Cervical osteochondrosis, or spondylosis, occurs as a result of changes in the shape and structure of the vertebrae.Although the cervical region is quite short compared to the total length of the spine, it is perhaps the most important part of the spine.Each pair of adjacent vertebrae forms intervertebral foramina, through which nerve roots emerge that are directed to each muscle and organ of the upper half of the body.Vital vessels that provide blood supply to the brain pass through other openings - in the lateral processes of these vertebrae.
Causes of osteochondrosis of the cervical spine
The causes of osteochondrosis are:
- injuries,
- “sedentary” work on a monitor located below eye level,
- physical work associated with carrying heavy loads,
- drive a car for a long time,
- work "on the phone" without using remote devices (in this case the operator places the receiver to his ear with his shoulder)
- constitutional characteristics (stiff neck, congenital alterations of the cervical vertebrae, short neck)
Formation of pathological changes in the vertebrae
With osteochondrosis, small sharp spots begin to form on the edges of the vertebral bodies that can damage nearby structures.Most often, this occurs in response to excessive load on the cervical spine and is not only the result of "aging" of the intervertebral joints (remember that osteochondrosis was previously considered a natural "age-related" degenerative disease, like osteoarthritis).As the disease progresses, the vertebral plaques become denser and the height of the intervertebral discs decreases.These discs normally play the role of shock absorbers between the vertebrae and, among other things, prevent damage to the spinal roots.With progressive osteochondrosis, a protrusion (herniation) of the nucleus pulposus of the intervertebral disc occurs, on which, in the course of the disease, increasing pressure is exerted while the ligaments that “hold” on all sides weaken.This herniation can also compress spinal structures and cause neurological manifestations of the disease.
What are the symptoms of cervical osteochondrosis?
Osteochondrosis of the cervical spine with painful syndrome
Any pain in the neck area raises suspicions of a pathology of the cervical spine.According to the increasing intensity of the pain syndrome, they are divided into 4 stages, in the first the patient feels numbness, tingling, a feeling of "tightness" in the area of a certain muscle group, in the fourth stage - the most severe - the pain is so intense that it leads to the patient's immobility and loss of performance.
In addition to pain in the cervical and occipital region, the patient notes “referred” (radiating) pain to the upper limb and lateral subscapular areas of the chest.
Osteochondrosis of the cervical spine with radicular syndrome
The involvement of nerve roots in the process is indicated when pain, numbness and tingling spread to the lower jaw, upper back, forearm and fingers.At the same time, the patient draws attention to the fact that he "seemed to rest" his hand and slept uncomfortably.There is morning stiffness in the joints of the fingers, which lasts no more than 10-15 minutes.With the development of radicular syndromes, a decrease in muscle strength of the upper extremities may be noted on examination.
Osteochondrosis of the cervical spine with “vertebral artery syndrome”
The involvement of blood vessels in the process (compression by a hernial protrusion or an osteophyte) is indicated when the patient complains of frequent attacks of headaches, especially after being in a certain position for a long time, when throwing his head back (for example, when swimming breaststroke), if there is tinnitus and dizziness.This clinical situation is well identified using ultrasound (with “Doppler mapping mode”).Ultrasound reveals tortuosity of the vertebral arteries and narrowing of their lumen.In this case, we could talk about surgery, since a pronounced change in blood flow in the vertebral arteries is a risk factor for stroke.
Osteochondrosis of the cervical spine with “cardiac syndrome”
This syndrome forces the patient to first turn to a cardiologist, since the main complaints concern pain in the left half of the chest, the subscapular region, which weakens or intensifies during physical activity or changing body position.After excluding myocardial infarction and other heart diseases, the patient is hospitalized under the supervision and treatment of a neurologist and orthopedist.
Diagnostics
To clarify the diagnosis, four methods are used: x-ray, ultrasound, computed tomography and magnetic resonance imaging.
The most accessible method still remains the x-ray of the cervical spine;the most informative is the lateral projection (“lateral view”) x-ray.This method allows, as a first approximation, to determine the presence of lesions and gross structural changes in the vertebrae.
Ultrasound examination (ultrasound) is performed to clarify the condition of the vertebral arteries.With this method it is determined whether blood flow is impaired and, if so, to what extent and what type of obstacles have occurred and where they are located.
Computed tomography (CT).It allows you to more accurately evaluate the state of bone structures, the degree of density of bone tissue and allows you to see smaller osteophytes (bony growths) than is possible with x-ray.
Magnetic resonance imaging (MRI).This type of examination is essential if the presence of hernias is suspected, the exact location of damage to the spinal cord and the extent of this damage.This study is necessary if the question of operative (surgical) treatment of diseases of the cervical spine is raised.
Treatment of cervical osteochondrosis
Pharmacological treatment
The standard set of remedies for the treatment of cervical osteochondrosis reflects the goals of treatment: to relieve pain by eliminating painful muscle spasms and inflammation of the nerve roots, while increasing the mobility of the spine.To achieve these goals, mainly painkillers, NSAIDs - non-steroidal anti-inflammatory drugs, muscle relaxants are used.It should be remembered that self-medication with drugs from these groups can be dangerous, since there is a possibility of misinterpretation of symptoms, as well as underestimation of the side effects of these drugs.Local (cutaneous) NSAID drugs in the form of gels are widely used, and when the pain disappears, these same drugs can be used in the form of ointments.
To treat osteochondrosis at a deeper, "basic" level, slow-acting systemic drugs are used.These substances restore the cartilaginous structures of the vertebrae and prevent further damage.The treatment cycles are long, the effect lasts for many months.
Cervical osteochondrosis has significant differences from the pathology of other parts of the spine.Pain in the neck area in this case can be provoked not by signals from the suffering spinal nerves, but by chronic painful muscle strain - in the aggregate this is called tonic-muscular syndrome.This is a completely “benign” condition that responds well to treatment with the same set of drugs: nonsteroidal anti-inflammatory drugs, muscle relaxants, using intramuscular “blockades” with steroids.Usually, the doctor detects acute pain by palpating the so-called "trigger" points along the entire cervical spine, as well as in the area of \u200b\u200bthe muscles of the upper shoulder girdle.More often, this pathology occurs in women, most of them under 40 years old.Despite the severe pain syndrome, the neurovascular structures remain intact and the blood flow in the head area is not affected.
Manual therapy
This treatment method may be effective for recent neck pain (often following a minor injury, subluxation) that is not accompanied by dizziness or other changes in the nervous system and circulatory system.It is permissible to resort to manual therapy only after a thorough examination;in addition, the doctor performing this procedure must have sufficient experience in the field of traumatology and orthopedics.For "old" forms of the disease, the use of manual therapy is dangerous!
There are two known methods for this type of intervention:
- manipulation (short, sharp blows of significant force aimed at eliminating subluxations, the famous "bone clicks");
- mobilization (the method is based on regular stretching of the neck after warming up and relaxing the neck muscle corset).
A combined method is also used, based on the combination of two main ones.It is important to remember that in addition to these contraindications, manual therapy is prohibited for any disease accompanied by increased blood pressure, for any pathology of the thyroid and ENT organs.
Treatment of cervical osteochondrosis at home
Therapeutic exercises for cervical osteochondrosis
The first and main rule for beginners in physiotherapy is not to perform exercises overcoming painful sensations.It goes without saying that you shouldn't start in the "acute" period, when the pain has just appeared.Another important recommendation is to avoid sudden and circular movements of the cervical spine.
Each session should begin with a short and light self-massage of the neck muscles.
This is followed by a “warm-up” warm-up:
- The arms are lowered along the body, the shoulders are level, the back is straight (you can control your posture by lightly pressing your heels, shoulder blades and buttocks against the wall).We walk in place for 1 minute on the entire foot, 1 minute on the toes, 1 minute on the heels.
- The starting position is the same.We clench our hands into fists, raise and lower our shoulders, arms straight.The movements are slow, we do 20 repetitions, the last leavening takes more than 5 seconds.We make sure that the neck muscles do not contract.
- The starting position is the same.We tilt our heads one by one to the right, then to the left.The movements are smooth, one tilt for 8 counts, at the extreme point of the tilt - hold for 8 seconds.
- The starting position is the same, i.e. sitting on a hard chair.Smooth inclinations of the head forward, at the extreme point: hold for 8 seconds
- The starting position is the same, i.e. sitting on a hard chair.Slowly tilt your head forward until your chin touches your chest, then slowly turn your head to the right (for a count of 4) and to the left (for a count of 4).Avoid overloading your muscles.
- The starting position is the same, i.e. sitting on a hard chair.We raise our shoulders for 4 counts, then gently lower them for 4 counts.10 repetitions.
- The starting position is the same, i.e. sitting on a hard chair.We shrug our shoulders, but now perform circular movements from front to back, for 8 counts.10 repetitions.
- We straighten our back and check our posture.For 4 counts we join the shoulder blades behind the back, trying to connect them, at the final point we linger for 8 seconds, then we return to the starting position.
Cushions
As already mentioned, hypertonicity of the neck muscles is the first and often the main cause of the development of cervical osteochondrosis.The rational selection of pillows and mattresses, ensuring a relaxed and comfortable position during sleep, is no less important than gymnastics, physiotherapy and medications.
When choosing a mattress, pay attention to the composition of the filler (products that are at least half made of coconut flakes are suitable, that is, with a sufficient degree of rigidity).Soft spring mattresses do not provide sufficient straightening of the spine.The optimal sleeping position is on your side, with one or both knees raised towards your stomach.The pillow should be positioned in such a way as to fill all the space between the shoulder, ear and mattress, while the parietal part (crown) of the head is on the same horizontal line with the spine.Pillows that are too high and too low, as well as soft pillows, should be avoided.The ideal option is a product with an ergonomic shape, that is, in this case with a small squeezing roller on one side.
General recommendations
Pay attention to your posture.When walking or standing, the correct position is when the chest protrudes forward and the stomach is retracted.
Avoid sitting for long periods of time.A simple rule for the prevention of cervical osteochondrosis is known: after every 60 minutes of work, a period of 10-15 minutes of walking or warming up is necessary.
A work chair must have a headrest or a high backrest.
When you are sitting, your feet should rest on the floor and your neck should not be tense.For this purpose, use special orthopedic devices: pillows under the neck when driving in the car, a pillow under the back.
Avoid heavy lifting.If necessary, get on your knees, hold a heavy object against your torso, and then stand up smoothly, using the strength of your leg muscles, but not the “pull” of your back.
Don't bend over with your legs straight.Use stands or work surfaces to bring your subject closer to you, rather than tilting your face towards them.Try doing homework while sitting in a chair or on an exercise ball.
If you must use a brush, broom or rake, do not strain your arms, back, neck or lean sideways.
Avoid breaststroke swimming.