Cervical osteochondrosis

Woman with symptoms of cervical osteochondrosis.

Cervical osteochondrosis is a degenerative disease of the articular cartilage, which is one of the main causes of pain in the neck with characteristic radiation to the arms. With this disease, there is a change in the structure of the cartilage and muscle-ligamentous structures located nearby.

Since cervical osteochondrosis as it progresses can lead to a number of serious complications, including disability of the patient, its timely diagnosis and treatment are among the urgent tasks of modern medicine.

Stages of development of pathology and typical symptoms.

The disease goes through 4 successive stages of development with corresponding changes in the body and accompanying symptoms:

  1. The first stage is the initial morphological changes in the intervertebral discs. The nucleus of the intervertebral disc (nucleus pulposus) gradually dries out, and cracks appear in the annulus fibrosus structure. This is accompanied by tolerable pain or discomfort in the neck, which intensifies when turning or tilting the head. There is also a slight smoothing of the cervical lordosis and almost constant muscle tension.

  2. In the second stage, the destruction of the annulus fibrosus continues, which is accompanied by the first signs of pathological mobility of the vertebrae and their instability. The distance between the vertebrae decreases and a protrusion occurs. At this time, the patient notices an increase in pain and its radiation to the arm or shoulder area. Along with this, severe headaches appear, the person complains of a feeling of weakness and reduced performance.

  3. The third stage is characterized by the complete destruction of the annulus fibrosus, due to which the unfixed nucleus extends beyond the vertebrae and penetrates into the zone of the spinal canal, forming a hernial protrusion. This, in turn, puts pressure on the nerves and elements of the vascular bed, causing a disruption of blood flow in the cervical region. Patients in this stage complain of severe and continuous pain in the neck that radiates to the arms and shoulders. The muscles weaken and numbness of the upper extremities is systematically noted. Added to the clinical picture are episodes of dizziness, difficulties with orientation in space and rigidity of movement.

  4. The fourth stage is represented by the replacement of the cartilage of the intervertebral disc by a connective tissue structure and the participation of adjacent spinal segments in pathological changes. Due to the fusion of the joints, their immobility occurs. For the patient, this is the most difficult stage, since they feel intense and constant pain in the neck, arms, chest and area between the shoulder blades. Added to this are signs of impaired blood supply to the brain, sensitivity disorders, and the likelihood of suffering a stroke increases significantly.

It should be noted that in addition to the main clinical picture accompanying cervical osteochondrosis in various stages, additional symptoms can be observed:

  • Decreased visual acuity;

  • anxiety episodes that occur due to insufficient blood supply to the brain;

  • hearing loss and tinnitus;

  • the appearance of a crunch when moving the head;

  • sleep disturbances up to insomnia;

  • the appearance of spots before the eyes;

  • cases of loss of consciousness;

  • paralysis of facial muscles;

  • Pain in the arms that occurs at night.

If spinal cord compression occurs, myelopathy may develop, accompanied by:

  • difficulties in limb movements;

  • coordination or balance problems;

  • loss of bowel or bladder control;

  • weakness or numbness in any area of the body below the neck;

  • Stabbing pains in the extremities, which increase when leaning forward.

Causes of the disease

The key factor due to which cervical osteochondrosis develops is excessive and unbalanced load on this part of the spine. In most cases, pathology is formed against the background of involutional degenerative changes that accompany the aging process. Osteochondrosis can also occur due to traumatic injury to the neck or metabolic disorders.

In addition, there are other factors that contribute to increased load on the neck, muscle spasms and the development of chronic diseases:

  • spinal anomalies, congenital or acquired;

  • over weight;

  • complicated inheritance (for example, congenital and genetically determined weakness of connective tissues);

  • prolonged or frequent overload of the spine (staying in a forced position, physical inactivity);

  • vitamin deficiencies;

  • autoimmune pathologies accompanied by damage to connective tissue structures (collagenosis);

  • deficiency of micro or macroelements;

  • intense physical activity, sports with an increased risk of spinal cord injury (for example, professional wrestling);

  • smoking, which impedes the flow of nutrients to the intervertebral discs;

  • metabolic disorders;

  • unbalanced diet with excess carbohydrates and fats combined with protein deficiency;

  • frequent stressful situations;

  • pathologies of the musculoskeletal system, leading to a decrease in the mobility of the cervical spine;

  • repeated or severe hypothermia of the neck.

What is the danger of osteochondrosis?

The first problem, typical for most patients who have developed cervical osteochondrosis, is severe and frequent pain in the head and neck area. Because of this, people are forced to look for the most comfortable position in which the pain weakens or disappears completely. This, in turn, leads to a decrease in performance.

As the disease progresses, a bulge (partial release of disc tissue beyond the intervertebral space) forms, the tissue between the vertebrae begins to collapse, and the gap narrows. At the last stage of the pathological process, the disc is completely destroyed and replaced by a connective tissue structure. This leads to a limitation of motor activity, since the patient loses the ability to turn or tilt his head.

In addition, cervical osteochondrosis is dangerous because it can lead to the following complications:

  • hernia;

  • cervicocranialgia (painful sensation located at the base of the skull);

  • osteophyte formation;

  • compression of the arteries;

  • radiculopathy (compression of the roots of the spinal cord);

  • chronic pain syndrome.

In the most severe and advanced cases, cervical osteochondrosis causes compression of the spinal cord, paralysis and disability of the patient.

Diagnostic methods

Diagnosis of a patient with suspected cervical osteochondrosis begins with an appointment with a doctor, who conducts a comprehensive interview, clarifies the symptoms and history of the development of the disease, and also conducts a physical examination. During the examination, the doctor focuses on identifying areas of pain, evaluating the mobility of the spine and the quality of reflexes.

After receiving the initial data, the specialist creates a plan for additional diagnostics, which may include:

  • multi-slice computed tomography;

  • positron emission and magnetic resonance imaging;

  • bone scan;

  • duplex scanning of vessels in the area of the pathological process.

Imaging techniques allow the doctor to determine the genesis of the clinical picture, identify signs of degenerative processes or other conditions that may cause the appearance of symptoms that bother the patient. Duplex scanning allows you to evaluate the quality of blood flow and detect vasoconstriction.

As a complement to the main diagnostic program, consultations with related specialists (vertebrologist, endocrinologist, orthopedic traumatologist, neurosurgeon, oncologist) can be carried out and the following prescribed:

  • ultrasound examination of nearby organs;

  • electrocardiograph;

  • Standard and advanced studies of biomaterials (blood, urine).

Only after the diagnosis is confirmed and the causes and severity of the disease are clarified, the doctor begins to work on the optimal and most effective treatment program.

Treatment options

Treatment for cervical osteochondrosis is selected based on the stage at which the disease was detected, as well as the patient's age, current condition and existing complications or concomitant pathologies.

Conservative approach

When cervical osteochondrosis is identified in the initial stages, conservative therapeutic methods are chosen. Its goal is to prevent the progression of the disease, relieve unpleasant symptoms and restore spinal mobility.

As part of conservative therapy, the doctor combines drug treatment with physiotherapy procedures and gymnastics. You can prescribe medications from the following categories:

  • chondroprotectors;

  • non-steroidal anti-inflammatory drugs;

  • analgesics;

  • angioprotectors;

  • B vitamins;

  • hormones;

  • muscle relaxants;

  • vasodilators;

  • nootropics.

Physiotherapeutic procedures are used as an adjunct to medications and, taking into account the patient's condition, the doctor can prescribe:

  • acupuncture;

  • kinesio tape;

  • massage sessions;

  • photodynamic therapy;

  • the use of ultrasound or diadynamic currents;

  • electrophoresis;

  • magnetotherapy.

At the same time, in case of cervical osteochondrosis in the acute period, the use of an orthopedic collar may be recommended. This medical accessory is necessary to repair bones and joints, reduce the load on the affected area of the spine and relieve pain. A cervical collar for osteochondrosis, the price of which varies depending on the manufacturer, type and material, is selected exclusively by the doctor individually for each patient.

The last, but not least, part of conservative therapy is gymnastics. The doctor prepares for the patient a series of special exercises aimed at strengthening the muscle structure, correcting posture and improving blood flow in the upper part of the spine.

Surgical approach

If conservative methods were unsuccessful or cervical osteochondrosis was detected in later stages, treatment is carried out by surgical intervention. The doctor may prescribe the patient one of the following operations:

  • laminectomy;

  • endoscopic or percutaneous decompression;

  • radiofrequency ablation;

  • endoscopic removal of a hernia, tumor process or area of degenerative-dystrophic changes;

  • epidural lysis of adhesions;

  • spinal stabilization;

  • endoscopic foraminotomy;

  • Laser nucleoplasty with stab puncture.

Precautionary measures

Cervical osteochondrosis is a pathology for which no specific prevention measures have been developed. To significantly reduce the likelihood of the occurrence of the disease, its recurrence or the development of complications, doctors give a number of recommendations. According to them, patients need:

  • adhere to the principles of a healthy lifestyle;

  • eliminate lifting and carrying heavy objects;

  • use orthopedic mattresses and pillows for sleeping;

  • regularly engage in dosed physical activity and swim;

  • eat a balanced diet;

  • exclude situations in which hypothermia of the cervical spine is possible;

  • continually monitor your posture;

  • systematically take breaks for short sessions of therapeutic exercises in case of sedentary work;

  • be careful when turning and tilting your head;

  • undergo periodic examination by a specialized specialist for preventive purposes.

How is the rehabilitation going?

The supervising doctor draws up a plan for the rehabilitation period, taking into account several aspects:

  • at what stage cervical osteochondrosis was detected;

  • general health and well-being of the patient;

  • age category and body weight of the patient;

  • existing concomitant pathologies or complications of the disease.

Depending on the situation, the doctor may include massage, gymnastics and physiotherapy sessions in the rehabilitation program. These comprehensive measures will not only speed up the recovery process and eliminate complications or relapses, but will also help improve the patient's overall health.

Cervical osteochondrosis is a serious problem in which the patient needs correct and timely medical care. If signs of this disease appear, you can undergo diagnosis and subsequent treatment in a medical facility. All specialists select an individual approach for each patient, are guided by modern methods of treating osteochondrosis and provide a wide range of services, the price of which is in a comfortable range for patients.

Question answer

Cervical osteochondrosis has been identified, how long does it take to treat this pathology?

The duration of treatment directly depends on the stage at which the patient with cervical osteochondrosis sought help. Only a doctor who has assessed the severity of the pathological process and follows the dynamics of progress during treatment can determine the most likely period.

Which doctor should I contact if I suspect I have cervical osteochondrosis?

Cervical osteochondrosis is identified and subsequently treated by a neurologist, but in some cases a traumatologist-orthopedist can supervise the patient.