A diagnosis of "cervical osteochondrosis" is often made if a person complains of neck pain. Some also attribute dizziness, memory loss, numbness of the hands and other unpleasant symptoms. It is wrongly believed that the disease is related to age-related wear and tear of the intervertebral discs and other elements of the spine.
How does the cervical spine work?
The cervical region consists of 7 vertebrae. Between them are intervertebral discs - semi-rigid structures with a dense ring along the circumference and a jelly-like center, which act as shock absorbers. To the right and left of each vertebra there are two joints, between which the surfaces of the vertebral processes, covered with cartilage, protrude. The joints are connected by ligaments and muscles of the back.
Why does neck pain occur?
Typically, neck pain occurs in response to awkward movement, injury, or inflammation of any of the structures of the cervical spine. In addition, the cause of pain can be excessive stretching of muscles or ligaments, for example, when lifting weights, unsuccessful rotation of the head or the background of articulation of the joints themselves between the articular processes. "Nerve entrapment", or cervical radiculopathy, specific processes (metastases, spinal tumors, spinal cord membranes in the cervical region) are relatively rare.
26% of men and 40% of women over 30 have experienced neck pain in the past month, and 5% of men and 7% of women feel it all the time.
Acute neck pain usually goes away on its own within 1-2 weeks. Chronic pain in most cases occurs due to 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 tear of the intervertebral discs and other elements of the spine. But such pain, as a rule, has nothing to do with real osteochondrosis.
Osteochondrosis of the cervix
According to the International Classification of Diseases (ICD), osteochondrosis (osteochondropathy) is a group of rare hereditary diseases associated with disruption of normal bone growth and development. As a rule, osteochondrosis begins in childhood and is severe: part of the joint or bone is deformed and sometimes dies. With this disease, most often it is not the cervical spine that is affected, but the thoracic spine (lower thoracic vertebrae). Hence the main clinical manifestation of osteochondrosis is the pronounced curvature of the thoracic spine, the so-called thoracic kyphosis.
Symptoms associated with damage to the thoracic spine:
- shortness of breath,
- constant weakness
- inability to breathe fully,
- pain and burning behind the sternum,
- attacks of rapid heartbeat.
Conditions accompanied by neck pain
Cervical spondylosis
In people over 50, neck pain is usually caused by cervical spondylosis, age-related wear and tear of the vertebrae and related structures. With this disease, the intervertebral discs are dehydrated and flattened, causing deterioration in the cervical region, and many movements are accompanied by pain.
But changes in the spine as we age are normal. Thus, its structures begin to wear out after 30 years on average, and by the age of 60, 9 out of 10 people already have cervical spondylosis. However, most people are asymptomatic.
Other reasons
Less often, neck pain occurs due to hypothermia or severe stress, due to herniated discs or abnormalities of the cervical vertebrae - bony growths (spurs) that compress the nerves that extend from the spinal cord.
The most common source of pain in the cervical spine and shoulder girdle is excessive tension (tightening) of the muscles: trapezius, long dorsal muscles of the cervical spine.
In addition, the muscles of the cervical spine are closely connected to the aponeurosis - a wide plate of tendons that surrounds the head. The muscular elements of the aponeurosis in the occipital, temporal and frontal regions are connected to the muscles of the neck region, so neck pain is often accompanied by a headache. Thus, neck pain, which occurs after prolonged sitting work or sleeping in an uncomfortable position and is combined with a headache, is in most cases related to a lack of physical activity and incorrect posture and is not dangerous to health.
The phenomenon of tech neck, the so-called techno-neck or neck of the Internet age, is related to pain that arises due to an awkward posture. Techneck is the result of constant computer and smartphone use, due to which a person is forced to bend his neck. The fact is that the relative mass of the head increases with forward inclination. Thus, in the "straight" 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. As a result of constant overload, the neck muscles are strained, microtraumas, inflammations, fibrosis (overgrowth of connective tissue) and, consequently, pain may occur.
Reasons contributing to the development of degenerative changes in the cervical spine
The occurrence of pain in the cervical spine is facilitated by birth or any other injury to the spine, abnormalities in its development, postural disorders, muscle dystonia, as well as prolonged immobilization, obesity and some autoimmune diseases.
- Long-term immobilization is a condition in which a person, due to an underlying disease, is forced to lie down for more than a month. As a result, the muscles weaken - and during standing, when their load increases, they become overstretched. Pain occurs.
- Obesity: Excess body weight increases the pressure on the structures of the spine 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: intervertebral discs become thinner, mild discomfort occurs in the neck area.
- Stage II: the intervertebral discs are deformed, the distance between the vertebrae is reduced. The pain increases with movements in the cervical spine.
- Stage III: the cartilage and vertebrae rub against each other, the pain in the neck becomes constant and the movements are limited. With very severe deformations of the cervical spine, vertebral artery syndrome with visual and vestibular disorders, headache may occur.
- IV stage: degenerative changes are intense, movements in 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 experience chronic neck pain and stiffness. 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 worsens with movement or standing;
- the pain radiates to the shoulder or arm.
- numbness, tingling, and weakness in the hands and arms.
- clicking or rubbing in the neck (especially when turning the head).
- headache;
- bouts 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 "Cervical Osteochondrosis" Symptoms
All symptoms of "cervical osteochondrosis" can be conditionally classified into 3 groups or syndromes: vertebral, radicular and vertebral artery syndrome.
Symptoms of vertebral (spinal) syndrome:
- crunch in throat when moving;
- limited mobility;
- violation of the position of the vertebrae in relation to each other in the neck.
- normalization of natural cervical lordosis or lateral curvature in the cervical spine (can only be seen on an X-ray, MRI or CT scan);
Symptoms of radicular syndrome:
- numbness of the fingers in one or both hands;
- shooting, burning pain in neck, radiation in arm or both arms.
- dystrophy of the muscles of the neck and hands.
Symptoms of vertebral artery syndrome:
- paroxysmal dizziness, until loss of consciousness.
- sudden jumps in blood pressure.
- tinnitus;
- blurred vision or spots in the eyes.
- loss of balance and motion sickness.
- headache (severe pain on one or both sides);
Diagnosis of degenerative changes in 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 should conduct an examination, study the medical history, evaluate the resultslaboratory tests and instrument tests.
The 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: check reflexes, muscle strength, sensitivity and the condition of the vestibular apparatus.
With "cervical osteochondrosis", visible areas of muscle atrophy (muscle wasting), decreased or increased muscle tone of the long back muscles, and static disturbances in the cervical region may be seen 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.
In addition, patients may experience movement disorders in the hands (weakness), problems with vision and hearing.
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 if the coordination of movements is reduced, if there are problems with gross and fine motor skills.
Laboratory diagnosis
To assess the general state of the bones, blood tests for total and ionized calcium, as well as indicators of bone tissue growth and destruction - osteocalcin and osteoprotegerin, alkaline phosphatase are prescribed to patients with suspected cervical osteochondrosis.
With progressive cervical osteochondrosis, the joints are destroyed, the calcium content may decrease, and osteocalcin and osteoprotegerin, on the contrary, increase.
Total creatine kinase is also considered a marker of muscle tissue destruction in cervical myositis.
In addition, the doctor may need to evaluate the blood levels of trace elements involved in the regulation of muscle tone: magnesium, potassium, sodium.
Instrumental diagnosis
To establish the cause of neck pain and related disorders, imaging studies are required: X-ray of the cervical spine, computed tomography and magnetic resonance imaging, electroneuromyography.
- X-ray.Using X-rays, you can identify bone deformities, malignant tumors and degenerative changes in the joints.
- Computed tomography and magnetic resonance imagingperformed if pathology of the spine, spinal cord or brain is suspected. Computed tomography shows hemangiomas of the vertebral bodies and gross deformities of the cervical spine. MRI is most informative for visualizing the muscles, roots, and spinal cord.
- Electroneuromyography- a method for studying the efficiency of impulse transmission 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 the roots, nerves and from the nerves to the muscles, to confirm the damage to the nerves or muscles and to clarify the nature and level of damage.
Treatment of degenerative changes in the cervical spine
The main goals of treating degenerative changes in the cervical spine are to relieve pain, prevent nerve compression in the neck, and restore cervical mobility.
Depending on the severity of the condition, the doctor may prescribe medication, physical therapy or massage. Surgery may be required if nerves are pinched or joints are deformed.
Drug treatment of degenerative changes in the cervical spine
Neck pain can be relieved with medication.
Medicines 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 in the area of the affected joint.
- muscle relaxants to relieve muscle spasms.
- antidepressants to relieve chronic pain.
Non-pharmacological treatment of cervical osteochondrosis
Along with drug therapy, it is important for patients with cervical osteochondrosis to do neck exercises. For this purpose the person is referred to a physical therapist for consultation. Teaches how to properly stretch and strengthen neck and shoulder muscles.
Your doctor may recommend mats or rollers with metal or plastic needles. They are used for 15-30 minutes before bed to relax the muscles.
The use of a Shantz splint (neck brace) is a passive exercise therapy for the deep muscles of the neck area, which are difficult to affect with exercise. When a person puts on a splint, the muscles relax and when they take it off they stretch. If you wear a brace for 15-20 minutes several times a day, you can train and strengthen it.
It makes sense to only wear it for 2-3 hours if you have serious neck injuries. In addition, you should not lie on it, much less sleep.
Surgical treatment of degenerative changes in the cervical spine
As a rule, surgery is required for patients with severe spinal deformity who have a pinched nerve.
During the operation, the surgeon removes pathological elements (hernia protrusions, formations, etc. ) or part of the vertebra. After such treatment, a long recovery period is required: use of a Shants splint or rigid cervical spine splint, physiotherapy, regular walking, painkillers.
Complications and consequences of degenerative changes in the cervical spine
Without treatment, the intervertebral discs gradually wear out and the vertebrae "disappear".
Common complications of degenerative changes in the cervical spine:
- syndrome of intractable pain in the head, neck, chest.
- cramps, movement disorders and numbness of the hands.
- frequent dizziness, reduced coordination of movements, fine and gross motor skills.
Prevention of degenerative changes in the cervical spine ("cervical osteochondrosis")
There is no specific prevention of true cervical osteochondrosis, because it is an inherited disease.
To avoid the occurrence of non-specific pain in the neck, which is mistakenly associated with cervical osteochondrosis, it is important to ensure the correct posture of the body and to 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 to avoid excessive straining of the neck muscles and the occurrence of pain: tilting the head forward, backward, alternately on each shoulder and rotating it, as well as sleeping on an orthopedic pillow.
You should avoid injuries to the cervical spine: do not jump into the water upside down, wear seat belts in the car (prevent injury from impact in the 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 someone mainly sleeps on their back, the height of the pillow should be on average 6–11 cm. For side sleepers, the pillow should be thicker: from 9 to 13 cm. In this way, the desired angle willmaintained between the shoulder and the head, the cervical spine will not sag and the muscles are strained to compensate for the discomfort.
Additionally, the heavier the person, the higher the pillow should be. You also need to pay attention to the hardness of the mattress. The softer it is, the more it will sag under the weight of the body and the higher the pillow should be. In addition, it is better not to always sleep on only one side - this leads to muscle imbalance.
If a person prefers to sleep on their stomach, they may suffer more often from back and neck pain. The fact is that in this position it is difficult to keep the spine in a neutral position. To relieve tension from your back, you can put a pillow under your pelvis and abdomen and choose a flat pillow under your head or even sleep without one.
In addition, you can use a special orthopedic pillow.
FAQ
- Where can the pain from "cervical osteochondrosis" be radiated?
Pain from 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 dizziness, you should take a comfortable position in which the probability of falling is minimal (sit in a chair with a back support or lie down) and call for help. After 5-7 minutes, you can try to turn your head: most likely, the dizziness will pass during this period. If dizziness persists or worsens, nausea, vomiting or other neurological symptoms (impaired speech, vision, movement, swallowing, sensitivity) appear, you should call an ambulance as soon as possible.
- How to sleep properly 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 a flare-up of "osteochondrosis" of the cervical spine last?
On average, the flare-up 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?
The diagnosis and treatment of pain in the cervical region is carried out by a neurologist, neurosurgeon, orthopedist and general practitioner.