Cervical Osteochondrosis - Symptoms, Treatment, Exercise, Gymnastics And Massage. How To Treat Osteochondrosis Of The Cervical Spine?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, symptoms and treatment methods for cervical osteochondrosis

Content:

• What is cervical osteochondrosis?
• Symptoms of cervical osteochondrosis
• Causes of cervical osteochondrosis
• Why is cervical osteochondrosis dangerous?
• Cervical osteochondrosis syndromes
• Treatment of osteochondrosis of the cervical spine
• Preparations and medicines
• Prevention of cervical osteochondrosis

Dystrophic processes and dysfunction of the intervertebral discs of the cervical spine are called cervical osteochondrosis (SHO).

What is cervical osteochondrosis?

Cervical osteochondrosis is a disease in which the soft intervertebral pulp, which acts as a shock absorber between the vertebrae, degenerates into ossified tissue, while nerve roots and blood vessels are involved in pathogenesis. This pathology is disguised as a variety of disorders. A distinctive feature of osteochondrosis of the cervical spine is pain in the head, neck and upper back. Also, patients go to the doctor with dizziness, nausea, surges in blood pressure, loss of consciousness, lack of air, numbness of the tongue, with suspicion of angina pectoris and other pathologies of the cardiovascular system.

This means that a person who feels pain in the back of the head, shoulders, arms, sternum and in the retrosternal region complains not only to a neurologist, but also to doctors of other medical specialties (cardiologist, therapist, orthopedist), which seriously complicates the initial diagnosis of the disease …

Dystrophic changes in the tissues of the cervical spine are widespread among middle-aged and older people. This is due to the vertical position of the human skeleton and the distribution of static and dynamic loads.

The widespread occurrence of cervical osteochondrosis is explained by the peculiarities of the exit of the roots of the nerve endings in the upper part of the spinal column and the mobility of the joints of the neck, which carry the load to keep the skull in an upright position.

Approximately 60% of the adult population of European countries suffers to one degree or another from clinical manifestations of osteochondrosis. It is noticed that this disease manifests itself earlier in men - at the age of 45-50. Women usually get sick a little later, at about 50-55 years.

In modern society, neck osteochondrosis is rejuvenated. When examining representatives of different generations with a tendency to this disease, it has been reliably established that today's young people begin to experience difficulties with the spine much earlier than representatives of the older generation of the family, sometimes even in adolescence. People born 60-70 years ago go to a medical institution for the first time for osteochondrosis of the cervical spine in adulthood or even in old age, but people born 20-40 years ago often fall ill with osteochondrosis at a young age. This indicates a significant deterioration in the health of the younger generation, which is associated with a sedentary lifestyle and a decrease in the quality of nutrition.

Osteochondrosis is usually considered in two ways, always in the relationship between physiological (natural aging of the body) and pathological (dystrophic and inflammatory processes) factors:

• Physiological process - the inevitable aging of the cartilage of the spinal column, regulated by the neuro-endocrine mechanisms of the body as a result of natural irreversible phenomena;
• The pathological process is the destruction of the intervertebral structures and the nerve nodes and vessels surrounding the vertebrae - the less healthy the lifestyle, the faster the disease develops.

From the point of view of localization of the pathological process:

• Physiological changes are located in the center of the intervertebral disc, accompanied by the replacement of the pulp of the disc with fibrous tissue, are part of the aging process of the body, do not manifest themselves clinically or appear only when the nerve endings are irritated

• Pathological changes spread outside the cartilage, always cause irritation of the nerve endings and squeezing of blood vessels, which is manifested by local and reflected pain reactions (dyscalgia).

The pathological form of osteochondrosis is the replacement of physiological aging with a pathological process.

The disease can self-liquidate, compensate and manifest itself sporadically. This feature is associated with the ability of the organism of higher mammals and humans to develop compensatory and protective mechanisms that level pathology. Meanwhile, it is inappropriate to test the body for strength.

The pathological form of the disease is always associated with aging of the body, even in young people. Further destruction of the tissues of the annulus fibrosus without replacing the pulp with fibrous tissue leads to the formation of microcracks, impaired fixation of the vertebrae and the development of symptoms of spinal instability.

The pathogenesis is accompanied by:

• Impregnation of the nucleus pulposus with calcium salts;
• By pressing the structures of the vertebra into the body of the adjacent vertebra (like a hernia);
• Gradual wear of the vertebrae (spondylosis)
• Ossification of the ligaments (ossifying ligamentosis).

Symptoms of cervical osteochondrosis

Diagnosis of the disease is difficult, pain sometimes does not appear, and the symptoms are erased, moreover, the uncontrolled use of strong analgesics masks the signs of the disease. A patient who does not feel pain considers himself healthy, and this continues until the development of irreversible processes in the tissues of the neck joints.

Dizziness, headaches, and blood pressure surges are important symptoms of cervical osteochondrosis.

Dizziness with cervical osteochondrosis

This condition does not always unambiguously indicate osteochondrosis of the cervical spine.

Dizziness may result from:

• Inflammation in the middle or inner ear;
• Vascular spasms of the brain;
• Disturbances in the transmission of nerve impulses;
• Problems with the vestibular apparatus;
• Diseases of the cardiovascular system.

There are no clear criteria for dizziness in osteochondrosis. However, there are systemic and non-systemic vertigo, they have obvious differences.

It is recommended to know the differences between systemic and non-systemic dizziness, this will help to independently determine the causes of an unusual state:

• Systemic dizziness is a sensation of a circular movement of the surrounding objects or the body, which is a consequence of disruption of the vestibular apparatus, visual analyzers and receptors in the joints, muscles and epidermis (osteochondrosis of various etiologies);
• Non-systemic dizziness is a feeling of lightheadedness, a feeling of being stunned, unsure of being in an upright position. With non-systemic dizziness, the sensation of circular rotation is absent, and this is an important difference between the compared signs.

A person who feels dizziness of one of these types should be examined by an experienced doctor, first of all, by a neurologist or (if there is a suspicion of ear and nasopharyngeal disease) by an otolaryngologist.

The reason for emergency hospitalization, not associated with osteochondrosis of the cervical spine, is the identification of the patient (except for dizziness) of such signs as:

• Paralysis of the facial muscles and numbness of a part of the shoulder girdle;
• Severe headache against a background of deterioration in health;
• Movement coordination disorders;
• Loss or extinction of consciousness.

Headache with cervical osteochondrosis

This is one of the most common non-specific signs of many human diseases. Headaches are especially common in the female population. It can be difficult to determine the cause of headaches, and even more so, to associate it with lesions of the spine. About 14 different causes of headache in humans have been identified.

The most common causes of headache in the pathology we are describing:

• Vascular spasms of the brain;
• Pinched nerve roots;
• Reflex increase in intracranial pressure.

A headache with cervical osteochondrosis can resemble sensations in arterial hypertension, angina pectoris, or stroke. Moreover, middle-aged and older people, as a rule, have risks of developing strokes or heart attacks.

Feels like the pain can be paroxysmal, constant, throbbing and dull.

With heart pathologies, patients complain of discomfort in the chest area, accompanied by a disturbance in the rhythm of cardiac activity. Only a qualified doctor can determine the cause. In case of headaches, combined with nausea, dizziness and chest pain, an ECG is required.

Pain in osteochondrosis of the cervical spine

The pain is not always localized precisely in the region of the head and neck. There are cases of other localization of pain.

Neck pain (cervicalgia) can radiate to the shoulder area and to various parts of the arms. A distinctive feature of such sensations is the suddenness of attacks after sleep, sudden movements, tensions that are hardly noticeable to a person, for example, when laughing or sneezing. The pain associated with osteochondrosis, if the process has not become chronic, usually subsides after a short time and is combined with a crunch in the cervical vertebrae.

Without preliminary examination, you should not relieve pain with manual therapy (massage). In some cases, inept manipulation can only aggravate the pathology, disrupt the innervation and lead to the patient's disability.

In intensity, pain can be moderate or severe. In terms of duration - both short and long.

Typical sensations described by patients:

• Localization of pain in the depths of the neck;
• Crunching and cracking sensation when trying to turn your head;
• Muscle weakness or decreased sensitivity in different parts of the body.

In the cervical region of all mammals, including humans, there are seven vertebrae and eight pairs of nerve nodes. SHOC can also develop on the border of the cervical and thoracic vertebrae.

It has been noticed that osteochondrosis of the cervical spine is most often associated with damage to the sixth and seventh cervical vertebrae.

There are tests to determine the localization of the focus of the pain impulse. A lesion in the region of the sixth vertebra is complemented by pain in the thumb, and a lesion in the region of the seventh vertebra is accompanied by pain in the middle finger.

Blood pressure in cervical osteochondrosis

The connection of cervical osteochondrosis with surges in blood pressure has long been established. The cervical vertebrae have important nerve endings and blood vessels.

Pressure surges during the day are characteristic. Hypertension for a long time is not characteristic of this disease. Reflex irritation of nerve endings and short-term spasms of blood vessels cause an abrupt daily dynamics of arterial hypertension.

A distinctive feature of increased pressure in cervical osteochondrosis is a combination with the following symptoms:

• Headache;
• Pain in the limbs and chest;
• Decreased sensitivity in the neck area;
• The occurrence of pressure surges after stress, muscle tension, prolonged uncomfortable posture and other similar situations.

These signs should be taken into account when self-differentiating hypertension of various origins.

Sharp jumps in blood pressure and a rapid deterioration in well-being are the basis for seeking emergency medical help.

Causes of cervical osteochondrosis

The reasons are always associated with the aging of the body and the developed pathology of bone and cartilage tissue. However, not all people in old age suffer from various types of skeletal pathologies.

Numerous observations have established that cervical osteochondrosis has provoking factors, including:

• Sedentary lifestyle;
• Forced postures during work;
• Overweight;
• Excessive nervous tension and prolonged stress;
• Previous injuries to the occiput and neck;
• Local hypothermia;
• Autoimmune diseases that lead to degeneration of cartilage tissue;
• Congenital anomalies of the structure of the spine.

Moderate physical activity, healthy diet and proper lifestyle significantly reduce the risk of osteochondrosis, or minimize its effect on well-being in old age.

Why is cervical osteochondrosis dangerous?

Reduced flexibility in joints, muscle elasticity and other signs of aging of the body - unconditional companions of the elderly - is a natural process.

Pain during movement and at rest begins to annoy a person much earlier than the natural aging period, sometimes it ends in disability or a significant decrease in the quality of life.

Inexperienced treatment is just as dangerous as inaction, because in the first case, the pathology without high-quality treatment is aggravated, in the second, inept therapy can result in sudden disability or persistent deterioration of well-being, because therapeutic manipulations affect the two most important systems of the body - the nervous and vascular.

Cervical osteochondrosis syndromes

Syndromes are a combination of several symptoms. There are several symptom complexes of cervical osteochondrosis, the main ones are:

• Vertebral or vertebral;
• Vertebral artery;
• Cardiac or cardiac;
• Nerve endings (radicular).

The combination of different syndromes, like a mosaic, develops into a single picture of cervical osteochondrosis.

Vertebral syndrome

This syndrome means that pathological processes are associated with the body of bone and cartilage tissue.

In the case of clinical manifestation, the syndrome consists of three symptoms associated with damage to the bone or cartilage tissue of the vertebrae, namely:

• Impaired neck mobility;
• Pain when trying to turn your neck;
• Morphological changes in the vertebral body or in the intervertebral space (the symptom is determined on the radiograph).

These symptoms must be combined with each other. In the absence of one of them, vertebral syndrome is also absent - this is a medical axiom. In the presence of pain during head rotation, it is always possible to assume morphological changes in the tissues of the bones and cartilage of the cervical skeleton, and by indirect signs (change in the place of sensitivity), it is possible to determine a specific vertebra or a group of joints involved in the pathology.

The difficulty in diagnosing vertebral syndrome lies in the fact that a similar clinical picture (limitation of neck mobility) can be found in lesions of the neck muscles (myositis), and the main symptom of the syndrome - pain with an active change in the position of the neck - is often the result of other pathological processes in the human body.

Vertebral artery syndrome

This syndrome means that pathological processes are associated with the vertebral arteries that supply the brain. The manifestation of symptoms should be considered in direct connection with a violation of the blood supply to the brain and cervical tissues.

The syndrome consists of several symptoms. The main ones are related to:

• Insufficient blood flow in one of the trunks due to compression of the artery (tinnitus, stunned state, dizziness, pressure surges, nausea and vomiting);
• Irritation of the nerve endings of the artery (severe pain and migraine or vice versa, numbness, decreased sensitivity, temporary one-sided blindness or `` flies '' in the eyes);
• Oxygen starvation (drowsiness, fainting, mild aching headache, decreased performance and concentration, depression).

This syndrome can develop not only with osteochondrosis, but also with other pathologies (deposition of atherosclerotic plaques on the inner wall of blood vessels, squeezing of the vessel by tumors, inflammatory infiltrate, and so on).

Cardiac syndrome

Signs of this syndrome resemble cardiac abnormalities, angina pectoris, and even a condition preceding a heart attack. The syndrome includes the following symptoms:

• Pain and burning in the sternum;
• Shortness of breath, weakness and fatigue;
• Heart palpitations.

The main methods of differential diagnosis of pathologies of the cardiovascular system and osteochondrosis are the ECG method and functional tests. On the ECG, a shortened ST segment is noted, with angiography - the absence of atherosclerosis. It can be difficult to exclude cardiac syndrome in osteochondrosis, and this requires a long study.

Radicular syndrome

The clinical manifestation of this syndrome is associated with one of eight pairs of spinal nerve roots that innervate the cervical portion of the spinal column. One-sided lesion of the body is characteristic.

The syndrome is associated with a violation of nerve conduction: with pain, or, conversely, with semi-paralysis (paresis), paralysis and decreased sensitivity.

Conductivity disorders are characterized by the following symptoms:

• The first and second roots - numbness or, conversely, pain in the occipital region;
• The third pair of roots - numbness of the tongue and the area behind the ears, difficulty in chewing food, a feeling of bursting of the tongue;
• The fourth pair - pain in the clavicle, hiccups, difficulty in swallowing as in the case of angina;
• Fifth pair - violations are felt in the shoulder area in the form of difficulty moving the arms;
• The sixth pair - discomfort in the shoulder blades and forearm;
• The seventh pair - numbness in the hands and, in particular, the index and middle fingers;
• Eighth pair - leads to difficulties in handling ring fingers and little fingers.

In practice, very rarely single vertebrae are affected, more often several pairs of nerve roots are involved in the pathogenesis, therefore, the syndromes mix and confuse the clinical picture. It is advisable for the patient to independently listen to his own body.

Treatment of osteochondrosis of the cervical spine

Depending on the stage of the pathology (remission or exacerbation), the form of the disease (acute or chronic), the severity of clinical manifestations (presence or absence of pain syndrome), various methods of therapy are selected.

This could be:

• Conservative treatment (medication and non-medication);
• Surgical intervention;
• Combinations of conservative and operational techniques.

Let's dwell on the classic methods of therapy. Knowledge and competent use of simple techniques, including physiotherapy exercises, massage and self-massage, significantly facilitates the well-being of a person experiencing neck pain with osteochondrosis. In the case of long-term degenerative processes, it is better to undergo an examination in a hospital or on an outpatient basis, and only then apply medical procedures.

If it is not possible to undergo an examination, then it is recommended to use gentle methods, for example, perform exercises aimed at hydration - saturation of the inter-articular space with fluids by improving blood supply in the neck and back of the head.

Exercise therapy (physiotherapy exercises) for cervical osteochondrosis

Therapeutic gymnastics, when done correctly, works wonders. Many techniques have been proposed, but all of them are based on enhanced nutrition of cartilage and bone tissues. The principle of exercise therapy is to restore blood supply in the damaged area of the body.

It is forbidden to strongly rotate and bend your head during exercise therapy, only imitation of such movements is allowed. This method has shown its effectiveness, despite its obvious simplicity.

The correct use of exercise therapy is the use of physical exercise without:

• Long-term loads on the joints of the neck (one set of exercises is performed no more than 2 minutes);
• Turns, tilts and rotations of the neck (such exercises aggravate pathological processes in the joints and intervertebral discs).

Shallow (shallow) head tilts are shown, which do not lead to joint movement, but increase blood flow to them. Such inclinations in movement resemble a subtle nodding of the head, which means the answer is "yes". After a while, about 30 minutes later, the movement is repeated, resembling the answer "no".

You can also do exercises that simulate the movement of the head forward (restricting the frontal part of the head with the hand) and back (restricting the movement of the head with the hands in the back of the head).

Massage for cervical osteochondrosis

Massage should be done carefully, without power exertion. Inexperienced, unprofessional massage can end in disaster. Movements should extend to the cervical region, collar area and part of the back.

The massage is performed in a prone position, in extreme cases, in a sitting position.

The techniques are based on the following techniques:

• Stroking. Impact on the surface layers of the skin. With the palms of the hands or fingertips from the head down to the upper third of the middle of the back. Stroking from the base of the neck can also be in a zigzag pattern;
• Squeezing. Impact on the deep layers of the skin in the upper third of the back. Fingers (thumb and forefinger) across the neck carry out movements to grasp the skin, reminiscent of squeezing. This is done carefully, tissues close to the vertebrae are not involved;
• Trituration. The purpose of the procedure is to warm up the skin and increase blood flow in the neck area. This is done very carefully. Impact on the spinous processes of the vertebrae is not allowed. Rubbing can be replaced with movements reminiscent of sawing or circular stroking;
• Kneading. It is of limited value, since it affects very deeply lying tissues, which can aggravate the pathology.

Self-massage for cervical osteochondrosis is performed while sitting in a comfortable position. Methods of stroking, circular rubbing in the neck or shoulders are used. It is advisable to combine the self-massage method with rubbing in various ointments that increase blood flow and relieve pain in the kneaded area.

Applicator Kuznetsov

It is a simple plastic device with spikes that act on areas of the skin. A person lies down on the thorns or applies them to the body, thereby causing irritation of the skin receptors responsible for the physiological processes in the body.

In some cases, the applicator helps and permanently reduces pain caused by cervical osteochondrosis. In addition, the device sometimes increases a person's working capacity, has a beneficial effect on skin turgor, normalizes sleep and blood circulation, and restores joint mobility.

Contraindications to the use of Kuznetsov's applicator are infectious, tumor, skin and vascular diseases. Before using the device, the patient should consult with the attending physician or independently test this simple device on himself with the help of short-term application of the applicator and monitoring his well-being.

On the subject: Treatment of osteochondrosis at home

Orthopedic pillows for cervical osteochondrosis

Orthopedic sleep pillows are an effective preventive measure. In many cases, osteochondrosis is aggravated by additional compression of the cervical artery and nerve roots while sleeping on an uncomfortable pillow. The orthopedic product ensures a uniform horizontal position of a person during sleep and, thus, guarantees a physiologically adequate blood supply to the brain.

When choosing a pillow, one should take into account the individual anatomical features of a person and correlate them with the volume and characteristics of the filler. A properly selected pillow brings tangible benefits to a patient with osteochondrosis of the cervical spine.

Drugs and medicines for cervical osteochondrosis

The arsenal of medicines and drugs for the treatment of cervical osteochondrosis is very extensive:

• Analgesics (non-steroidal drugs that relieve pain). They are usually prescribed as tablets or capsules. It should be remembered that most of these medications irritate the lining of the digestive tract. Among the modern drugs used to relieve pain in osteochondrosis are diclofenac, piroxicam.

  

  When choosing NSAIDs, it should be borne in mind that it is the selectivity of the drug that ensures optimal safety and minimizes the risks of side effects. Etoricoxib is a prominent representative of highly selective drugs. At the beginning of 2020, the first Russian etoricoxib was launched on the market - the drug Etorelex, which is more affordable than foreign analogues, is easy to use and has a minimum number of side effects;

• Anti-inflammatory (steroid). These are hormonal drugs that relieve inflammation and, thereby, eliminate pain. Most often, for osteochondrosis of the cervical spine, tablets and ointments based on hydrocortisone, prednisolone or dexamethasone are used;
• Muscle relaxants are drugs that relax muscle tone. They are used in surgery and orthopedics as aids to relieve pain. These medications are administered parenterally and therefore always under medical supervision. For the treatment of osteochondrosis, drugs from two pharmacological groups are used: glycerol and benzimidazole. There is an extensive list of contraindications;
• Vitamins. With osteochondrosis of the cervical spine, vitamins are prescribed that have a beneficial effect on the peripheral nervous system and improve conductivity. Water-soluble vitamins: B ₁, B ₆, B ₁₂, fat-soluble vitamins: A, C, D, E. In recent years, combined preparations containing both painkillers and vitamin components have become more often prescribed. One of these medicines is Milgamma compositum. An effective preparation consists of B vitamins based on pyridoxine and thiamine, and contains lidocaine as an anesthetic;
• Ointments and gels for external use. This is the most accessible group of medicines for use at home. They are divided into relieving inflammation, warming and pain relievers. Such products are often advertised, the most popular are: voltaren emulgel, nurofen, fastum gel.

On the subject: Modern dietary supplements for the restoration of joints

Prevention of cervical osteochondrosis

It is better to prevent the disease, or to minimize the factors contributing to the development of pathology. It is known that the basis of health is a correct lifestyle. It includes moderate physical activity, weight control, regular warm-ups for sedentary work, especially if it is performed in a static position. All of the above is independently controlled by a person and often depends on the habits established in childhood.

But throughout life, a person is exposed to risks that cannot be eliminated. These include congenital and acquired microtrauma of the spine, diseases of the musculoskeletal system.

If a person has a tendency to clinical manifestations of osteochondrosis, then it is advisable not to choose a job associated with increased physical activity, as well as to avoid sudden movements in everyday life. Overweight over 10 kg is considered critical for people with back problems.

If it is impossible to completely abandon intense physical activity, you should:

• Transfer weights alternately on one side of the body, then on the other;
• Use a corset to protect the spine;
• After completing the work, unload the spine, namely, lie down for a while, or hang on the horizontal bar.

On the subject: What can and cannot be done with osteochondrosis?

Abrupt changes in weather and climate should be avoided. Risks increase with higher humidity and lower temperatures.

To protect yourself from exacerbation of cervical osteochondrosis will help:

• Sleep on an orthopedic mattress and pillow in the correct position that does not interfere with blood circulation in the spine;
• Regular swimming;
• Healthy eating.

With osteochondrosis, sports that increase the load on the spine and contribute to its trauma are contraindicated: running, jumping, weightlifting. During the period of exacerbation, you should refuse to visit the steam room in the bath.

The implementation of simple rules of prevention, exercise therapy and massage (in some cases) allows you to lead a comfortable life with osteochondrosis of the cervical spine, even in old age.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".