Cervical osteochondrosis, or spondylosis, occurs as a result of changes in the shape and structure of the vertebrae.Despite the fact that the cervical region is quite short compared to the total length of the spine, it is perhaps the most important part of the spinal column.Each pair of adjacent vertebrae forms intervertebral openings, through which nerve roots exit and are directed to each muscle and organ of the upper half of the body.The vital vessels that supply the brain with blood pass through other openings - in the lateral processes of these vertebrae.
Causes of osteochondrosis of the cervical spine
The causes of osteochondrosis are:
- injuries,
- "sitting" work on a monitor that is 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 handset to the ear with his shoulder)
- constitutional characteristics (torticollis, congenital changes in the neck vertebrae, short neck)
The formation of pathological changes in the vertebrae
In osteochondrosis, small sharp points begin to form on the edges of the vertebral bodies, which can injure nearby structures.Most often this happens in response to excessive loading of the cervical spine, and is not only a result of the "aging" of the intervertebral joints (recall that osteochondrosis was previously considered a degenerative, natural "aging" disease, like osteoarthritis).As the disease progresses, the end plates of the vertebrae become thicker 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.In progressive osteochondrosis, there is a protrusion (hernia) of the nucleus pulposus of the intervertebral disc, which is subjected to increasing pressure during the disease, while the ligaments that "retain" on all sides are weakened.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 leads to suspicion of cervical spine pathology.According to the increased 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 strongest - the pain is so intense that it leads to immobility of the patient and loss of performance.
In addition to pain in the cervical and occipital region, the patient notes "referred" (radiating) pain in the upper extremity and subscapular lateral areas of the chest.
Osteochondrosis of the cervical spine with radicular syndrome
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 be resting" his arm and that he slept uncomfortably.Morning stiffness occurs in the joints of the fingers, which does not last longer than 10-15 minutes.With the development of radicular syndromes, after examination, a decrease in muscle strength of the upper extremities can be observed.
Osteochondrosis of the cervical spine with "vertebral artery syndrome"
Involvement of blood vessels in the process (compression by a hernial protrusion or osteophyte) is indicated when the patient complains of frequent headache attacks, especially after a long stay in a certain position, when throwing back the head (for example, when swimming breaststroke), if there is ringing in the ears and dizziness.This clinical situation is well identified by ultrasound (with "Doppler mapping").Ultrasound reveals the curvature of the vertebral arteries and the narrowing of their lumen.In this case, we may be talking about surgery, because a pronounced change in blood flow in the vertebral arteries is a risk factor for stroke.
Osteochondrosis of the cervical spine with "cardiac (cardiac) syndrome"
This syndrome forces the patient to consult a cardiologist first, because the main complaints are related to pain in the left half of the chest, the subscapular region, which weakens or intensifies when performing physical activity or changing the position of the body.After excluding myocardial infarction and other heart diseases, the patient is admitted under the supervision and treatment of neurologists and orthopedists.
Diagnostics
Four methods are used to clarify the diagnosis: radiography, ultrasound, computer tomography and magnetic resonance.
The most available method is still radiography of the cervical spine;the most informative is the radiograph in the lateral projection ("side view").This method allows, in the first approximation, to determine the presence of injury and gross structural changes in the vertebrae.
An ultrasound examination (ultrasound) is performed to clarify the condition of the vertebral arteries.This method determines whether the blood flow is disturbed, and if so, to what extent and what kind of obstacles have arisen and where they are located.
Computed tomography (CT).It allows you to more accurately assess the state of bone structures, the degree of density of bone tissue and allows you to see fewer osteophytes (bone growths) than is possible with radiography.
Magnetic resonance imaging (MRI).This type of examination is necessary if there is a suspicion of the presence of a hernia, the exact location of the damage to the spinal cord and the degree of this damage.This study is necessary if the question of operative (surgical) treatment of cervical spine disease is raised.
Treatment of cervical osteochondrosis
Drug treatment
The standard set of drugs for the treatment of cervical osteochondrosis reflects the treatment goals: pain relief by removing 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 primarily used.It should be remembered that self-medication with drugs from these groups can be dangerous, because there is a possibility of misinterpretation of symptoms, as well as underestimation of the side effects of these drugs.Topical (skin) NSAID medications in gel form are widely used, and when the pain stops, these same medications can be used in ointment form.
For the treatment of osteochondrosis at a deeper, "basic" level, slow-acting systemic drugs are used.These substances restore the cartilage structures of the vertebrae and prevent their further damage.Treatment courses are long, the effect lasts for several 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 caused not by painful spinal nerve signals, but by painful chronic muscle strain - all together is called muscle-tonic syndrome.This is a completely "benign" condition that responds well to treatment with the same set of drugs: non-steroidal anti-inflammatory drugs, muscle relaxants, application of intramuscular "blockades" using steroids.Usually, the doctor detects sharp pain when 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.This pathology occurs more often in women, mostly under the age of 40.Despite the severe pain syndrome, the neurovascular structures remain intact, and the blood flow in the head area is not affected.
Manual therapy
This method of treatment can be effective for recent (often as a result of a minor injury, subluxation) pain in the neck that is not accompanied by dizziness or other changes in the nervous system and blood flow.It is allowed 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 of this type of intervention:
- manipulation (sharp short blows of significant force in order to remove subluxations, well-known "bone clicks");
- mobilization (the method is based on smooth stretching of the neck after warming up and relaxation of the muscular corset of the neck).
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 all diseases 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 physical therapy 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 short, light self-massage of the neck muscles.
This is followed by a warm-up "warm-up":
- The arms are down by the body, the shoulders are straight, the back is straight (you can check the posture by lightly pressing the heels, shoulder blades and buttocks against the wall).We walk in place for 1 minute on the whole 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 ascent is longer by 5 seconds.We make sure that the neck muscles do not tighten.
- 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 incline for 8 counts, at the end point of the incline - hold for 8 seconds.
- The starting position is the same or sitting on a hard chair.Smooth tilts of the head forward, at the end 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 4 counts) and to the left (for 4 counts).Avoid overexerting your muscles.
- The starting position is the same or sitting on a hard chair.We raise our shoulders for 4 counts and then lower them smoothly for 4 counts.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, for 8 counts.10 repetitions.
- We straighten our backs and check our posture.For 4 counts, we connect the shoulder blades behind the back, trying to connect them, at the end point we stay for 8 seconds, and then return to the starting position.
Pillows
As already mentioned, the hypertonus of the neck muscles is the first and often the main cause of the development of cervical osteochondrosis.Rational selection of pillows and mattresses, ensuring a relaxed and comfortable position during sleep are no less important than gymnastics, physical therapy and medication.
When choosing a mattress, pay attention to the composition of the filler (products that are at least half made of coconut flakes, i.e. with a sufficient degree of stiffness are suitable).Mattresses with soft springs do not provide enough spinal straightening.The most optimal sleeping position is on your side, with one or both knees pulled towards your stomach.The pillow should be placed so that it fills the entire space between the shoulder, ear and mattress, while the parietal part (top) of the head is in the same horizontal line with the spine.Avoid too high and too low, as well as soft pillows.The ideal option is a product with an ergonomic shape, that is, in this case, with a small pressing 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 tucked in.
Avoid sitting for long periods of time.A simple rule for the prevention of cervical osteochondrosis is known: after every 60 minutes of work, you need 10-15 minutes of walking or warming up.
The work chair must have a high head or back rest.
When sitting, your feet should rest on the floor and your neck should not be tense.For this purpose, use special orthopedic devices: supports under the neck when driving in a car, a pillow under the back.
Avoid heavy lifting.If necessary, drop to your knees, hold a heavy object against your torso, then stand up smoothly, using the strength of your leg muscles but not "pulling" your back.
Do not bend with your legs straight.Use stands or work surfaces to bring the subject closer to you, rather than tilting your face towards the subject.Try doing your homework while sitting on a chair or exercise ball.
If you must use a mop, broom or rake, do not strain your arms, back, neck or lean to the side.
Avoid breaststroke.