Cervical osteochondrosis or spondylosis occurs as a result of changes in the shape and structure of the vertebrae.Although the cervical region is quite short compared to the total length of the spine, it is perhaps the most important part of the spine.Each pair of adjacent vertebrae forms intervertebral foramina through which nerve roots exit and are directed to each muscle and organ of the upper half of the body.Vital vessels that supply blood 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,
- work "sitting" on a monitor below eye level,
- physical labor related to the transportation of heavy loads,
- driving for a long time,
- working "on the phone" without using remote devices (in this case, the operator puts the receiver on his shoulder to his ear)
- constitutional features (torticollis, congenital changes in cervical vertebrae, short neck)
The formation of pathological changes in the spine
With osteochondrosis, small sharp points begin to form on the edges of the vertebral bodies, which can damage nearby structures.Often this happens in response to excessive loading of the cervical spine, and not only as a result of the "aging" of the intervertebral joints (remember that osteochondrosis was previously considered 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 act as shock absorbers 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, which exerts increasing pressure during the course of the disease, while the "holding" ligaments weaken from all sides.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 region is suspected of the pathology of the cervical spine.According to the increasing intensity of the pain syndrome, they are divided into 4 stages, first the patient feels numbness, tingling, "squeezing" in the area of a certain muscle group, in the fourth stage - the most severe - the pain is so strong that it causes the patient to immobilize and lose performance.
In addition to pain in the cervical and occipital region, the patient notes "referred" (radiating) pain in the upper extremities and lower lateral regions of the chest.
Osteochondrosis of the cervical spine with radicular syndrome
Involvement of 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 notes that he "rests" his hand and sleeps restlessly.There is morning stiffness in the joints of the fingers, which lasts no more than 10-15 minutes.With the development of radicular syndromes, during the examination, a decrease in the muscle strength of the upper limbs can be noted.
Osteochondrosis of the cervical spine with "vertebral artery syndrome".
Involvement of blood vessels in the process (hernial protrusion or compression by osteophytes) is indicated when the patient often complains of headache attacks, especially after being in a certain position for a long time, throwing his head back (for example, when swimming in a swimming pool), tinnitus and dizziness.This clinical condition is best identified using ultrasound (with the "Doppler mapping mode").Ultrasound reveals curvature and narrowing of the lumen of the vertebral arteries.In this case, we can talk about surgery, because a sharp change in blood flow in the vertebral arteries is a risk factor for stroke.
Osteochondrosis of the cervical spine with "heart (heart) syndrome".
This syndrome forces the patient to consult a cardiologist first, because the main complaints refer to pain in the left half of the chest, in the scapula region, which weakens or intensifies when engaging in physical activity or changing body position.After excluding myocardial infarction and other heart diseases, the patient is admitted under the supervision and treatment of a neurologist and orthopedist.
Diagnostics
Four methods are used to clarify the diagnosis: X-ray, ultrasound, computed tomography and magnetic resonance imaging.
The most accessible method is still X-ray of the cervical spine;The most informative is a radiograph in a lateral projection ("side view").This method makes it possible to determine the presence of damage and gross structural changes in the vertebrae in the first approximation.
An ultrasound examination (ultrasound) is performed to clarify the condition of the vertebral arteries.Using this method, it is determined whether the blood flow is disturbed, if any, to what extent and what obstacles are created and where they are located.
Computed tomography (CT).It allows for a more accurate assessment of the state of bone structures, the degree of density of bone tissue, and allows to see smaller osteophytes (bone protrusions) than is possible with radiography.
Magnetic resonance imaging (MRI).This type of examination is indispensable if there are hernias, the exact location of the spinal cord injury and the degree of this injury is in doubt.This study is necessary when the issue of operative (surgical) treatment of cervical spine diseases is raised.
Treatment of cervical osteochondrosis
Drug treatment
The set of standard tools for the treatment of cervical osteochondrosis reflects the goals of treatment: relieving pain by increasing the mobility of the spine, eliminating painful muscle spasms and inflammation of the nerve roots.To achieve these goals, they are primarily used 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 misinterpretation of symptoms, as well as underestimation of the side effects of these drugs.Topical (skin) NSAIDs in the form of a gel are widely used, and when pain is relieved, the same drugs can be used in the form of an ointment.
Slow-acting systemic drugs are used to treat osteochondrosis at a deeper, "core" level.These substances restore the cartilage structures of the vertebrae and prevent their further damage.Treatment courses are long, the effect lasts for several months.
Cervical osteochondrosis has significant differences from the pathology of other parts of the spine.In this case, neck pain may not be caused by signals from the affected spinal nerves, but by painful chronic muscle tension - all together called myotonic syndrome.This is a completely "good" condition that responds well to treatment with the same set of drugs: non-steroidal anti-inflammatory drugs, muscle relaxants, 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 whom are under 40 years old.Despite the severe pain syndrome, neurovascular structures remain intact and blood flow to the head region is not affected.
Manual therapy
This method of treatment can be effective for terminal pain in the neck (often due to a minor injury, subluxation) 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 comprehensive examination;in addition, the doctor performing this procedure must have sufficient experience in the field of traumatology and orthopedics.The use of hand therapy for "old" forms of the disease is dangerous!
There are two known methods of such interference:
- manipulation (sharp short effects of significant force aimed at eliminating subluxations, well-known "bone clicks");
- mobilization (the method is based on smooth stretching of the neck after warming up and relaxing the neck muscle corset).
A combined method based on the combination of two bases is also used.It should be remembered that in addition to these contraindications, manual therapy is prohibited for any disease accompanied by an increase in blood pressure, thyroid gland and any pathology of the ENT organs.
Treatment of cervical osteochondrosis at home
Therapeutic exercises for cervical osteochondrosis
The first and foremost rule for beginners in physical therapy is not to perform exercises while relieving painful sensations.It goes without saying that you should not start during 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 straight, back is straight (you can check your posture by lightly pressing your heels, shoulder blades and hips against the wall).We walk on the ground for 1 minute with the whole leg, 1 minute on the toes, and 1 minute on the heels.
- The starting position is the same.We clench our hands into fists, raise and lower our shoulders, straighten our arms.Movements are slow, we do 20 repetitions, the last ascent is 5 seconds longer.We ensure that the neck muscles are not stretched.
- The starting position is the same.We bend our heads one by one to the right, then to the left.The movements are smooth, a bend for 8 counts, at the extreme point of the bend - hold for 8 seconds.
- The starting position is to sit on the same or a hard chair.Smooth bends of the head, at the extreme point - hold for 8 seconds
- The starting position is to sit on the same or a hard chair.Slowly tilt your head forward until your chin touches your chest, then slowly turn your head to the right (4 counts) and to the left (4 counts).Avoid excessive muscle tension.
- The starting position is to sit on the same or hard chair.We raise our shoulders to 4 counts, then smoothly lower them to 4 counts.10 repetitions.
- The starting position is to sit on the same or a hard chair.We raise our shoulders, but now we make circular movements from front to back for a count of 8.10 repetitions.
- We straighten our backs and check our posture.For a count of 4, we bring the shoulder blades together behind our backs, try to connect them, at the end point we stretch 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 reason for the development of cervical osteochondrosis.The rational selection of pillows and mattresses, ensuring a comfortable and comfortable position during sleep is no less important than gymnastics, physiotherapy and medication.
When choosing a mattress, pay attention to the composition of the filler (at least half of the products are made of coconut flakes, that is, they correspond to a sufficient degree of hardness).Soft spring mattresses do not provide sufficient alignment of the spine.The most optimal sleeping position is on your side, with one or both knees pulled toward your stomach.The pillow should be placed in such a way that it fills the entire space between the shoulder, ear and mattress, the parietal part of the head (crown) is in the same horizontal line as the spine.Pillows that are too high and too low, as well as soft, should be avoided.The ideal choice is a product with an ergonomic shape, that is, in this case, 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 is forward and the stomach is pulled back.
Avoid sitting for long periods of time.A simple rule for the prevention of cervical osteochondrosis is known: after every 60 minutes of work, you need a 10-15 minute walk or warm-up period.
The office chair should have a high headrest or back.
While sitting, your feet should rest on the floor and your neck should not be tense.For this purpose, use special orthopedic devices: supports under the neck when driving in a car, a pillow under the back.
Avoid heavy loads.If necessary, drop to your knees, hold a heavy object against your body, and then stand up smoothly, using the strength of your leg muscles, not the "pull" of your back.
Do not bend with straight legs.Use stands or work surfaces to bring the subject closer to you rather than tilting your face toward the subject.Try doing your homework sitting on a chair or exercise ball.
If you must use a mop, broom or rake, do not strain your arms, back, neck or bend to the side.
Avoid breaststroke swimming.