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KRAPA Effective methods of treating osteochondrosis of the cervical spine.

In the modern world, almost all people over the age of 25 have this disease.Cervical osteochondrosis occurs much more often than in other parts of the spine.The importance of this topic is difficult to overestimate.In this article we will consider why this disease occurs, how it manifests itself, how to treat cervical osteochondrosis, which drugs are effective in its treatment, which non-drug methods exist, and we will also find out the answers to the most common questions from patients with a similar diagnosis.Osteochondrosis of the cervical spine is a degenerative-dystrophic (progressive) lesion of the intervertebral discs in the cervical spine.

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Causes of cervical osteochondrosis

As a result of the action of the factors listed below, an increase in the load on the cervical spine is observed, the neck muscles try to compensate for the excess load, their spasm appears, blood circulation in this area is disrupted, which causes 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, bone growths of the vertebral bodies appear due to the increased load on the changed intervertebral discs.Click to enlarge - exercise therapy for osteochondrosis of any part of the spine.Factors that contribute to the development of osteochondrosis of the cervical spine:

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

The rate of development of cervical osteochondrosis

The degree of osteochondrosis is determined by the clinical picture and the patient's complaints.The concept of scale should not be confused with the stages of osteochondrosis.The stages will be discussed below.

First degree

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

Second degree

The patient is worried about the 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 compression of the nerve roots.The pain intensifies when you lean and turn your head.The patient may notice a decrease in performance, weakness and headache.

The third degree

the symptoms of cervical osteochondrosis intensify, the pain becomes constant, radiating to the arm or shoulder.Numbness or weakness occurs in the arm muscles as herniated intervertebral discs form (see symptoms of lumbar herniation).I am worried about weakness and dizziness.After examination, limited mobility in the cervical spine and pain during palpation of the cervical spine are revealed.

The fourth degree

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

Symptoms depending on the damaged vertebra

Separately, we can distinguish radicular syndromes that lead to certain 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 the back of the head;
  • C3: speech impairment, tongue sensitivity, pain and reduced sensation on the side where the spinal nerve is pressed;
  • C4: pain in the heart, left hypochondrium, shoulder, scapula, breathing disorders, decreased neck muscle tone;
  • C5: shoulder pain in the outer 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 shoulder blade, radiating to the forearm up to 2-4 fingers;
  • C8: pain from neck to shoulder, from forearm to little finger.

Diagnosis of cervical osteochondrosis

Basic diagnostic methods:

  • X-ray of the cervical spine.It is a method with little information, especially in the later stages of the disease.
  • Computed tomography.It better shows changes in the vertebrae, but it is difficult to determine the size and presence of intervertebral hernias, as well as the presence of disc-medullary conflict (compression from a spinal hernia).
  • 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 the blood flow in the vertebral arteries is suspected, a duplex ultrasound scan is used.This method allows you to accurately determine if there is a decrease in the speed of blood flow or if there are obstacles to normal blood flow.

X-ray stages of cervical osteochondrosis.

  • Stage 1 - minimal changes in the configuration of the vertebrae, softening of the cervical lordosis (curvature).
  • Stage 2 - instability between vertebrae, possible displacement of one vertebra relative to another, rotation (rotation around the axis of the spine), slight decrease in the height of the intervertebral disc.
  • Stage 3 - reduction of the height of the intervertebral disc by ¼ compared to the disc located above it, changes in the intervertebral joints, posterior osteophytes (bone protrusions), narrowing of the intervertebral foramina and narrowing of the spinal canal in which the spinal cord is located with its membranes.
  • Stage 4 - significant decrease in the height of the intervertebral disc, significant changes in the intervertebral joints, large posterior osteophytes, significant narrowing of the intervertebral foramina and significant narrowing of the spinal canal with the formation of myelopathy.

Symptoms

Damage to the upper part of the spine can manifest itself in a variety of symptoms, depending on the location and severity of the dystrophic process, as well as how seriously the radicular structures of the cervical spine are affected.Often, patients' complaints are reduced to seemingly 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.
  • Spine, in which symptoms of impaired motor and sensory innervation are observed, in addition, impaired trophism of the cervical region causes gradual atrophy of the muscles of the shoulder girdle and arms.
  • Radicular, expressed in pain symptoms in the area of peritoneal organs and chest, which requires additional comprehensive diagnosis 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 damage to 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 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.The treatment of osteochondrosis of the neck is aimed at eliminating pain, inflammation, partial or complete restoration of affected tissue structures and prevention of complications.Treatment should be mainly outpatient;any procedure at home can be performed only in connection with medical prescriptions, after instrumental and laboratory diagnostics.In advanced cases, in the severe stages of the development of neurological lesions and accompanying pathologies, hospital treatment of cervical osteochondrosis with the possibility of surgical intervention may be indicated.

Drug treatment of cervical osteochondrosis

It consists in prescribing courses of drugs that relieve the symptoms of pain and inflammation.In the acute period, drugs in the form of injection are indicated;after the pain subsides, the patient takes tablets, agents with local action 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 various dosage forms.They reduce swelling of soft tissues, thus reducing pain;local agents have a warming effect, which improves blood flow in the affected area of the cervix.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 form of administration of tablets.It is worth remembering that long-term treatment with NSAIDs negatively affects the mucosa of the gastrointestinal tract, therefore 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 in the affected area or tablets.Drugs of this group are prescribed to patients with cervical radicular syndrome to relieve nerve fiber swelling.
  • Anesthetics.They are prescribed in the form of local neuromuscular blockades, which eliminates the symptoms of severe pain.The block can be intradermal, subcutaneous, muscular, perineural or radicular, depending on the site of injection.To prolong the analgesic effect, anesthetics are given 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 in specific biologically active points;this treatment technique is a type of acupuncture and is called pharmacopuncture.
  • Antispasmodics and medications that improve microcirculation in the cervical and collar areas.To treat muscle tension in the affected area, nicotinic acid and others may be prescribed.Relieving neck muscle spasms and improving blood circulation, blood circulation in the diseased area is stimulated and the symptoms of cervical osteochondrosis and inflammation are alleviated.During the exacerbation period, diuretics are also taken to reduce vascular spasm and thereby improve microcirculation in the affected area.
  • Tranquilizers, such as tincture of valerian, peony and herbal teas are recommended for prolonged pain and to reduce the risk of developing neuroticism in the patient, which contributes to the effectiveness of the treatment of cervical osteochondrosis.
  • Local bullies.These are ointments, gels, rubs with local action that have a warming, 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 ingredients of the herb and if its irritating effect is high, it is better not to use them, so as not to provoke even greater swelling.
  • Vitamins.During the period of further treatment and rehabilitation, the use of multivitamin complexes is recommended.Typically, this is a group of B vitamins, whose representatives 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 cartilage 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.

Orthopedic treatment methods

Unpleasant symptoms in the cervical spine are often provoked and aggravated by the wrong position of the body during sleep, prolonged exposure to a forced position or injury.Therefore, during 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 medical consultation, as it comes in several varieties.The collar is a densely framed roller that goes around the neck and fixes the beads in the required position.The neck, therefore, does not bend and the head does not turn to the side, which ensures the immobilization of the diseased area, which is important during acute periods.The neck collar of Shants can also be made in the form of two rolls with an inflated layer, in which air is pumped with a rubber bulb.The swelling of the layer between the vertebrae stretches the spine, which makes it possible to increase the interarticular gaps in the cervical spine.The degree of extension is determined by the doctor;it is not recommended to solve this issue yourself, in order to avoid damage to the neurovascular bundles of the neck.During the recovery period, a fully inflated collar is used, which maintains some mobility of the neck and head.

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