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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, consisting of seven discs and having a relatively weak muscular corset combined with increased mobility and instability of the cervical vertebrae.The cervical vertebrae have a relatively smaller height and thickness of the discs and a fairly tight fit with each other, and since the neck muscles are quite developed, with regular loads this can provoke the displacement of the intervertebral discs.

The high sensitivity 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, to control turns and bends.

Causes of cervical osteochondrosis

Until recently, the diagnosis of osteochondrosis was considered very old people;nowadays it is rapidly becoming newer.

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

  • Pathological impact of the focus of degenerative changes on the peripheral nervous system.
  • When the blood supply of the vertebral arteries to 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 back injuries;
  • physical inactivity, a sedentary lifestyle;
  • metabolism is impaired;
  • excess weight;
  • excessive physical activity;
  • errors during the training process among athletes;
  • stressful conditions;
  • poor level of physical fitness;
  • hypothermia;
  • infectious diseases;
  • hereditary factor;
  • incorrect habits, for example - the habit of holding the telephone receiver with your shoulder;
  • the condition of back strain associated with work in a sitting position in office workers, as well as with long periods of driving, etc.;
  • abnormal development of the spine in the cervical region;
  • age-related changes.

All the above factors affect the increase in the load on the cervical spine.The excessive load is compensated by the neck muscles, but as a result of excessive tension, the muscles spasm, 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 disrupted and changes appear in the small intervertebral joints.An increased load on the changed intervertebral discs leads to growth of the bones of the vertebral bodies.

The rate of development of osteochondrosis of the cervical spine

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

  • Graduate– with minimal clinical manifestations.There is usually no pain, or the patient complains of mild pain and discomfort, which intensify with turning the head, rapid fatigue of the neck muscles after prolonged exercise.An examination may reveal mild tension in the neck muscles.All this happens as a result of the partial loss of moisture and elasticity in the core of the intervertebral disc and its compression occurs.
  • degree II– an increase in changes in which the pain in the cervical spine bothers the patient, becomes more pronounced and the pain intensifies as a result of sitting for a long time, especially with the head down.The pain radiates to the shoulder and arm.
  • degree III- increased manifestations of cervical osteochondrosis.It is characterized by constant, aching pain in the cervical spine, radiating to the shoulder and arm.Symptoms of arm muscle numbness or weakness, 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, as the vertebral artery, which supplies the occipital lobe of the brain and the cerebellum, is involved in this 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 according to the degree of change in the intervertebral disc - radiological stages:

  • Phase I– no changes in the disc, slight changes in the configuration of the vertebrae, direction of physiological lordosis;
  • Phase II– small changes related to the instability of the spinal segment, possible development of subluxation in it, twisting of the vertebrae, the height of the intervertebral segment is slightly reduced.
  • Phase III– pronounced changes in the disc – the height of the disc is reduced by ¼ compared to the one above, while preserving the outer surface, the intervertebral foramina and the spinal canal are narrowed, the presence of anterior, posterior and posterolateral compact osteophytes;
  • Phase 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 holes 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 occurs when you lie down after waking up and intensifies when you try to roll over.Increased pain is caused by an unsuccessful turn of the head, coughing, sneezing or laughing.The pain is dull, boring in nature, sometimes shooting and is localized deep in the neck.The nature of pain in the cervical spine can be either periodic or constant.The intensity of the pain decreases during the day, and may even disappear completely.

Signs of uncomplicated cervical osteochondrosis:

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

Then, 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 damage to the vertebral artery by tense muscles and a 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 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 pain in the head, which begins with throbbing 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;
  • feeling of heaviness in the head;
  • tinnitus;
  • fainting;
  • decreased vision;
  • hearing loss;
  • numbness of the tongue with severe deterioration 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, most often develops with cervical osteochondrosis of the vertebral discs between the IV and V cervical vertebrae. The innervation in the shoulder - scapular area is interrupted and due to this, dystrophic changes develop, gradually increasing.A tissue nutritional disorder that occurs 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 localized at the attachment points of ligaments and tendons.The gradual destruction of the disc leads to irritation of the autonomic nerve fibers, which in the form of impulses enter the shoulder joint.The nutrition of the periarticular tissues is interrupted, 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, limitations 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 as a result of degenerative changes in the spine, reduction of intervertebral discs and loss of elasticity of the fibrous ring.The appearance of certain symptoms of cervical osteochondrosis depends on the location of the changes.

If a 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 the 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 sensitivity of half of the neck, where compression of the spinal nerve occurs, impaired speech 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 neck and head muscles.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 in it.A rather rare pathology.
  • C 5 in the segment C IV-C V – causes pain in the shoulder girdle and outer surface of the shoulder.Weakening of the deltoid muscles, 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 case 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 in the skin as well.In case C 7 - radiating pain from the neck to the scapula, in the forearm, on the back of the shoulder, on the surface of the forearm and on the back of the second and fourth fingers, with loss of skin sensitivity in these areas.
  • From 8 to 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 sensation in the little finger, but there will be 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 vertebrae and is attached to the first rib, the medial scalene muscle is also attached to it and, through the gap created between these muscles, the subclavian artery and the brachial plexus pass.Autonomic nerve fibers are irritated as a result of disc destruction, and impulses are sent to the scalene anterior muscle.

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

Symptoms of cervical osteochondrosis, characteristic of the anterior scalene syndrome:

  • The pain ranges from sharp to aching, spreading to the forearm and hand.
  • Pain that increases with 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 the degenerative growths of the bones.
  2. MRI – Magnetic Resonance Imaging– is the most informative diagnostic method, which allows high accuracy to detect the localization of pathological changes in osteochondrosis of the cervical spine.It reveals 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 scan– a method that allows you to determine a decrease in the speed of blood flow and the presence of obstacles in the normal flow of blood.

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

Principles of treatment of cervical osteochondrosis

The main methods of treatment of cervical osteochondrosis are:

  • drug therapy,
  • physiotherapeutic treatment,
  • massage of the cervical 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 circulation.
  • 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 an anti-inflammatory effect.

Therapeutic exercises

For cervical osteochondrosis, physical therapy is prescribed during the recovery period, after the pain has eased, since pain and discomfort should not be present when performing a set of exercises.It is better if a patient with such a diagnosis regularly engages in 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 on a comfortable bed with an anatomical mattress, combining 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 weights.

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 different 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 consequences such as paresis and paralysis.

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

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