The diagnosis of "cervical osteochondrosis" is often made if a person complains of neck pain. Some also attribute dizziness, memory loss, numbness in the hands and other unpleasant symptoms to it. It is mistakenly believed that the disease is associated with age-related wear and deformation of the intervertebral discs and other elements of the spine.
How does the cervical spine work?
The cervical region consists of 7 vertebrae. Among them are intervertebral discs, semi-rigid structures with a dense ring on the periphery and a gelatinous center that act as shock absorbers. To the right and left of each vertebra there are two joints, between which the surfaces of the cartilage-covered vertebral processes protrude. The joints are connected by ligaments and muscles of the back.
Why does neck pain occur?
Neck pain typically occurs in response to uncomfortable movements, injuries, or due to inflammation of any of the structures of the cervical spine. Also, the cause of pain may be excessive stretching of muscles or ligaments, for example, when lifting weights, unsuccessfully turning the head, or against the background of arthrosis of the same joints between the articular processes. Specific processes of "nerve entrapment" or cervical radiculopathy (metastases, tumors of the vertebrae, membranes of the spinal cord in the cervical region) are relatively rare.
26% of men and 40% of women over 30 have experienced neck pain in the last month, and 5% of men and 7% of women feel it all the time.
Acute neck pain usually goes away on its own within 1 to 2 weeks. Chronic pain in most cases appears due to lack of physical activity or, conversely, too intense exercise.
However, unexplained pain and discomfort in the neck is often mistakenly called cervical osteochondrosis and its development is associated with age-related wear and deformation of the intervertebral discs and other elements of the spine. But such pain, as a rule, has nothing to do with real osteochondrosis.
Cervical osteochondrosis
According to the International Classification of Diseases (ICD), osteochondrosis (osteochondropathy) is a group of rare hereditary diseases associated with disruption of normal bone development and growth. As a rule, osteochondrosis begins in childhood and is severe: part of the joint or bone is deformed and sometimes even dies. In this disease, most often not the cervical spine is affected, but the thoracic spine (lower thoracic vertebrae). Hence, the main clinical manifestation of osteochondrosis is a pronounced curvature of the thoracic spine, the so-called thoracic kyphosis.
Symptoms associated with damage to the thoracic spine:
- dyspnoea,
- constant weakness
- inability to breathe fully,
- pain and burning behind the breastbone,
- Tachycardia attacks.
Conditions accompanied by neck pain.
Cervical spondylosis
In people over 50, neck pain is often caused by cervical spondylosis, age-related wear and tear of the vertebrae and related structures. In this disease, the intervertebral discs become dehydrated and flattened, causing the depreciation in the cervical region to worsen, and many movements are accompanied by pain.
But changes in the spine as we age are normal. Thus, their structures begin to wear out at the age of 30 on average, and by the age of 60, 9 out of 10 people already suffer from cervical spondylosis. However, in most people it is asymptomatic.
Other reasons
Less commonly, neck pain occurs due to hypothermia or severe stress, due to herniated discs or abnormalities of the cervical vertebrae, bone growths (spurs) that compress the nerves extending from the spinal cord.
The most common source of pain in the cervical spine and shoulder girdle is excessive tension (defense) of the muscles: trapezius, long back muscles of the cervical spine.
Additionally, the muscles of the cervical spine are closely connected to the aponeurosis, a wide tendon plate that surrounds the head. The muscular elements of the aponeurosis in the occipital, temporal and frontal regions connect with the muscles of the cervical region, which is why neck pain is often accompanied by a headache. Thus, neck pain, which appears after prolonged sedentary work or sleeping in an uncomfortable position and is combined with headache, in most cases is associated with lack of physical activity and incorrect posture and does not pose any danger to health.
The phenomenon of tech neck, the so-called techno-neck or neck of the Internet era, is associated with pain that arises due to an uncomfortable posture. Techneck is the result of constant use of a computer and smartphone, due to which a person is forced to bend his neck. The fact is that the relative mass of the head increases with forward tilt. Thus, in a "straight" position, the average weight of an adult's head is 5 kg. If you tilt your head forward at least 15°, the load on the neck muscles will be 13 kg, at 30° - 20 kg, at 60° - 30 kg. As a result of constant overload, the neck muscles are overloaded, microtrauma, inflammation, fibrosis (excessive growth of connective tissue) and, consequently, pain may occur.
Reasons contributing to the development of degenerative changes in the cervical spine.
The appearance of pain in the cervical spine is facilitated by birth or any other injury to the spine, anomalies of its development, postural disorders, muscle dystonia, as well as prolonged immobilization, obesity and some autoimmune diseases.
- Prolonged immobilization is a condition in which a person, due to an underlying illness, is forced to remain lying down for more than a month. As a result, the muscles weaken and during verticalization, when the load on them increases, they become excessively tense. Pain occurs.
- Obesity: Excess body weight increases stress on spinal structures and can cause pain.
- Autoimmune diseases in which cartilage tissue is destroyed (autoimmune arthritis, polychondritis) also cause neck pain.
Stages of degenerative changes in the cervical spine.
There are 4 main stages of degeneration (destruction) of the cervical spine:
- Stage I: intervertebral discs become thinner, slight discomfort appears in the neck area;
- Stage II: the intervertebral discs are deformed, the distance between the vertebrae is reduced. The pain increases with movements of the cervical spine;
- Stage III: cartilage and vertebrae rub together, neck pain becomes constant and movements become limited. In case of very severe deformities of the cervical spine, vertebral artery syndrome may appear with visual and vestibular disturbances, headache;
- stage IV: degenerative changes are pronounced, movements of the cervical spine are very limited and painful. The neck area can be almost completely immobilized.
Symptoms of degenerative changes in the cervical spine.
Most people with cervical osteochondrosis experience chronic pain and stiffness in the neck. As the disease progresses, other symptoms may appear (especially if the spinal roots, vertebral artery, and adjacent nerve plexuses are compressed).
Symptoms of degenerative changes in the cervical spine:
- neck pain that worsens with movement or standing;
- pain radiates to the shoulder or arm;
- numbness, tingling, and weakness in arms and hands;
- clicking or grinding in the neck (especially when turning the head);
- headache;
- attacks of dizziness;
- impaired coordination of movements;
- loss of bladder or bowel control.
If these symptoms appear, it is advisable to consult a neurologist as soon as possible.
Types of symptoms of "cervical osteochondrosis"
All symptoms of "cervical osteochondrosis" can be conditionally classified into 3 groups or syndromes: vertebral, radicular and vertebral artery syndrome.
Symptoms of vertebral (spinal) syndrome:
- crunching in the neck when moving;
- limited mobility;
- violation of the location of the vertebrae relative to each other in the neck;
- Smoothing of the natural cervical lordosis or lateral curvature of the cervical spine (can only be seen on x-rays, MRIs or CT scans).
Symptoms of radicular syndrome:
- numbness of the fingers of one or both hands;
- stabbing, burning pain in the neck, radiating to the arm or both arms;
- dystrophy of the muscles of the neck and arms.
Symptoms of vertebral artery syndrome:
- paroxysmal dizziness, up to loss of consciousness;
- sudden jumps in blood pressure;
- noise in the ears;
- blurred vision or spots in the eyes;
- loss of balance and attacks of nausea when moving the head;
- headache (severe pain on one side or both sides).
Diagnosis of degenerative changes in the cervical spine.
To understand the cause of neck pain and make a diagnosis of "degenerative changes in the cervical spine" (commonly called cervical osteochondrosis), the doctor will need to perform an examination, study the medical history, evaluate the results of laboratory tests and examinations. instrumental. .
Diagnosis and treatment of cervical osteochondrosis is carried out by a neurologist.
Inspection
During the examination, the doctor will listen to the patient's complaints, clarify the details of the medical history and conduct an examination: check reflexes, muscle strength, sensitivity and the condition of the vestibular apparatus.
In "cervical osteochondrosis" visible areas of muscle atrophy (loss of muscle mass), decreased or increased muscle tone of the long muscles of the back and static alterations in the cervical region can be observed in the neck area. When palpating the muscles, a person complains of pain, and when tilting the head, the pain may radiate to the head or arms, and dizziness or headache may occur.
Additionally, patients may experience motor impairments in the hands (weakness), vision and hearing problems.
The doctor may also ask the patient to walk, stand on one leg with their eyes closed, or touch their nose. In this way, the specialist will be able to evaluate if the coordination of movements is altered, if there are problems with gross and fine motor skills.
Laboratory diagnosis
To assess the general condition of the bones, patients with suspected cervical osteochondrosis are prescribed blood tests for total and ionized calcium, as well as markers of growth and destruction of bone tissue: osteocalcin and osteoprotegerin, alkaline phosphatase.
With progressive cervical osteochondrosis, the joints are destroyed, the calcium content may be reduced, and, on the contrary, osteocalcin and osteoprotegerin may increase.
Total creatine kinase is also considered a marker of muscle tissue destruction in cervical muscle myositis.
In addition, the doctor may need to evaluate the blood levels of microelements involved in the regulation of muscle tone: magnesium, potassium, sodium.
Instrumental diagnosis
To establish the cause of neck pain and associated disorders, imaging studies are necessary: x-ray of the cervical spine, computed tomography and magnetic resonance imaging, electroneuromyography.
- Bone scan.With the help of X-rays, bone deformations, malignant tumors and degenerative changes in the joints can be identified.
- Magnetic resonance and computed imagingIt is performed if pathology of the spine, spinal cord or brain is suspected. CT scan shows hemangiomas of the vertebral bodies and severe deformities of the cervical spine. MRI is most informative for visualizing muscles, roots, and spinal cord.
- Electroneuromyography- a method for studying the efficiency of impulse transmission along a nerve fiber using low-intensity electrical current. The test can be a little uncomfortable. The study helps clarify the conduction of impulses along the roots, nerves and from nerves to muscles, confirm damage to nerves or muscles, and clarify the nature and level of damage.
Treatment of degenerative changes in the cervical spine.
The main goals of treating degenerative changes in the cervical spine are to relieve pain, prevent compression of the neck nerves, and restore cervical mobility.
Depending on the severity of the condition, the doctor may prescribe medication, physical therapy, or massage. Surgery may be required if nerves are pinched or joints are deformed.
Pharmacological treatment of degenerative changes in the cervical spine.
Neck pain can be relieved with medication.
Medications to relieve neck pain and stiffness:
- local anesthetic ointments, gels and patches;
- non-steroidal anti-inflammatory drugs;
- hormonal medications in the form of tablets or injections into the affected joint area;
- muscle relaxants to relieve muscle spasms;
- Antidepressants to relieve chronic pain.
Non-pharmacological treatment of cervical osteochondrosis.
In addition to drug therapy, it is important for patients with cervical osteochondrosis to perform neck exercises. To do this, the person is referred to a consultation with a physiotherapist. Teaches how to properly stretch and strengthen the muscles of the neck and shoulders.
Your doctor may recommend mats or rollers with metal or plastic needles. They are used 15 to 30 minutes before bedtime to relax the muscles.
The use of a Shantz splint (collar) is a passive exercise therapy for the deep muscles of the cervical region, which are difficult to influence with exercise. When a person puts on a splint, the muscles relax and when they are removed, they tense. By wearing a splint for 15 to 20 minutes several times a day, you can train and strengthen them.
It only makes sense to use it for 2 or 3 hours if you have serious neck injuries. Also, you should not lie on it, much less sleep.
Surgical treatment of degenerative changes of the cervical spine.
As a rule, surgery is required in patients with severe deformation of the spine who have a pinched nerve.
During the operation, the surgeon removes pathological elements (hernial protrusions, formations, etc. ) or part of the vertebra. After such treatment, a long period of rehabilitation is required: use of a Shants splint or a rigid splint for the cervical spine, physiotherapy, regular walking and pain relievers.
Complications and consequences of degenerative changes in the cervical spine.
Without treatment, the intervertebral discs gradually wear out and the vertebrae become "effaced. "
Common complications of degenerative changes in the cervical spine:
- intractable pain syndrome in the head, neck, chest;
- cramps, movement disorders and numbness of the hands;
- frequent dizziness, impaired coordination of movements, fine and gross motor skills.
Prevention of degenerative changes in the cervical spine ("cervical osteochondrosis")
There is no specific prevention of true cervical osteochondrosis, because it is a hereditary disease.
To avoid the appearance of nonspecific neck pain, which is mistakenly associated with cervical osteochondrosis, it is important to maintain correct posture and be physically active: the more a person moves, the better the condition of the muscles, bones, ligaments and joints. .
To maintain physical activity, adults need 150 minutes of moderate-intensity aerobic activity per week. Walking briskly, swimming, cycling, playing tennis, dancing or skating are suitable. Pilates and yoga will help you strengthen your muscles.
In addition, gymnastics helps to avoid overstrain of the neck muscles and the appearance of pain: tilting the head forward, back, alternately to each shoulder and turning it, as well as sleeping on an orthopedic pillow.
You should avoid injuries to the cervical spine: do not jump into the water face down, use seat belts in the car (prevention of whiplash injuries in the event of an accident).
Sleeping position for back pain.
Pain in the neck and back, which is often attributed to osteochondrosis, may be the result of an uncomfortable sleeping position.
During sleep, the head and spine should be approximately at the same level. This position minimizes additional pressure on the neck area.
If a person sleeps mainly on his back, the height of the pillow should be 6 to 11 cm on average, for those who sleep on his side, the pillow should be thicker - from 9 to 13 cm, this way the desired angle will be obtained . If it is kept between the shoulder and the head, the cervical spine will not sag and the muscles will tighten to compensate for the inconvenience.
Also, the greater the weight of the person, the higher the pillow should be. You also have to pay attention to the hardness of the mattress. The softer it is, the more it will sink under your body weight and the higher the pillow should be. Furthermore, it is better not to always sleep on one side, as this causes muscle imbalance.
If a person prefers to sleep on their stomach, they are more likely to suffer from back and neck pain. The fact is that in this position it is difficult to keep the spine in a neutral position. To relieve back tension, you can place a pillow under your pelvis and lower abdomen, and choose a flat pillow under your head, or even sleep without it.
Additionally, you can use a special orthopedic pillow.
Frequently asked questions
- Where can the pain due to "cervical osteochondrosis" radiate?
Pain due to degenerative changes in the cervical spine may radiate to the shoulder or arm and also intensify with movement or standing.
- How to relieve an attack of dizziness with "cervical osteochondrosis"?
To relieve an attack of dizziness, it is advisable to adopt a comfortable position in which the probability of falling is minimal (sitting in a chair with a backrest or lying down) and ask for help. After 5-7 minutes, you can try to turn your head: the attack of dizziness will most likely disappear during this time. If dizziness persists or worsens, nausea, vomiting or other neurological symptoms appear (alterations in speech, vision, movement, swallowing, sensitivity), an ambulance should be called as soon as possible.
- How to sleep correctly with "cervical osteochondrosis"?
During sleep, the head and spine should be approximately at the same level. This position minimizes additional pressure on the neck area.
- How long does an exacerbation of "osteochondrosis" of the cervical spine last?
On average, the exacerbation of symptoms due to degenerative changes in the cervical spine ("cervical osteochondrosis") lasts 4 to 7 days. Non-steroidal anti-inflammatories and muscle relaxants are used to reduce pain. During this time, it is best for the person to stay calm and wear a neck brace.
- Which doctor treats "osteochondrosis" of the cervical spine?
Diagnosis and treatment of pain in the cervical region is carried out by a neurologist, neurosurgeon, orthopedist and general practitioner.