The diagnosis "cervical osteochondrosis" is often made if a person complains of neck pain. Some attribute this to dizziness, memory loss, numbness in the hands and other unpleasant symptoms. It is wrongly believed that the disease is related to the wear and tear and age-related deformation of the intervertebral discs and other elements of the spine.
How does the cervical spine work?
The cervical department consists of 7 vertebrae. Between them are intervertebral discs - semi-solid structures with a dense ring on the periphery and a jelly-like center that act as shock absorbers. On the right and left of each vertebra there are two joints, between which the surfaces of the spinal processes, covered with cartilage, protrude. The joints are connected by ligaments and muscles of the back.
Why does neck pain occur?
Usually, neck pain occurs in response to an awkward movement, injury or due to inflammation of one of the structures of the cervical spine. In addition, the cause of the pain may be overstretching of the muscles or ligaments, for example, when lifting weights, failing to turn 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 the age of 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 occurs due to lack of physical activity or, on the contrary, too intense exercises.
However, people often mistakenly call unexplained pain and discomfort in the neck area cervical osteochondrosis and associate its development with wear and age-related deformation 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 associated with disruption of normal bone development and growth. As a rule, osteochondrosis begins in childhood and is severe: part of the joint or bone is deformed, and sometimes even dies. In this disease, the thoracic region (lower thoracic vertebrae) is most often affected, not the cervical spine. Therefore, the main clinical manifestation of osteochondrosis is the pronounced distortion of the chest, the so-called thoracic kyphosis.
Symptoms related to chest damage:
- dyspnea,
- persistent weakness
- inability to breathe fully,
- pain and burning behind the sternum,
- attacks of rapid heart rate.
Conditions accompanied by neck pain
Cervical spondylosis
In people over 50, neck pain is usually caused by cervical spondylosis, an age-related wear and tear on the vertebrae and related structures. In this disease, the intervertebral discs are dehydrated and flattened, which leads to deterioration of cushioning in the cervical region and many movements are accompanied by pain.
But changes in the spine with age are normal. Thus, its structures begin to wear out after an average of 30 years, and by the age of 60, 9 out of 10 people already have cervical spondylosis. However, most people are asymptomatic.
Other reasons
Less often, neck pain occurs due to hypothermia or severe stress, due to disc herniation or anomalies of the cervical vertebrae - bone growths (spines) that press on the nerves exiting the spinal cord.
The most common source of pain in the cervical vertebrae and shoulder girdle is excessive tension (protection) of the muscles: trapezius, long spinal muscles of the cervical vertebrae.
In addition, the muscles of the cervical vertebrae are closely related to the aponeurosis - a broad tendon plate that wraps around the head. The muscular elements of the aponeurosis in the occipital, temporal and frontal regions connect with the muscles of the cervical region, so neck pain is often accompanied by a headache. Thus, neck pain that occurs after prolonged sedentary 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 their neck, the so-called techno neck or Internet age neck, is associated with pain arising from an awkward posture. Techneck is the result of constant computer and smartphone use, 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 a "straight" position, the average weight of an adult's head is 5 kg. If you tilt your head forward at least 15°, the load on the neck muscles will be 13 kg, at 30° - 20 kg, at 60° - 30kg As a result of the constant overload, the muscles of the neck are overstretched, microtraumas, inflammations, fibrosis (overgrowth of connective tissue) and pain may occur.
Causes contributing to the development of degenerative changes in the cervical vertebrae
The appearance of pain in the cervical spine is facilitated by childbirth or other injuries to the spine, abnormalities in its development, postural disorders, muscle dystonia, as well as prolonged immobilization, obesity and some autoimmune diseases.
- Prolonged 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 occurs.
- 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 vertebrae
There are 4 main stages of degeneration (destruction) of the cervical spine:
- Stage I: the intervertebral discs become thinner, slight discomfort appears in the neck area;
- Stage II: the intervertebral discs are deformed, the distance between the vertebrae is reduced. The pain intensifies during movements in the cervical spine;
- Stage III: the cartilages and vertebrae rub against each other, the pain in the neck becomes constant and the movements are restricted. In very severe deformations of the cervical spine, vertebral artery syndrome may appear with visual and vestibular disorders, headache;
- IV stage: degenerative changes are pronounced, movements in the cervical vertebrae are severely limited and painful. The neck area can be almost completely immobilized.
Symptoms of degenerative changes in the cervical vertebrae
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 vertebrae:
- neck pain that worsens with movement or standing;
- the pain radiates to the shoulder or arm;
- numbness, tingling, and weakness in hands and arms;
- clicking or grinding in the neck (especially when turning the head);
- headache;
- attacks of vertigo;
- 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:
- crunch in neck when moving;
- limited mobility;
- violation of the location of the vertebrae relative to each other in the neck area;
- flattening of the natural cervical lordosis or lateral curvature of the cervical spine (can only be seen on X-ray, MRI or CT).
Symptoms of radicular syndrome:
- numbness in the fingers of 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, until loss of consciousness;
- sudden spikes in blood pressure;
- noise in the ears;
- blurred vision or spots in the eyes;
- loss of balance and bouts of nausea when moving the head;
- headache (severe pain on one or both sides).
Diagnosis of degenerative changes in the cervical spine
In order to understand the cause of neck pain and diagnose "degenerative changes in the cervical vertebrae" (often called cervical osteochondrosis), the doctor will need to conduct an examination, study the medical history, evaluate the results of laboratory tests and instrumental tests. .
The 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: he will check reflexes, muscle strength, sensitivity and the condition of the vestibular apparatus.
With "cervical osteochondrosis" in the neck region, visible areas of muscle atrophy (muscle loss), reduced or increased muscle tone of the long back muscles and static disorders in the cervical region can be observed. When palpating the muscles, a person complains of soreness, andwhen tilting the head, the pain may radiate to the head or arms, dizziness or headache may occur.
In addition, patients may experience movement disorders in the hands (weakness), vision and hearing problems.
The doctor may also ask the patient to walk, stand on one leg with their eyes closed, or touch their nose. Thus, the specialist will be able to assess whether the coordination of movements is impaired, whether there are problems with gross and fine motor skills.
Laboratory diagnostics
To assess the general condition of the bones, blood tests for total and ionized calcium, as well as markers for the growth and destruction of bone tissue - osteocalcin and osteoprotegerin, alkaline phosphatase are prescribed to patients with suspected cervical osteochondrosis.
In progressive cervical osteochondrosis, the joints are destroyed, the calcium content can be reduced, and osteocalcin and osteoprotegerin, on the contrary, increased.
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 establish the cause of neck pain and related disorders, imaging studies are necessary: X-ray of the cervical vertebrae, computed tomography and nuclear magnetic resonance, electroneuromyography.
- Radiography.With the help of X-rays, you can identify bone deformities, malignant tumors and degenerative changes in the joints.
- Computed and magnetic resonance imagingperformed in case of suspected pathology of the spine, spinal cord or brain. Computed tomography showed hemangiomas of the vertebral bodies and gross deformities of the cervical vertebrae. Magnetic resonance imaging is more informative for visualizing muscles, roots, and the spinal cord.
- Electroneuromyography- a method of studying the effectiveness of the transmission of impulses along a nerve fiber using an electric current of low intensity. The test may be slightly uncomfortable. The examination helps to clarify the conduction of impulses along the roots, nerves and from the nerves to the muscles, to confirm nerve or muscle damage and to clarify the nature and extent of damage.
Treatment of degenerative changes in the cervical vertebrae
The main goals of treating degenerative changes in the cervical spine are to relieve pain, prevent compression of the nerves of the neck and restore the mobility of the cervical spine.
Depending on the severity of the disease, the doctor may prescribe medication, physiotherapy 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.
Medicines to relieve neck pain and stiffness:
- Ointments, gels and patches for local anesthesia;
- nonsteroidal anti-inflammatory drugs;
- hormonal drugs in the form of tablets or injections in the area of the affected joint;
- 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 to a physiotherapist for consultation. Teaches how to properly stretch and strengthen neck and shoulder muscles.
Your doctor may recommend mats or rollers with metal or plastic needles. They are used for 15-30 minutes before going to bed to relax the muscles.
Wearing a Schantz splint (neck brace) is a passive exercise therapy for the deep muscles of the cervical region that are difficult to engage with exercise. When a person puts on a splint, the muscles relax, and when they take it off, they tense. If you wear a splint for 15-20 minutes several times a day, you can train and strengthen them.
It only makes sense to wear it for 2-3 hours if you have serious neck injuries. Also, you shouldn't lie in it, much less sleep.
Surgical treatment of degenerative changes in the cervical spine
As a rule, surgery is required in patients with severe spinal deformity who have a pinched nerve.
During the operation, the surgeon removes pathological elements (hernial protrusions, formations, etc. ) or part of the vertebra. After such treatment, a long period of rehabilitation is necessary: wearing a Shants splint or a rigid splint for the cervical spine, physical therapy, regular walking, painkillers.
Complications and consequences of degenerative changes in the cervical spine
Without treatment, the intervertebral discs gradually wear out and the vertebrae "wear out".
Common complications of degenerative changes in the cervical spine:
- syndrome of unbearable 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 vertebrae ("cervical osteochondrosis")
There is no specific prevention of true cervical osteochondrosis, as it is a hereditary disease.
In order to avoid the appearance of non-specific pain in the neck, which is mistakenly associated with cervical osteochondrosis, it is important to ensure correct posture and be physically active: the more a person moves, the better the condition of the muscles, bones, ligaments andthe joints.
To maintain physical activity, adults need 150 minutes of moderate-intensity aerobic activity per week. Brisk walking, swimming, cycling, tennis, dancing or rollerblading are suitable. Pilates and yoga will help you strengthen your muscles.
In addition, gymnastics helps to avoid overstraining the muscles of the neck and the appearance of pain: tilting the head forward, backward, alternately to each shoulder and turning it, as well as sleeping on an orthopedic pillow.
You must avoid injuries to the cervical vertebrae: do not jump into the water with your head down, wear seat belts in the car (prevent whiplash injury in an accident).
Sleeping position for back pain
Neck and back pain, which is often attributed to osteochondrosis, may 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 mainly sleeps on their back, the height of the pillow should be on average 6-11 cm. For those who sleep on their side, the pillow should be thicker: from 9 to 13 cm. This is how you will achieve the desired angle. is supported between the shoulder and the head, the cervical spine will not sag, and the muscles tighten to compensate for the discomfort.
Also, the greater the person's weight, the higher the pillow should be. You should also pay attention to the firmness 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 - 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 maintain the spine in a neutral position. To relieve back strain, you can place a pillow under your pelvis and lower abdomen and choose a flat pillow under your head or even sleep without one.
You can also use a special orthopedic pillow.
FAQ
- Where can pain from "cervical osteochondrosis" radiate?
Pain from degenerative changes in the cervical spine can radiate to the shoulder or arm, and also increase when moving or standing up.
- How to relieve an attack of dizziness with "cervical osteochondrosis"?
To relieve an attack of vertigo, you need to take a comfortable position in which the probability of falling is minimal (sit in a chair with a back support or lie down) and call for help. After 5-7 minutes, you can try to turn your head: most likely, the vertigo attack will pass during this time. If vertigo persists or worsens, nausea, vomiting or other neurological symptoms (impaired speech, vision, movement, swallowing, sensitivity) appear, you should call an ambulance as soon as possible.
- How to sleep properly 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 the exacerbation of "osteochondrosis" of the cervical vertebrae last?
On average, the exacerbation of symptoms due to degenerative changes in the cervical vertebrae ("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 to keep calm and wear a neck brace.
- Which doctor treats "osteochondrosis" of the cervical vertebrae?
Diagnosis and treatment of pain in the cervical region is carried out by a neurologist, neurosurgeon, orthopedist and general practitioner.