Osteochondrosis of the cervical spine

Work in the office, "rest" in front of the TV, lack of physical activity, unhealthy diet - the causes of a variety of diseases that have become especially widespread at the end of the last century. One of them is osteochondrosis. More precisely, osteochondrosis of the cervical spine.

Features

Everyone has experienced the symptoms of osteochondrosis at least once. But if they seriously annoy and even interfere with living and working, you can and should fight with them. See your doctor if you are concerned about:

• neck pain that extends to the back of the head, eyes and ears, shoulder girdle, and does not disappear even at night
• pain in the arms (shoulder, forearm, hand) that gets worse with the slightest exertion
• difficulty in movement of hands, hands, fingers, decreased sensitivity and weakened muscle strength
• neck muscle tension and cervical stiffness in the morning
• feeling of "lulling" of the neck in the morning
• neck pain when bending and turning the head
• numbness, burning, tingling in hands or feet
• recurrent throbbing pain in the neck and occipital head
• headache that starts in the occiput and spreads to the crown of the head and temples
• dizziness, darkening of the eyes, fainting on sudden head turning
• tinnitus
• decreased visual acuity and hearing
• tongue numbness
• pain in the region of the heart, the intensity of which depends on the position of the body and is not relieved by nitroglycerin
• overgrowth of connective tissue - the "withers" - in the cervical spine.

With degenerative changes in the spine (intervertebral discs are reduced, the annulus fibrosus loses its elasticity), the so-called radicular syndrome develops, and, depending on the location of the changes, certain symptoms appear. The number of cervical roots (eight) is greater than the number of cervical vertebrae (seven). The first pair of cervical roots extends between the base of the skull and the first cervical vertebra (C1), the second between the first and second vertebrae, etc. Thus, each cervical nerve exits above its corresponding vertebra.

If the nerve root of the first cervical vertebra (C1) is affected, then the sensitivity in the occipital region is impaired, the second (segment CI-II) has pain in the parietal and occipital regions. The defeat of the nerve root (C3) in the region of the CII-III segment occurs rarely. In this case, there is pain and a decrease in sensitivity in the half of the neck where the spinal nerve is pinched, a decrease in the sensitivity of the tongue and speech impairment are possible.

Pain and decreased sensitivity in the shoulder girdle and clavicle, hypotonia of the muscles of the head and neck (belt, trapezius, levator scapula) occur when the C4 nerve root is affected (segment CIII-IV). Respiratory distress, hiccups and pain in the heart area can also be associated with the C4 root, since the phrenic nerve is present in it. But this is also a rather rare pathology.

Radicular syndrome at the level of the 5th vertebra (segment CIV-V) causes pain that extends to the shoulder girdle, the outer surface of the shoulder. The deltoid muscle weakens, the sensitivity in the outer surface of the shoulder is disturbed. The most common violations are pinching of the C6 and C7 roots (segments CV-VI and CVI-VII). In the first case, pain radiates from the neck along the scapula, forearm, outer surface of the shoulder, radial surface of the forearm to the thumb. Sensitivity is impaired not only in these areas, but even in the skin. In the second case, the pain spreads from the neck to the scapula, forearm, back of the shoulder, surface of the forearm to the back of the II-IV fingers of the hand. The skin in these areas also loses sensitivity.

When the C8 root is affected (segment CVII-TI), pain and sensory impairment spreads from the neck to the back of the shoulder, along the ulnar edge of the forearm to the little finger. You may not feel pain in the little finger, but the muscles in that finger are weakened.

Description

Osteochondrosis is a degenerative-dystrophic lesion of the intervertebral discs in the spine. The cervical spine is the most vulnerable part of the spine, since it has a special structure and suffers from a weak muscular corset in the neck region, as well as anatomically different structures of the cervical vertebrae, which are very close to each other. Therefore, even with a slight load on the neck, the vertebrae are displaced, which leads to compression of blood vessels and nerves. This is very dangerous, because in this section, vertebral arteries pass through the holes located in the transverse processes of the cervical vertebrae, which are involved in the blood supply to the brain. So any pinching of the vertebrae is fraught with the most serious consequences.

Compression of nerve roots and vessels in cervical osteochondrosis can cause displacement of the disc in the lateral and postero-lateral directions, protrusion (the initial stage of disc herniation, in which the integrity of the disc is not broken, it only protrudes into the spinal canal) and hernial disc protrusion, directed inward of the intervertebral canal.

Degenerative changes, in which bone growths appear in the region of the joints of the spine in cervical osteochondrosis, reduce the lumen of the intervertebral canal and squeeze the neurovascular formations passing there. The osteophytes formed on the sides of the vertebral bodies irritate the muscles, the muscles tense in response, increasing the pressure of the vertebrae against each other. At the same time, the height of the intervertebral disc decreases, exacerbating the pathological process. Overgrown osteophytes, directed towards the canal of the vertebral artery, squeeze it, causing cerebral circulation failure even with a sharp turn of the head.

In addition, even if there are no physiological changes in the cervical spine, prolonged tense posture can lead to pain and numbness.

Until recently, it was precisely the presence of cervical osteochondrosis that explained all tension headaches and dizziness.

As for meteorological and morning headaches, studies by foreign neurologists conducted back in the 1980s showed that cervical osteochondrosis is not always the cause. They believe that this is an example of replacing a clinical diagnosis with an X-ray one, a traditional medical error is overdiagnosis of osteochondrosis, which nowadays can be found even in adolescents. Often there is no relationship between the findings on X-ray, MRI, CT and the named clinical manifestations. Muscle tension headache, if it has a meteorological character and is observed in the morning hours, is understood to mean neck and head pain caused by intracranial venous congestion. This is easy to verify with a duplex scan. Wrong diagnosis - wrong treatment means the problem will get worse.

A person begins to feel the manifestations of osteochondrosis most often after 35 years, and the older he is, the more manifestations. But in recent years, more and more people between the ages of 18 and 30 are complaining of neck pain. The reasons are poor physical fitness, poor posture and curvature of the spine, flat feet or excessive weight. Most often, neck problems appear in those who work a lot at the computer or drive a car.

The main reasons for the early development of cervical osteochondrosis:

• hereditary (genetic) predisposition
• metabolic disorders in the body, infections, intoxication
• overweight
• malnutrition (lack of trace elements, vitamins and fluids)
• spinal injuries (bruises, fractures)
• poor posture, curvature of the spine
• instability of spinal column segments
• flat feet
• unfavorable environmental conditions
• sedentary lifestyle
• heavy lifting
• work associated with frequent changes in body position (turns, flexion and extension, jerks)
• prolonged uncomfortable posture in standing, sitting, lying position, when lifting and carrying weights, when performing any work that exerts a load on the cervical spine and the spine as a whole
• excessive physical activity with undeveloped musculoskeletal system
• nervous strain, stress
• hypothermia
• using the wrong pillow while sleeping.

First Aid

When you can't stand the pain, take a pain reliever from your home medicine cabinet. If these medications do not help, you will have to use non-steroidal anti-inflammatory drugs. However, these drugs have a negative effect on the gastrointestinal tract, therefore, without consulting a doctor, they can only be used as an emergency measure, and then you should consult a specialist for advice. You can reduce the intensity of pain by using anti-inflammatory pain relieving ointments. If edema has formed in the area of ​​inflammation, you can take diuretics or herbal infusions for 3-4 days, if there are no contraindications. You can wear pepper plaster during the day, it also has a distracting effect, but at night it is useless. If problems with the neck cause numbness or pain in the arm, it is pointless to smear it with any ointment, the medicine should be applied to the affected area - the neck.

If you use a special collar to immobilize your neck, do not wear it for long. When motionless, the neck muscles weaken and atrophy, and it becomes even difficult for them to keep their head on their shoulders.

Physiotherapy should not be done during an exacerbation - you can start it only after the exacerbation has been removed.

Diagnostics

Diagnosis is by X-ray, computed tomography, and magnetic resonance imaging. To check the condition of the vessels of the neck, Doppler ultrasound or duplex scanning is prescribed.

Treatment

Therapy for cervical osteochondrosis should be as comprehensive as possible, using both drug and non-drug therapy, as well as in the prevention of possible complications.

Medical treatment consists of prescribing drugs that relieve pain and inflammation, as well as drugs that improve cerebral circulation. In addition, in case of pathological muscle tension, it is recommended to take medications to relax them, as well as vitamins in a therapeutic dose, calcium, phosphorus, magnesium, manganese preparations.

Common drugs called chondroprotectors that promise to restore intervertebral disc tissue are, according to doctors, useless. There is no clinical evidence of their effectiveness.

Physiotherapy plays an important role in the treatment of cervical osteochondrosis - electrophoresis, magnetotherapy, water procedures (various therapeutic baths, showers), paraffin applications . . .

Alternative therapy methods are widely used - reflexology, manual therapy, massage, hirudotherapy, apitherapy, osteopathy. However, the most important for the treatment and prevention of osteochondrosis is therapeutic exercises.

Lifestyle

So that the problems associated with cervical osteochondrosis do not bother, you should remember about the causes of its development and the appearance of complications and, if possible, prevent them. Since the main reason for the development of cervical osteochondrosis is a sedentary lifestyle and an unphysiological position of the body in tension, it is necessary to do daily exercises for the neck, including them in morning exercises or performing them at the workplace. At the same time, remember that doctors do not recommend doing circular rotational movements of the head, their implementation is fraught with injury to the neck.

Sitting and standing exercises

1. Place your palm on your forehead, press your forehead against your palm, tightening your neck muscles. In this case, the palm must resist the pressure of the forehead for 7-10 seconds. Do the exercise 3-4 times. Repeat the same exercise with your palm to the back of your head 3-4 times.
2. Place your left palm on your left temple and press it against your palm, contracting your neck muscles for 7-10 seconds. Do the exercise 3-4 times. Repeat the same exercise, pressing with the right temple on the right palm.
3. The above two exercises can be done differently: rest your forehead against a wall and press on it, straining your neck muscles. Then press the back of your head against the wall, then the left, then the right half of your head.
4. Tilt your head back a little. Overcome the resistance of the tense neck muscles, gradually lower it. Finish the exercise by pressing your chin against the jugular fossa. Repeat this exercise 5-6 times.
5. Stand straight with your shoulders open. Slowly turn your head to the maximum right 5-6 times, then to the left.
6. Lower your chin to your neck and in this position slowly turn your head: 5-6 times to the right, then to the left.
7. Tilt your head back a little. Try to reach with your right ear to your right shoulder, then with your left ear to your left shoulder. Repeat each exercise 5 times.
8. Clasp your fingers together on the back of your head, bring your elbows together, rest your chin on folded forearms. Clasp your fingers so that the edge of the palm rests against the back of the head, lift the forearms together as high as possible. Stay in this position without straining for 10-15 seconds.

Lying exercises:

1. Lie on your back, straighten your legs, and stretch your arms along your body. Bend your knees and clasp them with your hands, pull them to your stomach, in this position raise your head and touch your knees with your forehead. Slowly straighten your legs, raise your head. Do this exercise 4-5 times.
2. Bend your knees and grasp the edge of the sofa or headboard with your hands. Slowly raise your torso, reaching with your feet to the hands. Do the exercise 4-5 times.
3. Lie on your stomach with your legs straight. Hands lie along the body. Leaning on your legs, belly, and lower body, raise your head and shoulders. Do this exercise 4-5 times.
4. Lie straight with your arms out to the sides. Slightly lifting it off the floor, turn the torso to the left, take out your left palm with your right hand. Do the same with your left hand reaching your right palm. Do this exercise 4-5 times.
5. Lie on your stomach with your arms extended along your torso, palms up, chin level with your torso. Relax and slowly turn your head to the right - to the starting position - to the left. Try to turn your head so that your ear touches the floor. Do this exercise 8-10 times.
6. Lie on your stomach, rest your chin on your palms, and relax your neck muscles. Turn your head to the right and left, trying to touch the floor with your ear. Do this exercise 8-10 times.

Regular exercise will help relieve muscle tension and improve blood circulation in the collar area, as well as improve the mobility of the vertebrae themselves. However, while performing the exercises, you should monitor your feelings - do not increase the intensity of movements and tension if pain occurs. In such cases, exercise should be done with great care and not for long.

Prevention

To prevent osteochondrosis, doctors recommend regular visits to an orthopedist from early school age and, if necessary, correct spinal curvature and posture disorders. To form a muscular corset - to play sports, primarily swimming. Eat foods that provide the body with calcium and magnesium (fish and seafood, spinach, beans, nuts, seeds, peas, wholemeal bread, dairy products, cheeses) and vitamins. Avoid the accumulation of excess weight. Follow the recommendations of doctors when working at a computer. Do not carry bags by hanging them on your shoulder.