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Cervical osteochondrosis

Cervical osteochondrosis often affects people who work in a sitting position

Cervical osteochondrosisis a progressive degenerative-dystrophic disease of the most mobile part of the spine, which consists of seven discs and has a relatively weak muscular corset combined with increased mobility and instability of the cervical vertebrae.The cervical vertebrae have relatively the smallest height and thickness of the discs and adhere quite tightly 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 essentially osteochondrosis and various injuries, is explained by constant physical activity with the need for head support, control of turns and bending.

Causes of cervical osteochondrosis

Until recently, the diagnosis of osteochondrosis was considered the fate of older people;today he is rapidly getting younger.

Cervical osteochondrosis and its manifestations can be caused by disorders of three body systems:

  • Pathological influence of focal points of degenerative changes on the peripheral nervous system.
  • When the blood supply of the vertebral arteries to the brain cells is disturbed.
  • In severe cases – compression and disruption 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 disturbed;
  • excess weight;
  • excessive physical activity;
  • mistakes during the training process among athletes;
  • stressful conditions;
  • poor level of physical fitness;
  • hypothermia;
  • infectious diseases;
  • hereditary factor;
  • wrong habits, for example - the habit of holding the telephone receiver on the shoulder;
  • a tight back condition associated with work in a sitting position in office workers, as well as long periods of driving, etc.;
  • abnormal development of the spine in the cervical region;
  • age changes.

All of the above factors influence the increase in the load on the cervical spine.The excess load is compensated by the muscles of the neck, but as a result of excessive tension, the muscles spasm, which leads to poor circulation and as a result of 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.The increased load on the changed intervertebral discs leads to bony growth of the vertebral bodies.

The degree of development of osteochondrosis of the cervical spine

When determining the degree of cervical osteochondrosis, they rely on the patient's clinical picture and complaints.

  • I degree– with minimal clinical manifestations.There is usually no pain, or the patient complains of mild pain and discomfort, which is aggravated by turning the head, rapid fatigue of the neck muscles after prolonged exercise.Examination may reveal mild 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.
  • II degree- increasing changes in which pain in the cervical spine torments the patient, becomes more and more pronounced, and the pain intensifies as a result of prolonged sitting, especially with the head down.The pain spreads to the shoulder and arm.
  • III degree- increased manifestations of cervical osteochondrosis.It is characterized by constant, aching pain in the cervical spine, which spreads to the shoulder and arm.Symptoms of stiffness or weakness of arm muscles, dizziness.Often this stage is the beginning of the formation of an intervertebral hernia.
  • IV degree- acute pain in the neck, partial loss of control over the limbs, vestibular disorders, headache, dizziness, loss of consciousness, because the process involves the vertebral artery that supplies the occipital lobe of the brain and the cerebellum.The intervertebral disc is completely destroyed and replaced by connective tissue.This leads to the growth of bony osteophytes, the vertebrae may fuse, which causes the neck to lose mobility.

Classification of cervical osteochondrosis according to the degree of intervertebral disc change - radiological stage:

  • Phase I- no changes on the disc, slight changes in the configuration of the vertebrae, correction of physiological lordosis;
  • Phase II- minor changes associated with the instability of the spinal segment, possible development of subluxation in it, torsion of the vertebrae, the height of the intervertebral segment is slightly reduced.
  • Phase III- marked changes in the disc - the height of the disc is reduced by ¼ compared to the one above, while the outer surface is preserved, the intervertebral openings and the spinal canal are narrowed, the presence of front, back and posterolateral compact osteophytes;
  • IV stage- 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 openings and the spinal canal.

Signs and symptoms of cervical osteochondrosis

The first symptom of cervical osteochondrosis, which is observed in almost all patients, is neck pain.This pain occurs when you lie down after waking up and gets worse when you try to roll over.Increased pain is caused by unsuccessfully turning the head, coughing, sneezing or laughing.The pain is dull, dull in nature, sometimes shooting, 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 during the day, and may even disappear completely.

Signs of cervical osteochondrosis without complications:

  • stiffness, limited mobility in the neck;
  • pain and discomfort in the area of the cervix;
  • adopting a forced head position;
  • when moving the head there is a feeling of "crunching" in the neck;
  • tension in the muscles of the cervical region.

After that, the development of symptoms of cervical osteochondrosis occurs as a result of compression of blood vessels and nerve roots.Specific signs appear that are characteristic only for osteochondrosis of the cervical spine.

Vertebral artery syndrome

The development of this syndrome of cervical osteochondrosis occurs as a result of injury to the vertebral artery by tense muscles and deterioration of the blood supply to the occipital lobe of the brain and cerebellum, organs of hearing and vision.

Arterial spasm can also occur as a reaction to irritation of the nerve fibers that go from the spinal cord to the artery.As a result of compression, cerebral ischemia can occur.

Signs of vertebral artery syndrome:

  • paroxysmal migraine-like pain in the head, beginning with a throbbing in the back of the head, then spreading to the temples, forehead, and ears;
  • pain that is aggravated by turning or tilting the head in a sitting position;
  • neck muscle tension;
  • dizziness;
  • lack of coordination;
  • feeling of heaviness in the head;
  • tinnitus;
  • fainting;
  • reduced vision;
  • hearing loss;
  • numbness of the tongue with severe deterioration of the blood supply to the brain;
  • memory impairment;
  • sleep disorders.

Humeroscapular periarthrosis is a disease that affects periarticular soft tissues - muscles and tendons of the shoulder joint and shoulder blade, and most often develops with cervical osteochondrosis of the spinal discs between the IV and V cervical vertebrae.The innervation in the shoulder-scapular zone is disturbed, due to which dystrophic changes develop that gradually increase.Tissue nutrition 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 recede into the background.Deep pain is localized at the points of attachment of ligaments and tendons.The gradual destruction of the disc leads to irritation of the autonomic nerve fibers, which enter the shoulder joint in the form of impulses.The nutrition of periarticular tissues is disturbed, which affects joint functions.

Characteristic symptoms of glenohumeral periarthrosis:

  • pain in the shoulder joint, which spreads to the neck and arm;
  • when moving the arm to the side, there is a limitation and pain;
  • increased pain when lying on the affected side;
  • the development over time of atrophy of the muscles of the shoulder and scapula.

Radicular syndrome

Radicular syndrome occurs as a result of degenerative changes in the spine, reduced intervertebral discs and loss of elasticity of the fibrous ring.The appearance of certain symptoms of cervical osteochondrosis depends on the localization of the changes.

If the nerve root is damaged:

  • in C 1 (first cervical vertebra) - there is a loss of sensitivity in the back of the head.
  • radicular syndrome C 2 in segment C I-C II - localization of pain in the parietal and occipital region.
  • With 3 in the C II-C III segment, it is quite rare.Painful sensations are accompanied by a decrease in the sensitivity of half of the neck, where the spinal nerve is compressed, impaired speech and reduced sensitivity of the tongue.
  • with damage to the C 4 nerve root in the C III-C IV segment, localization of pain and reduced sensitivity in the area of the shoulder girdle and clavicle may be accompanied by hypotonus of the neck and head muscles.Damage to the C 4 root can cause breathing problems, heart pain and hiccups, due to the presence of the phrenic nerve in it.A rather rare pathology.
  • C 5 on the segment C IV-C V – causes pain in the shoulder girdle and outer surface of the shoulder.Weakening of the deltoid muscle, disturbed shoulder sensitivity on the outer surface.
  • C 6 and C 7 in segments C V-C VI and C VI-C VII are the most common disorders.In the case of C 6 – radiation of pain from the neck to the scapula, the forearm, the outer surface of the shoulder, the radial surface of the forearm and further to the thumb.Loss of sensitivity even in the skin.In the case of C 7 - radiating pain from the neck to the shoulder blade, to the forearm, the back of the shoulder, the surface of the forearm and the back of the second and fourth fingers, with loss of skin sensitivity in these areas.
  • From 8 on segment C VII-T I – localization of pain and loss of sensitivity from the neck spreads to the back surface of the shoulder, ulnar edge of the forearm, little finger.There may be no pain in the little finger, but there will be a noticeable weakening of the finger muscles.

Anterior Scale 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 the subclavian artery and brachial plexus pass through the gap created between these muscles.Autonomic nerve fibers are irritated as a result of disc destruction, and impulses are sent to the anterior scalene muscle.

A muscle spasm occurs, resulting in compression of the brachial plexus and the vertebral artery.

Symptoms of cervical osteochondrosis, characteristic of anterior scale syndrome:

  • The pain varies from sharp to aching, spreading to the forearm and hand.
  • Pain that is aggravated by moving the arm to the side and tilting the head.
  • A pinched artery is characterized by a cold hand, numbness and swelling.

Diagnosis of cervical osteochondrosis

The main methods for diagnosing osteochondrosis of the cervical spine are:

  1. X-ray examination of the spinal column- in direct and lateral projection and in the patient's functional positions - (with open mouth) to determine the reduction in the height of intervertebral discs and degenerative bone growths.
  2. MRI – Magnetic Resonance- is the most informative diagnostic method that enables high precision in detecting the localization of pathological changes in osteochondrosis of the cervical spine.It detects protrusions and intervertebral hernias, the size and direction of their growth.
  3. CT – computerized tomography- determines the presence of changes on the vertebrae in cervical osteochondrosis, but this diagnostic technique is less informative.
  4. Ultrasound duplex scan- a method that allows you to determine a decrease in the speed of blood flow and the presence of obstacles to normal blood flow.

In order to exclude pathological processes from the central nervous system, cardiovascular system, organs of sight and hearing, digestive organs, for differential diagnosis, types of examinations such as ultrasound, EKG, electroencephalography are used, and laboratory tests are also prescribed.

Principles of cervical osteochondrosis treatment

The main methods of treating cervical osteochondrosis are:

  • drug therapy,
  • physiotherapy treatment,
  • massage of the cervical and neck area,
  • therapeutic exercises.

The following main groups of drugs are used to treat cervical osteochondrosis with drugs:

  • nonsteroidal anti-inflammatory drugs that reduce pain, help relieve swelling of the damaged nerve root and inflammation;
  • B vitamins that improve metabolic processes;
  • drugs for improving the rheological properties of blood and blood flow, improving the nutrition of damaged roots;
  • chondroprotectors – for restoring cartilage tissue;
  • muscle relaxants - to relieve muscle spasms.

Physiotherapy in the treatment of cervical osteochondrosis

  • Electrophoresis to relieve pain or improve blood flow.
  • Ultrasound – to improve metabolic processes, as an analgesic and anti-inflammatory method.
  • Magnetic therapy – to relieve swelling and pain.
  • Laser therapy – for improving blood circulation and for anti-inflammatory effect.

Therapeutic exercise

In cervical osteochondrosis, physical therapy is prescribed during the recovery period, after pain relief, because pain and discomfort should not be present when performing a set of exercises.It is best for a patient with such a diagnosis to regularly engage in physical therapy, thereby limiting excessive strain on the cervical spine.Restoring muscle tone is the main task in the treatment of 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 proper posture and proper nutrition are the keys to cervical spine health.You should try to avoid neck injuries and lifting excessive weight.

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.

The complications of this disease are diverse 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, the compression of which can lead to such consequences as paresis and paralysis.

Another danger of osteochondrosis of the cervical spine is a violation of blood flow to the brain.Reduced blood circulation as a result of compression of the vertebral artery can cause conditions such as ischemia of the brain and spinal cord, and in the worst case, spinal stroke.

In order to avoid irreversible damage, it is recommended to consult a doctor as soon as possible.