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BACK Effective methods for the treatment of osteochondrosis of the cervical spine.

In the modern world, almost all people over the age of 25 suffer from 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 look at why this disease occurs, how it manifests itself, how to treat cervical osteochondrosis, what drugs are effective in treating it, what non-drug methods exist, and we will also find answers to the most common questions of patients with a similar diagnosis.Osteochondrosis of the cervical spine is a degenerative-dystrophic (progressive) lesion of the intervertebral discs of the cervical spine.

Pain

Causes of cervical osteochondrosis

As a result of the action of the factors listed below, an increased load on the cervical spine occurs, the neck muscles try to compensate for the excess load, a spasm occurs, blood circulation in this area is disrupted, causing degenerative changes.Due to a number of factors, changes occur in the intervertebral discs of the cervical spine, their structure changes, their nutrition is disrupted, changes occur in the small joints between the vertebrae, bony outgrowths of the vertebral bodies appear due to increased load on the altered intervertebral discs.Click to enlarge - physical therapy for osteochondrosis of any part of the spine.Factors contributing to the development of osteochondrosis of the cervical spine:

  • Bad posture and scoliosis
  • Overweight
  • Physical inactivity, sedentary work
  • Previous spinal injuries
  • Metabolic disorder
  • Great physical activity
  • Constant stress and nervous tension
  • Low level of physical fitness
  • Hereditary predisposition
  • Habitual and incorrect body positions, such as holding the telephone receiver with your shoulder
  • Constant tension in the back and neck due to the nature of the work (state of tension in a sitting position) among drivers and employees.
  • Developmental anomalies of the cervical spine

Degree of development of cervical osteochondrosis

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

First degree

the clinical manifestations are minimal, the patient may complain of low intensity pain in the cervical spine, which may intensify when the head is turned.Physical examination may reveal mild tension in the neck muscles.

Second degree

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

Third degree

the symptoms of cervical osteochondrosis intensify, the pain becomes constant, radiating to the arm or shoulder.Numbness or weakness appears in the muscles of the arm, when intervertebral disc herniations form (see symptoms of lumbar hernia).I am worried about weakness and dizziness.Examination reveals limited mobility in the cervical spine and pain on palpation of the cervical spine.

Fourth degree

The intervertebral disc is completely destroyed and replaced with connective tissue.Dizziness increases, tinnitus appears, and coordination is impaired, since the vertebral artery supplying the cerebellum and the occipital lobe of the brain is involved in the process.

Symptoms depend on the damaged vertebra

Separately, we can distinguish radicular syndromes that lead to some 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 neck;
  • C3: slurred speech, sensitivity of the tongue, pain and decreased 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 external area;
  • 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 scapula, radiating to the forearm up to 2-4 fingers;
  • C8: Pain from neck to shoulder, forearm to little finger.

Diagnosis of cervical osteochondrosis

Basic diagnostic methods:

  • X-ray of the cervical spine.It is an uninformative method, especially in the later stages of the disease.
  • Computed tomography.It shows changes in the vertebrae better, but it is difficult to determine the size and presence of intervertebral hernias, as well as the presence of disc-medullary impingement (compression by a herniated spinal cord).
  • Magnetic resonance imaging.The most informative method.Not only bone structures are clearly visible, but also intervertebral discs, hernias, their size and the direction of their growth.
  • If a violation of blood flow in the vertebral arteries is suspected, duplex ultrasound scanning is used.This method allows you to accurately determine whether there is a decrease in the speed of blood flow or whether there are obstacles to normal blood flow.

Radiographic stages of cervical osteochondrosis.

  • Stage 1 – minimal changes in the configuration of the vertebrae, smoothing 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 decrease in the height of the intervertebral disc.
  • Stage 3 – reduction in the height of the intervertebral disc by ¼ compared to the disc located above it, changes in the intervertebral joints, posterior osteophytes (bony growths), narrowing of the intervertebral holes and narrowing of the spinal canal in which the spinal cord with its membranes is located.
  • Stage 4 – significant reduction in the height of the intervertebral disc, significant changes in the intervertebral joints, huge posterior osteophytes, significant narrowing of the intervertebral holes and significant narrowing of the spinal canal with the formation of myelopathy.

Symptoms

Damage to the upper spine can manifest itself with a variety of symptoms, depending on the location and severity of the dystrophic process, as well as the severity of the root structures of the cervical spine.Often patient complaints are reduced to at first glance unrelated symptoms, 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:

  • Vertebral, characterized by various types of pain in the back of the head and neck.
  • Spinal, in which symptoms of compromised motor and sensory innervation are observed; furthermore, the compromised trophism of the cervical area causes a gradual atrophy of the muscles of the shoulder girdle and arms.
  • Radicular, expressed in painful symptoms in the area of the peritoneal and thoracic organs, requiring further in-depth diagnostics to differentiate osteochondrosis and diseases of internal organs.
  • Vertebral artery syndrome with cervical osteochondrosis is a vestibular disorder that manifests itself with headaches, hearing impairment, dizziness and even loss of consciousness.These phenomena occur due to cerebral ischemia due to violation of the vertebral artery and weakening of the blood supply.

How to treat cervical osteochondrosis?

Osteochondrosis of the cervical segment develops gradually, and patients usually seek treatment already at the stage of clinical manifestations that interfere with the quality of life, during periods of exacerbation.How to treat osteochondrosis of the cervical spine is decided only by a doctor after an adequate diagnosis;self-medication in this case is unacceptable.Treatment of osteochondrosis of the neck is aimed at eliminating pain, inflammation, partial or complete restoration of the affected tissue structures and preventing complications.Treatment must be predominantly outpatient;any home interventions can only be carried out in conjunction with medical prescriptions, following instrumental and laboratory diagnosis.In advanced cases, in severe stages of development of neurological lesions and concomitant pathologies, hospital treatment of cervical osteochondrosis with the possibility of surgical intervention may be indicated.

Pharmacological treatment of cervical osteochondrosis

It consists of prescribing courses of drugs that relieve the symptoms of pain and inflammation.In the acute period, drugs in the form of injections are indicated;after the 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.Available in different dosage forms.They reduce soft tissue swelling, thus reducing pain;local agents have a warming effect, which improves blood flow in the affected cervical area.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 mucosa 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 paravertebral anesthetic blocks in the cervical spine with glucocorticosteroids as a treatment for pain, most often an injection of dexamethasone or hydrocortisone into the affected area or tablets.Drugs from this group are prescribed to patients with cervical radicular syndrome to relieve swelling of the nerve fiber.
  • Anesthetics.They are prescribed in the form of local neuromuscular blocks, which eliminate the symptoms of severe pain.The blockage can be intradermal, subcutaneous, muscular, perineural or radicular, depending on where the injection is given.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 administered by injection into special biologically active points;This treatment technique is a type of acupuncture and is called pharmacopuncture.
  • Antispasmodics and drugs that improve microcirculation in the cervical and collar area.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 diseased area is stimulated and the symptoms of cervical osteochondrosis and inflammation are relieved.During the flare-up period, diuretics are also taken to reduce vascular spasm and therefore improve microcirculation in the affected area.
  • Sedatives, such as valerian tincture, peony and herbal teas, are recommended for prolonged pain and to reduce the risk of developing neurosis in the patient, which contributes to the effectiveness of treatment of cervical osteochondrosis.
  • Local irritants.These are ointments, gels, local action rubs that have a heating, irritating and distracting effect.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.If you have hypersensitivity 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 greater swelling.
  • Vitamins.During the period of treatment and further rehabilitation, the use of multivitamin complexes is recommended.Typically this is a group of B vitamins, representatives of which are involved in ensuring normal nerve conduction, 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 promote the restoration of the cartilaginous tissue of the vertebral discs of the cervical segment.Treatment of cervical osteochondrosis with chondroprotectors is carried out for a long period of time, 6-12 months.

Methods of orthopedic treatment

Unpleasant symptoms in the cervical spine are often caused and aggravated by incorrect body position during sleep, prolonged exposure to a forced position or injuries.Therefore, in the treatment of the disease, a method such as the cervical collar or Shants collar is often used.It is prescribed individually for each patient, after consulting the doctor, as it is available in different varieties.The collar is a framed dense roller that fastens around the neck and fixes the vertebrae in the required position.The neck therefore does not bend and the head does not turn to the side, which ensures immobilization of the diseased area, which is important in acute periods.Shants neck collar can also be made in the form of two rollers with an inflatable layer, into which air is pumped with a rubber bulb.Inflating the layer between the rollers lengthens the spine, allowing you to increase the interarticular spaces in the cervical spine.The degree of elongation is determined by the doctor;it is not recommended to solve this problem on your own, to avoid damage to the neurovascular bundles of the neck.During the recovery period, a fully inflatable collar is used, which preserves some mobility of the neck and head.

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