Cervical osteochondrosisis a progressive degenerative-dystrophic disease of the most mobile part of the spine, consisting of seven discs and having a relatively weak muscle corset combined with increased mobility and instability of the cervical vertebrae.The cervical vertebrae have a relatively smallest height and thickness of the discs and a fairly tight fit to each other, and since the neck muscles are rather poorly developed, with regular loads this can provoke 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 bends.
Causes of cervical osteochondrosis
Until recently, the diagnosis of osteochondrosis was considered the lot of older people; 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 on the peripheral nervous system.
- When the blood supply to the vertebral arteries of brain cells is disrupted.
- In difficult 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;
- 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, as an example – the habit of holding the telephone receiver with your shoulder;
- strained back condition associated with working in a sitting position 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 increase in load in the cervical spine.The excess load is compensated by the muscles of the neck, but as a result of excessive tension, the muscles spasm, this leads to poor circulation and, as a consequence, degenerative changes - cervical osteochondrosis.
Pathological changes occur in the structure of the intervertebral discs, their nutrition is disrupted, and changes in small intervertebral joints appear.An increased load on the altered intervertebral discs leads to bone growths of the vertebral bodies.
Degree of development of osteochondrosis of the cervical spine
When determining the degree of cervical osteochondrosis, they rely on the clinical picture and complaints of the patient.
- I degree– with minimal clinical manifestations.There is usually no pain, or the patient complains of mild pain and discomfort, intensifying with turning the head, rapid fatigue of the neck muscles after prolonged exercise.An examination may reveal slight 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– an increase in changes in which pain in the cervical spine bothers the patient, becomes more pronounced, and pain intensifies as a result of prolonged sitting, in particular 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.
- IV degree– acute pain in the neck, partial loss of control over the limbs, vestibular disorders, headaches, dizziness, loss of consciousness, since 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 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– minor 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 relative to the one located above, while maintaining the outer surface, the intervertebral foramina and the spinal canal are narrowed, the presence of anterior, posterior and posterolateral compact osteophytes;
- IV stage– 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 lying 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 laughter.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 throughout the day, and it may even disappear completely.
Signs of cervical osteochondrosis without complications:
- stiffness, limited mobility in the neck;
- pain and discomfort in the cervical area;
- adoption of a forced head position;
- when moving the head there is a feeling of “crunching” 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 appear that are characteristic only of osteochondrosis of the cervical spine.
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 a deterioration in 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 can occur.
Signs of vertebral artery syndrome:
- paroxysmal, migraine-like pain in the head, which begins with pulsation 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 developing with cervical osteochondrosis of the vertebral discs between the IV and V cervical vertebrae.The innervation in the shoulder - scapular zone is disrupted, and due to this, dystrophic changes develop, increasing gradually.A tissue nutritional disorder that occurs at the very 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 disrupted, 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 muscles of the shoulder and scapula.
Radicular syndrome
Radicular syndrome develops as a result of degenerative changes in the spine, decreased 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 segment C I-C II - localization of pain in the parietal and occipital region.
- With 3 in segment C II-C III, it is quite rare.Painful sensations are accompanied by a decrease in the sensitivity of half the neck, where compression of the spinal nerve occurs, speech impairment, 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 collarbone 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 cardiac region, and hiccups, due to the presence of the phrenic nerve in it.Quite a rare pathology.
- C 5 at segment C IV-C V – causes pain in the shoulder girdle and outer surface of the shoulder.Weakening of the deltoid muscle, impaired sensitivity of the shoulder in 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 – radiating pain 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 case C 7 - radiating pain from the neck to the scapula, to the forearm, the back of the shoulder, the surface of the forearm and to the back of the second and fourth fingers, with loss of sensitivity of the skin in these areas.
- From 8 at 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 sensation of pain in the little finger, but there will be noticeable weakening of the muscles in 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 formed 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 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 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:
- X-ray examination of the spine– in direct and lateral projections and in the patient’s functional positions – (with an open mouth) to determine the decrease in the height of the intervertebral discs and degenerative bone growths.
- 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.Detects protrusions and intervertebral hernias, the size and direction of their growth.
- CT – computed tomography– determines the presence of changes in the vertebrae in cervical osteochondrosis, but this diagnostic technique is less informative.
- Ultrasound duplex scanning– a method that allows you to determine a decrease in blood flow speed and the presence of obstacles to normal blood flow.
In order to exclude pathological processes from the central nervous system, cardiovascular system, organs of vision and hearing, and 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 treating cervical osteochondrosis are:
- drug therapy,
- physiotherapeutic treatment,
- massage of 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 the damaged nerve root and inflammation;
- B vitamins that improve metabolic processes;
- drugs to improve the rheological properties of blood and blood flow, improving 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 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
For cervical osteochondrosis, physical therapy is prescribed during the recovery period, after pain has been relieved, since pain and discomfort should not be present when performing a set of exercises.It is best if a patient with such a diagnosis engages in physical therapy regularly, 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 in a comfortable bed with an anatomical mattress, a combination of prolonged sitting with periods of warm-up, maintaining correct posture and proper nutrition are the 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.
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 such consequences 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 provoke conditions such as ischemia of the brain and spinal cord, and, in the worst case, spinal stroke.
To avoid irreversible damage, it is strongly recommended to consult a doctor as soon as possible.