Cervical osteochondrosis

Cervical osteochondrosis is a chronic degenerative disease in which there is thinning of the intervertebral discs between the vertebrae, followed by their replacement with bone tissue. As the degenerative process progresses, the surrounding structures are affected. This causes the development of a whole complex of symptoms that completely subdue the patient's life.

General information

The intervertebral discs consist of a gel-like core and a dense fibrous ring surrounding it, which is covered on top by a layer of cartilage tissue. They perform a shock-absorbing function, prevent vertebral damage when running, walking and jumping, and also contribute to the mobility and flexibility of the entire spine.

In the course of natural aging and under increased stress conditions, the height of the intervertebral disc gradually decreases. The metabolism in its core is disturbed, cracks appear in the surrounding fiber ring. There are protrusions of intervertebral discs - protrusions and hernias. As the disease progresses, cartilage and bone become involved, osteophytes appear - bone overgrowths that cause limited mobility and severe pain.

Since pathological changes take place in the immediate vicinity of the spinal cord and its roots, this leads to their compression and inflammation, as well as the reflex development of muscle spasms. As a result, a person experiences characteristic symptoms by which a disease can be suspected.

The reasons

Osteochondrosis of the cervical spine refers to multifactorial diseases. It occurs against the background of a whole complex of factors, each of which aggravates the course of pathology. The list of reasons includes:

• overweight;
• sedentary lifestyle;
• sedentary work;
• incorrect posture;
• chronic diseases of the musculoskeletal system (scoliosis, flat feet), contributing to uneven distribution of the load on the spine;
• congenital pathologies of the development of the spine, as well as injuries;
• excessive, repetitive loads on the spine;
• hereditary predisposition.

Symptoms and Syndromes

Symptoms of cervical osteochondrosis do not appear immediately and are often disguised as other diseases.

The most common signs include:

• Dizziness: In osteochondrosis, it is usually systemic, i. H. it seems to a person that the surrounding objects rotate before his eyes;
• Pain in the back of the head, neck, collar area: their intensity depends on the degree of development of the disease; mild and episodic at an early stage, it spreads to the whole head and becomes permanent; periodic attacks become unbearable, as a result of which a person cannot even move his head;
• Noise or ringing in the ears: occurs when changing position after prolonged immobility, often accompanied by dizziness;
• a feeling of lack of air, the inability to breathe deeply; in severe cases, severe shortness of breath develops;
• Nausea and vomiting: associated with impaired blood flow to certain areas of the brain, aggravated when trying to turn your head;
• Reduced visual acuity, flickering flies or fog in front of the eyes: indicate insufficient blood supply to the brain; occur in advanced stages of the disease;
• blood pressure fluctuations that are difficult to correct with medication;
• sudden fainting due to vasospasm;
• Throat lump, sweating, dryness, difficulty swallowing: they are often one of the first signs of a pathology.
• shoulder pain
• numbness of fingers

In addition to the general signs of cervical osteochondrosis, there are several syndromes characteristic of this disease.

vertebral syndrome

The symptom complex is associated with damage to the bones and cartilage of the spine. It contains:

• limited mobility in the neck area;
• pain when turning the head;
• X-ray signs of damage to the vertebrae themselves and the space between them.

vertebral artery syndrome

Symptoms are caused by narrowing or spasms of the vertebral arteries, which are partially responsible for blood supply to the brain. It manifests itself through the following symptoms:

• noise in the ears;
• Dizziness;
• jumps in blood pressure;
• nausea and vomiting;
• Headache;
• visual impairment;
• decrease in working capacity;
• Sleepiness;
• fainting.

cardiac syndrome

It resembles a condition with damage to the heart muscle and includes:

• pain or burning behind the breastbone;
• weakness and fatigue;
• fast pulse.

radicular syndrome

The condition is associated with damage (compression or pinching) to the nerve roots that exit the spine in the neck area. Depending on the level of damage, a person may experience:

• numbness or pain in the back of your head;
• numbness of tongue;
• collarbone pain, difficulty swallowing, hiccups;
• Discomfort in the shoulder area, aggravated by hand movements;
• pain in the shoulder blades and forearms;
• numbness of the index and middle finger;
• Numbness of ring finger and little finger.

Most often, several nerve roots are involved in the pathological process at once, as a result of which several characteristic symptoms are observed at once.

stages

Cervical osteochondrosis, as it develops, passes through four consecutive stages (grades), which determine the severity of symptoms and the general condition of the patient.

• 1st stage. The thickness of the intervertebral discs is slightly reduced. Symptoms are practically absent, sometimes there is a slight discomfort in the neck, for example, with a long stay in an uncomfortable position.
• 2 level. The height of the intervertebral disc becomes even smaller, pathological growth of cartilage tissue begins, protrusions (protrusions) appear. The pain increases, accompanied by stiffness in the neck region.
• 3 steps. The fibrous ring that surrounds the core of the intervertebral disc is torn, an intervertebral hernia forms. The spine is noticeably deformed, the risk of dislocation and subluxation of the vertebrae increases. The pain becomes permanent, other symptoms of osteochondrosis appear.
• 4 levels. Irreversible changes occur in the spine: bone growth occurs, the intervertebral disc is replaced by scar tissue and loses its ability to bear the load. The symptoms become more pronounced and have a significant impact on the patient's lifestyle and well-being. The quality of life decreases.

diagnosis

In search of the causes of pain or dizziness, the patient can turn to doctors of various specialties: therapists, cardiologists, gastroenterologists, neurologists. Diagnosing osteochondrosis requires a comprehensive examination, which includes:

• X-ray and computed tomography: effective only in later stages of disease development, when changes become clearly visible;
• Magnetic resonance tomography: Due to the high degree of visualization, you can already see the first changes. is currently the main diagnostic method;
• Duplex scanning of the arteries of the head and neck: allows assessment of blood flow quality to detect vasoconstriction; used to determine the causes of headaches and dizziness.

It is mandatory to conduct an interview and examination of the patient, determine the pain zones and the degree of mobility of the spine, and assess the quality of the reflexes. For differential diagnosis in other diseases with similar symptoms, the following can be prescribed:

• ECG, ultrasound of the heart;
• daily monitoring of ECG and blood pressure;
• chest X-ray;
• Consultations of narrow specialists: cardiologist, ENT.

treatment

Treatment of cervical osteochondrosis requires an integrated approach and includes:

• medicinal effect;
• Physical therapy;
• physiotherapeutic exercises;
• Massage;
• Surgery.

Medical treatment

The main goal of drug treatment is to relieve pain and dizziness, restore normal function of nerve roots and, if possible, stop or slow down the destruction of cartilage tissue. Depending on the situation are assigned:

• nonsteroidal anti-inflammatory drugs (meloxicam, diclofenac, nimesulide, etc. ): to relieve pain and inflammation; are used in the form of tablets, injections, ointments, patches;
• Steroid drugs (hydrocortisone, dexamethasone): also used to reduce inflammation when NSAIDs are ineffective;
• Muscle relaxants (Mydocalm): Drugs that eliminate reflex muscle spasms, thereby relieving pain and improving blood flow;
• Group B vitamins in the form of injections or tablets (Milgamma, Neuromultivit): help improve the conduction of nerve impulses;
• Sedatives for severe pain to improve sleep and reduce the emotional component of pain;
• decongestants for pinched nerve roots;
• Chondroprotectors: drugs that help restore cartilage tissue.

Depending on the symptoms, drugs to improve microcirculation in the cerebral vessels, drugs for nausea and dizziness, etc. may also be prescribed.

Non-drug treatment

Non-pharmacological methods of treatment are used without aggravation. Depending on the clinical situation, the following are used:

• Physical therapy:
• laser therapy;
• magnetotherapy;
• UHF therapy;
• phonophoresis and electrophoresis;

Non-drug treatment helps reduce the severity of symptoms and decrease the frequency and severity of exacerbations. It works indirectly:

• improves blood circulation in the affected area, metabolism and regeneration processes;
• enhances the effect of drugs;
• helps strengthen the muscular frame and stabilize the spine;
• reduces the load on the intervertebral discs;
• eliminates muscle spasms and blockages.

surgery

The help of surgeons is required in advanced cases of the disease, when medical methods are no longer effective. Several operations are currently used:

• surgical removal of a herniated disc (microdiscectomy, endoscopic or transfacettic surgery);
• Laminectomy: Removal of the spinous processes or vertebral arch, reducing stress on the spinal root;
• Nucleoplasty: Repair of a hernia by removing part of the nucleus of the disc.

It is important to remember that only a doctor can decide how to treat osteochondrosis of the cervical spine. The scheme is drawn up individually, taking into account the stage of the disease, comorbidities and the individual characteristics of the patient's body.

complications

Osteochondrosis causes disruption of the most important structures: blood vessels and nerves. Without treatment, the disease can lead to the following complications:

• ischemic stroke;
• loss of sensation or motor function of the hand;
• Difficulties swallowing;
• violation of the thyroid gland;
• Loss or marked reduction in visual acuity.

In addition, damage to intervertebral discs and joints leads to a significant restriction in neck mobility.

prevention

If attention is paid to the prevention of cervical osteochondrosis, its progression slows down significantly even with existing changes. Doctors recommend:

• lead an active lifestyle, avoid hypodynamia;
• minimize or eliminate heavy lifting;
• Sleep on an orthopedic mattress and pillow;
• Do regular warm-up exercises if you have to work at the computer for a long time.

The ideal sport for osteochondrosis is swimming. Water relieves the spine and active movements contribute to the formation of the muscular framework.

treatment in the clinic

The doctors of the clinic offer their patients complex methods of treating cervical osteochondrosis, including:

• Consultations of a vertebrologist;
• modern drug therapies for pain relief and alleviation of the disease;
• drug blockade for quick pain relief;
• effective forms of physiotherapy;
• Exercise therapy exercises under the supervision of an experienced instructor, development of a complex for homework;
• Consultations of a rehabilitation doctor;
• massage therapy;
• Acupuncture;
• Services of a manual therapist if required.

Pathologies of the cervical spine

Injuries to the cervical spine are very often accompanied by weakness and headaches because important blood vessels, the vertebral arteries, pass through them. They are responsible for providing adequate nutrition to the brain, and therefore when they are squeezed by displaced vertebrae or other structures, the blood supply to the brain is disrupted. This leads to the development of tissue ischemia, which is accompanied by headache, weakness and a number of other symptoms. These include:

Very often today people of different ages, sexes and social status are diagnosed with osteochondrosis, as well as its complications - protrusions and intervertebral hernias. These diseases are characterized by the occurrence of degenerative-dystrophic changes in the intervertebral discs separating the vertebrae. As a result, their height decreases, which leads to the convergence of the vertebrae and creates conditions for the injury of the spinal roots passing there.

If untreated, degenerative-dystrophic changes in the intervertebral discs progress, over time a protrusion forms - a protrusion of part of the intervertebral disc outward. It tends to gradually increase in size and subsequently turn into an intervertebral hernia. In such cases, the risk of nerve root compression increases dramatically.

Also, osteochondrosis and its complications are accompanied by the formation of bone and cartilaginous proliferations - osteophytes - on the surface of the vertebral bodies. They can reach large sizes and, like hernias, mechanically compress the vertebral arteries, causing weakness and headaches. At the same time, cephalgia is one of the main symptoms of osteochondrosis of the cervical spine, even if the vertebral arteries are not damaged.

Other symptoms of cervical osteochondrosis are:

• crunching of the neck when tilting, turning the head;
• Neck pain radiating to the back of the head, into the arms;
• Reflex spasm of the neck muscles, increasing pain;
• mobility restrictions;
• Violations of the sensitivity of various parts of the upper limbs, occiput, neck;
• difficulty swallowing, etc.

The disease cannot go away on its own. It is characterized by periods of exacerbation and remission, but it is progressive and, in advanced cases, requires surgery to remove large hernias. Therefore, if symptoms appear, you should contact a neurologist immediately.

When you urgently need to see a doctor

In some cases, when a headache occurs in combination with weakness, you should immediately consult a doctor, as this may indicate the development of dangerous diseases and conditions, including stroke and meningitis (inflammation of the meninges).

Warning symptoms are:

• severe headache that comes on suddenly;
• limited ability to tilt the head forward and press the chin to the chest, combined with general weakness;
• Confusion;
• visual impairment, speech;
• limb numbness.

diagnosis and treatment

Headaches and weakness can be associated with both relatively harmless conditions and serious illnesses. If they appear with enviable regularity, and other symptoms appear, you should consult a doctor: a neurologist, a cardiologist, an endocrinologist. But if it is difficult to guess for yourself what exactly caused the violation of general well-being and headache, it is better to first contact a therapist. If necessary, the doctor will prescribe additional research methods and, based on their results, taking into account the clinical picture, will make a diagnosis or refer the patient to a certain specialist for treatment.

To diagnose the causes of headache and weakness, the following is prescribed:

• KLA, OAM, biochemical blood test - allow you to detect inflammatory processes, as well as disorders in the work of individual organs and metabolism;
• ECG, ultrasound of the heart, neck and head vessels - provide data on the work and condition of the blood vessels, heart muscle;
• EEG - allows you to detect changes in the functioning of individual parts of the brain;
• X-ray, CT, MRI of the cervical spine - are indicated to detect pathologies of the spine and assess their severity.

Based on the results of the studies, it is almost always possible to determine the cause of headaches and weakness and thus choose an effective treatment strategy. It is developed individually for each patient and is aimed both at improving the general condition and at eliminating the established disease. Therefore, to treat headache and weakness can be used:

• drug therapy, including individually selected drugs, especially NSAIDs, for migraines, to improve blood supply to the brain, highly specific drugs;
• physiotherapeutic procedures that help increase the effectiveness of other methods of treatment and consolidate the results obtained;
• Manual therapy, the main purpose of which is to restore the spine, the condition of which depends on the work of all organs and systems.

In any case, alarming symptoms such as headaches and weakness should not be ignored, especially if they occur frequently. In such cases, you should definitely consult a doctor. As a result, increased weakness, the progression of existing pathological changes and associated complications are avoided in a short time. After all, the earlier the disease is diagnosed, the easier it is to get rid of it.