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 in relation 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 lead to every muscle and organ in the upper half of the body.Vital vessels supplying blood 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 presses the receiver to his ear with his shoulder)
- constitutional features (torticollis, congenital changes in the cervical vertebrae, short neck)
Formation of pathological changes in the vertebrae.
With osteochondrosis, small sharp points begin to form on the edges of the vertebral bodies, which can damage nearby structures.In most cases, 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 an "age-related" degenerative and natural disease, like osteoarthritis).As the disease progresses, the vertebral plates 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 roots of the spine.With progressive osteochondrosis, a protrusion (herniation) of the nucleus pulposus of the intervertebral disc occurs, on which, during the course of the disease, increasing pressure is exerted while the "holding" ligaments on all sides weaken.This hernia 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 pain syndrome.
Any pain in the neck area raises the suspicion 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 "tension" 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 notices “referred” (radiated) pain in the upper limb and in the 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 extends to the lower jaw, upper back, forearm and fingers.At the same time, the patient draws attention to the fact that “his hand seemed to be at rest” and he was sleeping uncomfortably.There is morning stiffness in the joints of the fingers, which lasts no more than 10 to 15 minutes.With the development of radicular syndromes, during examination, a decrease in the strength of the muscles of the upper extremities may be noted.
Osteochondrosis of the cervical spine with “vertebral artery syndrome”
The involvement of blood vessels in the process (compression by a hernial protrusion or osteophyte) is indicated when the patient complains of frequent attacks of headaches, especially after staying for a long time in a certain position, when throwing the head back (for example, when swimming breaststroke), if there is tinnitus and dizziness.This clinical situation is well identified by ultrasound (with “Doppler mapping mode”).Ultrasound reveals tortuosity of the vertebral arteries and narrowing of their lumen.In this case, we may be talking 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 (heart) syndrome”
This syndrome forces the patient to go to the cardiologist first, since the main complaints refer to pain in the left half of the chest, the subscapular region, which weakens or intensifies when performing physical activity or changing body position.After ruling out myocardial infarction and other heart diseases, the patient is admitted under the supervision and treatment of a neurologist and orthopedist.
Diagnosis
Four methods are used to clarify the diagnosis: x-ray, ultrasound, computed tomography and magnetic resonance imaging.
The most accessible method remains x-ray of the cervical spine;the most informative is the radiograph in lateral projection (“lateral view”).This method allows, in a first approximation, to determine the presence of injuries and important structural changes in the vertebrae.
An ultrasound examination (ultrasound) is performed to clarify the condition of the vertebral arteries.This method determines whether blood flow is affected and, if so, to what extent, what type of obstacles have arisen and where they are located.
Computed tomography (CT).It allows you to more accurately assess the condition of bone structures, the degree of density of bone tissue, and allows you to see smaller osteophytes (bone growths) than is possible with X-ray.
Magnetic resonance imaging (MRI).This type of examination is essential if the presence of hernias, the exact location of spinal cord damage, and the degree of this damage are suspected.This study is necessary if the question of operational (surgical) treatment of diseases of the cervical spine arises.
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, painkillers, NSAIDs (non-steroidal anti-inflammatory drugs) and muscle relaxants are mainly 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 stops, 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.Treatment cycles are long and the effect lasts for many months.
Cervical osteochondrosis has significant differences from the pathology of other parts of the spine.In this case, pain in the neck area may be provoked not by signals from the suffering spinal nerves, but by chronic, painful muscle tension;Collectively, this is called muscle tonic syndrome.This is a completely "benign" condition that responds well to treatment with the same set of medications: nonsteroidal anti-inflammatories, muscle relaxants, and intramuscular steroid "blocks."Usually, the doctor detects sharp pain by palpating the so-called "trigger" points along the entire cervical spine, as well as in the area of the muscles of the upper shoulder girdle.More often, this pathology occurs in women, most of them under 40 years of age.Despite the severe pain syndrome, the neurovascular structures remain intact and blood flow to the head area is not affected.
manual therapy
This treatment method can be effective for new neck pain (often resulting from a minor injury, subluxation) that is not accompanied by dizziness or other changes in the nervous and circulatory system.It is permissible to resort to manual therapy only after a thorough examination;In addition, the doctor who performs 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 of this type of intervention:
- manipulation (brief and sudden impacts of great force aimed at eliminating subluxations, the well-known “bone clicks”);
- mobilization (the method is based on gentle stretching of the neck after warming up and relaxing the neck muscle corset).
A combined method is also used, based on a 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 gland 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 while overcoming painful sensations.It goes without saying that you should not start in the “acute” period, when the pain has just appeared.Another important recommendation is to avoid sudden movements and circular movements in the cervical spine.
Each session should begin with a brief, light self-massage of the neck muscles.
This is followed by a “warm-up” warm-up:
- The arms are lowered along the body, shoulders level, back straight (you can check 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, with our arms stretched.The movements are slow, we do 20 repetitions, the last ascent is 5 seconds longer.We make sure that the neck muscles do not tense.
- The starting position is the same.We tilt our heads one by one to the right and then to the left.The movements are smooth, an incline counting 8, at the extreme point of the incline, hold it for 8 seconds.
- The starting position is the same or sitting on a hard chair.Gentle head tilts forward, at the extreme point: hold for 8 seconds
- The starting position is the same or 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 4 count) and to the left (for a 4 count).Avoid straining your muscles too much.
- The starting position is the same or sitting on a hard chair.We raise our shoulders for a count of 4 and then gently lower them for a count of 4. 10 repetitions.
- The starting position is the same or sitting on a hard chair.We raise our shoulders, but now we perform circular movements from front to back, counting up to 8. 10 repetitions.
- We straighten our back and check our posture.Counting 4, we bring the shoulder blades together behind the back, trying to connect them, at the final point we stay for 8 seconds, then we return to the starting position.
pillows
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 that ensure 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 made at least half 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 most optimal sleeping position is on your side, with one or both knees toward your stomach.The pillow should be placed in such a way that it fills the entire space between the shoulder, ear and mattress, while the parietal (crown) part of the head is on the same horizontal line as the spine.Pillows that are too high, too low and soft should be avoided.The ideal option is a product with an ergonomic shape, that is, in this case, with a small squeeze 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 protrudes back.
Avoid sitting for long periods of time.A simple rule is known for the prevention of cervical osteochondrosis: every 60 minutes of work, it is necessary to walk or warm up for 10-15 minutes.
A task chair should have a headrest or high backrest.
When sitting, your feet should rest on the floor and your neck should not be tense.To do this, use special orthopedic devices: pillows under the neck when driving, a pillow under the back.
Avoid lifting heavy objects.If necessary, kneel, hold a heavy object against your torso, and then gently stand up, using the strength of your leg muscles, but not the "pull" of your back.
Do not bend over with your legs straight.Use stands or work surfaces to bring your subject closer to you, rather than leaning your face toward them.Try doing your homework sitting in a chair or on an exercise ball.
If you must use a mop, broom, or rake, do not strain your arms, back, neck, or bend sideways.
Avoid breaststroke swimming.