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Cervical osteochondrosis

Cervical osteochondrosis often affects people who work in a sedentary 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 a relatively small height and thickness of discs and a fairly close fit to each other, and since the neck muscles are rather underdeveloped, with regular loads this can lead to displacement of the intervertebral discs.

The high susceptibility of the cervical spine to degenerative changes, which, in essence, are 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 exclusive to older people;Nowadays it is rapidly getting younger.

Cervical osteochondrosis and its manifestations can be due to an alteration of three body systems:

  • Pathological influence of the focus of degenerative changes in the peripheral nervous system.
  • When the blood supply to the vertebral arteries of the brain cells is disturbed.
  • In difficult 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 spinal injuries;
  • physical inactivity, sedentary lifestyle;
  • metabolism is disturbed;
  • overweight;
  • excessive physical activity;
  • errors during the training process among athletes;
  • stressful conditions;
  • low level of physical fitness;
  • hypothermia;
  • infectious diseases;
  • hereditary factor;
  • incorrect habits, for example: the habit of holding the telephone receiver with your shoulder;
  • back pain associated with sitting work in 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.The excess load is compensated by the neck muscles, but as a result of excessive tension, the muscles spasm, which leads to poor circulation and, as a consequence, 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.An increased load on the altered intervertebral discs causes bone growths of the vertebral bodies.

Degree of development of osteochondrosis of the cervical spine.

To determine the degree of cervical osteochondrosis, they are based on the clinical picture and the patient's complaints.

  • I degree– with minimal clinical manifestations.Usually there is no pain or the patient complains of mild pain and discomfort, which intensifies when turning the head, and rapid fatigue of the neck muscles after prolonged exercise.An exam may reveal slight tightness in the neck muscles.All of this occurs as a result of the partial loss of moisture and elasticity in the core of the intervertebral disc, and its compaction occurs.
  • second grade– an increase in changes in which pain in the cervical spine bothers the patient, becomes more pronounced and the pain intensifies as a result of prolonged sitting, in particular with the head down.The pain radiates to the shoulder and arm.
  • III degree– increased manifestations of cervical osteochondrosis.It is characterized by constant, aching pain in the cervical spine, which radiates to the shoulder and arm.Symptoms of numbness or weakness of the arm muscles, dizziness.Often this stage is the beginning of the formation of an intervertebral hernia.
  • grade IV– acute pain in the neck, partial loss of control of the limbs, vestibular disorders, headaches, 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, as a result of which the neck loses its mobility.

Classification of cervical osteochondrosis depending on the degree of change in the intervertebral disc - radiological stages:

  • Stage I– absence of changes in the disc, slight changes in the configuration of the vertebrae, straightening of the physiological lordosis;
  • Stage II– minor changes associated with instability of the spinal segment, possible development of subluxation in it, 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 the one above, while the outer surface is maintained, the intervertebral foramina and spinal canal are narrowed, the presence of compact anterior, posterior and posterolateral osteophytes;
  • stage IV– the height of the intervertebral disc is significantly reduced – 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 you try to roll over.Increased pain is caused by unsuccessful turning of the head, coughing, sneezing or laughing.The pain is dull, dull, sometimes stabbing, and is located deep in the neck.The nature of pain in the cervical spine can be periodic or constant.The intensity of the pain decreases throughout the day, and may even disappear completely.

Signs of cervical osteochondrosis without complications:

  • stiffness, limited mobility in the neck;
  • pain and discomfort in the cervical area;
  • adoption of a forced position of the head;
  • 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 occurs as a result of compression of blood vessels and nerve roots.Specific signs appear that are characteristic only of osteochondrosis of the cervical spine.

Vertebral artery syndrome

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

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

Signs of vertebral artery syndrome:

  • paroxysmal, migraine-like headache that 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 in a sitting position;
  • 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 impairment of blood supply to the brain;
  • memory impairment;
  • sleep disorders.

Humeroscapular periarthrosis is a disease that affects the periarticular soft tissues - the muscles and tendons of the shoulder joint and scapula, and most often develops with cervical osteochondrosis of the vertebral discs between the IV and V cervical vertebrae. The innervation in the shoulder-scapula zone is disturbed and, due to this, gradually increasing dystrophic changes develop.A nutritional disorder of the tissues that arises at the 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 located at the attachment points of ligaments and tendons.The gradual destruction of the disc causes irritation of the autonomic nerve fibers, which in the form of impulses enter the shoulder joint.The nutrition of the periarticular tissues is disturbed, 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 muscles of the shoulder and scapula.

radicular syndrome

Radicular syndrome develops as a result of degenerative changes in the spine, a decrease in the 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:

  • at C 1 (first cervical vertebra): there is loss of sensation 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 is quite rare.Painful sensations are accompanied by a decrease in sensitivity of the middle of the neck, where compression of the spinal nerve occurs, speech disturbance and decreased sensitivity of the tongue.
  • with damage to the C 4 nerve root in the C III-C IV segment, localization of pain and decreased sensitivity in the area of the shoulder girdle and clavicle may be accompanied by hypotonicity of the muscles of the neck and head.Damage to the C 4 root can cause breathing problems, pain in the cardiac region and hiccups, due to the presence of the phrenic nerve there.A rather rare pathology.
  • C 5 in the C IV-C V segment: causes pain in the shoulder girdle and the outer surface of the shoulder.Weakening of the deltoid muscle, impaired sensitivity of the shoulder on the outer surface.
  • C 6 and C 7 in the C V-C VI and C VI-C VII segments are the most common disorders.In case C 6 – pain radiating 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 case C 7 - pain radiating from the neck to the scapula, forearm, back of the shoulder, surface of the forearm and the back of the second and fourth fingers, with loss of skin sensitivity in these areas.
  • Starting from 8 in the C VII-T I segment – the localization of pain and loss of sensitivity from the neck extends to the posterior surface of the shoulder, ulnar edge of the forearm and little finger.There may be no sensation of pain in the little finger, but there will be a noticeable weakening of the muscles of the finger.

Anterior scalene syndrome

The anterior scalene muscle is located in the area of the third and fourth cervical vertebra 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.The autonomic nerve fibers are irritated as a result of the destruction of the disc and impulses are sent to the anterior scalenus muscle.

A muscle spasm occurs and, as a result, compression of the brachial plexus and vertebral artery occurs.

Symptoms of cervical osteochondrosis, characteristic of anterior scalene syndrome:

  • The pain ranges from sharp to aching and extends to the forearm and hand.
  • Pain that increases when 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 spine.– in direct and lateral projections and in the functional positions of the patient – (with the mouth open) to determine the decrease in the height of the intervertebral discs and degenerative bone growths.
  2. MRI – Magnetic resonance imaging– is the most informative diagnostic method, which makes it possible to detect with high accuracy the localization of pathological changes in osteochondrosis of the cervical spine.Detects intervertebral protrusions and hernias, the size and direction of their growth.
  3. CT – computed tomography– determines the presence of changes in the vertebrae in cervical osteochondrosis, but this diagnostic technique is less informative.
  4. Duplex ultrasound scanning– a method that allows you to determine a decrease in the speed of blood flow and the presence of obstacles to normal blood flow.

To exclude pathological processes of 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,
  • physiotherapy treatment,
  • massage of the cervical neck area,
  • therapeutic exercises.

For the drug treatment of cervical osteochondrosis, the following main groups of drugs are used:

  • non-steroidal 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, 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 flow.
  • 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 have an anti-inflammatory effect.

therapeutic exercise

For cervical osteochondrosis, physiotherapy is prescribed during the recovery period, after the pain has been relieved, since pain and discomfort should not occur when performing a series of exercises.It is best for a patient with such a diagnosis to undergo regular physical therapy, limiting excessive stress 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 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 evaluation of the health of the most mobile part of the spine.

The complications of this disease are varied and dangerous in their manifestations.The minimal 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 consequences such as paresis and paralysis.

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

To avoid irreversible damage, it is strongly recommended to consult a doctor as soon as possible.