Cervical osteochondrosis or spondylosis occurs due to changes in the shape and structure of the vertebrae.Although the neck area is quite short relative to the total length of the spine, it is probably the most important part of the spine.Each pair of adjacent vertebrae forms an intervertebral foramen, through which nerve roots extend and are directed to every muscle and organ in the upper body.Important blood vessels that provide blood supply to the brain pass through other openings in the side processes of these vertebrae.
Causes of cervical osteochondrosis
Causes of osteochondrosis include:
- Injuried,
- "Sedentary" work on a monitor below eye level,
- Physical labor associated with moving heavy objects,
- Driving a car for a long time,
- Works "over the phone" without using a remote device (in this case, the operator presses the receiver to the ear with his shoulder)
- Physical characteristics (torticollis, congenital changes in cervical spine, short neck)
The formation of pathological changes in 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 result of overloading the cervical spine and is not simply a result of "aging" of the intervertebral joints (remember, 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 disc decreases.These discs normally act as shock absorbers between the vertebrae and, among other things, prevent damage to the roots of the spinal cord.Progressive osteochondrosis causes the disc nucleus to herniate (herniate), and over the course of the disease, increasing pressure is exerted and the "retaining" ligaments on each side weaken.This hernia can also compress spinal structures and contribute to the neurological manifestations of the disease.
What are the symptoms of cervical osteochondrosis?
Cervical osteochondrosis with pain syndrome
Any pain in the neck area raises suspicion of pathology in the cervical spine.The pain symptoms are divided into 4 stages based on their gradually increasing intensity. First, the patient feels numbness, tingling, and a "tight" feeling in a certain muscle group area. In the fourth stage - the most severe - the pain is so severe that the patient is unable to move and lose the ability to work.
In addition to pain in the cervical spine and occipital region, the patient also noted "referred" (radiating) pain in the upper extremities and in the infrascapular area of the chest.
Cervical osteochondrosis with radicular syndrome
When pain, numbness, and tingling spread to the jaw, upper back, forearm, and fingers, it indicates that nerve roots are involved in the process.At the same time, the patient drew attention to the fact that he "seemed to be resting" his hands and was sleeping uncomfortably.Morning stiffness occurs in finger joints, lasting no more than 10-15 minutes.As radiculopathy progresses, decreased upper extremity muscle strength may be noted on examination.
Cervical osteochondrosis accompanied by "vertebral artery syndrome"
When a patient complains of frequent headaches, especially after being in a certain position for a long time, when the head is tilted back (for example, when swimming breaststroke), tinnitus and dizziness, it is an indication that the blood vessels are involved in the process (herniation or osteophyte compression).This clinical situation can be well identified using ultrasound (using "Doppler mapping mode").Ultrasound shows tortuosity of the vertebral artery and narrowing of the lumen.In this case, we are probably talking about surgery, since significant changes in blood flow in the vertebral artery are a risk factor for stroke.
Cervical Osteochondrosis with "Heart Syndrome"
This syndrome forces patients to first see a cardiologist because the main complaint is pain in the left hemithorax, subscapular region, which decreases or worsens when performing physical activities or changing body positions.After ruling out myocardial infarction and other heart diseases, the patient was admitted to the hospital under the supervision and treatment of a neurologist and an orthopedic surgeon.
diagnosis
To confirm the diagnosis, four methods are used: radiography, ultrasound, computed tomography, and magnetic resonance imaging.
The most convenient method remains a cervical spine X-ray; the most informative is a radiograph in the lateral projection ("lateral view").This method can provide a first approximation to determine the presence of damage and overall structural changes to the vertebrae.
An ultrasound test (ultrasound) is performed to determine the condition of the vertebral arteries.Using this method, it is possible to determine whether blood flow is compromised and, if so, the extent and type of obstruction and where they are located.
Computed tomography (CT).Allows you to more accurately assess bone structural condition, bone tissue density, and see smaller osteophytes (bone growths) than radiographs can.
Magnetic resonance imaging (MRI).This type of examination is essential if a hernia is suspected, the exact location of the spinal cord injury, and the extent of the injury.This study is necessary if the question of surgical treatment of cervical spine disease is raised.
Treatment of cervical osteochondrosis
drug treatment
Standard therapies for the treatment of cervical osteochondrosis reflect the goals of treatment: to relieve pain by eliminating painful muscle spasms and nerve root inflammation while increasing spinal mobility.To achieve these goals, they are mainly used through the use of painkillers, NSAIDs (non-steroidal anti-inflammatory drugs), muscle relaxants.It should be remembered that self-treatment with these medications can be dangerous, as symptoms may be misinterpreted, and the side effects of these medications may be underestimated.Topical (skin) NSAIDs are widely used in gel form, and these same drugs can be used in ointment form when the pain stops.
To treat osteochondrosis at a deeper "basal" level, slow-acting systemic medications are needed.These substances restore the cartilage structure of the vertebrae and prevent further damage.The treatment course is long and the results last for several months.
Cervical osteochondrosis is significantly different from pathology in other parts of the spine.In this case, the neck pain may not be caused by signals from a distressed spinal nerve, but by painful, chronic muscle strains—all of which are collectively known as muscle tension syndrome.This is a completely "benign" condition that responds well to treatment with the same group of medications: nonsteroidal anti-inflammatory drugs, muscle relaxants, intramuscular "blocking" with steroids.Often, doctors find severe pain when they palpate so-called "trigger points" throughout the cervical spine and in the upper shoulder girdle muscle area.The condition is more common in women, most of whom are under the age of 40.Despite the severe pain syndrome, the neurovascular structure remains intact and blood flow to the head region is unaffected.
manual therapy
This treatment is effective for recent (usually due to minor injury, subluxation) neck pain that is not associated with dizziness or other changes in the nervous system and circulatory system.Manual therapy is allowed only after a thorough examination; in addition, the doctor performing this operation must have sufficient experience in the fields of traumatology and orthopedics.Using manual therapy for "old" illnesses is dangerous!
There are two known methods of this type of intervention:
- Manipulation (forceful, brief thrusts designed to eliminate subluxation, known as "bone clicking");
- Mobilization (this method is based on smooth neck extension after warming up and relaxing the neck muscle bundles).
A combined approach based on a combination of two main approaches is also used.It is important to remember that, in addition to these contraindications, manual therapy is prohibited in any disease accompanied by an increase in blood pressure, in any pathology of the thyroid and ear, nose and throat organs.
Home Treatment for Cervical Osteochondrosis
Treatment exercises for cervical osteochondrosis
The first rule of thumb for beginners in physical therapy is not to exercise while overcoming pain.It goes without saying that you should not start during the "acute" phase when pain is just beginning.Another important tip is to avoid sudden movements and circular movements of the cervical spine.
Each session should begin with a brief, gentle self-massage of the neck muscles.
Next is the "warm-up" warm-up:
- Lower your arms along your body, shoulders level, and back straight (check your posture by gently pressing your heels, shoulder blades, and hips into the wall).We walked with our whole feet in place for 1 minute, 1 minute on the toes, and 1 minute on the heels.
- The starting position is the same.We balled our hands into fists, raised and lowered our shoulders, and straightened our arms.The movement was slow, we repeated it 20 times, and the last rise was 5 seconds longer.We ensure that the neck muscles do not tighten.
- The starting position is the same.One by one our heads tilted to the right, then to the left.With smooth movements, tilt once for a count of 8, at the extreme point of the tilt - hold for 8 seconds.
- Start in the same position or sit on a hard chair.Lean your head forward smoothly to the extreme point - hold for 8 seconds
- Start in the same position or sit on a hard chair.Slowly tilt your head forward until your chin touches your chest, then slowly move your head to the right (count of 4) and to the left (count of 4).Avoid excessive muscle tension.
- Start in the same position or sit on a hard chair.We raise our shoulders for a count of 4 and then smoothly lower our shoulders for a count of 4.10 times
- Start in the same position or sit on a hard chair.We lift our shoulders, but now we move in a circular motion from front to back for a count of 8.10 times
- We straighten our backs and check our posture.After a count of 4 seconds, we bring our shoulder blades behind our backs, trying to connect them, holding at the end for 8 seconds, then return to the starting position.
Pillow
As mentioned before, excessive neck muscle tone is the first and often the main cause of cervical osteochondrosis.Reasonable selection of pillows and mattresses to ensure a relaxed and comfortable posture during sleep is as important as gymnastics, physical therapy and medicine.
When choosing a mattress, pay attention to the composition of the filling (products made at least half from coconut flakes, that is, with sufficient rigidity, are suitable).Soft spring mattresses do not provide adequate spinal straightening.The best sleeping position is to lie on your side with one or both knees pulled up toward your abdomen.The pillow should be placed so that it fills the entire space between the shoulders, ears, and mattress, with the crown of the head (the top of the head) level with the spine.Pillows that are too high, too low, and too soft should be avoided.The ideal option is a product with an ergonomic shape, that is, in this case, a small squeeze roller on one side.
general advice
Pay attention to your posture.When walking or standing, the correct posture is to protrude your chest forward and retract your abdomen.
Avoid sitting for long periods of time.A simple rule for preventing osteochondrosis of the cervical spine is well known: after every 60 minutes of work, walk or warm up for 10-15 minutes.
Task chairs must have high headrests or backrests.
While sitting, your feet should be on the floor and your neck should not be tense.For this, use special orthopedic devices: a cushion under the neck and a pillow under the back when driving.
Avoid lifting heavy objects.If necessary, kneel down and hold a weight against your torso, then stand up smoothly, using the strength of your leg muscles but not "pulling" your back.
Don't bend over when your legs are straight.Use a stand or work surface to bring your subject closer to you, rather than pointing your face towards the subject.Try doing 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 sides.
Avoid breaststroke.