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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 have 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 cervical osteochondrosis is treated, what drugs are effective for its treatment, what drug-free methods exist, and we will also find out the answers to the most frequently asked questions from patients with a similar diagnosis.Osteochondrosis of the cervical spine is a degenerative-dystrophic lesion (progressive) of the intervertebral discs in the cervical spine.

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Causes of cervical osteochondrosis

As a result of the action of the factors listed below, there is an increase in the load on the cervical spine, the neck muscles try to compensate for the excessive load, their spasm occurs, the blood circulation in this area is disturbed, which causes degenerative changes.Due to certain factors, changes occur in the intervertebral discs of the cervical spine, their structure changes, their nutrition is disturbed, changes in small joints between the vertebrae, bone growths 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:

  • Poor posture and scoliosis
  • Excess weight
  • 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 on the back and neck due to the nature of the work (tense sitting position) among drivers and office workers.
  • Developmental abnormalities in the cervical spine

Degree of development of cervical osteochondrosis

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

First grade

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 slight tension in the neck muscles.

Second degree

The patient is worried about the pain in the cervical spine, its intensity is much greater, the pain can radiate to the shoulder or arm.This happens due to a decrease in the height of the intervertebral disc and pinching of the nerve roots.The pain intensifies when tilting and rotating the head.The patient may notice reduced performance, weakness and headache.

Third degree

the symptoms of cervical osteochondrosis intensify, the pain becomes constant, radiating to the arm or shoulder.Numbness or weakness in the arm muscles occurs as a herniated disc forms (see symptoms of lumbar herniation).I am worried about weakness and dizziness.Examination reveals limited mobility in the cervical spine and pain on palpation of the cervical spine.

Fourth grade

The intervertebral disc is completely destroyed and replaced by connective tissue.Dizziness increases, tinnitus appears and coordination is disturbed, since 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

Separately, we can distinguish the root syndromes that lead to certain sensory and motor disorders.They differ depending on which vertebra compresses the spinal root:

  • 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 sensation on the side where the spinal nerve is pinched.
  • C4: pain in the heart, left hypochondrium, shoulder, scapula, respiratory disorders, decreased muscle tone of the neck.
  • C5: shoulder pain in the outer region.
  • 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 down the forearm to 2-4 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.It is a method of low information, especially in the last 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 collision (compression by spinal cord herniation).
  • Magnetic resonance imaging.The most informative method.Not only the bony structures are clearly visible, but also intervertebral discs, hernias, their size and direction of growth.
  • If a violation of the blood flow in the vertebral arteries is suspected, a double-sided ultrasound is used.This method allows you to accurately determine if there is a decrease in the speed of blood flow or if there are obstacles to normal blood flow.

X-ray stages of cervical osteochondrosis.

  • Stage 1 – minimal changes in the configuration of the vertebrae, normalization of the 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 reduction in the height of the intervertebral disc.
  • Stage 3 – reduction of the height of the intervertebral disc by ¼ in relation to the disc located above it, changes in the intervertebral joints, posterior osteophytes (bone protrusions), narrowing of the intervertebral foramen and narrowing of the spinal canal in which the spinal cord is located with its membranes.
  • Stage 4 – significant reduction in the height of the intervertebral disc, significant changes in the intervertebral joints, massive posterior osteophytes, significant narrowing of the intervertebral foramen and significant narrowing of the spinal canal with myelopathy formation.

Symptoms

Damage to the upper spine can manifest itself in a variety of symptoms, depending on the location and severity of the dystrophic process, as well as how seriously the root structures of the cervical spine are affected.Often, patients' complaints are reduced to symptoms that at first glance are unrelated, which can complicate the diagnosis and further treatment of the disease.In general, the clinical picture of cervical osteochondrosis consists of the following series of syndromes:

  • Vertebralgia, characterized by various types of pain in the back of the head and neck.
  • Spinal column, in which symptoms of impaired motor and sensory innervation are observed, in addition, impaired atrophy of the cervical zone causes gradual atrophy of the muscles of the shoulder girdle and arms.
  • Radical, expressed in pain symptoms in the region of the organs of the peritoneum and chest, requiring additional thorough diagnosis to differentiate osteochondrosis and diseases of internal organs.
  • Vertebral artery syndrome with cervical osteochondrosis is a vestibular disorder manifested by headaches, hearing problems, dizziness, and even loss of consciousness.These phenomena appear 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 part develops gradually and patients usually seek treatment already at the stage of clinical manifestations that affect the quality of life, during periods of exacerbation.How to treat osteochondrosis of the cervical spine is decided only by a doctor after a proper diagnosis.Self-medication in this case is unacceptable.The treatment of osteochondrosis of the neck is aimed at eliminating pain, inflammation, partial or complete restoration of affected tissue structures and prevention of complications.Treatment should be primarily outpatient.any procedures at home can be carried out only in conjunction with medical prescriptions, after instrumental and laboratory diagnosis.In advanced cases, in severe stages of development of neurological damage and accompanying pathologies, inpatient treatment of cervical osteochondrosis with the possibility of surgery may be indicated.

Pharmacological treatment of cervical osteochondrosis

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

  • Non-steroidal anti-inflammatory drugs.They are considered the drugs of choice in the treatment of cervical osteochondrosis to relieve pain and inflammation.It is available in various dosage forms.They reduce soft tissue swelling, thus reducing pain.Topical agents have a warming effect, which improves blood flow to the affected area of the cervix.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 remembering that long-term treatment with NSAIDs negatively affects the mucous membrane of the gastrointestinal tract, for this reason the course of treatment usually does not exceed 10 days.
  • hormones.If NSAIDs are ineffective, the patient may be prescribed paraspinal anesthetic blocks in the cervical spine with glucocorticosteroids as pain treatment, most commonly an injection of dexamethasone or hydrocortisone in the affected area or tablets.Drugs of this group are prescribed to patients with cervical radicular syndrome to relieve the swelling of the nerve fiber.
  • Anesthetics.They are prescribed in the form of local neuromuscular blockades, which eliminate severe pain symptoms.The block can be intradermal, subcutaneous, muscular, perineural, or radicular, depending on where the injection is made.To prolong the analgesic effect, anesthetics are administered together 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 injected into specific biologically active sites.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 flow, blood flow to the affected area is stimulated and 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.
  • Tranquilizers such as tincture of valerian, peony, and herbal decoctions are recommended for prolonged pain and to reduce the patient's risk of developing neuroticism, which contributes to the effectiveness of the treatment of cervical osteochondrosis.
  • Local irritants.These are ointments, gels, topical rubs that are heating, irritating and distracting.They are not used in the treatment of the acute stage.They contain biologically active substances of plant and animal origin, for example, bee or snake venom.If you are hypersensitive to the components of the drug and if its irritating effect is high, it is better not to use them, so as not to cause even more swelling.
  • Vitamins.During the period of treatment and further rehabilitation, multivitamin complexes are recommended for use.Usually this is a group of B vitamins, the representatives of which participate in ensuring the normal conduction of nerves, as well as vitamins A and C, to strengthen the walls of blood vessels and improve blood flow.Taking vitamins reduces vestibular disorders - nausea syndrome, dizziness, hearing loss.
  • Carboprotectors.These are substances that promote the restoration of the cartilaginous tissue of the vertebral discs of the cervical part.Treatment of cervical osteochondrosis with chondroprotectors is carried out for a long time, 6-12 months.

Orthopedic treatment methods

Unpleasant symptoms in the cervical spine are often caused and aggravated by incorrect body position during sleep, prolonged exposure to a forced position or injury.Therefore, when treating the disease, a method such as the cervical collar or Shants collar is often used.It is prescribed individually for each patient, after medical advice, as it is available in different varieties.The collar is a framed dense cylinder that ties around the neck and fixes the vertebrae in the required position.Therefore, the neck does not bend and the head does not turn to the side, which ensures immobilization of the affected area, which is important during acute periods.The neck collar of Shants can also be made in the form of two cylinders with an inflatable mattress, into which air is pumped with a rubber bulb.The inflation of the mattress between the cylinders stretches the spine, which makes it possible to increase the inter-articular spaces in the cervical spine.The degree of stretching is determined by the doctor.it is not recommended to solve this issue yourself, in order to avoid damage to the neurovascular bundles of the neck.During the recovery period, a fully inflated collar is used, which maintains some mobility of the neck and head.

The collar can be worn at home, no more than 3 hours a day, the total course of use is about a month.The final regulations of use are determined by the doctor, depending on the severity of the condition and the existing symptoms.