The clinical picture of osteochondrosis of the cervical spine

Doctor examines a patient with cervical osteochondrosis

Cervical osteochondrosis implies degenerative disorders in the intervertebral discs. The disease is accompanied by a complex of different symptoms. The clinical picture develops as the disease progresses - each stage corresponds to certain signs and the intensity of their manifestation.

Symptoms of cervical osteochondrosis by degrees (stages)

Osteochondrosis is a progressive disease, so the clinical picture develops gradually. This refers to the number of symptoms of the disease and the intensity of their manifestation. In total, there are 4 stages of the disease.

The first stageosteochondrosis of the cervical spine is initial. Changes occur mainly at the biochemical level. This stage of the disease is accompanied by mild symptoms or is asymptomatic, therefore it is called preclinical. It has the following features:

  • discomfort appears in the neck, which can spread to the arms and shoulders, sometimes the sensations become painful;
  • headache;
  • motor activity in the cervical spine is slightly limited;
  • there are visual impairments that quickly pass;
  • the sensitivity of the skin of the collar zone decreases;
  • Symptoms increase with head tilt.

The initial stage of osteochondrosis is ignored by many patients. The symptoms of the disease that appear are often attributed to age, fatigue, and stress.

The second stageof cervical osteochondrosis is characterized by the development of protrusions. This stage involves dehydration of the intervertebral disc, a decrease in its elasticity and height, and the appearance of cracks in the annulus fibrosus. In this case, the disc bulges into the intervertebral canal.

This stage of the disease is characterized by the following symptoms:

Neck pain with osteochondrosis
  • severe pain in the neck, crunching is possible;
  • painful sensations are shooting in nature, radiating under the scapula;
  • The pain increases with prolonged holding of the head in one position;
  • significant loss of sensitivity in the skin of the shoulders and arms;
  • frequent and long-lasting headaches;
  • visual disturbances, flies in the eyes;
  • tinnitus, ringing;
  • muscle weakness in the upper limbs;
  • decrease in the clarity of tendon reflexes;
  • development of insomnia, less often - other sleep disorders;
  • there is a lump in the throat, difficulty swallowing.

The second stage of cervical osteochondrosis manifests itself quite clearly, so many patients consult a doctor at this stage. In this case, conservative treatment is sufficient.

The third stageof the disease is characterized by the destruction of the annulus fibrosus and the formation of an intervertebral hernia. At this stage, the spine is deformed, the vertebrae are displaced, against the background of their weak fixation, subluxations and dislocations develop.

This stage of the disease is characterized by the following symptoms:

  • intense sharp pain that can spread to the heart;
  • partial or complete violation of skin sensitivity in the back of the head, shoulders, arms;
  • paresis, paralysis of the upper limbs;
  • almost complete absence of tendon reflexes.

Last, fourth stageosteochondrosis involves the replacement of intervertebral disc tissue with scar tissue. At this stage, remission of the disease often occurs, but pathological changes also spread to other structures of the spine, therefore, clinical signs of different stages of osteochondrosis can be observed simultaneously.

General signs of cervical osteochondrosis

The clinical picture of cervical osteochondrosis is quite diverse. This is due to impaired blood flow, involvement of the peripheral nervous system in the pathological process, possible compression and disruption of the integrity of the spinal cord. Against this background, various symptoms develop, but several common signs of the disease are distinguished.


This symptom in cervical osteochondrosis is the main one. The main localization of painful sensations is the neck. Head and facial pains are also observed. Painful sensations can radiate to various parts of the body.

This feature of the pathology depends on the affected area:

  • if the C4-C5 disc is affected, the pain is radiated to the outer surface of the shoulder and the medial part of the scapula;
  • with a C5-C6 disc lesion, painful sensations spread to the lateral surface of the forearm, hand, thumb and index finger;
  • C6-C7 pathology is accompanied by painful sensations along the back of the shoulder and forearm, which extend to the index and middle fingers;
  • if the C7-Th1 disc is involved, the pain radiates along the inner surface of the forearm and hand to the ring finger and little finger.

Decreased sensitivity and reflexes

Decreased sensitivity in cervical osteochondrosis

These symptoms occur against the background of a violation of the innervation of the nerve roots. Painful sensations may be absent. Features of reduced sensitivity and reflexes depend on the localization of pathological changes:

  • When the C4-C5 disc is affected, sensitivity in the upper part of the outer shoulder is reduced. There is a decrease in the reflex from the biceps muscle.
  • Osteochondrosis of the C5-C6 disc is accompanied by decreased sensitivity of the lateral surface of the forearm, hand, thumb and index finger. The reflex from the biceps muscle is also reduced.
  • C6-C7 disc pathology reduces sensitivity of the index and middle fingers, back of the hand and forearm. There is a decrease in the reflex from the triceps muscle.
  • The defeat of the C7-Th1 disc is accompanied by a decrease in the sensitivity of the ring finger, little finger, inner surface of the hand and forearm. Reflexes are not affected.


This symptom often develops at the initial stage of cervical osteochondrosis and is one of the first manifestations of the disease. Dizziness is caused by a decrease in the volume of oxygen supplied to the semicircular canals of the inner ear. They are located in the brain and provide balance. Simultaneously with dizziness, there may be fluctuations in the pupils in the horizontal or vertical direction.


With osteochondrosis of the cervical spine, the blood flow through the vessels of the brain is disturbed. This provokes nausea and belching of air. These symptoms often occur when turning and tilting the head, and sometimes during normal walking. Symptoms can grow and reach indomitable vomiting.

Against the background of such signs, the following consequences are possible:

  • decreased appetite;
  • weight loss;
  • nutritional deficiency, alimentary dystrophy.

Lack of air

With osteochondrosis of the cervical spine, irritation of the phrenic nerve is possible, which regulates the depth and frequency of breathing. With the defeat of this nerve, a person has difficulty breathing in, cannot breathe fully. Against this background, there is a lack of oxygen, which is fraught with the development of shortness of breath and even suffocation.

During night sleep, especially if the head is uncomfortable, there is a risk of respiratory arrest. Usually these attacks are accompanied by snoring. In the absence of fresh air, hypoxia develops, against the background of which the following symptoms arise:

  • tiredness even after the duration of sleep;
  • malaise;
  • weakness;
  • weakening of attention and memory.

Hearing impairment, noise and ringing in the ears

Against the background of circulatory disorders in cervical osteochondrosis, the vestibular apparatus suffers. This leads to dysfunction of the inner ear and provokes cochlear syndrome, which is also called cochlear. It has the following symptoms:

  • tinnitus;
  • ringing;
  • general hearing loss.

A distinctive feature indicating cervical osteochondrosis is the occurrence of tinnitus against the background of a prolonged stay in a forced position.


This symptom occurs against a background of blood flow disorders provoked by cervical osteochondrosis. Normally, blood constantly moves through the cerebral arteries. With osteochondrosis, the bone processes of the vertebrae are deformed and irritate the nerve endings. This leads to a pronounced spasm of the arteries, against the background of which the blood flow temporarily stops, and the person suddenly loses consciousness. Fainting usually lasts no more than 2-3 minutes.

Discomfort in the throat is a symptom of cervical osteochondrosis

Pharyngeal symptoms

This manifestation of cervical osteochondrosis implies a whole range of pathological signs:

  • perspiration;
  • foreign body sensation;
  • Difficulty swallowing
  • dry throat;
  • itching sensations.

Pharyngeal symptoms develop against the background of disorders of the neurovascular trunks, the source of which is the spinal cord. When they appear, differential diagnosis is necessary, since a similar clinical picture is characteristic of the inflammatory process and tumors.

Visual impairment

Such a disorder in cervical osteochondrosis often occurs against the background of low blood pressure or atherosclerosis of the arteries of the brain. Visual impairment can manifest itself as follows:

  • a veil before the eyes, objects are visible, as if in a fog;
  • visual acuity decreases;
  • dots flash before the eyes;
  • loses focus on certain subjects.

A distinctive feature of visual disturbances against the background of cervical osteochondrosis is the lack of effect from special gymnastics for the eyes or the use of glasses.

Temperature change

With cervical osteochondrosis, such a deviation occurs at the local level. This means hyperemia in the pathological area, that is, a local increase in the temperature of the skin.

Syndromes due to cervical osteochondrosis

Symptoms accompanying cervical osteochondrosis are quite common and accompany many other diseases of various organs and systems of the body. To facilitate the diagnosis, clinical signs are grouped into groups called syndromes:

  • Cervicalgia. This syndrome is reflexive and involves neck pain. It may indicate damage to the spine or muscles in this area.
  • Cervicocranialgia. This syndrome is also reflex. It means painful sensations in the cervico-occipital region and occurs against the background of trauma, inflammation or degenerative changes.
  • Cervicobrachialgia. This reflex syndrome involves neck pain radiating to the arm. It occurs against the background of compression of the nerve roots of the cervical spine. With osteochondrosis, this syndrome is accompanied by muscle-tonic, vegetative-vascular or neurodystrophic manifestations.
  • Radicular syndrome. It is also called in another way - cervical radiculitis. It implies a creepy feeling on the affected area, tingling in the fingers and forearms, slight swelling with spread to some fingers (depending on the location of the lesion).
  • Irritative reflex syndrome. It implies cervicocranialgia. Painful sensations are sharp and burning, can radiate to the shoulder, chest. Symptoms increase with a change in the position of the head, a sharp turn, sneezing.
  • Vertebral artery syndrome. This symptom complex includes headache, discomfort with certain movements, imbalance, loss of hearing and visual acuity, weakness, nausea and loss of consciousness. The headache is throbbing, it can be constant or paroxysmal.
  • Cardiac syndrome. The clinical picture resembles angina pectoris. Long-term pain suddenly develops, which intensifies against the background of a sharp movement of the neck, coughing, sneezing. It does not go away with heart medications, and an electrocardiogram does not show a violation of the blood flow of the heart muscle. The clinical picture can be supplemented by tachycardia and extrasystole.
  • Vegetative-dystonic syndrome. Occurs when subluxation with displacement of the C1 vertebra. This syndrome usually implies neurological symptoms of impaired cerebral blood flow - muscle spasms, intracranial pressure drops, dizziness, decreased visual acuity, fainting, headache, nausea.

Cervical osteochondrosis is accompanied by various symptoms. Features of clinical manifestations and their intensity largely depend on the stage of the disease, which implies certain pathological changes. Some of the symptoms of the disease are combined into syndromes - such groups of symptoms facilitate the diagnosis.