The diagnosis of "cervical osteochondrosis" is often made if a person complains of neck pain. Some also attribute it to dizziness, memory loss, numbness of the hands and other unpleasant symptoms. It is mistakenly believed that the disease is associated with age-related wear and tear of the intervertebral discs and other elements of the spine.
How does the cervical spine work?
The cervical region consists of 7 vertebrae. Among them are intervertebral discs - semi-rigid structures with a dense ring along the periphery and a jelly-like center, which act as shock absorbers. To the right and to the left of each vertebra there are two nodes, between which the surfaces of the vertebral processes, covered with cartilage, emerge. The joints are connected to the ligaments and muscles of the back.
Why does neck pain occur?
Typically, neck pain occurs in response to difficult movement, injury or due to inflammation of any of the structures of the cervical spine. In addition, the cause of pain can be excessive stretching of muscles or ligaments, for example, during weight lifting, unsuccessful turning of the head or against the background of arthrosis of the joints themselves between the articular processes. "Nerve entrapment", or cervical radiculopathy, specific processes (metastases, tumors of the vertebrae, membranes of the spinal cord in the cervical region) are relatively rare.
26% of men and 40% of women over 30 have experienced neck pain in the past month, and 5% of men and 7% of women feel it all the time.
Acute neck pain usually goes away on its own within 1-2 weeks. Chronic pain in most cases appears due to lack of physical activity or, on the contrary, excessively intense exercises.
However, people often mistakenly call unexplained pain and discomfort in the cervical neck osteochondrosis and associate its development with age-related wear and tear of the intervertebral discs and other elements of the spine. But such pain, as a rule, has nothing to do with true osteochondrosis.
Cervical osteochondrosis
According to the International Classification of Diseases (ICD), osteochondrosis (osteochondropathy) is a group of rare hereditary diseases that are associated with disruption of normal bone development and growth. As a rule, osteochondrosis begins in childhood and is severe: a part of the joint or bone is deformed and sometimes even dies. With this disease, the cervical spine is not most often affected, but the thoracic spine (lower thoracic vertebrae). Therefore, the main clinical manifestation of osteochondrosis is a pronounced curvature of the thoracic spine, the so-called thoracic kyphosis.
Symptoms associated with thoracic spine injury:
- dyspnea,
- persistent weakness
- inability to breathe fully
- pain and burning behind the sternum,
- attacks of rapid heartbeat.
Conditions associated with neck pain
Cervical spondylosis
In people over 50, neck pain is usually caused by cervical spondylosis, the age-related wear and tear of the vertebrae and related structures. With this disease, the intervertebral discs are dehydrated and flattened, causing the cushioning in the cervical region to deteriorate and many movements are accompanied by pain.
But changes in the spine with age are normal. So, its structures begin to wear out on average after 30 years, and at the age of 60, 9 out of 10 people already have cervical spondylosis. However, in most people it is asymptomatic.
Other reasons
Less often, neck pain occurs due to hypothermia or severe stress, due to herniated discs or abnormalities of the cervical vertebrae - bone growths (spurs) that press on the nerves that extend from the spinal cord.
The most common source of pain in the cervical spine and shoulder girdle is excessive tension (protection) of the muscles: trapezius, long muscles of the back of the cervical spine.
In addition, the muscles of the cervical spine are closely connected to the aponeurosis - a wide tendinous plate that wraps the head. The muscular elements of the aponeurosis in the occipital, temporal and frontal regions are connected to the muscles of the cervical region, so neck pain is often accompanied by headaches. Thus, neck pain, which appears after prolonged sitting work or sleeping in an uncomfortable position and is combined with a headache, is in most cases associated with a lack of physical activity and incorrect posture and is not dangerous to health.
The phenomenon of technology neck, the so-called techno-neck or internet age neck, is associated with pain that arises due to an uncomfortable posture. Techneck is the result of constant use of a computer and smartphone, due to which a person is forced to bend his neck. The fact is that the relative mass of the head increases with forward tilt. Thus, in the "upright" position, the average weight of an adult's head is 5 kg. If you bend your head forward at least 15°, the load on the neck muscles will be 13 kg, at 30° - 20 kg, at 60° - 30 kg. As a result of constant overload, the neck muscles are overstrained, microtrauma, inflammation, fibrosis (excess growth of connective tissue) and, accordingly, pain may appear.
Reasons that contribute to the development of degenerative changes in the cervical spine
The appearance of pain in the cervical spine is facilitated by childbirth or any other injury to the spine, abnormalities in its development, postural disorders, muscle dystonia, as well as prolonged immobilization, obesity and some autoimmune diseases.
- Long-term immobilization is a condition in which a person, due to an underlying illness, is forced to lie down for more than a month. As a result, the muscles weaken - and during verticalization, when the load on them increases, they become excessively tense. Pain appears.
- Obesity: Excess body weight increases stress on spinal structures and can cause pain.
- Autoimmune diseases in which cartilage tissue is destroyed (autoimmune arthritis, polychondritis) also lead to neck pain.
Stages of degenerative changes in the cervical spine
There are 4 main stages of degeneration (destruction) of the cervical spine:
- Phase I: intervertebral discs become thinner, slight discomfort appears in the neck area;
- Phase II: the intervertebral discs are deformed, the distance between the vertebrae decreases. The pain increases with movements in the cervical spine;
- Phase III: cartilage and vertebra rub against each other, neck pain becomes constant and movements become limited. With very severe deformations of the cervical spine, the vertebral artery syndrome can appear with visual and vestibular disturbances, headaches;
- Phase IV: degenerative changes are pronounced, movements in the cervical spine are very limited and painful. The neck area may be almost completely immobilized.
Symptoms of degenerative changes in the cervical spine
Most people with cervical osteochondrosis experience chronic neck pain and stiffness. As the disease progresses, other symptoms may appear (especially if the spinal roots, vertebral artery, and adjacent nerve plexuses are compressed).
Symptoms of degenerative changes in the cervical spine:
- neck pain that gets worse with movement or standing;
- the pain radiates to the shoulder or arm;
- numbness, tingling and weakness in arms and hands;
- clicking or grinding in the neck (especially when turning the head);
- headache;
- dizziness attacks;
- impaired coordination of movements;
- loss of bladder or bowel control.
If such symptoms appear, you should consult a neurologist as soon as possible.
Types of symptoms of "cervical osteochondrosis"
All symptoms of "cervical osteochondrosis" can be conditionally classified into 3 groups or syndromes: vertebral, radicular and vertebral artery syndrome.
Symptoms of vertebral (spinal) syndrome:
- cracking in the neck when moving;
- limited mobility;
- violation of the location of the vertebrae in relation to each other in the neck;
- softening of the natural cervical lordosis or lateral curvature in the cervical spine (can only be seen on x-ray, MRI or CT).
Symptoms of radicular syndrome:
- numbness of the fingers in one or both hands;
- shooting, burning pain in neck, radiating to arm or both arms;
- dystrophy of the muscles of the neck and arms.
Symptoms of vertebral artery syndrome:
- paroxysmal dizziness, up to loss of consciousness;
- sudden jumps in blood pressure;
- tinnitus;
- blurred vision or spots in the eyes;
- loss of balance and nausea attacks during head movement;
- headache (severe pain on one or both sides).
Diagnosis of degenerative changes in the cervical spine
To understand the cause of neck pain and make a diagnosis of "degenerative changes in the cervical spine" (commonly called cervical osteochondrosis), the doctor will need to conduct an examination, study the medical history, evaluate the results of laboratory testsand instrumental examinations. .
Diagnosis and treatment of cervical osteochondrosis is carried out by a neurologist.
Inspection
During the examination, the doctor will listen to the patient's complaints, clarify the details of the medical history and conduct an examination: check reflexes, muscle strength, sensitivity and the condition of the vestibular apparatus.
With "cervical osteochondrosis", visible areas of muscle atrophy (muscle loss), decreased or increased muscle tone of the long back muscles and static discomfort in the cervical region can be observed in the neck area. When palpating the muscles, a person complains of pain, and when tilting the head, the pain may radiate to the head or arms, and dizziness or headaches may appear.
In addition, patients may experience motor disturbances in the hands (weakness), vision and hearing problems.
The doctor may also ask the patient to walk, stand on one leg with the eyes closed, or touch the nose. In this way, the specialist will be able to assess if the coordination of movements is impaired, if there are problems with gross and fine motor skills.
Laboratory diagnosis
To assess the general state of bones, patients with suspected cervical osteochondrosis are prescribed blood tests for total and ionized calcium, as well as markers of growth and destruction of bone tissue - osteocalcin and osteoprotegerin, alkaline phosphatase.
With progressive cervical osteochondrosis, joints are destroyed, calcium content may decrease, and osteocalcin and osteoprotegerin, on the contrary, increase.
Total creatine kinase is also considered a marker of muscle tissue destruction in cervical muscle myositis.
In addition, the doctor may need to evaluate the blood levels of trace elements involved in the regulation of muscle tone: magnesium, potassium, sodium.
Instrumental diagnostics
To determine the cause of neck pain and related disorders, imaging studies are needed: radiography of the cervical spine, computed tomography and magnetic resonance, electroneuromyography.
- Radiography.Using X-rays, you can identify bone deformities, malignant tumors and degenerative changes in joints.
- Computer imaging and magnetic resonanceperformed if pathology of the spine, spinal cord or brain is suspected. Computed tomography shows hemangiomas of the vertebral bodies and large deformations of the cervical spine. Magnetic resonance images are more informative for visualization of muscles, roots and spinal cord.
- Electroneuromyography- a method for studying the efficiency of impulse transmission along a nerve fiber using low-intensity electric current. The test can be a little uncomfortable. The study helps clarify the conduction of impulses along roots, nerves and from nerves to muscles, confirms damage to nerves or muscles, and clarifies the nature and level of damage.
Treatment of degenerative changes in the cervical spine
The main goals of treating degenerative changes in the cervical spine are to relieve pain, prevent nerve compression in the neck and restore cervical mobility.
Depending on the severity of the condition, the doctor may prescribe medication, physical therapy or massage. Surgery may be required if nerves are compressed or joints are deformed.
Drug treatment of degenerative changes in the cervical spine
Neck pain can be relieved with medication.
Medications to relieve neck pain and stiffness:
- local anesthetic ointments, gels and patches;
- non-steroidal anti-inflammatory drugs;
- hormonal drugs in the form of tablets or injections in the affected joint area;
- muscle relaxants to relieve muscle spasms;
- antidepressants to relieve chronic pain.
Non-drug treatment of cervical osteochondrosis
Along with drug therapy, it is important for patients with cervical osteochondrosis to do neck exercises. For this purpose, the person is referred for consultation to a physiotherapist. Learn how to properly stretch and strengthen your neck and shoulder muscles.
Your doctor may recommend mattresses or rollers with metal or plastic needles. They are used for 15-30 minutes before sleep to relax the muscles.
Wearing a Shantz splint (neck protector) is a passive exercise therapy for the deep muscles of the cervical region, which are difficult to influence with exercise. When a person puts on a splint, the muscles relax, and when they take it off, they tense. If you put on a splint for 15-20 minutes several times a day, you can train and strengthen them.
It makes sense to wear it for 2-3 hours only if you have serious neck injuries. In addition, you should not lie on it, let alone sleep.
Surgical treatment of degenerative changes in the cervical spine
As a rule, surgery is required for patients with severe spinal deformity who have a pinched nerve.
During the operation, the surgeon removes the pathological elements (hernial protrusions, formations, etc. ) or a part of the vertebra. After such treatment, a long period of rehabilitation is required: the placement of a Shants splint or a rigid cervical spine splint, physiotherapy, regular walking, sedatives.
Complications and consequences of degenerative changes in the cervical spine
Without treatment, the intervertebral discs gradually wear out and the vertebrae "disappear".
Common complications of degenerative changes in the cervical spine:
- syndrome of intractable pain in the head, neck, chest;
- cramps, movement disorders and numbness of the hands;
- frequent dizziness, impaired coordination of movements, fine and gross motor skills.
Prevention of degenerative changes in the cervical spine ("Cervical osteochondrosis")
There is no specific prevention of true cervical osteochondrosis, because it is a hereditary disease.
To avoid the appearance of non-specific neck pain, which is mistakenly associated with cervical osteochondrosis, it is important to ensure the correct posture and be physically active: the more a person moves, the better the condition of the muscles, bones, ligaments and joints.
To maintain physical activity, adults need 150 minutes of moderate-intensity aerobic activity per week. Brisk walking, swimming, cycling, tennis, jumping or rollerblading are suitable. Pilates and yoga will help strengthen your muscles.
In addition, gymnastics helps to avoid overloading the neck muscles and the appearance of pain: tilting the head forward, back, alternately on each shoulder and rotating it, as well as sleeping on an orthopedic pillow.
You must avoid injuries to the cervical spine: do not jump into the water upside down, wear seat belts in the car (prevention of whiplash injury in an accident).
Sleeping position for back pain
Pain in the neck and back, which is often attributed to osteochondrosis, can be the result of an uncomfortable sleeping position.
During sleep, the head and spine should be approximately at the same level. This position minimizes additional pressure on the neck area.
If a person sleeps mainly on his back, the height of the pillow should be on average 6-11 cm. For side sleepers, the pillow should be thicker: from 9 to 13 cm. In this way, the desired angle will be maintained between your shoulder and head, the cervical spine will not sag, and the muscles will be strained to compensate for the discomfort.
Moreover, the greater the weight of the person, the higher the pillow should be. You should also pay attention to the stiffness of the mattress. The softer it is, the more it will sag under the weight of the body and the higher the pillow should be. In addition, it is better not to always sleep on one side only - this leads to muscle imbalance.
If a person prefers to sleep on his stomach, he may suffer from back and neck pain more often. The fact is that in this position it is difficult to keep the spine in a neutral position. To relieve tension from the back, you can place a pillow under the pelvis and lower abdomen and choose a flat pillow under the head, or even sleep without it.
In addition, you can use a special orthopedic pillow.
FAQ
- Where can the pain from "cervical osteochondrosis" radiate?
Pain from degenerative changes in the cervical spine can radiate to the shoulder or arm, and also intensify with movement or standing.
- How to relieve an attack of dizziness with "cervical osteochondrosis"?
To relieve the attack of dizziness, you should take a comfortable position in which the likelihood of falling is minimal (sit in a chair with back support or lie down) and call for help. After 5-7 minutes, you can try to turn your head: most likely, the dizziness attack will pass during this time. If dizziness persists or worsens, nausea, vomiting or other neurological symptoms appear (speech, vision, movements, swallowing, impaired sensitivity), you should call an ambulance as soon as possible.
- How to sleep correctly with "cervical osteochondrosis"?
During sleep, the head and spine should be approximately at the same level. This position minimizes additional pressure on the neck area.
- How long does an exacerbation of "osteochondrosis" of the cervical spine last?
On average, the worsening of symptoms due to degenerative changes in the cervical spine ("cervical osteochondrosis") lasts from 4 to 7 days. Nonsteroidal anti-inflammatory drugs and muscle relaxants are used to reduce pain. During this time, it is best for a person to stay still and wear a neck brace.
- Which doctor treats "osteochondrosis" of the cervical spine?
Diagnosis and treatment of pain in the cervical region is carried out by a neurologist, neurosurgeon, orthopedist and general practitioner.