Cervical osteochondrosis, or spondylosis, occurs as a result of changes in the shape and structure of the vertebrae.Despite the fact that the cervical region is quite short in relation to the total length of the spine, it is perhaps the most important part of the spinal column.Each pair of adjacent vertebrae forms intervertebral foramina, through which nerve roots emerge and are directed to each muscle and organ of the upper half of the body.Vital vessels providing blood supply to the brain pass through other openings - in the lateral processes of these vertebrae.
Causes of osteochondrosis of the cervical spine
The causes of osteochondrosis are:
- injuries,
- “sedentary” work at a monitor located below eye level,
- physical labor associated with carrying heavy loads,
- driving a car for a long time,
- work “on the phone” without using remote devices (in this case, the operator presses the receiver to his ear with his shoulder)
- constitutional features (torticollis, congenital changes in the cervical vertebrae, short neck)
Formation of pathological changes in the vertebrae
With osteochondrosis, small sharp points begin to form at the edges of the vertebral bodies, which can injure nearby structures.Most often, this occurs in response to excessive load on the cervical spine, and is not only the result of “aging” of the intervertebral joints (remember that osteochondrosis was previously considered to be a degenerative, natural “age-related” disease, like osteoarthritis).As the disease progresses, the vertebral endplates become denser and the height of the intervertebral discs decreases.These discs normally play the role of a shock absorber between the vertebrae, and, among other things, prevent damage to the spinal roots.With progressive osteochondrosis, a protrusion (herniation) of the nucleus pulposus of the intervertebral disc occurs, on which, during the course of the disease, increasing pressure is exerted while the ligaments that “retain” on all sides are weakened.This hernia can also compress spinal structures and cause neurological manifestations of the disease.
What are the symptoms of cervical osteochondrosis?
Osteochondrosis of the cervical spine with pain syndrome
Any pain in the neck area makes one suspect a pathology of the cervical spine.According to the increasing intensity of the pain syndrome, they are divided into 4 stages, at the first the patient feels numbness, tingling, a feeling of “tightness” in the area of a certain muscle group, at the fourth stage - the most severe - the pain is so intense that it leads to immobility of the patient and loss of performance.
In addition to pain in the cervical and occipital region, the patient notes “referred” (radiating) pain in the upper limb and subscapular lateral areas of the chest.
Osteochondrosis of the cervical spine with radicular syndrome
The involvement of the nerve roots in the process is indicated when pain, numbness and tingling spread to the lower jaw, upper back, forearm and fingers.At the same time, the patient draws attention to the fact that he “seemed to be resting” his hand and slept uncomfortably.There is morning stiffness in the joints of the fingers, lasting no more than 10-15 minutes.With the development of radicular syndromes, upon examination, a decrease in muscle strength of the upper extremities may be noted.
Osteochondrosis of the cervical spine with “vertebral artery syndrome”
The involvement of blood vessels in the process (compression by a hernial protrusion or osteophyte) is indicated when the patient complains of frequent attacks of headaches, especially after being in a certain position for a long time, when throwing back the head (for example, when swimming breaststroke), if there is tinnitus and dizziness.This clinical situation is well identified using ultrasound (with “Doppler mapping mode”).Ultrasound reveals tortuosity of the vertebral arteries and narrowing of their lumen.In this case, we may be talking about surgery, since a pronounced change in blood flow in the vertebral arteries is a risk factor for stroke.
Osteochondrosis of the cervical spine with “cardiac (heart) syndrome”
This syndrome forces the patient to turn first to a cardiologist, since the main complaints concern pain in the left half of the chest, the subscapular region, which weakens or intensifies when performing physical activity or changing body position.After ruling out myocardial infarction and other heart diseases, the patient is admitted under the supervision and treatment of a neurologist and orthopedist.
Diagnostics
To clarify the diagnosis, four methods are used: radiography, ultrasound, computed tomography and magnetic resonance imaging.
The most accessible method is still radiography of the cervical spine; the most informative is radiography in the lateral projection (“side view”).This method allows, to a first approximation, to determine the presence of injury and gross structural changes in the vertebrae.
Ultrasound examination (ultrasound) is performed to clarify the condition of the vertebral arteries.Using this method, it is determined whether the blood flow is impaired, and if so, to what extent and what kind of obstacles have arisen and where they are located.
Computed tomography (CT).Allows you to more accurately assess the condition of bone structures, the degree of bone tissue density, and allows you to see smaller osteophytes (bone outgrowths) than is possible with radiography.
Magnetic resonance imaging (MRI).This type of examination is indispensable if there is a suspicion of the presence of hernias, the exact location of spinal cord damage and the degree of this damage.This study is necessary if the question of operative (surgical) treatment of diseases of the cervical spine is raised.
Treatment of cervical osteochondrosis
Drug treatment
The standard set of remedies for the treatment of cervical osteochondrosis reflects the goals of treatment: to relieve pain by eliminating painful muscle spasms and inflammation of the nerve roots, while increasing the mobility of the spine.To achieve these goals, they are used primarily by using painkillers, NSAIDs - non-steroidal anti-inflammatory drugs, muscle relaxants.It should be remembered that self-medication with drugs from these groups can be dangerous, since there is a possibility of erroneous interpretation of symptoms, as well as underestimation of the side effects of these drugs.Local (cutaneous) NSAID medications in the form of gels are widely used, and when the pain stops, these same drugs can be used in the form of ointments.
To treat osteochondrosis at a deeper, “basic” level, slow-acting systemic drugs are used.These substances restore the cartilage structures of the vertebrae and prevent their further damage.Treatment courses are long, the effect lasts for many months.
Cervical osteochondrosis has significant differences from the pathology of other parts of the spine.Pain in the neck area in this case can be provoked not by signals from the suffering spinal nerves, but by painful chronic muscle strain - all together this is called muscle-tonic syndrome.This is a completely “benign” condition that responds well to treatment with the same set of drugs: non-steroidal anti-inflammatory drugs, muscle relaxants, using intramuscular “blockades” using steroids.Usually, the doctor detects sharp pain when palpating the so-called “trigger” points along the entire cervical spine, as well as in the area of the muscles of the upper shoulder girdle.More often, this pathology occurs in women, most of them under 40 years of age.Despite the severe pain syndrome, the neurovascular structures remain intact, and the blood flow to the head area is not affected.
Manual therapy
This method of treatment can be effective for recent (often as a result of a minor injury, subluxation) pain in the neck that is not accompanied by dizziness or other changes in the nervous system and circulatory system.It is permissible to resort to manual therapy only after a thorough examination; in addition, the doctor performing this procedure must have sufficient experience in the field of traumatology and orthopedics.For “old” forms of the disease, the use of manual therapy is dangerous!
There are two known methods of this type of intervention:
- manipulation (sharp short impacts of significant force aimed at eliminating subluxations, the well-known “bone clicks”);
- mobilization (the method is based on smooth stretching of the neck after warming up and relaxing the muscular corset of the neck).
A combined method is also used, based on a combination of two main ones.It is important to remember that in addition to these contraindications, manual therapy is prohibited for any diseases accompanied by increased blood pressure, for any pathology of the thyroid gland and ENT organs.
Treatment of cervical osteochondrosis at home
Therapeutic exercises for cervical osteochondrosis
The first and main rule for beginners in physical therapy is not to perform exercises while overcoming painful sensations.It goes without saying that you should not start in the “acute” period, when the pain has just appeared.Another important recommendation is to avoid sudden movements and circular movements in the cervical spine.
Each session should begin with a short, light self-massage of the neck muscles.
This is followed by a “warm-up” warm-up:
- Arms are lowered along the body, shoulders are level, back is straight (you can check your posture by lightly pressing your heels, shoulder blades and buttocks against the wall).We walk in place for 1 minute on the entire foot, 1 minute on the toes, 1 minute on the heels.
- The starting position is the same.We clench our hands into fists, raise and lower our shoulders, arms straight.The movements are slow, we do 20 repetitions, the last rise is longer by 5 seconds.We make sure that the neck muscles do not tighten.
- The starting position is the same.We tilt our heads one by one to the right, then to the left.The movements are smooth, one tilt for 8 counts, at the extreme point of the tilt - hold for 8 seconds.
- The starting position is the same or sitting on a hard chair.Smooth tilts of the head forward, at the extreme point - hold for 8 seconds
- The starting position is the same or sitting on a hard chair.Slowly tilt your head forward until your chin touches your chest, then slowly turn your head to the right (by 4 counts) and to the left (by 4 counts).Avoid overstraining muscles.
- The starting position is the same or sitting on a hard chair.We raise our shoulders for 4 counts, then smoothly lower them for 4 counts.10 reps.
- The starting position is the same or sitting on a hard chair.We raise our shoulders, but now we perform circular movements from front to back, for 8 counts.10 reps.
- We straighten our back and check our posture.For 4 counts, we bring the shoulder blades together behind our back, trying to connect them, at the end point we linger for 8 seconds, then return to the starting position.
Pillows
As already mentioned, hypertonicity of the neck muscles is the first and often the main cause of the development of cervical osteochondrosis.Rational selection of pillows and mattresses, ensuring a relaxed and comfortable position during sleep are no less important than gymnastics, physical therapy and medications.
When choosing a mattress, pay attention to the composition of the filler (products that are at least half made of coconut flakes, that is, with a sufficient degree of rigidity, are suitable).Soft spring mattresses do not provide sufficient spinal straightening.The most optimal sleeping position is on your side, with one or both knees pulled up towards your stomach.The pillow should be positioned in such a way as to fill the entire space between the shoulder, ear and mattress, while the parietal part (crown) of the head is in the same horizontal line with the spine.Too high and too low, as well as soft pillows should be avoided.The ideal option is a product with an ergonomic shape, that is, in this case, with a small squeeze-roller on one side.
General recommendations
Pay attention to your posture.When walking or standing, the correct position is when the chest protrudes forward and the stomach is retracted.
Avoid sitting for long periods of time.A simple rule for the prevention of cervical osteochondrosis is known: after every 60 minutes of work, a 10-15 minute period of walking or warming up is necessary.
A work chair must have a high headrest or backrest.
When sitting, your feet should rest on the floor and your neck should not be tense.For this purpose, use special orthopedic devices: bolsters under the neck when driving in a car, a pillow under the back.
Avoid heavy lifting.If necessary, get down on your knees, hold a heavy object against your torso, and then stand up smoothly, using the strength of your leg muscles, but not the “pull” of your back.
Don't bend over with your legs straight.Use stands or work surfaces to bring the subject closer to you, rather than leaning your face towards the subject.Try to do your homework while sitting on a chair or an exercise ball.
If you must use a mop, broom, or rake, do not strain your arms, back, neck, or lean sideways.
Avoid breaststroke swimming.