It has been written and said many times that osteochondrosis of the cervical, cervicothoracic and lumbar spine is not a disease in itself. This, if you will, is our "curse of the species. "Man, as a biological species, has been moving on two legs for only a few million years, and even less. This, from the point of view of evolution, is still the "middle of the road". It is not known what new anatomical variants of spinal development we will reach in a million years.
Currently, osteochondrosis is the most common disease of the musculoskeletal system, and doctors from different specialties face it. Most often these are therapists and neurologists, since with the complication of osteochondrosis, various neurological syndromes can occur, which will be discussed below.
Osteochondrosis - what is it?
You shouldn't say the words "osteochondrosis is common" because that's not true. Osteochondrosis in its purest form is a process of normal aging and dehydration of the intervertebral discs, which, in the normal course, does not cause any complaints. This is possible in older adults who are vigorous, mobile, have good posture and are not overweight. They exercise, swim, avoid lifting weights, and lead what might be called a "healthy lifestyle. "
If we talk about osteochondrosis of any part of the spine, as a disease, we always refer to its complicated course, which causes various complaints and symptoms. And in this, the cervical spine is more vulnerable than other underlying departments. Obviously, the cervical region has less load - only the head, but at the same time, the vertebrae of the cervical region are more mobile than others, and at the same time they are less massive.
All this makes the lesions of the cervical region with complications of osteochondrosis more pronounced. The proximity of the head leads to the fact that headaches occur, which, of course, does not happen with injuries to the lower back. Also, it should be remembered that it is in the central canal of the cervical vertebrae that the spinal cord passes, which has absorbed all the underlying pathways. Therefore, in central canal compression syndromes, the patient may experience paralysis of the arms and legs, even complete immobility, decreased skin sensitivity throughout the body, and pelvic organ dysfunction. All this can, at the moment, render a person disabled, for example, with a fracture of the cervical vertebrae (diving in the head in unknown small places).
Obviously, such complex injuries are not related to osteochondrosis: patients are much more likely to be bothered by other symptoms. How to treat and cure osteochondrosis of the cervical spine? It is impossible to cure it. To do this, from childhood, it is enough to refuse to move on two legs and crawl on all fours or live in the ocean, like dolphins. Only then will the load on the intervertebral discs be minimal, or even absent.
Only exacerbations of osteochondrosis can be cured, and for this you need to know not only its signs and symptoms, but also its risk factors.
About risk factors
In the case of the cervical spine, obviously, lifting weights on the shoulder will not play as important a role in the occurrence of pain syndrome as in the lower back. What conditions and diseases can contribute to the development of cervical osteochondrosis symptoms? Here are the most common situations:
- Flat feet, both longitudinal and transverse. The spine is a flexible, curved rod. In the event that the arch of the foot does not dampen, and during the step there is not an "elastic" movement of the spine downwards, but a blow, then this blow with a "wave", like a whip, rises, and is justly extinguished. in the cervical region, at the site of the craniovertebral transition. That's where all the energy goes. Therefore, running on flat feet leads to pronounced changes in the intervertebral discs.
- Chronic injury. These are, first of all, slipping on ice in winter, falling on the back of the head, as well as constantly banging your head on low doors, which is often found in people whose height is above average.
- Wear heavy winter hats, high hairstyles and plenty of jewelry for women. All this leads to fatigue of the neck muscles, the occurrence of chronic spasm, circulatory disorders and the development of headaches and back pain.
- A sedentary lifestyle, "sedentary" work, the presence of stiffness in the upper thoracic and cervical spine.
We will not list the specific risk factors that occur in sick patients. Quite a few are these reasons for the deterioration of the condition that are found in ordinary and healthy people.
Symptoms and signs of osteochondrosis
The signs of cervical spine osteochondrosis are very multifaceted. Few doctors are aware that general prolapse of the abdominal cavity (splanchnoptosis) or prolapse of the liver, which is often misdiagnosed as its enlargement, may be due to osteochondrosis of the cervical region. In this case, the phrenic nerve becomes irritated, and the dome of the diaphragm, contracting, falls.
As a result, the liver is "pushed" out of the hypochondrium. But there are other more "usual" symptoms of cervical osteochondrosis - pain and muscle tension. We will not talk about the symptoms of hernias and bulges of the cervical spine - a separate article is dedicated to this. Let's talk about the clinic that occurs with "whole" intervertebral discs, especially since such situations are much more common.
Cervical osteochondrosis causes pain in the neck itself. Muscle pain is manifested by constant and aching pain of low intensity. It is aggravated by turning and tilting the head. Often accompanied by stiffness in the suboccipital region.
Headaches in osteochondrosis of the cervical region are almost always in the nature of a tension headache. The attack lasts for many hours and even days at a time. The pain rises from the neck through the occiput to the temples and covers the skull like a helmet or helmet. With this pain, the ability to work does not suffer, but if the radicular symptoms join it, they acquire a shooting character and it becomes very painful to move the head.
"Vertebral Artery" Syndrome
Speaking of cervical osteochondrosis, one cannot fail to mention this classic manifestation of cerebrovascular insufficiency caused by cervical osteochondrosis. Its symptoms are vomiting and nausea, dizziness and balance disorders. There is a noise in the head and ears (tinnitus), in severe cases there is a speech disorder (dysarthria), swallowing disorders. Much more often there are various visual disorders ("flies"), headache. Sometimes there are falling attacks, during which a person does not lose consciousness, but falls and then quickly gets up.
Compression of one of the two vertebral arteries can occur during sleep. In the event that a person simultaneously throws his head back and turns it to one side, the vertebral artery is pressed against the first vertebra - the atlas contralaterally, that is, on the opposite side.
If you lie like this for a while, in the morning, when you try to get out of bed, there is severe dizziness, nausea, vomiting, gait and balance disturbances. In some cases, "higher order" disorders also develop - for example, transient global amnesia, in which the patient simply does not remember anything.
There are also numerous neurological syndromes and symptoms, which we will list only briefly, indicating their diagnostic points of reference, so that the reader of the article can imagine and "experience" these symptoms for himself, in case he is unable to go to a neurologist:
- Inferior oblique head muscle syndrome (often occurs in patients over 50 years of age, especially in postmenopausal women). There are pains, disturbances of sensation in the back of the head, next to the auricle. The pain is aching, cutting in nature, both in the neck and in the back of the neck, constant, and its intensification is associated with prolonged immobility. Increased by turning the head to the healthy side;
- Anterior scalene syndrome - manifests in patients with additional "cervical ribs".
There are disturbances in sensitivity and "creeping" in the hand, pallor and coldness, sometimes swelling of the hand, appearance of weakness, hypotrophy of the muscles of the hand, as well as weakening of the pulse in the wrist. In severe cases, progressive paralysis or paresis of the hand muscles may occur. Patients cannot drive a car, sleep on the painful side, cannot lift weights and also work with their hands up (hanging curtains, towing). There are also complaints of stiffness and pain in the neck, forced head position in the morning.
- Middle scalene muscle syndrome. First, there is pain in the shoulder, in the region of the scapula, and then muscle atrophy begins. The mechanism is associated with damage to the long nerve of the trunk and the transverse artery of the neck;
- Shoulder-costal syndrome (levator syndrome of the muscle that lifts the scapula). First, aching pains appear in the area of the scapula, which "buzz". They give to the shoulder, there is also pain in the neck, which often hurts "in the weather". A crunch is usually heard when moving the scapula.
Thus, it is clear that many processes that began in the neck or in the immediate vicinity of its structures appear "on the periphery", for example, in the area of the hand. This requires a thoughtful and competent approach from the physician. Currently, the diagnosis of complications of osteochondrosis has become much simpler, especially with the introduction of MRI in clinical practice.
Treatment of cervical osteochondrosis
Modern therapy for neck pain of vertebrogenic origin and associated muscular and compressive syndromes provides for short courses of medication. Treatment of exacerbations of osteochondrosis of the cervical region quickly translates into a dimmed exacerbation phase, against which the main treatment methods are kinesiotherapy and physical therapy.
Ointments and medications for exacerbation
As you know, "injections", ointments and even locks have not been canceled. But the neck is the focus of a large number of nerves, blood vessels, autonomic fibers, fascia. Therefore, blocks are performed less often here than with acute back or lower back pain. In addition, the thin skin of the neck allows gels, creams and ointments to be absorbed more quickly than in the lower back.
Of the drugs, injectable forms of NSAIDs are used, preferably selective, centrally acting muscle relaxants, vitamins of the "B" group.
It should be remembered that if NSAIDs are used, it is imperative to protect the mucosa of the gastrointestinal tract using antisecretory drugs during treatment.
As for local treatment, there are currently many ointments, gels and creams containing NSAIDs, bee and snake venom, as well as agents that refresh and relieve pain. The main thing is not to use too hot ointments. They can cause high blood pressure, redness of the face and even a hypertensive crisis in old age. Treatment with ointments is desirable to be carried out prophylactically, without waiting for the next exacerbation.
About the Shants collar
In the early stages, in the acute stage, it is necessary to protect the neck from unnecessary movement. The Shants collar is great for this. Many people make two mistakes when purchasing this collar. They do not choose it according to its size, so it simply does not fulfill its function and causes a feeling of discomfort.
The second common mistake is using it for prophylactic purposes for too long. This leads to weakness in the neck muscles and only causes more problems. There are only two indications for the necklace, in the presence of which it can be used:
- The onset of sharp neck pain, stiffness and spread of pain to the head;
- If you are going to do physical work in full health, in which there is a risk of "pulling" the neck and getting worse. This is, for example, fixing a car when you lie under it or washing windows when you need to reach out and take uncomfortable positions.
It is necessary to wear a collar for no more than 2-3 days, as longer use can cause venous stasis in the neck muscles, at which time it is time to activate the patient.
patient activation
Kinesiotherapy (treatment by movement) involves therapeutic exercises, swimming. Gymnastics for osteochondrosis of the cervical spine is not aimed at the discs, but at the surrounding muscles. Its task is to relieve tonic spasm, improve blood flow and also normalize venous flow. This is what leads to a decrease in muscle tone, a decrease in the severity of pain and stiffness in the back.
Along with massages, swimming, acupuncture sessions, the purchase of an orthopedic mattress and a special pillow is indicated. A pillow for osteochondrosis of the cervical spine must be made of a special material with "shape memory". Its task is to relax the muscles of the neck and suboccipital region, as well as prevent blood flow disorders at night in the vertebrobasilar basin.
Autumn is an important stage in the prevention and treatment of home physical therapy products and devices - from infrared and magnetic devices, to the more common needle applicators and ebonite discs, which are a source of weak electrical currents during massage that have a beneficial effect on the patient.
What is the next?
Statistics show that the people of the Mediterranean, who often and at any age swim in the sea, the situation with diseases of the musculoskeletal system is often better.
However, the basis for preventing osteochondrosis, in addition to eliminating risk factors, is establishing a healthy diet, based on sour milk, plant foods, seafood, fiber and plenty of fluids. This will slow down the age-related dehydration process of the intervertebral discs and maintain a healthy neck and back well into later years.