Cervical spondylosis is a disease that affects the vertebrae and discs.Cervical osteoarthritis refers to deforming pathologies of the back.Related changes in the discs are observed as early as age 20. At the same time, they become more sensitive to tension, less elastic and lose their lubricating fluid.
Most often, the pathology occurs in the elderly, but now the incidence in children and young people is increasing significantly.Neurologists identify cervical spondylosis using the latest diagnostic tests.After clarifying the diagnosis, complex therapy is carried out with the most effective drugs, physiotherapeutic procedures and innovative physical rehabilitation methods.
The name of this disease is composed of two Greek terms “osteon” (bone) and “chondros” (cartilage).Cervical spondylosis begins with changes in the central part of the disc.The intervertebral disc loses moisture and reduces in size, leading to the convergence of the vertebral bodies and compression of nerve roots and blood vessels.The vertebrae receive nutrients from surrounding tissues, causing harm to the body.Compression of nerves and blood vessels leads to protective muscle spasms, which, as the disease progresses, become the cause of pain.
Which doctor treats this disease?
Treatment of osteoarthritis is the field of activity of neurologists.However, if symptoms of cervical osteoarthritis appear, you can contact your general practitioner.A neurologist will choose drugs for cervical spondylosis that have the least burden on the body, which is very important during drug treatment.
To determine the presence of a pathological process in cartilage tissue and cervical spondylosis, the patient is sent for a comprehensive examination.Strategies for how to treat cervical spondylosis are being developed according to research results.
Interdisciplinary collaboration also helps treat patient comorbidities.In addition, patients also receive complete information support: treatment plan, quote of service costs, information on consultation with specialists and diagnostic measures.
Reason
Cervical osteonecrosis develops under the influence of many different stimulating factors.No specific cause of cervical osteonecrosis has been identified.Usually the disease is related to metabolic disorders and aging of the vertebrae.
Researchers believe that cervical spondylosis develops for the following reasons:
- Excessive load on the spine.Large loads on the spine are observed with improper shoe wearing, flat feet, obesity and prolonged sitting;
- Metabolic disorders.Vitamin and mineral deficiencies and calcium metabolism disorders can cause spondylosis;
- Congenital and acquired defects in the development of the spine and ligamentous apparatus (ligamentous thickening, lumbar lordosis, sacralization);
- Pathology of the digestive tract leads to insufficient absorption of nutrients;
- Infection, poisoning;
- Injuries, bruises, fractures of the spine, as a result of which the blood supply and innervation of the spine are interrupted, cause degenerative disorders;
- Emphasize;
- Wear shoes with heels;
- Pregnancy, especially multiple pregnancy;
- Autoimmune connective tissue damage, pathological structure of collagen types 1 and 2;
- Occupational dangers (lifting heavy objects, prolonged shaking, working in a sitting position with the head tilted continuously);
- Atherosclerosis and other changes in the vertebral arteries;
- Curvature of the spine (kyphosis, scoliosis, kyphoscoliosis).
An important risk factor for the development of cervical spondylosis is family history.This fact proves the presence of osteoarthritis in children when the spine is not yet overloaded.
Degree
Thanks to the special structure of the spine, it can perform its functions.The main structural unit is considered the spinal motion segment (SMS).It consists of two adjacent vertebrae, an intervertebral disc and a musculo-ligamentary apparatus.Chondrolysis leads to dystrophic degeneration, first of the intervertebral discs, then of the vertebrae.When one vertebra is damaged, adjacent vertebrae take over its function.This leads to increased load and loss of mobility of the affected segment.
Doctors distinguish several stages in the development of cervical spondylosis:
- First degree of cervical spondylosis.Because the disc does not receive blood supply and nutrients from surrounding tissues, it is susceptible to degeneration.Osteonecrosis in the early stages of development is characterized by destruction of the nucleus pulposus and cracks in the annulus fibrosus.Clinically, this is manifested by acute or persistent localized pain in the neck (cervical pain) and stiffness;
- Second-degree osteonecrosis of the cervical spine.At this stage, destruction of the annulus fibrosus continues, pathological mobility and instability of the vertebrae appear.The patient complains of pain in the neck, which is aggravated by physical activity, tilting the head or being in a certain position;
- The third stage of the disease is characterized by complete destruction of the annulus fibrosus.The nucleus pulposus is not fixed.Hernias between vertebrae may occur, causing severe pain.At this stage, due to poor fixation of the SMS, the spine may become curved;
- In the fourth stage of the disease, the intervertebral disc is replaced by connective tissue and other neighboring segments are also affected.Spondylitis and arachnoiditis develop.The joints become completely immobile - ankylosis develops.Bone tissue grows around the affected area - bone is formed.With the fourth degree of cervical spondylosis, clear symptoms are observed: severe pain spreading to the arms, sternum, to the area between the shoulder blades and sensitivity disorders.
Symptoms and signs
Signs of cervical spondylosis in the early stages may be non-specific: dizziness, headache, weakness, crunching when moving the head.As the disease progresses, the following symptoms appear:
- Severe pain in the neck and shoulders;
- Numbness of hands;
- Dizzy;
- Hypertension;
- Impaired ability to coordinate movements;
- Increased sweating.
There are a number of syndromes that appear with the development of pathological conditions of the back muscles and cervical spine:
- Cervicogenic migraine syndrome.
- Vertebral artery syndrome.
- Hypertensive syndrome.
- Heart syndrome.
- Nerve root syndrome.
They occur when nerve endings are damaged, arteries and veins are compressed during the development of the disease.The most dangerous complication is considered vertebral artery syndrome.There is an interruption of blood flow through the arteries supplying the brain and spinal cord.The patient's hearing decreased, vision decreased, and dizziness continuously appeared.Patients may lose consciousness when moving due to sudden interruption of blood flow.
Due to compression of the nerves responsible for controlling the chest muscles and diaphragm, pain appears in the heart area, which is not related to heart disease, but at the same time, tachycardia, arrhythmia and hypotension can develop.Venous compression leads to the development of hypertensive alcohol syndrome.Intracranial pressure increases, nausea, vomiting and severe headaches appear due to impaired blood flow from the brain.
Due to compression in the neck, nerve root syndrome develops - severe pain appears in the neck, shoulders, shoulder blades and back of the head.With this syndrome, the arm and neck area becomes numb.With cervical migraine syndrome, the patient experiences severe pain in the back of the head, often accompanied by nausea and vomiting.
Reflex syndrome occurs when the spinal roots are not affected.The patient complains of pain in the neck, head (especially the back of the head), and arms on one or both sides.Reflex pain, unlike nerve root pain, is not associated with sensory disturbances.Cervical pain can be dull and aching.Acute sharp pains are called cervical.There are muscle spasms and aches and pains at points next to the spine.Signs of cervical cartilage degeneration increase in uncomfortable positions, when tilting the head, coughing or physical activity.Signs of epicondyle, periglenoid and hand-shoulder syndrome appear because nerve impulses from the annulus fibrosus of the affected segment cause compensatory muscle spasms.
Nerve root syndrome is accompanied by impaired motor activity and sensitivity.In this case, the nerves and blood vessels are violated, the flow of veins and lymph into the pathological focus is interrupted due to the narrowing of the intervertebral canal.The pain with nerve root syndrome is acute and intense.A common cause of spinal nerve compression is hernia formation.In the area where the pathology is concentrated, muscle tone is reduced.With ischemia, in addition to nerves, blood vessels are also compressed.
If the phrenic nerve is involved in the pathological process, cardiac syndrome will occur.It manifests as an acute, burning pain in the left side of the chest, radiating to the arm and interscapular area.The name of this syndrome is due to the nature of the pain, which is similar to angina.The main difference between angina is that the pain subsides after taking nitroglycerin, can occur at rest and is associated with disruption of heart rhythm (tachycardia, arrhythmia).
Signs of cervical spondylosis depend on the location of the pathological process.When the upper cervical vertebrae are affected, the blood supply to the brain is interrupted due to compression of the cerebral artery.This leads to headaches (especially in the occipital region), dizziness, fainting, and high blood pressure.Dizziness with cervical spondylosis is caused by reduced blood flow to the inner ear.Patients also have nausea, vestibular and eye symptoms.
With combined damage to the vertebrae, people talk about cervical thoracic osteonecrosis.The disease is manifested by the following symptoms:
- Dizzy;
- Pain in the neck and arms;
- Feeling of tingling and crawling in the upper limbs;
- Intercostal neuralgia.
Diagnose
Cervical spondylosis is a chronic disease that can lead to herniation and spinal cord compression.Therefore, it is important to establish an accurate diagnosis promptly and initiate treatment.To determine cervical spondylosis, the following types of diagnostic instruments are used:
- Spondylography or X-ray of the spine.This research method is painless, informative and does not require special preparation.X-rays of the spine allow you to evaluate its anatomical and functional features.In the image pay attention to the structure of the vertebrae, their relationship to each other, the distance between them, the lumen of the spinal canal;
- Computed tomography - provides information primarily about the condition of bone tissue, allowing you to determine spinal stenosis and disc herniation;
- Magnetic resonance imaging - allows you to determine changes in soft tissues.MRI images clearly show changes in the disc and spinal cord.
Treatment with medication
Treatment of cervical spondylosis includes pharmacological and non-pharmacological treatment.Even after complete recovery, neurologists carry out preventive measures to rule out recurrence.In the acute stage, to treat cervical spondylosis, doctors prescribe drugs to patients from the following pharmacological groups:
- Non-addictive pain relievers.They are administered orally or intramuscularly to quickly achieve results;
- Nonsteroidal anti-inflammatory drugs;
- Vitamin B in large doses.
To reduce fluid retention in the spinal root area and surrounding tissues, diuretics are used.Antihistamines increase the effects of pain relievers.Muscle spasms are eliminated with muscle relaxants.For persistent severe pain, neurologists perform nerve blocks.
To improve metabolic processes in the intervertebral disc, chondroprotectors are used.These drugs increase glycosaminoglycan content, increasing the firmness, elasticity and shock absorption of intervertebral discs.
Anti-vertigo medication
Patients often experience dizziness when suffering from cervical spondylosis.To reduce them, doctors prescribe nonsteroidal anti-inflammatory drugs.NSAIDs belonging to different groups differ in their mechanism of action and action, so only a qualified specialist can determine the appropriate drug.
It is important to remember that medication cannot be used to treat cervical spondylosis without a doctor's prescription.Nonsteroidal anti-inflammatory drugs have side effects, so before prescribing, the neurologist will determine the presence of contraindications in the patient and the required dosage.Medicines to treat dizziness in cervical spondylosis can improve the patient's quality of life.
Injecting drugs to treat osteoarthritis
Injections to treat cervical spondylosis help relieve pain during exacerbations.With this method of taking the drug, the effect occurs quickly.Neurologists use many different types of injections.
Nurses administer drug solutions subcutaneously, intramuscularly, or intravenously.During periods of more severe disease, drugs injected to treat cervical spondylosis only treat symptoms.
Headache treatment
Headache is a symptom that occurs with many different disorders.However, cervical spondylosis is characterized by severe headaches.Head movement increases symptoms so to eliminate them, doctors prescribe pain relievers and non-steroidal anti-inflammatory drugs.
Non-drug treatments
Complex non-drug therapy for cervical spondylosis in the spine includes:
- Protective mode - if the roots are compressed, the patient lies on a hard surface,
- Massage;
- Physical therapy;
- Spinal traction;
- Physical therapy procedures.
Massage for cervical spondylosis is used to reduce pain and swelling, improve peripheral blood supply and eliminate muscle spasms.Contraindication to performing this procedure is the presence of acute pain.Massage neck and back in the direction of lymph flow.Pay special attention to the intercostal and paravertebral areas.
Exercises for cervical osteoarthritis are aimed at eliminating muscle spasms and strengthening the muscle frame.Since vertebral instability often occurs in the cervical spine, the exercise therapy instructor conducts individual classes in which he teaches the patient how to perform the exercises safely.Some authors recommend conducting physiotherapy classes in a Shants collar.
To improve the mobility of the cervical vertebrae, rehabilitation specialists recommend performing the following exercises:
- Flexion and extension of the neck.Bend your head toward your sternum without pulling your shoulders forward and then back again.Hold the incline for 3 seconds, repeat each exercise 8-10 times;
- Neck rotation.First turn the neck to the left until it stops, then to the right without changing the position of the shoulders and the level of the chin;
- Bow your head as far as possible.Then tilt your head back without changing the level of your shoulders.Hold the position for 5 seconds.
The following exercises have been developed to strengthen the neck muscles:
- Place your hands behind your head.Tilt your head back, leaning on your hands;
- Place your hands on your temples.While tilting your head, use your hands to resist;
- Put your hand on your forehead, resist, tilt your head forward;
- Use your right hand to tilt your head to one side, and place your left hand behind your back.Otherwise, repeat the exercise.
Self-gravity therapy is the correct name for spinal traction.It is performed using special equipment.The goal of therapy is to reduce muscle spasms and restore the correct position of the vertebrae.To avoid complications, spinal traction is performed by a doctor.
To improve blood supply to the pathological focus, reduce swelling and eliminate pain, the following physiotherapy procedures are used:
- Electrodynamics.During this procedure, low-frequency electric current is applied using a special device, which stimulates the muscles, reducing spasms and pain.They have a positive effect by improving the nutritional capacity of tissues;
- Ultraviolet radiation.Under the influence of UV rays, vitamin D metabolism improves, calcium content increases, bone tissue becomes stronger;
- Ultrasound exposure - used for acceleration of blood flow, antispasmodic and restorative effects.Ultrasound has the ability to penetrate deep into tissues;It is sometimes used for better drug absorption;
- Amplipulse Therapy - allows you to relieve pain by blocking nerve impulses from the source of pain.
In the acute phase of the disease, which lasts 4-7 days, analgesics, antispasmodics, stimulants are used to relieve pain.The patient is allowed to rest.Immobilization of the cervical spine is performed using a Shants collar.Exercise and massage are contraindicated.Ultraviolet radiation is used.
The duration of the subacute phase is 29 days.After complete recovery, the patient should rest for a few days.You can then begin a course of rehabilitation therapy.In the chronic stage of the disease, patients are prescribed muscle relaxants, chondroprotectors, B vitamins and pain relievers, NSAIDs.Physical therapy and massage classes are offered.The patient was subjected to physiotherapeutic procedures (increased pulses, exposure to alternating current) and spinal traction was performed.
Food
Proper nutrition for osteoarthritis is an important condition for achieving remission.The progression of cervical thoracic osteonecrosis stops when diet and treatment measures are followed.Neurologists know how to treat cervical spondylosis, so they create a range of treatments, including procedures, exercise therapy, proper nutrition and lifestyle changes.
Many patients come to neurologists with questions about how to treat cervical spondylosis and whether there are any dietary restrictions.Specialists create individual nutrition programs taking into account patient preferences.The osteoarthritis diet is based on balanced, low-fat, nutrient-rich foods.The patient's daily diet includes foods rich in calcium.
How to sleep with cervical spondylosis
For patients with diseases of the musculoskeletal system, the question of how to sleep properly with cervical spondylosis is relevant.Sleeping on your stomach will further stimulate the disease, so it's better to avoid sleeping in this position.The most optimal locations are on the back and sides.
Neck cartilage degeneration progresses when lying on a bed with a soft mattress.Therefore, experts recommend that you prioritize using elastic mattresses as well as pillows with moderate softness.If the patient is diagnosed with cervical spondylosis, experienced specialists will tell you which type of bed is safe to sleep on.
prevent
To prevent the occurrence or progression of cervical spondylosis, doctors recommend:
- Maintain correct posture;
- Have an active lifestyle, rest at work;
- Perform physical therapy exercises regularly;
- Sleep on hard, flat surfaces, orthopedic mattresses and pillows;
- Quit bad habits, especially smoking;
- Choose shoes taking into account the physiological structure of the foot;
- Do not carry a bag with one hand, this will lead to curvature of the spine;
- Have a healthy lifestyle, eat properly, eat lots of fruits and vegetables;
- Don't sit with your head bowed for long;
- Go swimming.
To improve blood circulation, you should regularly undergo therapeutic massage.