The diagnosis of "cervical osteochondrosis" is often made when a person complains of neck pain. Some also attribute dizziness, memory loss, numbness of the hands and other unpleasant symptoms to it. It is incorrectly believed that the disease is associated with age-related wear and deformation of the intervertebral discs and other elements of the spine.
How does the cervical spine work?
The cervical region is made up of 7 vertebrae. Between them are intervertebral discs - semi-rigid structures with a dense ring along the periphery and a jelly-like center, which act as shock absorbers. To the right and left of each vertebra are two joints between which the cartilage-covered surfaces of the vertebral processes protrude. Joints are connected by ligaments and back muscles.
Why does neck pain occur?
Typically, neck pain occurs in response to awkward movement, injury, or inflammation of one of the structures of the cervical spine. In addition, the cause of pain may be excessive stretching of muscles or ligaments, for example, when lifting weights, unsuccessfully turning the head or against the background of arthrosis of the joints themselves between processesjoints. "Nerve entrapments", or cervical radiculopathy, specific processes (metastases, tumors of the vertebrae, membranes of the spinal cord in the cervical region) are relatively rare.
26% of men and 40% of women over the age of 30 have experienced neck pain in the past month, and 5% of men and 7% of women experience it constantly.
Acute neck pain usually goes away on its own within 1 to 2 weeks. Chronic pain appears in most cases due to a lack of physical activity or, on the contrary, too intense exercise.
However, people often mistakenly call unexplained pain and discomfort in the neck cervical osteochondrosis and associate its development with age-related wear and deformation of the intervertebral discs and other elements of the spine. 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 disruption of normal bone development and growth. As a rule, osteochondrosis begins in childhood and is serious: part of the joint or bone becomes deformed and sometimes even dies. In this disease, it is most 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, called thoracic kyphosis.
Symptoms associated with thoracic spine injuries:
- dyspnea,
- constant weakness
- inability to breathe fully,
- pain and burning behind the sternum,
- Rapid heartbeat attacks.
Conditions accompanied by neck pain
Cervical osteoarthritis
In people over 50, neck pain is usually caused by cervical spondylosis, age-related wear and tear of the vertebrae and associated structures. With this disease, the intervertebral discs become dehydrated and flatten, causing worsening depreciation of the cervical region, and many movements are accompanied by pain.
But changes in the spine with age are normal. Thus, its structures begin to wear out after 30 years on average, and at 60, 9 out of 10 people already suffer from cervical osteoarthritis. However, in most people it is asymptomatic.
Other reasons
More rarely, neck pain occurs due to hypothermia or severe stress, due to a herniated disc or abnormalities of the cervical vertebrae - bony growths (spurs) that compress the nerves extending 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 muscular elements of the aponeurosis in the occipital, temporal and frontal regions connect with the muscles of the cervical region, so neck pain is often accompanied by headaches. So, neck pain, which appears after prolonged sedentary work or sleep in an uncomfortable position and is associated with a headache, is in most cases associated with a lack of physical activity and poor posture andare not dangerous for health.
The phenomenon of tech neck, called techno-neck or Internet-age neck, is associated with pain due to uncomfortable posture. Techneck is the result of constant use of a computer and smartphone, because of which a person is forced to bend their neck. The fact is that the relative mass of the head increases with forward tilt. Thus, in the "upright" 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 will be 13 kg, at 30° - 20 kg, at 60° - 30 kg. Due to constant overload, the neck muscles are overworked, microtrauma, inflammation, fibrosis (proliferation of connective tissue) and, as a result, pain may occur.
Reasons contributing to the development of degenerative changes in the cervical spine
The appearance of pain in the cervical spine is facilitated by childbirth or any other injury to the spine, abnormalities in its development, postural disorders, muscular dystonia, as well as prolonged immobilization, obesity and someautoimmune diseases.
- Long-term immobilization is a condition in which a person, due to an underlying illness, is forced to lie down for more than a month. As a result, the muscles weaken - and during standing, when the load on them increases, they become excessively tense. Pain appears.
- Obesity: Excess weight increases stress on spinal structures 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 discs become thinner, slight discomfort appears in the neck;
- Stage II: the intervertebral discs are deformed, the distance between the vertebrae is reduced. The pain increases with movement of the cervical spine;
- Stage III: cartilage and vertebrae rub against each other, neck pain becomes constant and movements limited. In cases of very severe deformities of the cervical spine, vertebral artery syndrome may occur with visual and vestibular disorders, headaches;
- Stage IV: degenerative changes are pronounced, movements of the cervical spine are very limited and painful. The neck area can be almost completely immobilized.
Symptoms of degenerative changes in the cervical spine
Most people with cervical osteochondrosis suffer from chronic pain and stiff neck. As the disease progresses, other symptoms may appear (especially if the spinal roots, vertebral artery, and adjacent nerve plexuses are compressed).
Symptoms of degenerative changes in the cervical spine:
- neck pain that gets worse when moving or standing;
- the pain radiates towards the shoulder or arm;
- numbness, tingling, and weakness in the arms and hands;
- clicking or grinding noises in the neck (especially when turning the head);
- headache;
- attacks of dizziness;
- impaired coordination of movements;
- loss of bladder or bowel control.
If such symptoms appear, you should consult a neurologist as soon as possible.
Types of symptoms of "cervical osteochondrosis"
All symptoms of "cervical osteochondrosis" can be classically classified into 3 groups, or syndromes: vertebral, radicular and vertebral artery syndrome.
Symptoms of vertebral (spinal) syndrome:
- neck cracking when moving;
- reduced mobility;
- violation of the location of the vertebrae relative to each other in the neck;
- smoothing the natural cervical lordosis or lateral curvature of the cervical spine (visible only on X-ray, MRI or CT scan).
Symptoms of radicular syndrome:
- numbness of the fingers of one or both hands;
- stabbing, burning pain in neck, radiating to arm or both arms;
- dystrophy of the neck and arm muscles.
Symptoms of Vertebral Artery Syndrome:
- paroxysmal dizziness, leading to loss of consciousness;
- sudden jumps 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 of the cervical spine
To understand the cause of neck pain and make a diagnosis of "degenerative changes in the cervical spine" (commonly called cervical osteochondrosis), the doctor will need to conduct an examination, study the medical history, evaluate the results of laboratory tests and examinationsinstrumental. .
Diagnosis and treatment of cervical osteochondrosis is carried out by a neurologist.
Inspection
During the examination, the doctor will listen to the patient's complaints, clarify the details of the medical history and conduct an examination: checking reflexes, muscle strength, sensitivity and condition of the vestibular apparatus.
In case of "cervical osteochondrosis", visible areas of muscle atrophy (muscle loss), a decrease or increase in muscle tone of the long back muscles and static disturbances in the cervical region can 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 arms, and dizziness or headache may occur.
Additionally, patients may experience hand motor disturbances (weakness), vision and hearing problems.
The doctor may also ask the patient 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 the coordination of movements is impaired, whether there are problems with gross and fine motor skills.
Laboratory diagnosis
To assess the general condition of bones, patients with suspected cervical osteochondrosis are prescribed blood tests for total and ionized calcium, as well as markers of growth and destruction of bone tissue - osteocalcin and osteoprotegerin, alkaline phosphatase.
With progressive cervical osteochondrosis, the joints are destroyed, the calcium content may be reduced, and osteocalcin and osteoprotegerin, on the contrary, increased.
Total creatine kinase is also considered a marker of muscle tissue destruction in cervical muscle myositis.
In addition, the doctor may be required to evaluate the blood levels of microelements involved in the regulation of muscle tone: magnesium, potassium, sodium.
Instrumental diagnosis
To establish the cause of neck pain and associated disorders, imaging studies are necessary: x-ray of the cervical spine, computed tomography and magnetic resonance imaging, electroneuromyography.
- X-ray.With the help of 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. CT scan shows hemangiomas of the vertebral bodies and macroscopic deformities of the cervical spine. Magnetic resonance imaging is more informative for visualizing the muscles, roots and spinal cord.
- Electroneuromyography- a method for studying the efficiency of the transmission of impulses along a nerve fiber using a low intensity electric current. The test may be slightly uncomfortable. The study helps to clarify the conduction of impulses along roots, nerves and nerves to muscles, confirm damage to nerves or muscles, and clarify the nature and level of damage.
Treatment of degenerative changes of the cervical spine
The main goals of treatment for degenerative changes of the cervical spine are to relieve pain, prevent compression of the neck nerves, and restore cervical mobility.
Depending on the severity of the condition, the doctor may prescribe medication, physical therapy or massage. Surgery may be necessary if nerves are pinched or joints become deformed.
Drug treatment of degenerative changes of the cervical spine
Neck pain can be relieved with medication.
Medications 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 relaxants to relieve muscle spasms;
- antidepressants to relieve chronic pain.
Non-drug treatment of cervical osteochondrosis
Along with drug treatment, 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 mats or rollers with metal or plastic needles. They are used 15 to 30 minutes before bed to relax the muscles.
Wearing a Shantz brace (neck brace) is a passive exercise therapy for the deep muscles of the cervical region, which are difficult to influence through exercise. When a person puts on a splint, the muscles relax, and when they take it off, they tense. If you wear a splint for 15 to 20 minutes several times a day, you can train and strengthen them.
It only makes sense to wear it for 2-3 hours if you have serious neck injuries. Furthermore, you should not lie down there, let alone sleep.
Surgical treatment of degenerative changes of the cervical spine
Typically, surgery is required in patients with severe spinal deformity and a pinched nerve.
During the operation, the surgeon removes pathological elements (hernial protrusions, formations, etc. ) or part of the vertebra. After such treatment, a long period of rehabilitation is necessary: wearing a Shants splint or a rigid brace for the cervical spine, physiotherapy, regular walking, painkillers.
Complications and consequences of degenerative changes of the cervical spine
Without treatment, the intervertebral discs gradually wear out and the vertebrae are "erased".
Common complications of degenerative changes of the cervical spine:
- intractable pain syndrome in the head, neck and chest;
- cramps, movement disorders and numbness of the hands;
- frequent dizziness, problems with coordination of movements, fine and gross motor skills.
Prevention of degenerative changes of 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, wrongly associated with cervical osteochondrosis, it is important to take care of 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 suitable. Pilates and yoga will help you strengthen your muscles.
In addition, gymnastics helps prevent overstrain of the neck muscles and the appearance of pain: tilt your head forward, back, alternately on each shoulder and rotate it, as well as sleep on a pilloworthopedic.
Injuries to the cervical spine should be avoided: do not jump into the water upside down, wear a seat belt in the car (prevention of whiplash in the event of an accident).
Sleeping position for back pain
Neck and back pain, often attributed to osteochondrosis, can be the result of an uncomfortable sleeping position.
During sleep, the head and spine should be approximately at the same level. This position minimizes additional pressure on the neck area.
If a person sleeps mainly on their 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: 9 to 13 cm. In this way, the desired angle will be maintained between the shoulder and the head, the cervical spine will not sag and the muscles will contract to compensate for the discomfort caused.
Additionally, the greater the person's weight, the higher the pillow should be. You should also 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. Additionally, it is best not to always sleep on one side, as this leads to muscle imbalance.
If a person prefers to sleep on their stomach, they may experience back and neck pain more often. The fact is that in this position it is difficult to keep the spine in a neutral position. To relieve tension in your back, you can put a pillow under your pelvis and lower abdomen, and choose a flat pillow under your head, or even sleep without it.
Additionally, you can use a special orthopedic pillow.
FAQs
- Where can pain radiate from "cervical osteochondrosis"?
Pain due to degenerative changes in the cervical spine may radiate to the shoulder or arm and also intensify with movement or standing.
- How to relieve an attack of dizziness with "cervical osteochondrosis"?
To relieve an attack of vertigo, you should adopt a comfortable position in which the risk of falling is minimal (sit in a chair with a back or lie down) and call for help. After 5-7 minutes, you can try to turn your head: most likely, the attack of dizziness will pass during this time. If dizziness persists or worsens, nausea, vomiting or other neurological symptoms (problems with speech, vision, movement, swallowing, sensitivity) appear, you should call an ambulance as soon as possible. as possible.
- How to sleep well with "cervical osteochondrosis"?
During sleep, the head and spine should be approximately at the same level. This position minimizes additional pressure on the neck area.
- How long does an exacerbation of "osteochondrosis" of the cervical spine last?
On average, the exacerbation 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. During this time, it is best for a person to remain 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 a neurologist, neurosurgeon, orthopedist and general practitioner.