Cervical osteochondrosis or osteochondrosis of the cervical spine is a common disease of knowledge workers. Rapidly progressive disease. It is with cervical osteochondrosis, complicated by the development of disc hernias, that an increase in the incidence of early strokes is associated. For diagnosis, an MRI scan is required.
What is cervical osteochondrosis?
Cervical osteochondrosis is a common cause of neck pain, headache, pressure surges, shoulder pain, numbness in the fingers, pain under the scapula. Currently, the frequency of cervical osteochondrosis has increased significantly, as the role of the computer in our life has grown.
However, a fall or injury can stimulate the onset of osteochondrosis, and degeneration (wear) of the intervertebral discs over time can lead to symptoms.
Symptoms
In addition to moderate or mild pain, a feeling of stiffness in the neck and, in some cases, impaired mobility, many patients with cervical osteochondrosis feel numbness, tingling, and even weakness in the neck, arm, or shoulder as a result of chemical irritation and pinched nerves in the cervical spine.
For example, pinching a nerve root at the C6-C7 segment can cause weakness in the triceps, shoulder or forearm muscles, weakness in the wrist muscles, causing the hand to "hang", and a change in sensitivity in the middle finger.
Cervical osteochondrosis also often leads to the development of stenosis (narrowing) of the spinal canal and other progressive conditions, for example, intervertebral hernia. How does this happen?
Osteochondrosis is nothing more than degeneration of the vertebral structures, caused, as a rule, by natural aging of the body. With age, thickening of the ligaments, the formation of bone growths on the vertebrae and other changes occur. When the ligaments of the spine become thickened or bone growths appear, as well as for a number of other reasons, there is less space for the spinal cord and nerves inside the spinal canal. This condition is called stenosis, i. e. narrowing of the spinal canal. Severe narrowing of the spinal canal can lead to compression of the nerve roots or even the spinal cord itself.
Intervertebral hernia is also, in most cases, a consequence of degeneration. Intervertebral discs serve as shock absorbers of friction between the vertebrae, thus preventing their destruction. Over time, the disc loses moisture and nutrients, flattens, becomes more fragile and less elastic. As a result, a crack can form in the annulus, through which part of the nucleus pulposus is squeezed out into the spinal canal. This condition is called intervertebral hernia. If an intervertebral hernia compresses a nearby nerve root, pain syndrome and / or corresponding neurological symptoms occur.
Diagnostics
Successful diagnosis of cervical osteochondrosis begins with a doctor's consultation. The doctor compiles the patient's medical history and performs a physical exam to check for neck mobility and sensitivity. During the examination, the patient may be asked to perform certain movements and report how the pain symptoms change (increase or decrease).
If the examination indicates that further tests are needed, your doctor may recommend radiographic tests such as radiography, magnetic resonance imaging (MRI), or computed tomography (CT). These diagnostic examinations, with varying degrees of reliability, can confirm the presence and localization of osteochondrosis, as well as identify other conditions (for example, calcification or arthritis) that may be the cause of the patient's symptoms.
The best option for radiographic examination at the moment is MRI, becauseWith the help of a magnetic resonance imager, it is possible to obtain high-quality detailed images of not only bone tissue, as in radiography, but also soft tissues of the spine, including muscles, ligaments, vessels, nerves and intervertebral discs. CT is usually prescribed if there are any contraindications to MRI, the main of which is the presence of metal structures or devices in the body (artificial joints, pacemakers, etc. ). The quality of CT scans is lower than the quality of MRI scans, but they can also show the condition of the soft tissues of the spine.
Treatment of cervical osteochondrosis
Conservative (without surgery) treatment of osteochondrosis is always recommended as the primary strategy, and surgical intervention is considered only if complex conservative treatment for at least six months has not yielded results or if pain and other symptoms significantly interfere with the patient's daily routine. activities.
Methods used in the conservative treatment of cervical osteochondrosis may include:
- traction of the spine (traction). The non-load methods of spinal traction, which have been used recently, allow to completely remove the complications of this method of treatment, without which traction with a load cannot do. With an increase in the intervertebral distance, the nutrition of all intervertebral discs improves, the pain syndrome disappears.
- Remedial gymnastics . . Remedial gymnastics can improve the mobility of the spinal segment. In the mobile vertebral segment, hernias and protrusions do not grow or form, since the intervertebral discs perform their function.
- massotherapy.
- drug therapy. Includes NSAIDs (non-steroidal anti-inflammatory drugs) and pain relievers. In most cases, drug therapy has little or no temporary effect.
- cervical corsets, orthopedic pillows. They can be recommended to stabilize the cervical spine and reduce pressure on the nerve root after trauma and spinal fractures.
Surgical treatment of cervical osteochondrosis
If there is no significant relief after six months of conservative treatment and the daily routine becomes difficult for the patient, surgery may be considered. Typically, for cervical osteochondrosis, a procedure called spinal fusion is performed to immobilize the affected vertebral segment. This surgery involves removing the intervertebral disc, decompressing the nerve root, and placing a bone or metal implant to maintain or create a normal disc space and to stabilize the spinal segment.
As a rule, spinal fusion is performed on one vertebral segment; in rare cases, the question of performing an operation on two vertebral segments may be considered. Be that as it may, the patient needs to know that surgery to relieve the symptom of neck pain is much less likely to lead to positive results than a similar surgery to relieve pain in the arm with cervical osteochondrosis. Therefore, if neck pain is the main or only symptom, spinal fusion should only be recommended as a last resort or if all conservative treatments have been tried and failed. If disc space cannot be identified as the most likely source of neck pain, it is best to avoid surgery, even if conservative treatment does not provide significant relief from pain. In addition, do not forget that spinal surgery can be fraught with rather serious consequences both in the operated area (local infection, implant rejection, etc. ) and for the whole body (blood clots, allergic reactions to drugs, etc. ). ). Therefore, before making a decision on surgical treatment, it is necessary to discuss all the details of the operation directly with the surgeon who will perform it. It should also be noted that surgery on the cervical spine most often leads the patient to vertebral disability.
What is cervical osteochondrosis?
Official medicine interprets osteochondrosis as a degenerative-dystrophic lesion of the intervertebral discs.
From what part of the spine these discs are located, the definition of the disease is also given.
Let's consider specifically the symptoms of cervical osteochondrosis, which accounts for almost 80% of all diseases of our back.
The sad factor is that the disease affects the category of patients aged 30 to 50 years, that is, in the prime of their working capacity.
In young people, the disease acts as an independent ailment, at an older age it is already a pathology that has developed against the background of other diseases of the joints.
How does the disease develop?
For any part of the spine, a phased development of the disease is characteristic. Cervical osteochondrosis does not go beyond this framework, so it is worth dwelling in detail on each of its stages.
- In the initial stage, there is a gradual destruction of the intervertebral discs. An annulus fibrosus is located between them, in which cracks appear, leading to a decrease in the elasticity and strength of the discs themselves. They shrink and compress the nerve roots.
- The second stage is a consequence of the untreated first stage. The beginning destruction of the discs spills over into a chronic form, tissue compaction occurs, dislocations of the cervical vertebrae are observed. Falling head syndrome often develops at this stage.
- In the third stage, the pain sensations intensify, constant headaches appear, the sensitivity of the upper limbs is lost, and cervical "lumbago" is tormented. This is due to the fact that the fibrous ring at this stage is almost completely destroyed.
Often, there is a decrease in pain sensations of cervical osteochondrosis of the third degree. This happens at the moment when the cartilage tissue disappears and there is nothing to hurt.
Causes
Given the prevalence of osteochondrosis in general, doctors began to closely study its causes. Many of the negative factors have been identified, but there is no definitive list. Here are the ones that have been announced to date:
- sedentary lifestyle;
- all kinds of intoxication and infection;
- great physical activity;
- smoking;
- constant weight lifting;
- stress and nervous tension;
- uncomfortable shoes or an irregular foot that creates unnecessary pressure on the spine;
- improper nutrition;
- frequent hypothermia and exposure to bad weather;
- age-related changes;
- spinal injury;
- poor heredity;
- a sharp refusal to train, if before that they have been doing them for a long time.
Having familiarized yourself with the reasons, it becomes obvious that cervical osteochondrosis can come at any age. And if at the beginning the symptoms of osteochondrosis are insignificant and are marked by rare pain attacks, then over time it turns out that it is impossible to turn the neck either, and it is difficult to tilt the head. And these are not the only dangers of the disease.
What is the danger of the disease
Our neck is a great worker. She is involved all day, and her small vertebrae stoically withstand all our turns and tilts of the head. If the bones are displaced, nerves are pinched and blood vessels are compressed, and the vertebral artery, which is responsible for nourishing the brain, also passes through the cervical spine. The artery is compressed, the nerve root is compressed and the inflammatory process begins.
What does this lead to? Spinal stroke, ischemia, intervertebral hernia - these are the severe consequences of cervical osteochondrosis. We add here a general decrease in mobility and the formation of osteophytes. As a result, we have a disability threatening complete immobility. With such a disappointing prognosis, it is important to quickly recognize the symptoms of cervical osteochondrosis.
Symptoms
The shortest way to identify osteochondrosis is the patient's complaints. So what kind of sensations does a person talk about if his cervical vertebrae are destroyed? The picture of the disease looks like this:
- dizziness;
- Strong headache;
- "Flies" and colored spots in the eyes against the background of pain in the head;
- pain when turning, lifting weights;
- pain radiating to other organs (region of the heart, other organs).
Sometimes signs of osteochondrosis can be ranked among other diseases, but they cannot be ignored, even if they are temporary.
Diagnostics and treatment
In continuation of the feelings expressed by the patient, the neurologist proceeds to a more accurate diagnosis of the disease. A few years ago, only x-rays were in the arsenal of doctors for recognizing osteochondrosis. Computed tomography and magnetic resonance imaging are actively used today. They allow you to accurately determine the stage of the disease.
After evaluating the resulting picture, a specialist vertebroneurologist prescribes the necessary treatment. The first thing the doctor takes is to relieve pain, then swelling and inflammation. Such anti-inflammatory drugs are used for pain relief. As we remember, compression of the vertebral artery disrupts the supply of the brain, which means that it needs to be improved. This is done with the help of muscle relaxants.
Knowing that the symptoms and treatment of cervical osteochondrosis relate to the spine, massage and physiotherapy exercises must be included in the complex of health-improving measures. The massage is carried out by a professional and by the patient himself. There are also special exercises aimed at developing the cervical vertebrae and restoring their mobility.