Complex treatment of osteochondrosis of the cervical spine

1 December 2020

Osteochondrosis is a common disease of the degenerative-dystrophic type, in which the structure and function of the vertebrae and intervertebral discs are damaged, which causes damage to the roots of the intervertebral nerves, and thus symptoms. Osteochondrosis is a chronic pathology that occurs under the influence of a number of reasons - from the evolutionary and anatomical characteristics of the human skeleton to the influence of external factors, such as working conditions, lifestyle, excess weight, injuries and others. Osteochondrosis of the cervical and lumbar spine is most commonly diagnosed as the most exposed to stress. Treatment of cervical osteochondrosis is complex and long-term, mainly aimed at relieving symptoms and preventing complications.

Symptoms

Defeat of the upper spine can be manifested by a mass of symptoms, depending on the location and severity of the dystrophic process, as well as how severely the root structures of the spine of the cervical region are affected. Often, patients' complaints are reduced to symptoms that are not at first glance interrelated, which can complicate the diagnosis and further treatment of the disease.

In general, the clinic for osteochondrosis of the cervical spine is the following series of syndromes:

Spine, characterized by various types of pain in the back of the head and neck.
Spinal, in which symptoms of impaired motor and sensory innervation are observed, in addition to disturbed trophism of the cervical zone causes gradual atrophy of the muscles of the shoulder girdle and arms.
Radicular, expressed by symptoms of pain in the peritoneal and thoracic organs, which requires additional careful diagnosis to distinguish osteochondrosis and diseases of the internal organs.
Spinal artery syndrome in cervical osteochondrosis - vestibular disorders manifested by headaches, hearing impairment, dizziness, up to loss of consciousness.

These phenomena occur when the cause of cerebral ischemia is due to a violation of the spinal artery and a weakening of the blood supply.

How to treat cervical osteochondrosis?

Osteochondrosis of the cervical segment develops gradually, and patients usually seek treatment already in the phase of clinical manifestations that interfere with the quality of life, during the period of deterioration. How to treat osteochondrosis of the cervical spine is decided only by a doctor after proper diagnosis, self-medication in this case is unacceptable.

Treatment of osteochondrosis of the neck aims to eliminate pain, inflammation, partial or complete restoration of affected tissue structures and prevention of complications.

Treatment should be mainly outpatient, any procedures at home can be combined with medical prescriptions, after instrumental and laboratory diagnosis.

In advanced cases, in the severe stages of development of neurological lesions and concomitant pathologies, inpatient treatment of cervical osteochondrosis with the possibility of surgical intervention may be indicated.

Remedy for cervical osteochondrosis

It consists of prescribing medications that relieve the symptoms of pain and inflammation. In the acute period, the drugs are presented in the form of injections, after a certain relief of pain, the patient takes tablets, locally acting agents in the form of ointments and continues to receive injections.

Nonsteroidal anti-inflammatory drugs. They are considered the drugs of choice in the treatment of cervical osteochondrosis to relieve pain and inflammation. These are drugs based on diclofenac and indomethacin, available in different dosage forms. They reduce soft tissue swelling, thereby reducing pain, local agents have a warming effect, which improves blood flow in the affected cervical area. These medications 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 tablets. It is worth remembering that long-term treatment with nonsteroidal anti-inflammatory drugs adversely affects the mucous membrane of the gastrointestinal tract, which is why the course of treatment usually does not exceed 10 days.

Sedatives such as persen, glycosy, valerian tincture, peony, herbal teas are recommended for long-term pain and to reduce the risk of neurotization of the patient, which contributes to the effectiveness of treatment of cervical osteochondrosis. Local irritants. These are locally acting ointments, gels, rubs that act warming, irritating and disruptive. They are not used in the treatment of the acute phase. They contain biologically active substances of plant and animal origin, for example bee or snake venom. This group includes viprosal, apizartron, menovazin, nayatoks. In the presence of hypersensitivity to the components of the drug and with a high irritant effect, it is better not to use them, so as not to cause even greater edema. Vitamins. During the period of treatment and further rehabilitation, multivitamin complexes are recommended for use. It is usually a group of B vitamins, whose representatives are involved 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 - motion sickness syndrome, dizziness, hearing loss.

Chondroprotectors. These are substances that contribute to the regeneration of the cartilaginous tissue of the vertebral discs of the cervical segment. These include glucosaminoglycans and chondroitin sulfate. Treatment of osteochondrosis of the cervical spine with chondroprotectors is carried out for a long time, 6-12 months.

Orthopedic treatments

Unpleasant symptoms on the cervical spine are often caused and exacerbated by improper body position during sleep, prolonged stay in a forced posture, or trauma. Therefore, the treatment complex includes methods such as:

Neck necklace or Shants necklace. It is prescribed individually for each patient, after a medical consultation, because it exists in several types. The necklace is a frame-shaped pillow that attaches 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 the immobilization of the diseased area, which is important in acute periods. The shunt neck collar can also be made in the form of two rollers with an inflatable layer into which air is injected with a rubber bulb. Inflating the interlayer between the rollers stretches the spine, which enables the increase of inter-articular gaps on the cervical spine. The degree of elongation is determined by the doctor, it is not recommended to solve this problem alone, to avoid damage to the neurovascular bundles of the neck. During the recovery period, an inflatable collar is used, which retains a certain mobility of the neck and head.

You can wear the necklace at home, no more than 3 hours a day, the general wearing rate is about a month. The final regulations on wearing are determined by the doctor, depending on the severity of the condition and the symptoms.

Proper posture. During sleep it is necessary to maintain the body in an anatomically correct position, when the nerves and vessels of the cervical spine are not compressed, this can be done using orthopedic mattresses and pillows. During wakefulness, the patient must control body position and properly select a table and chair of appropriate height. Stretching. The treatment procedure consists of stretching the ligaments of the spine to increase the distance between the vertebrae by 1-3 mm. Traction helps reduce or completely eliminate compression of the root disc herniation or vertebral bone protrusions. The procedure removes intervertebral sprains, reduces muscle contractures. Traction should be performed by a doctor in an inpatient setting, and after the procedure the cervical spine is fixed with a collar or similar devices for several hours. The course of extraction treatment lasts on average 10-20 sessions.

Massage

Massage for osteochondrosis of the cervical spine is an important and mandatory part of treatment, along with courses of medication. It is prescribed during the period of remission, in order to speed up recovery and prevent recurrence. For massage, both classic hand and its variants from the method of oriental medicine are used.

A well-performed massage stimulates blood circulation in the neck and collar, improves the trophism of damaged tissues, relieves muscle and blood vessel spasms and relieves the patient. The general course of massage treatment is 10-14 procedures, every day or every other day, every 3-6 months. In case of severe pain, massage treatment of osteochondrosis is not performed. At home, you can do a self-massage of the diseased cervical zone.

Physiotherapy exercises

Exercise therapy is always performed, except in periods of worsening pain. Exercises for cervical osteochondrosis can be performed at home, although it is desirable to do it under the supervision of an instructor until proper execution is achieved. The set of exercises consists of:

Turn your head to the side. The head is tilted back and forth. Raise the shoulders with fixed or relaxed arms, holding for 15-20 seconds in this position. Static loads, when the flexor and extensor muscles of the cervical region are tightened, the head does not move.

The total number of repetitions is 5-7 times, the session lasts 15-20 minutes. As part of a treatment complex, exercise therapy helps speed recovery and increase remission.

Physiotherapy and reflexology

In the treatment of osteochondrosis of the cervical spine, electrophoresis with NSAIDs, anesthetics, hormonal drugs is used, diadynamic currents, laser and shock therapy are also effective. Physiotherapy in the initial stage of development can lead to a complete cure, and in severe cases - to an increase in remission time. These methods of treatment are used during the rehabilitation period after the treatment of exacerbations.

Reflexology, as a method of affecting certain points on the skin of the body, where the internal organs are projected, is also used during the recovery period and helps to calm inflammation, improve blood flow, alleviate tissue congestion and reduce muscle spasms. Among the methods of treatment, the most commonly used are acupuncture, acupressure and hirudotherapy - placing medicinal leeches on the skin of the cervical region.

Using these methods can shorten the time and amount of medication taken and speed recovery.

Things to do at home

If the patient's condition allows, the manifestations of cervical osteochondrosis can be treated at home. For example, therapeutic exercises can be performed at home if there are no contraindications and constant expert supervision is not required. It should be borne in mind that the appearance of pain and cramping in the neck is a reason to stop and seek qualified treatment.

The application of locally acting drugs in the form of ointments, gels, medicated patches is also done at home, strictly according to a doctor's prescription.

In addition, it is possible to treat at home using some devices for physiotherapy - for magnetotherapy and ultraviolet radiation and devices for reflex therapy.

Folk remedies are also used in the form of compresses and compresses on the painful area of the cervix from grated potatoes, horseradish leaves, propolis, aloe and other herbal ingredients. Traditional methods of treating cervical osteochondrosis are palliative, temporary relief of pain, edema, warming of the affected part and you should not limit yourself to them.

All treatments for osteochondrosis of the cervical spine should be complementary and performed in consultation with a physician, after a comprehensive diagnosis.

Medical treatment of osteochondrosis of the cervical spine involves the use of conservative methods to ensure adequate pain relief and there is no risk of significant disruption of the patient's daily activities.

Symptoms of the disease

Constant bending, lifting, turning and twisting over many years of life, of course, negatively affects the health of the door and the quality of its structural components. With all these repetitive stresses on the neck, it’s no surprise that approximately two-thirds of people experience neck pain at some point in their lives. Feelings of pain can be alarming symptoms of a disease such as osteochondrosis.

Attention! Osteochondrosis of the cervical spine is considered one of the most common pathologies. This disease most commonly affects people of working age who lead an inactive lifestyle.

The disease is initially asymptomatic. However, in the case of symptoms such as persistent headaches, as well as pain in the heart and under the shoulder blade, this disease requires immediate and effective treatment.

Degenerative processes can lead to the following manifestations:

acute pain;
double vision;
dizziness;
numbness in the shoulder area;
weakness in shoulders, arms.

This discomfort and loss of mobility can have a significant impact on career, family and quality of life.

The cervical spine consists of seven bones called vertebrae, which are separated from each other by discs filled with a jelly-like cushion substance. This design provides the ability to stabilize the door, smoothly rotate from side to side and tilt back and forth.

Over time, these natural shock absorbers wear out and can begin to deteriorate. The space between the vertebrae is narrowed and the nerve endings tightened. This process is known as cervical osteochondrosis. It should be especially noted that research shows that about 25% of asymptomatic persons younger than 40 years and 60% older than 40 years have a certain degree of osteochondrosis. As osteochondrosis progresses, the neck becomes less flexible, the feeling of pain in it increases, there is a feeling of stiffness, especially towards the end of the day. For these reasons, osteochondrosis developed.

Attention! Its complications can be life-threatening.

Diagnosis and treatment features

The diagnosis of the disease includes the following general manipulations:

initial inspection;
X-ray examination.

Drug therapy is the basis for the treatment of cervical osteochondrosis in combination, along with massage. Effective treatments include the following:

reflexology;
electrostimulation;
manual therapy.

Physical therapy can also help reduce pain over time. The most commonly used methods include:

acupuncture;
electrophoresis;
microcurrent electrical stimulation;
laser therapy.

Usually the course of this treatment of cervical osteochondrosis lasts about 14 days.

Simultaneously with the application of ice or heat, with the help of a special medicine, it will be possible to achieve pain relief and control pain and inflammation. In addition, neck and shoulder girdle exercises, performed independently or with the help of experts, will help. Exercise helps maintain flexibility. Exercise, especially stretching the neck as much as possible, is key to maintaining flexibility in the neck area. A doctor or physiotherapist should individually develop a particular set of exercises.

Medications that can provide relief include nonsteroidal anti-inflammatory drugs and pain relievers.

Attention! You should not use these medications for more than seven days without consulting your doctor, as kidney failure can be among the serious side effects they can cause.

Steroid medications and muscle relaxants can also be used.

Treatment during exacerbation

In the acute phase of the disease, when the painful pain dominates the clinical picture, the main goal of medical therapy is pain relief. In such situations, for a limited period of time, you can take analgesics (for example, tramadol, oxadol, orthophene) or more complex medications (arcoxia) very carefully and competently and only under the supervision of a doctor. They are able to relieve pain and muscle tension.

Non-steroidal drugs, which are mainly taken to relieve pain, can also eliminate the cause of pain - inflammatory edema that narrows blood vessels and nerve endings.

The use of muscle relaxants allows you to alleviate muscle spasms, normalize the condition of the cervical spine, nerve endings and blood vessels. The use of vitamins is very important.

For strong compression of nerve endings, doctors recommend anticonvulsants. If the pain is not reduced in another way, then it is blocked by novocaine.

If osteochondrosis of the cervical spine is in the acute phase and is accompanied by severe pain, specialists also prescribe topical application of lidocaine, a corticosteroid to relieve muscle tension in the spinal movement segment and reduce pain.

In the treatment of acute pain, medications are given by injection, then it will be possible to switch to treatment in the form of tablets and further alleviate the health condition with the help of ointments.

Antidepressants are prescribed as an adjunct in certain cases. These drugs help in the psychological coping of attacks of very severe pain and the specificity of disorders associated with the cervical spine.

Recommendations for treatment in remission

The mild treatment period suggests:

activation of blood circulation both in large vessels and on the periphery;
improving metabolism;
bone and cartilage regeneration and regeneration.

Most suitable for this purpose:

anti-inflammatory gels and ointments containing steroids and analgesics;
fats, whose action is aimed at spot heating of the affected area, able to increase blood flow to the affected area and improve tissue nutrition.

Chondroprotectors (chondroxide ointments and tablets) help repair cartilaginous intervertebral discs.

Massage creams and ointments with bee venom and herbal extracts have a regenerating, anti-inflammatory and analgesic effect. A therapeutic massage that, if done correctly, can be done at home to alleviate discomfort. To avoid harming your body, you need to follow a few simple rules:

do not press too hard on the neck and back;
all movements must be from top to bottom.

Local anesthetic creams include capsaicin. Creams are also effective in treating pain associated with osteochondrosis. The cream should be applied to the area where the feeling of pain is most present.

Attention! Wash your hands after rubbing in the cream, especially capsaicin, as the cream can irritate the skin of the hands or other parts of the body that will touch the hands.

Such an unpleasant symptom as dizziness in osteochondrosis occurs due to vasospasm and inflammation of the nervous tissue. To cope with this help vasodilators and means to improve blood circulation in the vestibular apparatus.

Vitamin B is also included in the complex therapy of cervical osteochondrosis, because it has the following properties:

restores tissue sensitivity;
reduces neurological damage.

You have to be very careful given the fact that, although there is a very different range of quality medications that help with osteochondrosis, taking many of them is often accompanied by tangible side effects. It happens that the condition of the back improves, but there are difficulties in various organs. It follows from this that the drugs are intended only to supplement the complex of other methods of combating this disease.

Thanks to the integrated approach to treatment, it is possible to achieve positive dynamics of the healing process only if the whole spectrum of therapeutic measures is carried out on a consistent, regular and systematic basis.

Often patients do not pay attention to the pain in the neck area, which causes complications.

Surgical treatment

If the pain persists after six months, during which the appropriate medication is carried out, and daily activities become more difficult, doctors may recommend resorting to surgery. The operation will be aimed at stopping the movement of the affected cervical spine. This will involve removing the disc, as well as inserting a metal device or bone graft to help maintain or restore normal disc height and stability and alignment of the neck. Special plates can be used to ensure the desired fixation between the two vertebrae.

Attention! Patients should be aware that surgery that results in severe neck pain is much less reliable than surgery to relieve osteochondrosis pain in another part of the body. Therefore, if the only or predominant symptoms are neck pain, surgery should be recommended only as a last resort, and after all other tried treatment options have failed.

Prevention

Preventive methods for neutralization of relapse are formed by complexes of physiotherapeutic exercises and therapeutic massage. Proper prevention is an important step towards success.

It will also be very important to pay attention to the fact that you need to adhere to a daily regular diet that minimizes, if not completely eliminates, the intake of salty and spicy foods to reduce swelling and improve metabolism. It will also be useful to practice yoga and swimming. Among the unconventional methods, acupuncture and chiropractic are often used.