if there is suspicion of the presence of hernias, the exact location of the spinal cord injury and the degree of this injury.This study is necessary if the question of operative (surgical) treatment of diseases of the cervical spine is raised.
Treatment of cervical osteochondrosis
Drug treatment
The standard set of remedies for the treatment of cervical osteochondrosis reflects the goals of treatment: relieving pain by eliminating painful muscle spasms and inflammation of the nerve roots, while increasing the mobility of the spine.To achieve these goals, they are mainly used with analgesics, NSAIDs - non-steroidal anti-inflammatory drugs, muscle relaxants.It should be remembered that self-medication with medicines from these groups can be dangerous, as there is a possibility of misinterpretation of symptoms, as well as underestimation of the side effects of these medicines.Local (cutaneous) NSAID medications in the form of gels are widely used and, when the pain stops, these same medications can be used in the form of ointments.
To treat osteochondrosis at a deeper, “basic” level, slow-acting systemic medications are used.These substances restore the cartilaginous structures of the vertebrae and prevent further damage.Treatment courses are long and the effect lasts for many months.
Cervical osteochondrosis has significant differences from the pathology of other parts of the spine.Pain in the neck area in this case can be provoked not by signals from the suffering spinal nerves, but by chronic and painful muscle tension - all this is called muscle-tonic syndrome.This is a completely “benign” condition that responds well to treatment with the same set of medications: non-steroidal anti-inflammatory drugs, muscle relaxants, the use of intramuscular “blocks” with steroids.Typically, the doctor detects sharp pains by palpating the so-called “trigger” points along the entire cervical spine, as well as in the region of the upper shoulder girdle muscles.More often, this pathology occurs in women, most of them under 40 years of age.Despite the intense pain syndrome, the neurovascular structures remain intact and blood flow to the head region is not affected.
Manual therapy
This method of treatment can be effective for recent pain (usually as a result of a minor injury, subluxation) in the neck that is not accompanied by dizziness or other changes in the nervous system and circulatory system.Recourse to manual therapy is only permitted after a thorough examination;Furthermore, the doctor performing this procedure must have sufficient experience in the field of traumatology and orthopedics.In “old” forms of the disease, the use of manual therapy is dangerous!
There are two known methods of this type of intervention:
- manipulation (sharp and short impacts of significant force aimed at eliminating subluxations, the well-known “bone clicks”);
- mobilization (the method is based on gentle stretching of the neck after warming up and relaxing the neck muscle corset).
A combined method is also used, based on the combination of two main methods.It is important to remember that in addition to these contraindications, manual therapy is prohibited for any diseases accompanied by an increase in blood pressure, for any pathology of the thyroid gland and ENT organs.
Treatment of cervical osteochondrosis at home
Therapeutic exercises for cervical osteochondrosis
The first and main rule for beginners in physiotherapy is not to perform exercises while overcoming painful sensations.It goes without saying that you should not start in the “acute” period, when the pain has just appeared.Another important recommendation is to avoid sudden and circular movements in the cervical spine.
Each session should begin with a short, light self-massage of the neck muscles.
This is followed by a “warm-up” warm-up:
- Arms are lowered along the body, shoulders are level, back is straight (you can check your posture by lightly pressing your heels, shoulder blades and buttocks against the wall).We walk in place for 1 minute with the entire foot, 1 minute on the toes, 1 minute on the heels.
- The starting position is the same.We clench our fists, raise and lower our shoulders, arms straight.The movements are slow, we do 20 repetitions, the last rise is 5 seconds longer.We make sure that the neck muscles are not tense.
- The starting position is the same.We tilt our heads one by one to the right and then to the left.Movements are smooth, an incline for 8 counts, at the extreme point of the incline - hold for 8 seconds.
- The starting position is the same or sitting on a hard chair.Gentle head tilts forward, at the extreme point - hold for 8 seconds
- The starting position is the same or sitting on a hard chair.Slowly tilt your head forward until your chin touches your chest, then slowly turn your head to the right (4 counts) and left (4 counts).Avoid overloading your muscles.
- The starting position is the same or sitting on a hard chair.We raise our shoulders for 4 counts and then gently lower them for 4 counts.10 repetitions.
- The starting position is the same or sitting on a hard chair.We raise our shoulders, but now we perform circular movements from front to back, for 8 counts.10 repetitions.
- We straighten our backs and check our posture.For 4 counts, we bring the shoulder blades together behind the back, trying to connect them, at the final point we take 8 seconds, then we return to the starting position.
Pillows
As already mentioned, hypertonicity of the neck muscles is the first and often the main cause of the development of cervical osteochondrosis.The rational selection of pillows and mattresses, ensuring a relaxed and comfortable position during sleep, is no less important than gymnastics, physiotherapy and medications.
When choosing a mattress, pay attention to the composition of the filler (products that are at least half made from coconut flakes are suitable, that is, with a sufficient degree of rigidity).Soft spring mattresses do not provide sufficient straightening of the spine.The ideal sleeping position is on your side, with one or both knees pulled toward your stomach.The pillow should be positioned so that it fills the entire space between the shoulder, ear and mattress, while the parietal part (crown) of the head is on the same horizontal line as the spine.Very high and very low pillows, as well as soft pillows, should be avoided.The ideal option is a product with an ergonomic shape, that is, in this case, with a small steamroller on one side.
General recommendations
Pay attention to your posture.When walking or standing, the correct position is when the chest is protruded forward and the stomach is retracted.
Avoid sitting for long periods of time.A simple rule for the prevention of cervical osteochondrosis is known: for every 60 minutes of work, a period of walking or warming up for 10 to 15 minutes is necessary.
A work chair should have a headrest or high backrest.
When sitting, your feet should be flat on the floor and your neck should not be tense.To do this, use special orthopedic devices: pillows under the neck when driving, a pillow under the back.
Avoid lifting weights.If necessary, kneel down, hold a heavy object against your torso and then gently stand up, using the strength of your leg muscles, but not the “pull” of your back.
Don't lean over with your legs straight.Use supports or work surfaces to bring your subject closer to you, rather than tilting your face toward them.Try doing your homework sitting in a chair or on an exercise ball.
If you need to use a mop, broom, or rake, do not strain your arms, back, neck, or lean sideways.
Avoid swimming breaststroke.