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 relatively short in relation to the total length of the spine, it is probably the most important part of the spinal column.Each pair of adjacent vertebrae forms an intervertebral foramen, through which nerve roots emerge and are directed to each muscle and organ of the upper body.An important vessel that provides blood supply to the brain through another opening - in the lateral process of this vertebra.
Causes of cervical spine osteochondrosis
The causes of osteochondrosis are:
- injury,
- "sedentary" work on a monitor located below eye level,
- physical labor related to carrying heavy loads,
- driving a car for a long time,
- work "on the phone" without using a remote device (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)
The formation of pathological changes in the vertebrae
With osteochondrosis, small sharp points begin to form on the edge of the vertebral body, which can injure nearby structures.Most often, this occurs in response to an excessive load on 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 end plates of the vertebrae become more dense and the height of the intervertebral discs decreases.These discs normally play the role of shock absorbers between the vertebrae, and, among other things, prevent damage to the spinal roots.With progressive osteochondrosis, protrusion (herniation) of the nucleus pulposus of the intervertebral disc occurs, in which, during the course of the disease, increased pressure is exerted while the "retaining" ligaments on all sides are weakened.This hernia can also compress the spinal structure 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 pathology of the cervical spine.According to the increasing intensity of the pain syndrome, they are divided into 4 stages, in the beginning the patient feels numbness, tingling, a feeling of "obedience" in the area of a certain muscle group, in the fourth stage - the worst - the pain is so strong that it causes the patient's disability and loss of performance.
In addition to pain in the cervical and occipital regions, the patient noted "referred" (radiating) pain in the upper and subscapular lateral regions of the chest.
Osteochondrosis of the cervical spine with radicular syndrome
The 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 draws attention to the fact that he "seems to be resting" his hands and sleeps uncomfortably.There is morning stiffness in the finger joints, lasting no more than 10-15 minutes.With the development of radicular syndrome, after examination, a decrease in upper extremity muscle strength can be observed.
Osteochondrosis of the cervical spine with "vertebral artery syndrome"
Involvement of blood vessels in the process (compression by protrusion of the hernia 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, during breaststroke swimming), if there is tinnitus and dizziness.This clinical condition is best identified using ultrasound (with "Doppler mapping mode").Ultrasound reveals vertebral artery entanglement and narrowing of its lumen.In this case, we may be talking about surgery, because a significant change in blood flow in the vertebral artery 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, because the main complaint concerns pain in the left side of the chest, subscapular area, which weakens or intensifies when doing physical activity or changing body position.After ruling out myocardial infarction and other heart diseases, the patient was admitted under the supervision and treatment of a neurologist and orthopedic specialist.
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 are radiographs in lateral projection ("side view").This method allows, to a first approximation, to determine the presence of injuries and gross structural changes in the vertebrae.
An ultrasound examination is performed to clarify the condition of the vertebral artery.Using this method, it is determined whether blood flow is affected, and if so, the extent and type of obstruction that arises and where it is located.
Computed tomography (CT).Allows you to more accurately assess the condition of the bone structure, the level of bone tissue density, and allows you to see smaller osteophytes (bone growths) than is possible with radiography.
Magnetic resonance imaging (MRI).This type of examination is very necessary if there is a suspicion of the presence of a hernia, the exact location of the spinal cord damage and the extent of this damage.This study is necessary if the question of surgical treatment (surgery) of cervical spine disease is raised.
Treatment of cervical osteochondrosis
Drug treatment
The standard set of remedies for the treatment of cervical osteochondrosis reflects the goal of treatment: to relieve pain by eliminating painful muscle spasms and nerve root inflammation, while improving spinal mobility.To achieve this goal, it is used mainly by using painkillers, NSAIDs - non-steroidal anti-inflammatory drugs, muscle relaxants.It should be remembered that self-medication with drugs from this group can be dangerous, because there is a possibility of misinterpretation of symptoms, as well as underestimating the side effects of these drugs.Local (skin) NSAID drugs 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 structure of the vertebrae and prevent further damage.The course of treatment is long, the effect lasts for several months.
Cervical osteochondrosis has a significant difference 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 tension - all 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 "blocks" using steroids.Usually, doctors detect sharp pain when palpating the so-called "trigger" points along the entire cervical spine, as well as in the area of the upper shoulder girdle muscles.More often, this pathology occurs in women, mostly under the age of 40.Despite the severe pain syndrome, the neurovascular structure remains intact, and blood flow to the head area is not affected.
Manual therapy
This treatment method can be effective for recent pain (often due to minor injuries, 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 thorough examination;in addition, the doctor who performs this procedure must have sufficient experience in the field of traumatology and orthopedics.For the "old" form of the disease, the use of manual therapy is dangerous!
There are two known methods for this type of intervention:
- manipulation (sharp short impact of significant force aimed at eliminating subluxation, the famous "bone click");
- mobilization (the method is based on smooth stretching of the neck after warming up and relaxing the neck muscle corset).
A combination method is also used, based on the combination of the two main ones.It is important to remember that in addition to these contraindications, manual therapy is prohibited for any disease 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 foremost rule for beginners in physical therapy is not to do exercises while coping with painful sensations.It goes without saying that you shouldn't start in the "acute" period, when the pain just appears.Another important recommendation is to avoid sudden movements and circular movements in the cervical spine.
Each session should begin with a short and light 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 gently pressing your heels, shoulder blades and back against 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, straight arms.The movement is slow, we do 20 repetitions, the last rise is longer by 5 seconds.We make sure that the neck muscles are not strained.
- The starting position is the same.We tilted our heads one by one to the right, then to the left.The movement is 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.Smoothly tilt 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 (for 4 counts) and to the left (for 4 counts).Avoid muscles that are too tense.
- The starting position is the same or sitting on a hard chair.We raise our shoulders for 4 counts, then slowly lower them for 4 counts.10 repetitions.
- The starting position is the same or sitting on a hard chair.We raise our shoulders, but now we do 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 us, try to connect them, at the end point we linger for 8 seconds, then return to the starting position.
Pillow
As already mentioned, hypertonicity of the neck muscles is the first and often the main cause of the development of cervical osteochondrosis.The rational selection of pillows and mattresses, ensuring a relaxed and comfortable position during sleep is no less important than gymnastics, physical therapy and medication.
When choosing a mattress, pay attention to the composition of the filler (a product that is at least half made of coconut flakes, that is, with a sufficient degree of rigidity, is suitable).Soft spring mattresses do not provide adequate spinal alignment.The most optimal sleeping position is on your side, with one or both knees pulled up towards your stomach.The pillow should be placed in such a way as to fill the entire space between the shoulders, ears and mattress, while the parietal part (crown) of the head is in the same horizontal line as the spine.Too high and too low, as well as soft pillows should be avoided.The ideal choice is a product with an ergonomic shape, that is, in this case, with a small roller squeezer 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 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, a period of 10-15 minutes of walking or warming up is required.
The work chair must have a high headrest or backrest.
When sitting, your feet should be on the floor and your neck should not be tense.For this purpose, use special orthopedic devices: a roll under the neck when driving in a car, a pillow under the back.
Avoid heavy lifting.If necessary, kneel, hold a heavy object on your body, and then stand smoothly, using the strength of your leg muscles, but not "pulling" your back.
Do not bend over with straight legs.Use a seat or work surface to bring the subject closer to you, instead of tilting your face towards the subject.Try doing your homework while sitting on a chair or exercise ball.
If you must use a mop, broom or rake, do not strain your arms, back, neck or lean to the side.
Avoid breaststroke swimming.