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

In the modern world, almost every person over the age of 25 suffers from 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 examine why this disease occurs, how it manifests itself, how to treat cervical osteochondrosis, what drugs are effective in its treatment, what non-pharmacological methods exist, and we will find out the answers to the most common questions of patients with a similar diagnosis.Osteochondrosis of the cervical spine is a degenerative-dystrophic change (progressive) of the intervertebral discs of the cervical spine.

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Causes of cervical osteochondrosis

As a result of the factors listed below, the load on the cervical spine increases, the neck muscles try to compensate for the overload, spasms occur, blood circulation in this area is disturbed, which causes degenerative changes.As a result of many factors, changes occur in the discs of the cervical spine, their structure changes, their nutrition is disturbed, changes occur in the small joints between the vertebrae, and bone growths of the vertebral bodies appear due to the increased load on the changed intervertebral discs.Click to enlarge - gymnastics therapy for osteochondrosis of any part of the spine.Factors contributing to the development of osteochondrosis of the cervical spine:

  • Bad posture and scoliosis
  • He is overweight
  • Physical inactivity, sedentary work
  • Previous spinal injuries
  • Metabolic disorder
  • Great physical activity
  • Stress and constant nervous tension
  • Low physical fitness
  • Hereditary tendency
  • Habitual incorrect body postures, such as holding the phone over the shoulder
  • Constant tension in the back and neck due to the nature of work (strained 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 the patient's complaints.The concept of degree should not be confused with the stages of osteochondrosis.The sections are 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 spine, the intensity of which is much greater, the pain can radiate to the shoulder or arm.This is 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 experience reduced 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 muscles of the arm when a herniated disc forms (see symptoms of lumbar herniation).I am concerned about weakness and dizziness.During the examination, the movement of the cervical spine is limited and pain during the palpation of the cervical spine is revealed.

Fourth degree

The intervertebral disc is completely destroyed and replaced by connective tissue.Dizziness increases, tinnitus appears and coordination deteriorates, as the vertebral artery supplying the cerebellum and the occipital lobe of the brain are involved in the process.

The symptoms depend on the damaged vertebra

We can distinguish radicular syndromes that lead to certain sensory and motor disturbances.They differ depending on which vertebra compresses the root of the spine:

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

Diagnosis of cervical osteochondrosis

Basic diagnostic methods:

  • X-ray of the cervical spine.Low informative method, especially in the later stages of the disease.
  • Computed tomography.It shows the changes of the vertebrae better, but it is difficult to determine the size and presence of the intervertebral hernia, as well as the presence of disc-medullary conflict (compression by the herniated disc).
  • Magnetic resonance imaging.The most informative method.Not only the bone structures are clearly visible, but also the intervertebral discs, hernias, their size and direction of growth.
  • If a violation of blood flow in the vertebral arteries is suspected, an ultrasound duplex scan is used.This method allows you to accurately determine whether the speed of blood flow is reduced 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 - intervertebral instability, possible displacement of one vertebra relative to another, torsion (rotation around the axis of the spinal column), a slight decrease in the height of the intervertebral disc.
  • Stage 3 - a decrease in the height of the intervertebral disc compared to the disc above it by ¼, changes in the intervertebral joints, posterior osteophytes (bone growths), narrowing of the intervertebral openings and narrowing of the spinal canal, in which the spinal cord and membranes are located.
  • Stage 4 - a significant decrease 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 development 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 the degree to which the radicular structures of the cervical spine are affected.Patients' complaints are often reduced to symptoms that are unrelated at first glance, which can make diagnosis and further treatment of the disease difficult.In general, the clinical picture of cervical osteochondrosis consists of the following syndromes:

  • Vertebralgia characterized by different types of pain in the back of the head and neck.
  • Spinalis, in which symptoms of damage to motor and sensory innervation can be observed, in addition, damaged trophism of the neck zone causes gradual atrophy of the muscles of the shoulder girdle and arms.
  • Radicular, expressed in symptoms of pain in the area of the peritoneal and thoracic organs, which requires further thorough diagnostics to distinguish between osteochondrosis and diseases of the internal organs.
  • Vertebral artery syndrome associated with cervical osteochondrosis is a vestibular disorder that manifests itself in headaches, hearing loss, dizziness, and even loss of consciousness.These phenomena occur due to cerebral ischemia due to damage to 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 affecting the quality of life, during periods of exacerbation.Treatment of osteochondrosis of the cervical spine is determined only by a doctor after a proper diagnosis;self-medication in this case is unacceptable.Treatment of cervical osteochondrosis is aimed at eliminating pain, inflammation, partial or complete restoration of the affected tissue structures, and prevention of complications.Treatment should be predominantly outpatient;all home procedures can only be performed with a doctor's prescription, after instrumental and laboratory diagnostics.In advanced cases, in the severe development stage of neurological changes and concomitant pathologies, the inpatient treatment of cervical osteochondrosis can be justified by the possibility of surgical intervention.

Drug treatment of cervical osteochondrosis

It consists of prescribing drugs that relieve the symptoms of pain and inflammation.In the acute period, injectable drugs are indicated;after the pain subsides, the patient takes tablets, locally acting agents in the form of ointments, and continues to receive injections.

  • Nonsteroidal anti-inflammatory drugs.In the treatment of cervical osteochondrosis, they are considered drugs to relieve pain and inflammation.It is available in different dosage forms.They reduce the swelling of soft tissues, thereby reducing pain;topical agents have a warming effect, which improves blood flow in the affected neck 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 noting that long-term treatment with NSAIDs negatively affects the mucous membrane of the gastrointestinal tract, so the duration of treatment usually does not exceed 10 days.
  • Hormones.If nonsteroidal anti-inflammatory drugs are ineffective, the patient may be prescribed paravertebral anesthetic blocks with glucocorticosteroids in the cervical spine as pain relievers, most often with dexamethasone or hydrocortisone injections into the affected area or tablets.Medicines in 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 eliminate the symptoms of severe pain.Depending on the site of injection, the blockade can be intradermal, subcutaneous, muscular, perineural or radicular.In order to prolong the pain-relieving effect, anesthetics are administered together with hormones.Treatment of cervical osteochondrosis is carried out every other day, a total of 5-7 such procedures are prescribed.Anesthetics can also be injected 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 neck and collar area.Nicotinic acid and others can be prescribed to treat muscle tension in the affected area.By alleviating neck muscle spasms and improving blood flow, blood flow is stimulated in the diseased area, and the symptoms of cervical osteochondrosis and inflammation are alleviated.During the period of exacerbation, diuretics are also taken to reduce vasospasm and thereby improve microcirculation in the affected area.
  • Sedatives such as catnip tincture, peony, and herbal teas are recommended to treat prolonged pain and reduce the risk of developing neuroticism, which contributes to the effectiveness of the treatment of cervical osteochondrosis.
  • Local irritants.These are topical ointments, gels, and rubs that have a warming, irritating, and distracting effect.It is not used to treat the acute stage.They contain biologically active substances of plant and animal origin, such as bee or snake venom.If you are hypersensitive to the ingredients of the medicine and if the irritating effect is strong, it is better not to use them, so as not to cause even more swelling.
  • Vitamins.The use of multivitamin complexes is recommended during treatment and further rehabilitation.Typically, 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 - motion sickness syndrome, dizziness, hearing loss.
  • Chondroprotectors.These are substances that promote the restoration of the cartilage tissue of the vertebral plates of the cervical segment.Cervical osteochondrosis is treated with chondroprotectors for a long time, 6-12 months.

Orthopedic treatment methods

Unpleasant symptoms of the cervical spine are often provoked and aggravated by incorrect body position during sleep, long-term strain or injury.Therefore, in the treatment of the disease, a method such as the collar or Shants collar is often used.It is prescribed to each patient individually, after a doctor's consultation, as it is available in several versions.The collar is a framed dense roller that fastens around the neck and fixes the vertebrae in the desired position.The neck therefore does not bend and the head does not turn to the side, which ensures the immobilization of the diseased area, which is important in acute periods.The neck collar of Shants can also be made in the form of two inflatable layers of rollers, into which air is pumped with a rubber bladder.Inflating the layer between the rollers tightens the spine, which allows the interarticular spaces of the cervical spine.The degree of stretching is determined by the doctor;it is not recommended to solve this problem independently in order to avoid damage to the neurovascular bundles of the neck.During the recovery period, a fully inflatable collar is used, which preserves the mobility of the neck and head.

The collar can be worn at home for a maximum of 3 hours a day, the total wearing time is approx.one month.The final wearing rules are determined by the doctor, depending on the severity of the condition and existing symptoms.