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BACK Effective methods of treatment of osteochondrosis of the cervical vertebrae.

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 relevance 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, what drugs are effective in its treatment, what non-drug methods exist, as well as find out the answers to the most common questions from patients with a similar diagnosis.Osteochondrosis of the cervical vertebrae is a degenerative-dystrophic (progressive) damage to the intervertebral discs in the cervical vertebrae.

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Causes of cervical osteochondrosis

As a result of the action of the factors listed below, the load on the cervical spine increases, the neck muscles try to compensate for the excess load, their spasm occurs, blood circulation in this area is disturbed, 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 disturbed, changes occur in the small joints between the vertebrae, bone growths appear on the vertebral bodies due to the increased load on the changed intervertebral discs.Click to enlarge - exercise therapy for osteochondrosis of any part of the spine.Factors contributing to the development of osteochondrosis of the cervical vertebrae:

  • Poor posture and scoliosis
  • Overweight
  • Lack of physical activity, sedentary work
  • Previous spinal injuries
  • Metabolic disorder
  • A lot of physical activity
  • Stress and constant nervous tension
  • Low level of physical fitness
  • Hereditary predisposition
  • Common incorrect body positions, such as holding a phone receiver with your shoulder
  • Constant strain on the back and neck due to the nature of work (strained sitting position) among drivers and office workers.
  • Abnormalities in the development of the cervical vertebrae

Degree of development of cervical osteochondrosis

The degree of osteochondrosis is determined by the patient's clinical picture and complaints.The concept of degree 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 vertebrae, which may increase when turning the head.Physical examination may reveal mild tension in the neck muscles.

Second degree

The patient is concerned about pain in the cervical spine, its intensity is much greater, the pain can radiate to the shoulder or arm.This is due to a decrease in the height of the intervertebral disc and pinching of the nerve roots.The pain intensifies when tilting and turning the head.The patient may notice reduced work capacity, weakness and headache.

Third degree

the symptoms of cervical osteochondrosis intensify, the pain becomes constant, radiating to the arm or shoulder.Numbness or weakness occurs in the muscles of the arm as the intervertebral discs herniate (see lumbar herniated disc symptoms).I am worried about weakness and dizziness.Examination reveals limited mobility in the cervical vertebrae and pain on palpation of the cervical vertebrae.

Fourth degree

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

Symptoms depending on the damaged vertebra

Separately, we can distinguish root 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 sensitivity in the back of the head;
  • C2: pain in the parietal region and the back of the head;
  • C3: speech disorder, tongue sensitivity, pain and decreased sensitivity on the side where the spinal nerve is pinched;
  • C4: pain in the heart, left hypochondrium, shoulder, scapula, respiratory disorders, decreased muscle tone in the neck;
  • C5: shoulder pain in the outer region;
  • 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 to 2-4 fingers;
  • C8: pain from neck to shoulder, forearm to little finger.

Diagnosis of cervical osteochondrosis

Main diagnostic methods:

  • X-ray of the cervical vertebrae.This is a low-informative method, especially in the later stages of the disease.
  • Computed tomography.It better shows the 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 spinal cord herniation).
  • Nuclear magnetic resonance.The most informative method.Not only bone structures are clearly visible, but also intervertebral discs, hernias, their size and direction of growth.
  • If a violation of the blood flow in the vertebral arteries is suspected, an ultrasound duplex 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.

  • 1 stage – minimal changes in the configuration of the vertebrae, smoothing of the cervical lordosis (distortion).
  • 2nd stage – instability between the vertebrae, possible displacement of one vertebra relative to another, torsion (rotation around the axis of the spine), a 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 growths), narrowing of the intervertebral openings and narrowing of the spinal canal in which the spinal cord with its membranes is located.
  • Stage 4 - a significant decrease in the height of the intervertebral disc, significant changes in the intervertebral joints, huge posterior osteophytes, significant narrowing of the intervertebral openings and significant narrowing of the spinal canal with the formation of myelopathy.

Symptoms

Damage to the upper part of the spine can manifest itself with different symptoms, depending on the location and severity of the dystrophic process, as well as how seriously the root 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.
  • Vertebral, in which symptoms of impaired motor and sensory innervation are observed, in addition, impaired trophism of the cervical area causes gradual atrophy of the muscles of the shoulder girdle and arms.
  • Radicular, expressed in pain symptoms in the area of peritoneal and thoracic organs, which requires additional in-depth diagnostics to distinguish between osteochondrosis and diseases of internal organs.
  • Vertebral artery syndrome with cervical osteochondrosis is a vestibular disorder manifested by headache, hearing impairment, dizziness, even loss of consciousness.These phenomena occur due to cerebral ischemia due to disruption of 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 impair the quality of life, during periods of exacerbation.How to treat osteochondrosis of the cervical spine is decided only by a doctor after a proper diagnosis;self-medication in this case is unacceptable.Treatment of osteochondrosis of the neck is aimed at eliminating pain, inflammation, partial or complete restoration of the affected tissue structures and prevention of complications.Treatment should be primarily outpatient;any procedures at home can only be performed on a doctor's prescription, after instrumental and laboratory diagnostics.In advanced cases, with severe stages of development of neurological lesions and accompanying pathologies, inpatient treatment of cervical osteochondrosis with the possibility of surgical intervention may be indicated.

Drug treatment of cervical osteochondrosis

It consists of prescribing courses of drugs that relieve the symptoms of pain and inflammation.In the acute period, drugs in injectable form are indicated;after a certain decrease in pain, the patient takes tablets, locally acting agents in the form of ointments and continues to receive injections.

  • Nonsteroidal anti-inflammatory drugs.They are considered drugs of choice in the treatment of cervical osteochondrosis to relieve pain and inflammation.It is available in various dosage forms.They reduce the swelling of soft tissues, thereby reducing pain;local agents have a warming effect, which improves blood flow in the affected cervical area.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 a tablet form of application.It is worth remembering that long-term treatment with NSAIDs has a negative effect on the mucosa of the gastrointestinal tract, which is why 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 pain management, most commonly injection of dexamethasone or hydrocortisone into the affected area or tablets.Medicines from this group are prescribed to patients with cervical radicular syndrome to relieve swelling of the nerve fibers.
  • Anesthetics.They are prescribed in the form of local neuromuscular blockades, which eliminates severe pain symptoms.The block can be intradermal, subcutaneous, muscular, perineural, or radicular, depending on where the injection is made.To prolong the analgesic effect, anesthetics are administered together with hormones.Treatment of osteochondrosis of the neck is carried out every other day, prescribing a total of 5-7 such procedures.Anesthetics can also be administered by injection into special biologically active points;this healing technique is a type of acupuncture and is called pharmacopuncture.
  • Spasmolytics and drugs that improve microcirculation in the area of the cervix and collar.Nicotinic acid and others may be prescribed to treat muscle tension in the affected area.By relieving spasms of the neck muscles and improving blood flow, blood flow to 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 thus improve microcirculation in the affected area.
  • Sedatives, 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 irritants.These are locally acting ointments, gels, rubs that have a warming, irritating and distracting effect.They are not used in the treatment of the acute stage.They contain biologically active substances of plant and animal origin, for example bee or snake venom.If you have hypersensitivity to the components of the drug and if its irritating effect is high, it is better not to use them, so as not to cause even greater swelling.
  • vitamins.During treatment and further rehabilitation, multivitamin complexes are recommended.Usually 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, vertigo, hearing loss.
  • Chondroprotectors.These are substances that promote the restoration of the cartilage tissue of the spinal discs of the cervical segment.Treatment of cervical osteochondrosis with chondroprotectors is carried out over a long period of time, 6-12 months.

Orthopedic methods of treatment

Unpleasant symptoms in the cervical spine are often provoked and aggravated by an incorrect position of the body during sleep, prolonged exposure to a forced position or injury.Therefore, in the treatment of the disease, a method such as a cervical collar or Shantz collar is often used.It is prescribed individually for each patient after a doctor's consultation, and is available in several varieties.The collar is a framed solid roll that fastens around the neck and fixes the vertebrae in the desired position.Therefore, the neck does not bend and the head does not turn to the side, which provides immobilization of the diseased area, which is important during acute periods.The Schantz neck collar can also be made in the form of two rolls with an inflatable layer, in which air is pumped with a rubber pear.Inflating the layer between the rollers stretches the spine, making it possible to increase the inter-articular spaces in the cervical spine.The degree of stretching is determined by the doctor;it is not recommended to solve this problem yourself to avoid damage to the neurovascular bundles of the neck.During the recovery period, a fully inflatable collar is used, which preserves 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 for wearing are determined by the doctor depending on the severity of the condition and existing symptoms.