Cervical osteochondrosisis a progressive degenerative-dystrophic disease of the most mobile part of the spine, consisting of seven discs and having a relatively weak muscular corset, associated with increased mobility and instability of the cervical vertebrae.The cervical vertebrae have a relatively smaller height and thickness of the discs and a fairly tight fit to each other, and since the neck muscles are rather poorly developed, with regular loads this can cause displacement of the intervertebral discs.
The high susceptibility of the cervical spine to degenerative changes, which are primarily osteochondrosis, and various injuries, is explained by constant physical activity with the need to support the head, control turns and bends.
Causes of cervical osteochondrosis
Until recently, the diagnosis of osteochondrosis was considered the lot of older people;today, he is rapidly rejuvenating.
Cervical osteochondrosis and its manifestations can be caused by disruption of three body systems:
- Pathological influence of the focus of degenerative changes on the peripheral nervous system.
- When the blood supply to the spinal arteries of the brain cells is disrupted.
- In difficult cases – compression and violation of the integrity of the spinal cord.
There are many reasons for the development of cervical osteochondrosis:
- curvature of the spine - scoliosis, kyphosis;
- other postural disorders;
- various back and spine injuries;
- physical inactivity, sedentary lifestyle;
- metabolism is impaired;
- excess weight;
- excessive physical activity;
- errors during the training process in athletes;
- stressful conditions;
- poor fitness level;
- hypothermia;
- infectious diseases;
- hereditary factor;
- bad habits, for example – the habit of holding the telephone receiver with your shoulder;
- back pain associated with sitting work among office workers, as well as long periods of driving, etc. ;
- abnormal development of the spine in the cervical region;
- age-related changes.
All of the above factors influence the increased load on the cervical spine.Excessive load is compensated by the neck muscles, but due to excessive tension, muscle spasms lead to poor circulation and, as a result, degenerative changes - cervical osteochondrosis.
Pathological changes occur in the structure of the intervertebral discs, their nutrition is disturbed and changes appear in the small intervertebral joints.Increased load on impaired intervertebral discs leads to bony growth of the vertebral bodies.
Degree of development of osteochondrosis of the cervical spine
To determine the degree of cervical osteochondrosis, they rely on the clinical picture and complaints of the patient.
- I graduated– with minimal clinical manifestations.There is usually no pain, or the patient complains of slight pain and discomfort, intensifying when turning the head, rapid fatigue of the neck muscles after prolonged exercise.An exam may reveal slight tension in the neck muscles.All this occurs as a result of partial loss of moisture and elasticity in the core of the intervertebral disc, and its compaction occurs.
- IInd degree– an increase in changes in which pain in the cervical spine bothers the patient, becomes more pronounced and the pain intensifies due to prolonged sitting, especially with the head down.The pain radiates to the shoulder and arm.
- IIIrd degree– increased manifestations of cervical osteochondrosis.Characterized by constant, aching pain in the cervical spine, radiating to the shoulder and arm.Symptoms of numbness or weakness in the arm muscles, dizziness.This stage often marks the beginning of the formation of an intervertebral hernia.
- IVth degree– acute neck pain, partial loss of control of the limbs, vestibular disorders, headache, dizziness, loss of consciousness, since the vertebral artery, which supplies the occipital lobe of the brain and the cerebellum, is involved in the process.The intervertebral disc is completely destroyed and replaced by connective tissue.This leads to the growth of bone osteophytes, fusion of the vertebrae may occur, which leads to loss of neck mobility.
Classification of cervical osteochondrosis according to the degree of development of the intervertebral disc - radiological stages:
- Stage I– no modification of the disc, slight modifications in the configuration of the vertebrae, recovery of physiological lordosis;
- Stage II– minor changes associated with instability of the spinal segment, possible development of subluxation, twisting of the vertebrae, the height of the intervertebral segment is slightly reduced.
- Stage III– pronounced changes in the disc – the height of the disc is reduced by ¼ compared to that located above, while maintaining the external surface, the intervertebral foramens and the spinal canal are narrowed, the presence of compact anterior, posterior and posterolateral osteophytes;
- Stage IV– the height of the intervertebral disc is significantly reduced – by 2 times, significant pathological changes in the intervertebral joints, the presence of massive posterior osteophytes, significant narrowing of the intervertebral foramina and the spinal canal.
Signs and symptoms of cervical osteochondrosis
The first symptom of cervical osteochondrosis, observed in almost all patients, is neck pain.This pain appears when lying down after waking up and intensifies when trying to turn over.Increased pain is caused by unsuccessful head turning, coughing, sneezing or laughing.The pain is dull, annoying in nature, sometimes throbbing, and is localized deep in the neck.The nature of pain in the cervical spine can be periodic or constant.The intensity of the pain decreases as the day goes on, and it may even disappear completely.
Signs of cervical osteochondrosis without complications:
- stiffness, limited mobility in the neck;
- pain and discomfort in the cervical region;
- adoption of a forced head position;
- when moving the head, there is a “crunching” sensation in the neck;
- tension in the muscles of the cervical region.
Subsequently, the development of symptoms of cervical osteochondrosis results from compression of blood vessels and nerve roots.Specific signs appear, characteristic only of osteochondrosis of the cervical spine.
Vertebral artery syndrome
The development of this syndrome of cervical osteochondrosis results from damage to the vertebral artery by tense muscles and a deterioration of the blood supply to the occipital lobe of the brain and cerebellum, organs of hearing and vision.
Arterial spasms can also occur in response to irritation of the nerve fibers running from the spinal cord to the artery.Due to compression, cerebral ischemia may occur.
Signs of vertebral artery syndrome:
- paroxysmal, migraine-like pain in the head, which begins with throbbing in the back of the head and then spreads to the temples, forehead and ears;
- pain that increases when turning or tilting the head while sitting;
- neck muscle tension;
- dizziness;
- lack of coordination;
- feeling of heaviness in the head;
- tinnitus;
- fainting;
- decreased vision;
- hearing loss;
- numbness of the tongue with severe deterioration of blood supply to the brain;
- memory problems;
- sleep disorders.
Humeroscapular periarthrosis is a disease that affects periarticular soft tissues - muscles and tendons of the shoulder joint and scapula, most often developing with cervical osteochondrosis of the vertebral discs between the IV and V cervical vertebrae. The innervation in the shoulder-scapular zone is disrupted and, due to this, dystrophic changes develop, gradually increasing.A tissue nutritional disorder that occurs at the very beginning of the pathological process remains unnoticed for a long time.With the development of glenohumeral periarthrosis, other symptoms of cervical osteochondrosis fade into the background.Deep pain is localized at the attachment points of ligaments and tendons.The gradual destruction of the disc leads to irritation of the autonomic nerve fibers, which, in the form of impulses, enter the shoulder joint.The nutrition of periarticular tissues is disrupted, which affects the functions of the joint.
Characteristic symptoms of glenohumeral periarthrosis:
- pain in the shoulder joint, radiating to the neck and arm;
- when moving the arm to the side, restriction and pain are observed;
- increased pain when lying on the affected side;
- development over time of atrophy of the shoulder and scapula muscles.
Radicular syndrome
Radicular syndrome develops as a result of degenerative changes in the spine, a decrease in intervertebral discs and loss of elasticity of the annulus fibrosus.The appearance of certain symptoms of cervical osteochondrosis depends on the location of the changes.
If a nerve root is damaged:
- in C 1 (first cervical vertebra) - there is a loss of sensitivity in the back of the head.
- C 2 radicular syndrome in the C I-C II segment - localization of pain in the parietal and occipital region.
- With 3 in the C II-C III segment, it's quite rare.Painful sensations are accompanied by a decrease in sensitivity in the half of the neck, where compression of the spinal nerve occurs, speech disturbances and decreased sensitivity of the tongue.
- in case of damage to the C 4 nerve root in the C III-C IV segment, the localization of pain and a decrease in sensitivity in the shoulder girdle and clavicle may be accompanied by hypotonia of the neck and head muscles.Damage to the C 4 root can cause breathing problems, pain in the heart region and hiccups, due to the presence of the phrenic nerve.A fairly rare pathology.
- C 5 at the level of the segment C IV-C V – causes pain in the shoulder girdle and the outer surface of the shoulder.Weakening of the deltoid muscle, impaired sensitivity of the shoulder in the external surface.
- C 6 and C 7 in segments C V-C VI and C VI-C VII are the most common disorders.In case C 6 – pain radiating from the neck to the shoulder blade, forearm, outer surface of the shoulder, radial surface of the forearm and further to the thumb.Loss of sensitivity even in the skin.In case C 7 - pain radiating from the neck to the shoulder blade, forearm, back of the shoulder, surface of the forearm and back of the second and fourth fingers, with loss of sensitivity of the skin in these areas.
- From 8 to segment C VII-T I – localization of pain and loss of sensitivity of the neck spreads to the back side of the shoulder, to the ulnar border of the forearm, to the little finger.There may be no sensation of pain in the little finger, but there will be a noticeable weakening of the finger muscles.
Anterior scalene syndrome
The anterior scalene muscle is located in the area of the third and fourth cervical vertebrae and is attached to the first rib, the medial scalene muscle is also attached to it and, through the space formed between these muscles, the subclavian artery and the brachial plexus pass.Autonomic nerve fibers are irritated as a result of disc destruction and impulses are sent to the anterior scalene muscle.
A muscle spasm occurs and, as a result, compression of the brachial plexus and vertebral artery occurs.
Symptoms of cervical osteochondrosis, characteristics of anterior scalene syndrome:
- The pain ranges from sharp to aching, extending to the forearm and hand.
- Pain that increases when the arm is moved to the side and the head is tilted.
- A pinched artery is characterized by a cold hand, numbness and swelling.
Diagnosis of cervical osteochondrosis
The main methods of diagnosing osteochondrosis of the cervical spine are:
- Radiological examination of the spine– in direct and lateral projections and in the functional positions of the patient – (with open mouth) to determine the reduction in the height of the intervertebral discs and degenerative bony growths.
- MRI – Magnetic Resonance Imaging– is the most informative diagnostic method, allowing to detect with high accuracy the localization of pathological changes in osteochondrosis of the cervical spine.Detects protrusions and intervertebral hernias, size and direction of their growth.
- CT – computed tomography– determines the presence of changes in the vertebrae in cervical osteochondrosis, but this diagnostic technique is less informative.
- Ultrasonic duplex scanning– a method that allows you to determine a decrease in blood flow speed and the presence of obstacles to normal blood flow.
In order to exclude pathological processes in the central nervous system, cardiovascular system, organs of vision and hearing and digestive organs, such types of examinations as ultrasound, ECG, electroencephalography are used for differential diagnosis and laboratory tests are prescribed.
Principles of treatment of cervical osteochondrosis
The main methods of treating cervical osteochondrosis are:
- drug therapy,
- physiotherapeutic treatment,
- massage of the cervical area,
- therapeutic exercises.
For drug treatment of cervical osteochondrosis, the following main groups of drugs are used:
- nonsteroidal anti-inflammatory drugs that reduce pain, help relieve swelling of the damaged nerve root and inflammation;
- B vitamins that improve metabolic processes;
- drugs to improve the rheological properties of blood and blood flow, thereby improving the nutrition of damaged roots;
- chondroprotectors – for the restoration of cartilage tissue;
- muscle relaxants - to relieve muscle spasms.
Physiotherapy in the treatment of cervical osteochondrosis
- Electrophoresis to relieve pain or improve blood circulation.
- Ultrasound – to improve metabolic processes, as an analgesic and anti-inflammatory method.
- Magnetic therapy – to relieve swelling and relieve pain.
- Laser therapy – to improve blood circulation and for an anti-inflammatory effect.
Therapeutic exercise
For cervical osteochondrosis, physiotherapy is prescribed during the recovery period, after the pain is relieved, since pain and discomfort should not be present when performing a set of exercises.It is best for a patient with such a diagnosis to undergo physical therapy regularly, thereby limiting excessive stress on the cervical spine.Restoration of muscle tone is the main task of treating osteochondrosis of the cervical spine.
Prevention of cervical osteochondrosis
Physical activity, sleeping in a comfortable bed with an anatomical mattress, a combination of prolonged sitting with warm-up periods, maintaining correct posture and proper nutrition are the key to the health of the cervical spine.You should try to avoid neck injuries and lifting excessive weights.
As the Japanese say: a crooked neck is a sign of a short life.
This is an assessment of the health of the most mobile part of the spine.
Complications of this disease are varied and dangerous in their manifestations.The minimum dimensions of the diameter of the spinal canal of the cervical spine make the spinal cord very vulnerable, compression of which can lead to consequences such as paresis and paralysis.
Another danger of osteochondrosis of the cervical spine is a violation of the blood supply to the brain.Reduced blood flow resulting from compression of the vertebral artery can cause conditions such as ischemia of the brain and spinal cord and, in the worst cases, stroke.
To avoid irreversible damage, it is strongly recommended to consult a doctor as soon as possible.