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BACK Effective methods of treating osteochondrosis of the cervical spine.

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

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Causes of cervical osteochondrosis

Due to the action of the factors listed below, the load on the cervical spine increases, the neck muscles try to compensate for the excessive load, their spasms occur, 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 disturbed, changes occur in the small joints between the vertebrae, bony outgrowths 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:

  • Bad posture and scoliosis
  • Overweight
  • Physical inactivity, sedentary work
  • Previous spinal injuries
  • Metabolic disorder
  • Great physical activity
  • Stress and constant nervous tension
  • Low fitness level
  • Hereditary predisposition
  • Common incorrect body positions, such as holding a telephone receiver with your shoulder
  • Constant tension in the back and neck due to the nature of the work (strained state when sitting) in drivers and office workers.
  • Developmental abnormalities of the cervical spine

Degree of development of cervical osteochondrosis

The degree of osteochondrosis is determined by the clinical picture and complaints of patients.The concept of degree should not be confused with the stages of osteochondrosis.The steps will be discussed below.

First degree

clinical manifestations are minimal, the patient may complain of low-intensity pain in the cervical spine, which can intensify when turning the head.Physical examination may reveal mild tension in the neck muscles.

Second degree

The patient is worried about pain in the cervical spine, its intensity 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 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 muscles of the arm when a herniated disc forms (see symptoms of a lumbar herniation).I worry about weakness and dizziness.On examination, limited mobility of the cervical spine and pain on palpation of the cervical spine are revealed.

Fourth degree

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 depending on the damaged vertebra

Furthermore, we can distinguish radicular syndromes which cause certain sensory and motor disorders.They differ depending on the vertebra that compresses the spinal root:

  • C1: causes numbness and loss of sensation in the back of the head;
  • C2: pain in the parietal region and back of the head;
  • C3: speech disturbances, tongue sensitivity, pain and decreased sensitivity on the side where the spinal nerve is pinched;
  • C4: pain in the heart, left hypochondrium, shoulder, scapula, respiratory problems, decreased muscle tone of the neck;
  • C5: shoulder pain in the external 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 to 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.This is an uninformative method, especially in advanced stages of the disease.
  • CT scan.It better shows changes in the vertebrae, but it is difficult to determine the size and presence of intervertebral hernias, as well as the presence of disc-medullary impingement (compression by a spinal cord herniation).
  • Magnetic resonance imaging.The most informative method.Not only bone structures are clearly visible, but also intervertebral discs, herniations, their size and direction of growth.
  • If a violation of blood flow in the vertebral arteries is suspected, duplex ultrasound 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.

Radiological stages of cervical osteochondrosis.

  • Stage 1 – minimal changes in the configuration of the vertebrae, smoothing of cervical lordosis (curvature).
  • Stage 2 – instability between the vertebrae, possible displacement of one vertebra relative to another, torsion (rotation around the axis of the spine), slight decrease in the height of the intervertebral disc.
  • Stage 3 – reduction in the height of the intervertebral disc by ¼ compared to the disc above it, changes in the intervertebral joints, posterior osteophytes (bony growths), 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 with various symptoms, depending on the localization and severity of the dystrophic process, as well as the severity of damage to the root structures of the cervical spine.Often, patient complaints are reduced to symptoms that, at first glance, are unrelated, which can complicate the diagnosis and subsequent treatment of the disease.In general, the clinical picture of cervical osteochondrosis includes 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 area causes progressive atrophy of the muscles of the shoulder girdle and arms.
  • Radicular, expressed by painful symptoms in the region of the peritoneal and thoracic organs, which require additional in-depth diagnostics to differentiate osteochondrosis and diseases of internal organs.
  • Vertebral artery syndrome with cervical osteochondrosis is a vestibular disorder manifested by headaches, hearing impairment, dizziness, and even loss of consciousness.These phenomena occur due to cerebral ischemia due to violation of the vertebral artery and weakening of 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 an appropriate diagnosis;self-medication in this case is unacceptable.Treatment of osteochondrosis of the neck is aimed at eliminating pain, inflammation, partial or complete restoration of affected tissue structures and preventing complications.Treatment should be primarily outpatient;any home intervention can only be carried out on medical prescription, after instrumental and laboratory diagnosis.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 medication that relieve the symptoms of pain and inflammation.In the acute period, medications in injectable form are indicated;after some pain has subsided, the patient takes tablets, local action agents in the form of ointments, and continues to receive injections.

  • Non-steroidal anti-inflammatory drugs.They are considered 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 circulation in the affected cervical area.These medications are used for 5 to 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 should be remembered that long-term treatment with NSAIDs negatively affects the mucous membrane of the gastrointestinal tract, therefore the duration of treatment usually does not exceed 10 days.
  • Hormones.If NSAIDs are ineffective, the patient may be prescribed paravertebral anesthetic blockades of the cervical spine with glucocorticosteroids as treatment for pain, most often an injection of dexamethasone or hydrocortisone 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 severe painful symptoms.The blockage can be intradermal, subcutaneous, muscular, perineural or radicular, depending on where the injection is made.To prolong the analgesic effect, anesthetics are administered in combination with hormones.Treatment of osteochondrosis of the neck 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 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 spasms and improving blood circulation, blood circulation 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 the patient developing neuroticism, which contributes to the effectiveness of the treatment of cervical osteochondrosis.
  • Local irritants.These are ointments, gels, frictions with local action which have a warming, irritating and distracting effect.They are not used in the treatment of the acute phase.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 its irritant effect is high, it is better not to use them, so as not to cause even greater swelling.
  • Vitamins.During the period of treatment and subsequent rehabilitation, the use of multivitamin complexes is recommended.Usually this is a group of B vitamins, representatives of which participate in ensuring normal nerve conduction, as well as vitamins A and C, to strengthen the walls of blood vessels and improve blood circulation.Taking vitamins reduces vestibular disorders - motion sickness syndrome, dizziness, hearing loss.
  • Chondroprotectors.These are substances that promote the restoration of the cartilaginous tissue of the vertebral discs of the cervical segment.Treatment of cervical osteochondrosis with chondroprotectors is carried out over a long period, 6 to 12 months.

Orthopedic treatment methods

Unpleasant cervical spine symptoms are often caused and aggravated by poor 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, because there are several varieties.The collar is a dense framed roll that attaches 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' collar can also be made in the form of two rollers with an inflatable layer, into which air is pumped using a rubber bulb.Inflating the layer between the rollers stretches the spine, which helps increase the interarticular spaces in the cervical spine.The degree of stretching is determined by the doctor;it is not recommended to solve this problem 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 wearing time is about a month.The final rules for wearing are determined by the doctor, depending on the severity of the condition and the existing symptoms.