Cervical osteochondrosis, or spondylosis, appears 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 probably the most important part of the spine.Each adjacent pair of vertebrae forms intervertebral foramina, through which nerve roots exit and are directed to every muscle and organ of the upper half of the body.Vital vessels that provide blood supply to the brain pass through other holes - 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 placed below eye level,
- physical work related to 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 the ear with his shoulder)
- constitutional features (torticollis, congenital changes in the cervical vertebrae, short neck)
The formation of pathological changes in the vertebrae
With osteochondrosis, small sharp points begin to form at the edges of the vertebral bodies, which can damage nearby structures.Most often, this occurs as a 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 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 (hernia) of the nucleus pulposus of the intervertebral disc appears, on which increasing pressure is exerted during the course of the disease, while the ligaments that "hold" it from all sides weaken.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 first the patient feels numbness, tingling, a feeling of "tightness" in the area of a certain muscle group, in 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 lateral subscapular areas 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 sensations 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 stiffness in the morning in the joints of the fingers, which lasts no more than 10-15 minutes.With the development of radicular syndromes, after examination, a decrease in the strength of the muscles of the upper extremities can be observed.
Osteochondrosis of the cervical spine with "vertebral artery syndrome"
Involvement of blood vessels in the process (compression from a hernial protrusion or osteophyte) is indicated when the patient complains of frequent attacks of headache, especially after being in a certain position for a long time, when throwing the head back (for example, when swimming in the breast), if there is tinnitus and dizziness.This clinical situation is best identified using ultrasound (with "Doppler mapping mode").Ultrasound reveals the rotation of the vertebral arteries and the narrowing of their lumen.In this case, we can talk about surgery, since a marked 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 go to the cardiologist first, since the main complaints are related to pain in the left half of the chest, the subscapular region, which weakens or intensifies when performing physical activity or changing the position of the body.After excluding myocardial infarction and other heart diseases, the patient is placed under the supervision and treatment of a neurologist and orthopedist.
Diagnosing
To clarify the diagnosis, four methods are used: radiography, ultrasound, computed tomography and magnetic resonance.
The most accessible method is still X-ray of the cervical spine;the most informative is the radiograph in the lateral projection ("side view").This method allows, in a first approximation, to determine the presence of damage and major 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 circulation is damaged and if so, to what extent and what kind of obstacles have appeared and where they are located.
Computed tomography (CT).It allows you to more accurately assess the state of bone structures, the degree of density of bone tissue and allows you to see smaller osteophytes (bone growths) than is possible with X-rays.
Magnetic resonance imaging (MRI).This type of examination is necessary if there is doubt about the presence of hernias, the exact location of the spinal cord injury and the degree of this injury.This study is necessary if the issue of operative (surgical) treatment of diseases of the cervical spine is raised.
Treatment of cervical osteochondrosis
Drug treatment
The standard group of remedies for the treatment of cervical osteochondrosis reflects the goals of treatment: to relieve pain by eliminating painful muscle spasms and inflammation of nerve roots, increasing the mobility of the spine.To achieve these goals, they are mainly used using pain relievers, NSAIDs - non-steroidal anti-inflammatory drugs, muscle relaxants.It should be remembered that self-medication with drugs from these groups can be dangerous, as there is a possibility of misinterpreting the symptoms, as well as underestimating the side effects of these drugs.Local (cutaneous) NSAID drugs in the form of gels are widely used, and when the pain stops, the same drugs can be used in the form of ointments.
To treat osteochondrosis at a deeper, "base" 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 affected spinal nerves, but by painful chronic muscle tension - all together it is called muscle-tonic syndrome.This is a completely "benign" condition that responds well to treatment with the same group 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 muscle area of the upper shoulder girdle.Most often, this pathology appears in women, most of them under 40 years of age.Despite the severe pain syndrome, the neurovascular structures remain intact and the blood flow in the head area is not affected.
Manual therapy
This method of treatment can be effective for recent pain (often as a result of a minor injury, subluxation) in the neck that is not accompanied by dizziness or other changes in the nervous system and circulatory system.It is allowed to use manual therapy only after a complete 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 (short sharp impacts of significant force aimed at eliminating subluxations, the well-known "bone clicks");
- mobilization (the method is based on the smooth stretching of the neck after warming up and relaxing the muscular belt of the neck).
A combined method is also used, based on a combination of the two main ones.It is important to remember that in addition to these contraindications, manual therapy is prohibited for any disease associated with 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 foremost rule for beginners in physical therapy is not to perform exercises 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 and light self-massage of the neck muscles.
This is followed by a "warm-up" warm-up:
- The arms are lowered along the body, the shoulders are level, the back is straight (you can check your posture by lightly pressing the heels, shoulder blades and back on the wall).We walk in place for 1 minute on the whole leg, 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 lift is longer for 5 seconds.We make sure that the neck muscles are not tightened.
- The starting position is the same.We tilt our heads one by one to the right, then to the left.The movements are smooth, a tilt for 8 charges, at the extreme point of the tilt - hold for 8 seconds.
- The starting position is the same or sitting on a strong chair.Smooth tilt of the head forward, at the extreme point - hold for 8 seconds
- The starting position is the same or sitting on a strong chair.Slowly tilt your head forward until your chin touches your chest, then slowly turn your head to the right (for 4 counts) and to the left (for 4 counts).Avoid overstraining the muscles.
- The starting position is the same or sitting on a strong chair.We raise our shoulders for 4 counts, then smoothly lower them for 4 counts.10 repetitions.
- The starting position is the same or sitting on a strong chair.We raise our shoulders, but now we make circular movements from front to back, for 8 counts.10 repetitions.
- We straighten our backs and check our posture.For 4 counts, we bring the shoulder blades together behind the back, trying to connect them, at the final point we stand for 8 seconds, then return to the starting position.
The pillows
As already mentioned, the hypertonicity of the neck muscles is the first and often the main cause of the development of cervical osteochondrosis.The rational choice 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 stiffness, are suitable).Soft spring mattresses do not provide enough spinal adjustment.The most optimal sleeping position is on your side, with one or both knees pulled towards your stomach.The pillow should be positioned in such a way that it fills the entire space between the shoulder, the ear and the 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 squeezing 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 retracted.
Avoid sitting for long periods of time.A simple rule is known for the prevention of cervical osteochondrosis: after every 60 minutes of work, a period of 10-15 minutes of walking or warming up is necessary.
A work chair should have a headrest or high backrest.
When you are sitting, your feet should rest on the floor and your neck should not be tense.For this purpose, use special orthopedic equipment: support under the neck when driving in a car, a pillow under the back.
Avoid heavy lifting.If necessary, sit 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.
Do not bend over with straight legs.Use stands or work surfaces to bring the subject closer to you, rather than tilting your face towards the subject.Try doing 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 sides.
Avoid breaststroke.