Cervical osteochondrosis

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 combined with increased mobility and instability of the cervical vertebrae.Cervical vertebrae have a relatively small height and thickness of discs that are relatively tight to each other, and because the neck muscles are relatively underdeveloped, with normal loads this can trigger displacement of the intervertebral discs.

The high susceptibility of the cervical spine to degenerative changes, which, in essence, is 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 many elderly people;nowadays it is fast getting younger.

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

• Pathological influence of focal degenerative changes on the peripheral nervous system.
• When the blood supply to the vertebral artery of the brain cells is interrupted.
• 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;
• impaired metabolism;
• overweight;
• excessive physical activity;
• mistakes during the training process among athletes;
• stressful conditions;
• poor physical fitness level;
• hypothermia;
• infectious diseases;
• hereditary factors;
• incorrect habits, for example - the habit of holding the telephone receiver with your shoulder;
• a strained back condition associated with working in a sitting position in an office worker, 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 affect the increased load on the cervical spine.Excessive load is compensated by the muscles of the neck, but as a result of excessive tension, muscle spasms, this leads 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 in the small intervertebral joints appear.Increased load on the transformed intervertebral disc leads to bone growth of the vertebral body.

Stages of development of osteochondrosis of the cervical spine

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

• I have a degree- with minimal clinical manifestations.Usually there is no pain, or the patient complains of mild pain and discomfort, aggravated by turning the head, rapid fatigue of the neck muscles after prolonged exercise.Examination may reveal slight tension in the neck muscles.All this happens due to partial loss of moisture and elasticity in the core of the intervertebral disc, and its compaction occurs.
• II degree– an increase in changes where the pain in the cervical spine bothers the patient, becomes more pronounced, and the pain worsens due to prolonged sitting, especially with the head down.The pain spreads to the shoulders and arms.
• III degree- increased manifestations of cervical osteochondrosis.Characterized by constant pain and pain in the cervical spine, radiating to the shoulders and arms.Symptoms of numbness or weakness of arm muscles, dizziness.Often this stage is the beginning of the formation of an intervertebral hernia.
• degree IV– acute pain in the neck, partial loss of control over the limbs, vestibular disorders, headache, dizziness, loss of consciousness, because 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 can occur, as a result of which the neck loses its mobility.

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

• Stage I– no change in the disc, little change in the configuration of the vertebrae, correcting the physiological lordosis;
• Stage II– small changes related to the instability of the spinal segments, the possibility of developing subluxations in them, torsion of the vertebrae, the height of the intervertebral segments is slightly reduced.
• Stage III– significant changes in the disc – the height of the disc is reduced by ¼ compared to the one located above, while maintaining the outer surface, the intervertebral foramina and spinal canal are narrowed, the presence of anterior, posterior and posterolateral compact 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 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 gets worse when you try to roll over.Increased pain caused by unsuccessful head turns, coughing, sneezing, or laughing.The pain is dull, dull in nature, sometimes shooting, and localized deep in the neck.The nature of pain in the cervical spine can be either periodic or continuous.The intensity of the pain decreases throughout the day, and it may disappear completely.

Signs of uncomplicated cervical osteochondrosis:

• stiffness, limited mobility in the neck;
• pain and discomfort in the cervical region;
• use of 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 due to the compression of blood vessels and nerve roots.Specific signs appear that are only characteristic of osteochondrosis of the cervical spine.

Vertebral artery syndrome

The development of this cervical osteochondrosis syndrome occurs as a result of violation of the vertebral artery by tense muscles and deterioration in 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 that run from the spinal cord to the arteries.As a result of compression, cerebral ischemia can occur.

Symptoms of vertebral artery syndrome:

• paroxysmal, migraine-like pain in the head, which begins with pulsations in the back of the head and then spreads to the temples, forehead and ears;
• pain that increases with turning or tilting the head in a sitting position;
• neck muscle tension;
• dizziness;
• lack of coordination;
• heaviness in the head;
• tinnitus;
• fainting;
• decreased vision;
• hearing loss;
• tongue numbness with severe impairment of blood supply to the brain;
• memory impairment;
• sleep disorder.

Humeroscapular periarthrosis is a disease that affects the periarticular soft tissues - muscles and tendons of the shoulder and scapula joints, most often develops with cervical osteochondrosis of the vertebral disc between cervical vertebrae IV and V. Innervation in the shoulder - scapular zone is disrupted, and due to this, dystrophic changes develop, increasing gradually.Disorders of tissue nutrition that occur at the beginning of the pathological process remain 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 point of attachment of ligaments and tendons.Disc destruction gradually leads to irritation of autonomic nerve fibers, which in the form of impulses enter the shoulder joint.Periarticular tissue nutrition is disrupted, which affects joint function.

Characteristic symptoms of glenohumeral periarthrosis:

• pain in the shoulder joint, radiating to the neck and arms;
• when moving the arm to the side, restriction and pain are observed;
• 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 develops due to degenerative changes in the spine, intervertebral disc degeneration, and loss of elasticity of the fibrous ring.The appearance of specific symptoms of cervical osteochondrosis depends on the location of the change.

If the 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 regions.
• 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 compression of the spinal nerve occurs, speech disorders, and a decrease in the sensitivity of the tongue.
• with damage to the root of the C 4 nerve 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 neck and head muscles.Damage to the C 4 root can cause breathing problems, pain in the heart area, and hiccups, due to the presence of the phrenic nerve in it.A relatively rare pathology.
• C 5 in the C IV-C V segment – causes pain in the shoulder girdle and outer surface of the shoulder.Weakness of the deltoid muscle, impaired sensitivity of the shoulder 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 – pain radiating from the neck to the scapula, forearm, outer surface of the shoulder, radial surface of the forearm and further to the thumb.Loss of sensitivity even in the skin.In the case of C 7 - pain radiates from the neck to the scapula, to the forearm, back of the shoulder, the surface of the forearm and to the back of the second and fourth fingers, with loss of skin sensitivity in this area.
• 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 muscle weakness in the finger.

Anterior scalene syndrome

The anterior scalene muscle is located in the region 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 gap formed between these muscles, the subclavian artery and the brachial plexus pass.Autonomic nerve fibers are irritated due to disc destruction, and impulses are sent to the anterior scalene muscle.

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, spreading to the forearm and hand.
• Pain that increases by moving the arm to the side and tilting the head.
• Pinched arteries are characterized by cold, numb and swollen hands.

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 projection and in the functional position of the patient – (with open mouth) to determine the decrease in the height of the intervertebral disc and degenerative bone growth.
2. MRI - Magnetic resonance imaging– is the most informative diagnostic method, allowing high accuracy to detect the localization of pathological changes in osteochondrosis of the cervical spine.Detect intervertebral protrusions and hernias, their size and direction of 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 the decrease in the speed of blood flow and the presence of obstacles to normal blood flow.

To exclude pathological processes from the central nervous system, cardiovascular system, organs of vision and hearing, and digestive organs, types of examinations such as ultrasound, ECG, electroencephalography are used for differential diagnosis, and laboratory tests are prescribed.

Principles of cervical osteochondrosis treatment

The main methods of treating cervical osteochondrosis are:

• drug therapy,
• physiotherapeutic treatment,
• massage the cervical collar 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 damaged nerve roots and inflammation;
• B vitamins that improve metabolic processes;
• drugs to improve the rheological properties of blood and blood flow, improve the nutrition of damaged roots;
• chondroprotectors - for the restoration of cartilage tissue;
• muscle relaxant - to relieve muscle spasms.

Physiotherapy in the treatment of cervical osteochondrosis

• Electrophoresis to relieve pain or increase 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 for anti-inflammatory effects.

Therapeutic exercise

For cervical osteochondrosis, physical therapy is prescribed during the recovery period, after the pain has subsided, because pain and discomfort should not be present when performing a set of exercises.It is better if patients with such a diagnosis engage in physical therapy regularly, limiting excessive pressure on the cervical spine.Restoring muscle tone is the main task in the treatment of cervical spine osteochondrosis.

Prevention of cervical osteochondrosis

Physical activity, sleeping on a comfortable bed with an anatomical mattress, a combination of prolonged sitting with warm-up periods, maintaining correct posture and proper nutrition are the keys to the health of the cervical spine.You should try to avoid neck injuries and lifting excessive loads.

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 vary and are 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 cervical spine osteochondrosis is a violation of the blood supply to the brain.Reduced blood circulation due to compression of the vertebral arteries can trigger conditions such as ischemia of the brain and spinal cord, and, in the worst cases, a spinal stroke.

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