It has already been written and said many times that osteochondrosis of the cervical, cervicothoracic and lumbar spine is not a disease in itself. This, if you like, is our "species curse". Man, as a biological species, has been moving on two legs for only about a couple of 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 the development of the spine we will come to in a million years.
Currently, osteochondrosis is the most common disease of the musculoskeletal system, and doctors of various specialties face it. Most often, these are therapists and neurologists, since with the complication of osteochondrosis, a variety of neurological syndromes can occur, which will be discussed below.
Osteochondrosis - what is it?
You should not say the words "osteochondrosis is common", because this is not true. Osteochondrosis in its purest form is a process of normal aging and dehydration of the intervertebral discs, which, in normal course, does not cause any complaints. This is possible in vigorous older people who are mobile, have good posture and are free from excess weight. They do gymnastics, swim, avoid heavy lifting, and lead what can be called a "healthy lifestyle. "
If we talk about osteochondrosis of any part of the spine, as a disease, then we always mean its complicated course, which causes various complaints and symptoms. And in this, the cervical spine is more vulnerable than other, underlying departments. Of course, the cervical region has the least 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. Proximity of the head leads to the fact that headaches occur, which, of course, does not happen with lesions of the lumbar region. In addition, it must 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, with central canal compression syndromes, the patient can get paralysis of the arms and legs, up to complete immobility, decreased skin sensitivity throughout the body, and dysfunction of the pelvic organs. All this can at the moment make a person disabled, for example, with a fracture of the cervical vertebrae (diving on the head in unfamiliar small places).
Of course, 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 him. To do this, from childhood, simply 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 altogether.
Only exacerbations of osteochondrosis can be cured, and for this you need to know not only their signs and symptoms, but also risk factors.
About risk factors
In the case of the cervical spine, obviously, lifting weights on the shoulder will not play such an important role in the occurrence of pain as in the lower back. What conditions and diseases can contribute to the development of symptoms of cervical osteochondrosis? 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 spinal column down, but a blow, then this blow with a "wave", like a whip, goes up, and is extinguished precisely in the cervical region, at the place of the craniovertebral transition. That's where all the energy goes. Therefore, running with flat feet leads to pronounced changes in the intervertebral discs.
- Chronic injury. These are, first of all, slipping on the ice in winter, falling on the back of the head, as well as constant hitting the head on low doorways, which is often found in people whose height is above average.
- Wearing heavy winter hats, high hairstyles and an abundance of jewelry for women. All this leads to fatigue of the neck muscles, the occurrence of their 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 affected patients. Quite enough are those reasons for the deterioration of the condition that are found in ordinary, healthy people.
Symptoms and signs of osteochondrosis
Signs of osteochondrosis of the cervical spine are very multifaceted. Few doctors even know that the general prolapse of the abdominal cavity (splanchnoptosis) or the prolapse of the liver, which is often mistakenly diagnosed as its increase, may be due to osteochondrosis of the cervical region. At the same time, the phrenic nerve is irritated and the dome of the diaphragm, contracting, falls down.
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 protrusions of the cervical spine - this is the subject of a separate article. 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 pains are manifested by constant, 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 in a row. The pain rises from the neck through the occiput to the temples, and covers the skull like a casque or helmet. With this pain, working capacity does not suffer, but if radicular symptoms join it, then 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 in the 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 drop - attacks, during which a person does not lose consciousness, but falls, and then quickly rises.
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, then the vertebral artery is pressed against the first vertebra - the atlas contralaterally, that is, from the opposite side.
If you lie down like this for a while, then in the morning, when you try to get out of bed, there is severe dizziness, nausea, vomiting, gait and balance disorders. In some cases, disorders of a "higher order" also develop - for example, global transient amnesia, in which the patient simply does not remember anything.
Numerous neurological syndromes and symptoms also arise, which we will only briefly list, indicating their reference diagnostic points, so that the reader of the article can imagine and "try on" these symptoms for himself if he cannot get to a neurologist:
- Inferior oblique muscle syndrome of the head (often occurs in patients over 50 years of age, especially in women after menopause). There are pains, disturbances of sensitivity in the back of the head, along to the auricle. The pain is aching, breaking in nature, both in the neck and in the back of the head, constant, and its intensification is associated with prolonged immobility. Increased by turning the head to the side that is healthy;
- Scalenus anterior syndrome - manifests itself in patients with additional "cervical ribs".
There are disturbances in sensitivity and "crawling" in the hand, its blanching and coldness, sometimes swelling of the hand, the appearance of weakness, hypotrophy of the muscles of the hand, as well as a weakening of the pulse at the wrist. In severe cases, progressive paralysis, or paresis of the muscles of the hand, may occur. Patients cannot drive a car, sleep on a sore side, cannot lift weights, and also work with their hands up (hanging curtains, plastering). There are also complaints of stiffness and pain in the neck, forced head position in the morning.
- Syndrome of the middle scalene muscle. First, there are pains in the shoulder, in the region of the scapula, and then muscle hypotrophy begins there. The mechanism is associated with damage to the long nerve of the trunk and the transverse artery of the neck;
- Shoulder-costal syndrome (levator 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 doctor. Currently, the diagnosis of complications of osteochondrosis has become much simpler, especially with the introduction of MRI into clinical practice.
Treatment of cervical osteochondrosis
Modern therapy of cervicalgia of vertebrogenic origin and associated compression and muscle syndromes provides for short courses of medication. The treatment of exacerbations of osteochondrosis of the cervical region quickly translates into a phase of fading exacerbation, against which the main methods of treatment are kinesiotherapy and physiotherapy.
Ointments and medicines for exacerbation
As you know, "injections", ointments and even blockades have not been canceled. But the neck is the focus of a large number of nerves, blood vessels, autonomic fibers, fascia. Therefore, blockades are performed less frequently here than with acute pain in the back or lower back. In addition, the thin skin on the neck allows gels, creams and ointments to be absorbed faster than in the lumbar spine.
Of the drugs, injectable forms of NSAIDs are used, preferably selective, muscle relaxants of central action, vitamins of group "B".
It must be remembered that if NSAIDs are used, then it is imperative to protect the mucosa of the gastrointestinal tract by using antisecretory drugs during treatment.
As for local treatment, there are currently a lot of ointments, gels and creams containing NSAIDs, bee and snake venom, as well as agents that cool and relieve pain. The main thing is not to use very hot ointments. They can cause an increase in 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 Shants collar
In the early stages, in the acute stage, it is necessary to protect the neck from unnecessary movements. The Shants collar is great for this. Many people make two mistakes when buying this collar. They do not choose it according to its size, which is why it simply does not fulfill its function and causes a feeling of discomfort.
The second common mistake is wearing it for a prophylactic purpose for a long time. This leads to weakness in the neck muscles, and only causes more problems. There are only two indications for the collar, in the presence of which it can be worn:
- The appearance of acute pain in the neck, stiffness and spread of pain to the head;
- If you are going to do physical work among full health, in which there is a risk of "pulling" your neck and getting aggravated. This is, for example, repairing a car when you lie down 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, since longer wearing can cause venous stasis in the muscles of the neck, at a time when 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 directed at all at the discs, but at the surrounding muscles. Its task is to relieve tonic spasm, improve blood flow, and also normalize venous outflow. This is what leads to a decrease in muscle tone, a decrease in the severity of pain and stiffness in the back.
Along with massage, swimming, acupuncture sessions, the purchase of an orthopedic mattress and a special pillow is indicated. A pillow for osteochondrosis of the cervical spine should 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 to prevent blood flow disturbance at night in the vertebrobasilar basin.
Autumn is an important stage in the prevention and treatment of home physiotherapy products and devices - from infrared and magnetic devices, to the most common needle applicators and ebonite discs, which are a source of weak electric currents during massage that have a beneficial effect on the patient.
What's next?
Statistics show that the peoples of the Mediterranean, who often and at any age swim in the sea, the situation with diseases of the musculoskeletal system is many times better.
However, the basis for the prevention of osteochondrosis, in addition to the elimination of risk factors, it is necessary to lay a healthy diet, which is based on sour-milk, plant foods, seafood, fiber, and plenty of liquid. This will slow down the process of age-related dehydration of the intervertebral discs, and maintain a healthy neck and back until the most advanced years.