It has already been written and said several 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 only been on two legs for about a couple of million years, and even less. This, from the point of view of evolution, is still the "center of the road". It is not known what new anatomical variants of spinal development we will arrive at in a million years.
Currently, osteochondrosis is the most common disease of the musculoskeletal system, and doctors of various specialties deal with 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 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 normally does not cause any disturbance. This is possible in vigorous older people who are mobile, have good posture and have no excess weight. They exercise, 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, we always mean its complicated course, which causes various ailments 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 are less massive.
All this makes 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, do not occur with injuries of the lumbar region. In addition, 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 pathways below. Therefore, with central canal compression syndromes, the patient may have 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 (immersion on the head in small unknown places).
Of course, such complex lesions 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, simply refuse to move on two legs and crawl on all fours or to live in the ocean, like dolphins. Only then will the load on the intervertebral discs be minimal or even completely absent.
Only exacerbations of osteochondrosis can be cured and for this it is necessary to know not only their signs and symptoms, but also the risk factors.
Speaking of risk factors
In the case of the cervical spine, obviously, weight lifting on the shoulder will not play as much of a role in the onset of pain syndrome 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 shaft. In the event that the arch of the foot does not subside, and during the step there is not an "elastic" movement of the spine down, but a blow, then this blow with a "wave", like a whip, goes up , and is extinguished precisely in the cervical region, in the place of the craniovertebral passage. 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, sliding on ice in winter, falling on the back of the head, as well as constantly hitting the head on low doors, which are often found in people whose height is above average.
- Wear heavy winter hats, tall 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.
- Sedentary lifestyle, "sedentary" work, presence of stiffness in the upper part of the thoracic and cervical spine.
We will not list the specific risk factors that occur in sick patients. Quite are those reasons for the deterioration of the condition that are found in normal and healthy people.
Symptoms and signs of osteochondrosis
The signs of osteochondrosis of the cervical spine are very multifaceted. Few doctors even know that general prolapse of the abdominal cavity (splancnoptosis) or prolapse of the liver, which is often misdiagnosed as its increase, may be due to osteochondrosis of the cervical region. In this case the phrenic nerve is 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 protrusions of the cervical spine - a separate article is devoted to this. We are talking 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 aches manifest as constant, aching pain of low intensity. It is aggravated by turning and tilting the head. Often accompanied by stiffness in the suboccipital region.
Headache in osteochondrosis of the cervical region almost always has the nature of a tension headache. The attack lasts several 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, the working capacity does not suffer, but if radicular symptoms join, 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 disturbances. 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 disturbances ("flies"), headaches. Sometimes there are fall attacks, during which a person does not lose consciousness, but falls and then quickly gets up.
Compression of one of the two vertebral arteries may 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, from the opposite side.
If you lie down 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.
Numerous neurological syndromes and symptoms also arise, 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 if he cannot contact a neurologist:
- Lower oblique head muscle syndrome (often occurs in patients over the age of 50, especially in postmenopausal women). There are pains, sensitivity disorders in the back of the head, along the auricle. The pain is aching, of a broken 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 sound side;
- Anterior scalenus syndrome - occurs in patients with additional "cervical ribs".
There are sensitivity disorders and "crawling" in the hand, whitening and coldness, sometimes swelling of the hand, the appearance of weakness, hypotrophy of the hand muscles and weakening of the wrist to the wrist. In severe cases, progressive paralysis or paresis of the hand muscles may occur. Patients cannot drive a car, sleep on a sore side, cannot lift weights, and also cannot work with raised hands (hanging curtains, plastering). There are also complaints of stiffness and pain in the neck, forced head position in the morning.
- Middle scalene syndrome. First, there are pains in the shoulder, in the region of the scapula, and then muscle wasting 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 levator syndrome of the muscle that raises the scapula). First, aching pains appear, in the shoulder blade area, which "buzz". Shoulder damage, there is also pain in the neck, which often hurts "with time". A crunch is usually heard when moving the shoulder blade.
Thus, it is clear that many processes initiated 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 on the part of the doctor. Currently, diagnosing the complications of osteochondrosis has become much easier, especially with the introduction of MRI into clinical practice.
Treatment of cervical osteochondrosis
The modern therapy of cervical pain of vertebrogenic origin and associated compression and muscle syndromes provides for short courses of therapy. Treatment of exacerbations of osteochondrosis of the cervical region quickly results in a phase of fading exacerbation, against which the main methods of treatment are kinesitherapy and physiotherapy.
Ointments and medicines for exacerbation
As you know, the "injections", ointments and even blockages have not been canceled. But the neck is the fulcrum of a large number of nerves, blood vessels, autonomous fibers, fascia. Therefore, blocks are performed here less frequently than in acute pain in the back or lower back. In addition, the thin skin of the neck allows for faster absorption of gels, creams and ointments than the lumbar spine.
Among the drugs, injectable forms of NSAIDs are used, preferably selective, centrally acting muscle relaxants, vitamins of group "B".
It should be remembered that if NSAIDs are used, it is imperative to protect the mucous membrane 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 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. It is desirable that ointment treatment be carried out prophylactically, without waiting for the next exacerbation.
About Collar Shants
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 based on its size, which is why it simply does not perform its function and causes a feeling of discomfort.
The second common mistake is to wear it prophylactically 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 in the head;
- If you intend to do physical work in full health, in which there is a risk of "pulling" your neck and aggravating yourself. This is, for example, repairing a car when you lie down under it or washing the windows when you need to reach out and take awkward positions.
It is necessary to wear a collar for no more than 2-3 days, as prolonged use can cause venous stasis in the neck muscles, by the time it is time to activate the patient.
Activation of the patient
Kinesiotherapy (treatment by movement) involves therapeutic exercises, swimming. Gymnastics for osteochondrosis of the cervical spine is not directed at all to the discs, but to 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 pain severity and stiffness in the back.
Along with massages, swimming, acupuncture sessions, the purchase of an orthopedic mattress and a special pillow is recommended. 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 prevent blood flow disturbances at night in the vertebrobasilar pelvis.
Autumn is an important step in the prevention and treatment of home physiotherapy products and devices - from infrared and magnetic devices, to the most common ebonite needle and disc applicators, which are a source of weak electric currents during the 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, a healthy diet is required, 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 keep your neck and back healthy into your later years.