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Cervical osteochondrosis is one of the popular diseases of the intervertebral discs located in the cervical spine.
For the first time, signs of the disease may appear at the age of 25-40 years. Osteochondrosis is often the cause of headaches (in about 30 percent of cases). If the disease is neglected, it can cause intervertebral protrusion or even a hernia. 85% of people in the world suffer from spinal diseases. Moreover, these sufferings come during the most active period of our lives. And if in the recent past osteochondrosis was considered the privilege of people over 40 years of age, today it has become much younger - signs of the disease appear in children 12 - 15 years old. Translated from Greek, “osteo” means bone, and chondros means cartilage.

There are many complaints about “cervical osteochondrosis,” a popular but medically incorrect expression. The correct medical name for the disease is “osteochondrosis of the cervical spine.” The medical encyclopedia gives it the following definition: a common disease of the dystrophic spine, characterized by damage to the intervertebral discs with subsequent damage to the interconnected vertebral joints and the associated spinal apparatus.

The neck has a significant degree of mobility, allowing a wide range of head rotation and supporting its weight. It is precisely because of its high mobility that the cervical spine is more vulnerable to injury and degenerative changes than the thoracic and sacral spine. The neck, like the entire spine, consists of vertebrae, intervertebral discs, ligaments and paraspinal muscles. The vertebrae in the neck have much closer contact with each other than in other sections. In addition, the skeletal muscles of the neck area are less developed due to the large number of blood vessels and nerves. Even minor loads on the cervical vertebrae cause partial displacement and some narrowing of blood vessels and nerves.

Causes of cervical osteochondrosis

The most mobile part of the spine is the cervical one, which has the following structure: seven vertebrae, and between them are highly elastic intervertebral discs. These discs give the spine flexibility and strength. Structurally, each such disc consists of a fibrous ring and a nucleus pulposus located inside the said ring. Cervical osteochondrosis causes metabolism in the spine. In addition, with this disease, the strength and elasticity of the intervertebral disc is lost. As a result, due to high load, the fibrous ring of the disc protrudes and begins to crack.

The main cause of cervical osteochondrosis is a sedentary lifestyle and frequent static loads that require concentration, for example, those associated with long driving, sewing, working in an office with a computer, any long stay in an unnatural position: for example, reading while lying down. Cervical osteochondrosis can also be caused by work associated with increased loads: lifting and carrying heavy loads, turning, flexion-extension, jerking, which negatively affects the spine as a whole.

Other causes of cervical osteochondrosis include

• Hereditary predisposition;
• Systemic diseases, infections, intoxications, metabolic disorders
• Poor nutrition (insufficient or excess), excess weight;
• Injuries (bruises and fractures), spinal curvatures (scoliosis, lordosis, kyphosis);
• Hypothermia;
• Using the wrong cushions, seats, office chairs and armchairs.

Hormonal disorders, hereditary predisposition, hypothermia, rheumatism, systemic lupus erythematosus and certain injuries to the cervical spine are the risk factors that lead to the onset of the disease.

Symptoms of cervical osteochondrosis include pain in the back of the head, shoulder, arm and neck, which intensifies with minimal exertion, as well as coughing or sneezing; headaches, most often starting in the back of the head and moving to the temples and crown of the head; dizziness and fainting that occur with sudden turns of the head; numbness and tingling in the arms or legs, as well as a burning sensation between the shoulder blades; weakness and rapid fatigue; pain in the neck and even a crunch that appears when bending and turning the head. In addition, it can be decreased vision, impaired hearing, tinnitus, and sometimes nagging pain in the heart.

Danger of cervical osteochondrosis

Cervical osteochondrosis is a very dangerous disease. This is explained by the fact that the cervical region is quite small in size, but at the same time it contains a large number of blood vessels and nerve canals leading to the brain. At the same time, the vertebrae of the cervical spine are adjacent to each other very tightly, which means that even a small change in one of them will inevitably cause compression or displacement of the above-mentioned nerve canals and blood vessels. Cerebral circulation is disrupted, which causes the appearance of vegetative-vascular dystonia, hypertension, migraines, as well as problems with vision, coordination, hearing, respiratory and cardiovascular systems.

Severe cervical osteochondrosis leads to vertebral artery syndrome, which normally supplies blood to the cerebellum and medulla oblongata. When it is compressed, a dangerous disease such as ischemia of the brain and spinal cord sometimes begins to develop, and sometimes leads to a spinal stroke.

With cervical osteochondrosis, the nerve roots are affected. This disease is called radiculopathy. With it, growths form on the vertebrae, and the person experiences partial or even complete loss of mobility. The most terrible form of cervical osteochondrosis is expressed in compression of the spinal cord, from which people die. However, there is no need to panic when a disease is discovered, since such serious consequences can be avoided if you promptly seek help from the specialists of our Mart clinic.

At the first symptoms of cervical osteochondrosis, contact us. Our experienced doctors will conduct a full comprehensive examination and, after making a diagnosis, prescribe an individual course of treatment. In their work, they use modern diagnostic methods - magnetic resonance imaging, ultrasound, electrocardiogram and other laboratory tests.

We have been treating osteochondrosis of the cervical spine for many years and know more than a dozen methods of its conservative treatment. Their use allows you to relieve the main symptoms of the disease and stop its development. When prescribing a course of treatment for a specific patient, we take into account the stage of the disease and the individual characteristics of the body. As a rule, the course is designed for six weeks, during which two or three times a week you should undergo prescribed procedures, including leech treatment, kinesiology, therapeutic massage, reflexology, etc.

After undergoing treatment at the Mart clinic, pain and inflammation in the affected areas are relieved, blood circulation improves, and compressed nerve roots are released. In patients, the possible appearance of protrusions and hernias is prevented, impaired metabolism and nutrition of the intervertebral discs are activated. Patients are given recommendations on how to behave further so that neck pain does not return.

Cervical osteochondrosis is not such a harmless disease as many of us tend to think, associating it only with pain and an unpleasant crunch in the neck. If you do not pay due attention to the health of your spine and the body as a whole, the development of severe consequences is inevitable.

If you have any questions, ask our specialist! Ask a Question

Osteochondrosis of the lumbosacral spine: aspects of pathogenesis, diagnosis and treatment

P.V. Galkin Candidate of Medical Sciences

Lower back pain (lumbago) and pain radiating down the leg along the sciatic nerve (sciatica) are one of the most common complaints with which patients seek medical help. Due to the fact that these symptoms occur quite often in the general population, and their steady increase is noted, the diagnosis and treatment of such patients will remain one of the main activities of neurosurgical hospitals. Despite the widespread prevalence of this pathology, surgical removal of a herniated intervertebral disc (IVD) is required in only 10% of patients with a clinical picture of lumbar ischialgia. In the remaining part of patients, the best effect is provided by conservative treatment, including drug therapy, physical therapy, the use of physiotherapeutic methods of treatment, as well as a return to previous daily physical activity. Surgical treatment is justified only in cases where the level of spinal root compression, determined clinically, corresponds to examination data confirming rupture of the fibrous ring with “prolapse” of the IVD hernia into the lumen of the spinal canal [3–6]. The results of surgical treatment in patients with small disc protrusions are usually disappointing to the doctor and the patient. A method that allows an accurate diagnosis to be made is magnetic resonance imaging (MRI). Approximately 10% of people in the general population are unable to undergo routine MRI due to claustrophobia (fear of enclosed spaces). For this category of people, it is possible to use the so-called “open” MRI, although with a corresponding loss in the quality of the resulting images. Patients who have previously undergone surgical treatment require contrast-enhanced MRI to distinguish postoperative scar-adhesive changes from true herniated disc protrusion. In patients with suspected hernial protrusion of the IVD, when MRI is impossible or the results obtained are uninformative, computed tomography (CT) myelography acquires special diagnostic value. Radiation diagnostic specialists interpreting the results of the studies, as a rule, exaggerate the degree of disc damage due to the impossibility of comparing clinical data with the “findings” of tomography. Conclusions such as “changes correspond to the patient’s age” are almost never found in research reports. Despite the improvement of neuroimaging techniques, the responsibility for a correct diagnosis lies on the shoulders of the clinician, since only he can compare the clinical picture with the data obtained from tomography. An increase in the resolution of tomographs slightly improved the outcomes of surgical treatment, but deviations from the norm began to be detected in asymptomatic patients. The study of the processes accompanying degenerative-dystrophic lesions of the spine has undergone serious progress in recent years. Arthropathy of the facet joints is widespread in the general population and is detected quite often in people of the middle and older age groups during CT studies. Degenerative changes in the IVD, which are also widespread, are detected quite often, and MRI is a more specific method for diagnosing them. In this case, pronounced changes in the IVD are not uncommon, not accompanied by rupture of the fibrous ring, but only manifested by a slight “bulging” of the disc into the lumen of the spinal canal or intervertebral foramina. In some cases, degenerative processes occurring in the IVD can lead to destruction of the fibrous ring with subsequent ruptures, which causes migration of part of the nucleus pulposus outside the disc with compression of the adjacent spinal cord roots. The statement that if there is pain in the leg, then there must be infringement of the spinal cord root is not entirely true. Pain in the buttock with irradiation along the posterior surface of the thigh can be caused by both degeneration of the IVD itself and the facet intervertebral joints. A true attack of ischalgia, caused by compression of the nerve root by a herniated IVD, is characterized by pain radiating along the back of the thigh and lower leg. Pain of an indeterminate nature, limited only to the gluteal region or the thigh area without spreading along the sciatic nerve, as well as bilateral pain in the gluteal region or thighs, pain that changes its localization (either on the right or on the left), is often caused by arthropathy of the facet joints or diffuse degeneration of the IVD . Concomitant pathology (for example, arthrosis of the knee joints) can also simulate the clinical picture of root compression by IVD hernia. In patients with such pain, surgical treatment will not have the desired effect, regardless of what pathology is detected during a tomographic examination. In other words, in patients with only back pain, removal of an IVD hernia will be ineffective, even if IVD protrusions are detected on tomograms, as is usually the case. But there are also patients in whom the typical picture of sciatica is accompanied by severe disabling pain syndrome, while studies performed using high-resolution tomographs do not detect compression of the spinal cord roots. It is not advisable for this category of patients to undergo surgical intervention, since over time their radicular symptoms, as a rule, subside. It is necessary to clearly understand the mechanisms leading to the development of hernial protrusion of the IVD in order to recommend to patients the range of permissible movements, not forgetting about work activity. The forces contributing to the formation of a hernial protrusion are a consequence of degenerative changes in the IVD and a decrease in the vertical dimensions (height) of both the fibrous ring and the nucleus pulposus. The protruding fragment of the IVD is displaced in 80% in the posterolateral direction, penetrating into the lumen of the spinal canal and the medial sections of the intervertebral foramen. This displacement of the IVD herniation away from the midline is facilitated by the holding force of the posterior longitudinal ligament. Up to 10% of hernial protrusions are localized laterally and extend into the intervertebral foramen (foraminal hernias) or at the outer edge of the foramen, where the spinal root emerges from it, thereby compressing it. During life, dehydration and degenerative changes lead to loss of IVD height. These pathological processes involve both the annulus fibrosus and the nucleus pulposus. More pronounced destruction of the nucleus pulposus against the background of concomitant degeneration of the fibrous ring, as a rule, leads only to a loss of IVD height without its significant bulging. With predominant changes in the fibrous ring, vertical forces acting on the remaining nucleus pulposus and being a derivative of its own weight, as well as the forces of the back muscles acting on the disc in the lateral direction, exert excess pressure on the remaining fragment of the nucleus pulposus, which is degeneratively unable to hold in place altered fibers of the fibrous ring. The summation of these two forces leads to an increase in centrifugal pressure on the IVD, which, together with the tensile component acting on the fibers of the fibrous ring, can lead to its rupture and bulging of fragments of the remaining nucleus pulposus. After a hernial protrusion has formed and the “excess” fragment of the nucleus pulposus is outside the annulus fibrosus, the IVD structure becomes stable again [2]. As a result, the forces acting on the degeneratively changed nucleus and the fibrous ring of the IVD are balanced, and their vector, which promotes further protrusion of nuclear fragments, fades away. In some cases, partial degenerative changes in the nucleus pulposus contribute to gas formation inside the IVD with subsequent excess pressure on its remaining fragment. The formation of a hernia is also accompanied by the process of gas formation inside the disc. Excessive and sudden physical stress placed on the patient’s back, against the background of existing degenerative-dystrophic lesions of the spine, as a rule, is only a trigger point that leads to a detailed clinical picture of compression radicular syndrome, which is often mistakenly regarded by the patient himself as the root cause of lumbar ischialgia. Clinically, IVD hernia can manifest itself as reflex and compression syndromes. Compression syndromes include syndromes in which the root, blood vessels or spinal cord are stretched, compressed and deformed over the hernial protrusion. Reflex syndromes include syndromes caused by the effect of a disc herniation on the receptors of these structures, mainly the endings of the recurrent spinal nerves, which leads to the development of reflex-tonic disorders, manifested by vasomotor, dystrophic, and myofascial disorders. As noted above, surgical treatment for degenerative-dystrophic lesions of the spine is advisable in only 10% of patients, the remaining 90% respond well to conservative measures. The main principles of using the latter are: 1) pain relief; 2) restoration of correct posture to maintain the fixation ability of the changed IVD; 3) elimination of muscle-tonic disorders; 4) restoration of blood circulation in the roots and spinal cord; 5) normalization of conduction along the nerve fiber; 6) elimination of scar-adhesive changes; 7) relief of psychosomatic disorders.

Methods of conservative treatment include various orthopedic effects on the spine (immobilization with a corset, traction, manual therapy), physiotherapy (massage therapy, physical therapy, acupuncture, electrotherapy, mud therapy, various types of heating), paravertebral, epidural blockades and drug therapy. Treatment of degenerative-dystrophic lesions of the spine should be comprehensive and step-by-step. As a rule, the general principle of conservative measures is the prescription of analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants and physiotherapy. The analgesic effect is achieved by prescribing diclofenac, ketoprofen, lornoxicam, tramadol. Lornoxicam, available in both injection and tablet forms, has a pronounced analgesic and anti-inflammatory effect. In the acute stage of inflammation, it is possible to prescribe up to 16 mg of lornoxicam per day, after the pain subsides; usually after 5–7 days it is advisable to switch to the tablet form and take it for up to 2 weeks. NSAIDs are the most widely used drugs for degenerative diseases of the spine. They have anti-inflammatory, analgesic and antipyretic effects associated with the suppression of the enzyme cyclooxygenase (COX-1 and COX-2), which regulates the conversion of arachidonic acid into prostaglandins, prostacyclin, thromboxane. In elderly patients and patients with risk factors for side effects, it is advisable to carry out NSAID therapy under the “cover” of gastroprotectors (omeprazole, ranitidine). In such patients, after completing a course of injection therapy with NSAIDs, it is advisable to switch to tablet forms of COX-2 inhibitors, which have less side effects from the gastrointestinal tract (nimesulide, meloxicam). To eliminate pain associated with increased muscle tone, it is advisable to include centrally acting muscle relaxants in complex therapy: tizanidine 2–4 mg 3–4 times a day or tolperisone orally 50–150 mg 3 times a day or intramuscularly 100 mg 2 once a day. The mechanism of action of tizanidine is significantly different from the mechanisms of action of other drugs used to reduce increased muscle tone, so its use is justified when there is no antispastic effect of other drugs. The advantage of tizanidine compared to other muscle relaxants used for the same indications is that when muscle tone decreases when tizanidine is prescribed, there is no decrease in muscle strength. Tizanidine is an imidazole derivative, and its effect is associated with stimulation of α2-adrenergic receptors. It selectively inhibits the polysynaptic component of the stretch reflex and has an independent antinociceptive and moderate anti-inflammatory effect. Tizanidine reduces resistance to passive movements, reduces spasms and clonic convulsions, and also increases the strength of voluntary contractions of skeletal muscles. Tizanidine also has a gastroprotective effect, which justifies its use in combination with NSAIDs. Surgical treatment of degenerative-dystrophic lesions of the spine is justified if complex conservative measures (within 2-3 weeks) are ineffective in patients with IVD hernias (usually larger than 10 mm) and intractable radicular symptoms. There are emergency indications for surgical intervention in case of a “fallen out” sequester into the lumen of the spinal canal and severe compression of the spinal cord roots. The development of caudal syndrome is facilitated by acute radiculomyeloischemia, leading to severe hyperalgic syndrome, when even the prescription of narcotic analgesics and the use of blockades (with glucocorticoids and anesthetics) do not reduce the severity of pain. It is important to note that the absolute size of the disc herniation is not decisive for making the final decision about surgical intervention and should be considered in connection with the clinical picture and findings detected during tomographic examination. In 95% of cases with IVD hernias, open access to the spinal canal is used. Various discopuncture techniques (cold plasma coagulation, laser reconstruction, etc.) are not currently widely used, and their use is justified only for IVD protrusions. Classical open microsurgical removal of a disc herniation is performed using microsurgical instruments, a binocular loupe or an operating microscope. Analysis of long-term treatment results (over 2 years) of 13,359 patients who underwent removal of IVD hernia, 6135 of whom underwent sequestration removal, and 7224 underwent aggressive discectomy, showed that relapse of pain was 2.5 times more common ( 27.8% versus 11.6%) in patients who underwent aggressive discectomy, while recurrence of herniation was noted 2 times more often (7% versus 3.5%) in patients who underwent only sequestration removal. The authors conclude: the quality of life decreases more in patients experiencing pain, while recurrent herniation is not always clinically manifested. In conclusion, I would like to once again emphasize the need for a thorough clinical examination and analysis of tomograms in order to make the optimal decision on the choice of treatment tactics for a particular patient.

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Symptoms of osteochondrosis of the cervical spine

The main symptom of the pathology is pain in the neck. They can be localized in one part or spread to the head, causing headaches and dizziness. Sometimes the pain expands, spreading to the collarbone, moving to the shoulder area. Muscle stiffness and neck stiffness are usually the result of muscle spasm, but can indicate significant pathological impairment, causing arm numbness, weakness, and even partial or complete paralysis.

With osteochondrosis, displacement of the intervertebral discs can lead to pinching of the cervical nerve roots and cause pain in the shoulder, pain radiating to the arm/fingers (neuritis, neuralgia, radiculitis), periodic numbness and tingling (paresthesia).

At the same time, due to compression of the vessels of the head and neck, dull pain in the head and dizziness appear, sometimes with a sudden turn of the head, causing discomfort and reducing performance.

Periodically, chest pain occurs, similar to an angina attack - squeezing pain in the heart area, which spreads to the shoulder blades and forearms. Unlike an attack of angina, which lasts no more than 5 minutes, pain with cervical osteochondrosis can last for several days. Hand pain causes tingling and numbness.

Sometimes numbness of the tongue occurs due to the restriction of its movement - the voice becomes rough.

Headaches and migraines caused by periodic disturbances in cerebral blood flow and increased intracranial pressure are early signs of cervical osteochondrosis. If attention is not paid to the spine, the progression of the disease is inevitable, cerebral vascular insufficiency becomes permanent, that is, chronic. The brain suffers from a lack of oxygen, VSD (vegetative-vascular dystonia), hypertension develops, there are surges in blood pressure, fainting, and the likelihood of a stroke increases. Chronic lack of oxygen leads to rapid deterioration of memory and integrative functions of the brain.

Another consequence of cervical osteochondrosis is coronary syndrome. Pain in the heart, sternum, between the shoulder blades, worsening when coughing or sneezing, as a result of compression of the spinal roots and fibrous growths cause a reflex contraction of the coronary arteries. Even in the absence of cardiovascular disease, especially angina, the situation can become critical and, under unfavorable circumstances, can lead to myocardial infarction.

Attention! The initial stages of cervical osteochondrosis can be almost asymptomatic and manifest themselves only indirectly: minor muscle tension in the neck or headaches. In this case, it is necessary to make an appointment with a neurologist and undergo an examination to clarify the diagnosis, stop the development of the disease and prevent serious consequences.

What is spinal osteochondrosis

Berezhkova Lyudmila Vasilievna

Neurologist, Chiropractor

April 24, 2021

Osteochondrosis of the spine is degeneration (malnutrition) of the tissues of the intervertebral disc with a weakening of its shock-absorbing properties. With osteochondrosis, the fixing ability of the spine, that is, the condition of the paravertebral muscles and ligaments, worsens, especially under load. First, dehydration of the nucleus pulposus and metabolic disorders in the cartilage occur. As a result, the disc loses its elasticity, dries out, decreases in size and cannot withstand physical activity. For example, a vertical force of 500 kg leads to rupture of a healthy disc, which has been confirmed experimentally. For osteochondrosis, an axial load of 200 kg is sufficient for a similar effect.

The processes of intervertebral disc degeneration during the further development of osteochondrosis entail compensatory changes in the bodies, joints, and ligaments with the involvement of blood vessels, muscles and nerves in the pathological process. With effective treatment, fibrotization (hardening) of the disc occurs with its self-fixation: the pain goes away, the mobility of the spine returns and the person feels healthy.

Neurosurgeon A.I. Osna proposed in 1971 a classification of the stages of osteochondrosis based on long-term experience in its study and surgical treatment.

Stage I - intradiscal movement of the nucleus occurs more than normal, which leads to stretching or compression of the fibrous ring.

Stage II - cracks in the fibrous ring and instability of the affected spinal segment occur.

Stage III - there is a complete rupture of the disc with prolapse of the hernia, an inflammatory process with possible pressure on the nerves and blood vessels.

Stage IV - there is degenerative damage to other components of the intervertebral disc with the addition of spondylosis, spondyloarthrosis and other compensatory changes.

Spondyloarthrosis (arthrosis of the joints of the spine)

It occurs from improper distribution of vertical load due to a decrease in the height of the intervertebral disc. A flattened disc reduces the distance between the facet joints. They are overloaded and destroyed with the development of arthrosis. The result of osteoarthritis is the infringement of the kniskoid joints of the spine, which blocks the joint and causes pain.

Spondylosis

A disease of the spine characterized by deformation of the vertebrae due to the growth of bone tissue on their surface in the form of protrusions and spines. Spondylosis fixes the area that is subject to overload, causing irritation of the nerve endings of the ligament. Patients experience dull, aching local pain and heaviness in the spine. Spondylosis is accompanied by muscle tension around the motion segment, and then these two fixing mechanisms not only aggravate the pain but also worsen the shock-absorbing function of the spine, straightening its physiological curves. In the early stages of osteochondrosis, the muscles tense, immobilizing and protecting the spine, creating a local muscular corset. In the later stages, immobility is supported by irreversible changes in the muscles, surrounding tissues and spondylosis.

Muscle syndrome

In osteochondrosis, it is associated with the fact that pathological irritating impulses go from the affected motor segment to the muscles, which, along with their dynamic overload, causes a tonic spasm. These nerve impulses cause vascular spasm, and first there is pain, and then the muscles themselves change due to disturbances in their blood supply. Condensed cords appear, containing dense and painful nodules (Cornelius), areas of hypertonicity or dense myogeloses. So-called trigger zones are formed, pressure on which causes sharp, widespread pain.

So, with osteochondrosis, the fixing abilities of the intervertebral disc first weaken, which is compensated by muscles and ligaments. If in the future unfavorable factors continue their destructive effect, then the compensatory capabilities of the fixing elements turn out to be insufficient. In this case, in the later stages of the disease, muscle fixation decreases, ligaments are stretched, and excessive mobility is formed in the spinal motion segment. Excessive mobility causes greater than normal movement of adjacent vertebrae in relation to each other. For example, at the moment of extension of the body, the overlying vertebra moves posteriorly, which does not happen in a healthy spine. Due to pathological mobility, which injures the vertebral bodies, and the rough tension of the ligaments, the endplates of the vertebral bodies become denser and their sclerosis develops. As a result, chronic growth of bone tissue of the vertebral bodies occurs, which compensatoryly increases their surface and reduces the load. These overgrown bone spines are called osteophytes. Spondyloarthrosis, spondylosis, pseudospondylolisthesis and osteophytes indicate late stages of osteochondrosis.

It should be noted that the above signs of osteochondrosis may not appear clinically and are only accidentally detected on radiographs. These phenomena may be the result of natural aging of the spine and not be accompanied by unpleasant sensations. However, there is another variant of the course of osteochondrosis with intense pain that torments patients from a young age. The difference between the two variants of the course of the disease is fundamental and lies in the pathologically early aging of the spine. The clinical manifestations of osteochondrosis are determined by the fact that in this case the degree of development of compensatory changes lags behind the intensity of the natural decrease in the height of the disc.

Diagnosis of cervical osteochondrosis

For neck pain, the diagnosis is made by studying the patient’s medical history, appropriate clinical examination, laboratory and instrumental studies.

The medical history will be able to determine previous injuries, hereditary predisposition to systemic diseases, the degree of chronicity of symptoms and their nature.

A clinical examination will determine the nature of the disease, that is, clarify local soreness and stiffness of the neck muscles, muscle strength, reflexes and other clinical factors, and show the type and level of damage depending on the symptoms. If possible, potential pathologies of other systems are identified, which may be similar to the symptoms of neck osteochondrosis. In fact, myofascial pain syndromes such as fibromyalgia are more likely to lead to chronic neck pain than cervical osteochondrosis. Therefore, it is important to obtain an accurate diagnosis confirmed by objective data.

MRI is currently undoubtedly the most sensitive, specific and reliable method in the diagnosis of degenerative diseases of the cervical spine. It has been proven that MRI can identify the cause of myelopathy in 90% of patients; with an accuracy of more than 90%, the presence of osteophytes or herniated discs requiring surgical treatment is detected. By using perfusion of a contrast agent into the spinal canal, complete information about the anatomical situation of the vertebrae and nerve roots can be obtained.

Considering the reliability and accuracy of the method, in the MART clinic, an MRI examination is considered a necessary imaging method for a complete and objective assessment of the patients’ condition. MRI shows degenerative changes in the cervical spine in a significant proportion of asymptomatic patients.

A spine scan may show intervertebral disc degeneration in a patient who is not experiencing any symptoms. Normal degeneration due to aging is very common and does not indicate a problem unless there are complaints of neck pain, shoulder pain or stiffness. The MRI results in each case must be correlated with the patient's clinical picture before any decision about treatment is made.

Thus, diagnosing this disease at our clinic involves a history of the patient's symptoms and a physical examination combined with an MRI scan of the spine.

Treatment of cervical osteochondrosis at the MART clinic

In the case of degenerative diseases of the spine, treatment of osteochondrosis is usually conservative.

Anti-inflammatory drugs and muscle relaxants are usually used to relieve acute pain. Depending on the patient’s condition, non-steroidal anti-inflammatory drugs are used for moderate pain, most often in the form of injections at the beginning of treatment.

If osteochondrosis of the cervical spine is accompanied by systemic diseases in the form of rheumatological and neurological pathologies, then additional special treatment will be required.

Then physiotherapeutic forms of treatment are used, such as UVF, magnetophoresis, laser phoresis, which affect the cervical spine with low-frequency currents and magnetic fields in order to improve blood circulation, achieve an antispastic effect, and reduce pain symptoms.

Transcutaneous electrical nerve stimulation (TENS) is a well-proven method of influencing joints and the spine, effectively blocking pain.

Manual therapy. The goal of manual therapy in the cervical region is to recreate the space between the bone structures in order to restore proper lymphatic circulation and nutrition of the spinal nerves. This form of therapy aims to reduce pain and prevent disability. As a result of the course of treatment procedures, there is an increase in blood circulation in the area of ​​the cervical vertebrae, neural decompression and stimulation, a decrease in pressure on the disks of the nucleus pulposus and an increase in intervertebral space.

Massotherapy. It has been proven by practice that therapeutic massage does lead to significant relief for some patients. The importance of relaxation is that many patients suffer from pain in the neck due to tension, muscle stiffness, most often in the neck and shoulder girdle. Massage can relieve excessive muscle tension. There are studies that clearly show that massage therapy is more effective as a treatment option than exercise. Another study supports the use of massage as a safe option for relieving chronic neck pain.

Physiotherapy. Physiotherapeutic treatment methods are complemented by a course of physical therapy. Individually selected exercises for the treatment of cervical osteochondrosis, carried out under the supervision of a doctor, are aimed at developing muscle groups and ligaments in the neck, increasing their blood supply, and improving spinal mobility. MARCH is a specialized treatment and diagnostic center equipped with modern diagnostic equipment and equipment for the treatment of diseases of the joints and spine, including osteochondrosis of the cervical spine. Specialists with extensive practical experience: neurologists, orthopedists, physical therapy doctors, physiotherapists are ready to provide highly qualified assistance to patients with osteochondrosis of the cervical spine.
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Treatment of osteochondrosis

Non-surgical methods

In the acute period, with severe pain, treatment is best done at home.
Visiting the clinic for treatment (injections, physiotherapy, massage, etc.) in the first days is not advisable. Complete rest, a hard but comfortable bed, and prescription of painkillers are required. To reduce pain and create peace, the lower back is fixed with an anti-radiculitis corset, and if the cervical spine is affected, with a special Shants collar. The use of heating pads, hot baths and any deep heat is contraindicated, as this will only worsen the pain. It is recommended to use your own body heat stored with woolen fabric.

Medicines are used as prescribed by a doctor, taking into account individual tolerance and contraindications. To reduce pain, distracting and irritating agents are prescribed to the area of ​​pain (pepper patch, mustard plasters, various ointments), painkillers and anti-inflammatory drugs - internally (tablets, capsules) or externally (ointments). For acute pain, some pain medications are used intramuscularly or intravenously.

After the acute phenomena subside, when pain decreases, treatment is supplemented with procedures that can be performed in the clinic (physiotherapy, massage, etc.). To improve the condition of the spine and paraspinal muscles, proper distribution of physical activity and regular physical therapy exercises are necessary.

After recovery, it is necessary to systematically engage in physical exercises aimed at strengthening the back muscles and avoid hypothermia of the lower back and neck, especially in the off-season.

Surgical methods

Surgical treatment is carried out according to strict indications in the following situations:

• Compression of the spinal cord, which causes paralysis of the muscles of the limb with numbness (urgent surgery is indicated).
• For long-term recurrent osteochondrosis, persistent pain that does not respond to conservative treatment (planned surgery).

Surgical intervention consists of eliminating compression (decompression) of the spinal cord and spinal roots, removing part of the intervertebral disc or disc herniation, sometimes followed by fixation of the vertebrae with a special design (spinal fusion).

Prevention of cervical osteochondrosis

As a preventive measure, yoga and swimming work well, often walking, but running, jumping and strenuous exercise in the gym should be excluded. When working at a computer, it is recommended to take five-minute breaks every hour, during which you should walk a little and bend your head and torso. For sitting, you need to choose armchairs and chairs that support the spine, and sit on them, keeping your head and back straight. Regular visits to the bathhouse or sauna help relieve neck muscle spasms, as well as a daily ten-minute hot shower. It is recommended to sleep on a special orthopedic mattress and a low pillow. And most importantly, categorically avoid any sudden head movements!

Diet for cervical osteochondrosis

As for nutrition, doctors advise eating at least five times a day, but in small portions. You should completely avoid alcohol and cigarettes, regularly consume steamed or boiled foods, and drink at least one and a half liters of water daily. Mandatory products on the menu are jellied meat, fish aspic and other dishes with gelatin, mushrooms, eggs and cereals, lean rabbit and chicken meat, dairy and seafood, vegetables and fruits, nuts and sunflower seeds. You should try to exclude salty, flour and smoked foods, as well as hot seasonings, and reduce grapes, legumes, meat broths and sugar to a minimum.

Conservative treatment

At an early stage, when no violations of the intervertebral discs are yet visible, lumbar osteochondrosis can be cured without medication. To correct weight and improve the health of the spine, the doctor will recommend swimming and physical therapy. At this stage, you need to give up intense physical activity and drink vitamin and mineral complexes.

At the second and subsequent stages of osteochondrosis, you will have to take anti-inflammatory drugs, analgesics and chondroprotectors. For severe attacks of pain, novocaine blockades are prescribed.

In addition to drug treatment for lumbar osteochondrosis, hardware physiotherapy is used - magnetic, laser and ultrasound, as well as mud therapy and taping.

The most effective method, along with a course of medication, is considered to be manual therapy and therapeutic massages. At the same time, the spine is stretched, releasing pinched nerves, and the intervertebral discs return to their original state.

Recommendations

To strengthen the neck muscles, it is recommended to use therapeutic exercises, before starting which you need to consult with the doctors of the Mart clinic. If during this exercise you experience severe pain in the neck area, stop exercising and consult a doctor again.

The article was reviewed by Doctor of Medical Sciences, Professor Grigory Isaakovich Shvartsman, Northwestern Medical University. I.I. Mechnikov.

Sign up at the MART medical center in St. Petersburg (see map) by phone, or leave a request on the website.

Symptoms of lumbar osteochondrosis

Minor signs of this disease appear already at the first stage, and they intensify over time.

Symptoms of the disease:

• lower back pain radiating predominantly along the back of the thigh, and may spread up the back;
• pain when lifting weights or changing position;
• lumbago (lumbago in the back) with hypothermia of the lower back;
• after sitting for a long time without changing posture, it is difficult to make any movement;
• back muscle strain;
• numbness of the buttocks and legs.