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Cervical osteochondrosis

Cervical osteochondrosis usually affects people who work in a sedentary position

Cervical osteochondrosisis a progressive degenerative dystrophic disease of the most mobile part of the spine, consisting of seven discs and with a relatively weak muscular corset combined with increased mobility and instability of the cervical vertebrae.The cervical vertebrae have a relatively smaller height and disc thickness and a very tight fit between them and, as the neck muscles are poorly developed, with regular loads this can cause 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 curves.

Causes of cervical osteochondrosis

Until recently, the diagnosis of osteochondrosis was considered the fate of the elderly;nowadays it is rapidly becoming younger.

Cervical osteochondrosis and its manifestations can be caused by disruption 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 interrupted.
  • In difficult cases – compression and violation 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 impaired;
  • overweight;
  • excessive physical activity;
  • errors during the athletes’ training process;
  • stressful conditions;
  • low level of physical fitness;
  • hypothermia;
  • infectious diseases;
  • hereditary factor;
  • incorrect habits, for example – the habit of holding the phone with your shoulder;
  • back strain condition associated with sitting 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 intervertebral discs, their nutrition is disturbed and changes appear in small intervertebral joints.An increased load on the altered intervertebral discs leads to bone growth of the vertebral bodies.

Degree of development of osteochondrosis of the cervical spine

When determining the degree of cervical osteochondrosis, they are based on the clinical picture and complaints of the patient.

  • I graduated– with minimal clinical manifestations.There is usually no pain, or the patient complains of mild pain and discomfort, intensifying when turning the head, rapid fatigue of the neck muscles after prolonged exercise.An examination may reveal mild tension in the neck muscles.All this occurs as a result of partial loss of moisture and elasticity in the core of the intervertebral disc, and its compaction occurs.
  • II degree– increased changes in which pain in the cervical spine bothers the patient, becomes more pronounced and the pain intensifies when sitting for a long time, especially with the head down.The pain radiates to the shoulder and arm.
  • III degree– increased manifestations of cervical osteochondrosis.Characterized by constant, aching pain in the cervical spine, radiating to the shoulder and arm.Symptoms of numbness or weakness of arm muscles, dizziness.Often this stage is the beginning of the formation of an intervertebral hernia.
  • Grade IV– sharp pain in the neck, partial loss of control of the limbs, vestibular disorders, headaches, dizziness, loss of consciousness, since the vertebral artery, which irrigates 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, which can cause fusion of the vertebrae, causing the neck to lose its mobility.

Classification of cervical osteochondrosis according to the degree of change in the intervertebral disc - radiological stages:

  • Stage I– no changes in the disc, slight changes in the configuration of the vertebrae, straightening of the physiological lordosis;
  • Stage II– small changes associated with instability of the spinal segment, possible development of subluxation in it, torsion 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 in relation to the one located above, maintaining the external surface, the intervertebral foramina and the 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 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 you lie down when you wake up and intensifies when you try to roll over.Increased pain is caused by unsuccessfully turning the head, coughing, sneezing or laughing.The pain is dull, dull in nature, sometimes sharp, 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 uncomplicated cervical osteochondrosis:

  • stiffness, limited mobility in the neck;
  • pain and discomfort in the cervical region;
  • adoption of a forced head position;
  • when moving the head there is a feeling of “crushing” 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 characteristic only of osteochondrosis of the cervical spine appear.

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 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 that run from the spinal cord to the artery.As a result of compression, cerebral ischemia may occur.

Signs of vertebral artery syndrome:

  • paroxysmal headache, similar to a migraine, 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;
  • muscle tension in the neck;
  • 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 developing with cervical osteochondrosis of the vertebral discs between the IV and V cervical vertebrae. The innervation in the shoulder-scapular zone is interrupted and, as a result, dystrophic changes develop, gradually increasing.A tissue nutritional disorder that occurs early in the pathological process remains unnoticed for a long time.With the development of glenohumeral periarthrosis, other symptoms of cervical osteochondrosis recede into the background.The deep pain is localized at the attachment points of the ligaments and tendons.The gradual destruction of the disc leads to irritation of the autonomic nerve fibers, which enter the shoulder joint in the form of impulses.The nutrition of the periarticular tissues is impaired, 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 shoulder and scapula muscles.

radicular syndrome

Radicular syndrome develops as a result of degenerative changes in the spine, shrinkage 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 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 region.
  • With 3 in the C II-C III segment, it is quite rare.Painful sensations are accompanied by a decrease in sensitivity in the middle of the neck, where compression of the spinal nerve occurs, impaired speech and a decrease in sensitivity of the tongue.
  • with damage to the C 4 nerve root in the C III-C IV segment, the localization of pain and decreased sensitivity in the region 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 heart region and hiccups, due to the presence of the phrenic nerve there.A very rare pathology.
  • C 5 in the C IV-C V segment – causes pain in the shoulder girdle and on the outer surface of the shoulder.Weakening of the deltoid muscle, decreased 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, external surface of the shoulder, radial surface of the forearm and subsequently to the thumb.Loss of sensitivity even in the skin.In case C 7 - pain radiating from the neck to the scapula, to the forearm, back of the shoulder, surface of the forearm and back of the second and fourth fingers, with loss of skin sensitivity in these areas.
  • From 8 in segment C VII-T I – localization of pain and loss of sensitivity in the neck spreads to the posterior surface of the shoulder, ulnar edge of the forearm, little finger.There may be no sensation of pain in the little finger, but there will be a noticeable weakening of the finger muscles.

anterior scalene syndrome

The anterior scalene muscle is located in the region of the third and fourth cervical vertebrae and is inserted into the first rib, the medial scalene muscle is also inserted into it and, through the space formed between these muscles, the subclavian artery and the brachial plexus pass.Autonomic nerve fibers become irritated as a result of disc destruction and impulses are sent to the anterior scalene 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, spreading 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 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 patient's functional positions – (with the mouth open) to determine the decrease in the height of the intervertebral discs and degenerative bone growths.
  2. Magnetic Resonance Imaging – Magnetic Resonance Imaging– is the most informative diagnostic method, allowing 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. Ultrasound duplex 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, types of examinations 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 treating cervical osteochondrosis are:

  • drug therapy,
  • physiotherapeutic treatment,
  • massage in the cervical collar region,
  • therapeutic exercises.

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

  • nonsteroidal anti-inflammatory medications that reduce pain, help relieve damaged nerve root swelling and inflammation;
  • B vitamins that improve metabolic processes;
  • medicines to improve the rheological properties of blood and blood flow, improving the nutrition of damaged roots;
  • chondroprotectors – for the restoration of cartilaginous 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 for an anti-inflammatory effect.

Therapeutic exercise

In cervical osteochondrosis, physiotherapy is prescribed during the recovery period, after pain relief, as pain and discomfort should not be present when performing a series of exercises.It is best for a patient with this diagnosis to practice physical therapy regularly, limiting excessive stress on the cervical spine.Restoration of 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, combining prolonged sitting with warm-up periods, maintaining correct posture and adequate nutrition are 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 assessment of the health of the most mobile part of the spine.

The complications of this disease are varied 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, compression of which can lead to consequences such as paresis and paralysis.

Another danger 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 lead to diseases such as ischemia of the brain and spinal cord and, in the worst case, stroke.

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