Treatment of osteochondrosis of the cervical spine: symptoms, causes, diagnosis

Cervical osteochondrosis is a degenerative and dystrophic disease of one of the parts of the spine. As the disease develops, the intervertebral discs in the neck suffer the most, and damage also spreads to the articular surfaces, ligaments, and vertebrae. Treatment of osteochondrosis of the cervical spine depends on the current stage of the disease. The pathology mainly occurs in patients over the age of 30, but cases are also recorded in young people, especially if the person leads an unhealthy lifestyle and is at risk.

The most common symptom is severe pain in the neck, which can spread lower down the spine, move to the upper limbs, and deform into a severe headache. Below we will consider for which symptoms of osteochondrosis of the cervical spine it is better to begin treatment, find out the causes of the disease and the methods that are used to combat the problem.

Causes and risk factors

The main reason for the development of osteochondrosis in humans is the ability to walk upright, acquired with evolution. When walking, the vertebrae put excessive pressure on each other. Every year this leads to the fact that the amount of intervertebral fluid and connective tissue between the vertebrae decreases, as a result, the bones begin to rub against each other, causing severe pain.

The longer cervical osteochondrosis develops without the necessary treatment, the less chance there is to stop the degenerative processes. In old age, it is almost impossible to restore connective tissue.

Cervical osteochondrosis in old age is predominantly a natural process that is not associated with the influence of external factors. If the problem begins to develop at an early age, if the painful sensations intensify too quickly, it is imperative to look for the cause of this disorder.

The development of cervical osteochondrosis at an early age is most often caused by the following factors:

Lack of physical activity in daily life. In the modern world, a person leads a predominantly sedentary lifestyle - he works all day in an office, spends time in the evening sitting on the couch or at the computer, and often drives a car;
In the process of performing work tasks, the human body often takes an unnatural, tense position (strong forward deviation when working at a computer);
Excessive exercise. The opposite reason is playing sports with uncontrolled loads. Not only ordinary citizens, but also professional athletes face this problem;
The reasons that cause the spine to be in the wrong position are flat feet, wearing uncomfortable high-heeled shoes, scoliosis, arthritis, etc.;
Abuse of junk food, obesity;
Severe hypothermia of the cervical spine;
Nervous stress – frequent stress in everyday life and at work, lack of proper sleep at night.

Diagnostics

The diagnosis of osteochondrosis of the cervical spine can be made based on data such as:

Medical history.
First, the doctor needs to study the symptoms and medical history in detail.
Physical examination
. The doctor will then perform a physical examination, palpating the neck and checking the range of motion in the neck. During the tests, patients may be asked to perform certain movements and report whether their neck pain increases or decreases.
If the pain is intense or if there are neurological symptoms such as pain, tingling or weakness in the shoulder, arm or hand, then your doctor will likely order medical imaging.
Medical imaging methods (radiography, CT, MRI, PET).
If the doctor determines that to determine the exact genesis of the symptoms it is necessary to obtain images of tissues (discs), then an MRI will most likely be prescribed. An MRI, X-ray, or possibly a CT scan can confirm whether there are signs of degeneration, as well as identify other conditions (such as osteoarthritis or stenosis) that may be causing symptoms.
After confirming an accurate diagnosis of osteochondrosis of the cervical spine, as well as any other associated conditions, the genesis of symptoms can be understood and an effective treatment program can be determined.

Symptoms of cervical osteochondrosis

All of these risk factors and lifestyle features lead to the intervertebral discs in the cervical spine experiencing nutritional deficiency. If the problem is not identified and corrected, the discs will gradually begin to deteriorate, the distance between them will decrease, and ultimately this will lead to constant friction of the bones against each other. As connective tissue depletes, bone growths begin to form on the spine, which are prone to uncontrolled growth. In advanced cases, the growths begin to put pressure on the surrounding tissues, vessels, and nerves that are located in the cervical spine.

Cervical osteochondrosis does not develop instantly; in the absence of proper treatment for the symptoms of osteochondrosis of the cervical spine, the problem worsens. The entire course of the disease can be divided into 4 stages. The symptoms experienced by the patient directly depend on the current stage of the problem. Among the symptoms of cervical osteochondrosis are:

Discomfort in the neck that spreads to the shoulder area;
The appearance of pain in the cervical spine when playing sports;
Stiffness when turning the neck;
Private headaches that are not caused by external factors;
When you change the position of your head, you can hear a characteristic crunch;
Numbness and loss of sensitivity in some areas of the skin of the neck, shoulders, arms, neck;
Hypoxia of tropho-dependent organs;
Development of pathologies of the circulatory system;
Severe pain leads to complete immobilization of the upper shoulder girdle.

The further the disease progresses, the more discomfort the patient experiences. In the final stages of the problem, the patient’s quality of life deteriorates significantly. Common symptoms for all stages of the problem include headache, ringing or noise in the ears, visual defects, nausea and vomiting with a sudden change in head position.

Less common symptoms

The more the cervical spine degenerates, the more likely it is that the spinal canal will narrow and increase the risk of spinal cord compression. If compression of the spinal cord occurs, myelopathy will develop and symptoms such as:

Difficulty moving arms and/or legs
Problems with coordination and/or balance
Loss of bowel and/or bladder control
Weakness and/or numbness anywhere below the neck
Shooting pain in the limbs, which may worsen when bending forward

Cervical myelopathy is a serious condition that requires immediate medical attention. This condition usually occurs in people over 50 years of age.

Diagnosis of osteochondrosis of the cervical spine

If you experience one of the symptoms listed above, it is advisable to immediately seek medical help. The sooner a problem is diagnosed, the higher the likelihood of it being completely eliminated. A neurologist is involved in the diagnosis and treatment of cervicothoracic osteochondrosis of the spine.

After the patient contacts, the neurologist will interview the patient and, based on his complaints, make a conclusion about the presence of the disease. Most often, patients complain of pain, discomfort, and problems with movement of the upper limbs. After the interview, the doctor will conduct a visual examination of the patient. Will be assessed:

Correct posture;
At what angle are the shoulder blades, shoulders and ilia bones located?
The location of the line of the spinous processes along the length of the spine.

A visual examination allows you to determine what pathological processes began in the spine and how much they affected the spine and surrounding tissues.

The final diagnosis is not made solely on the basis of examination and questioning of the patient. Additional examinations are required. Most often, the patient is sent for radiography and computed tomography. If for one reason or another it is impossible to make a final diagnosis, the patient is referred for magnetic resonance imaging. Additional examinations include Doppler sonography; the procedure allows you to find out the state of the circulatory system in the cervical region.

Kuznetsov Iplicator

The Kuznetsov iplicator is a simple, affordable means of reflexology for the neck area. This could be a plate with spikes that should be placed under the neck, or a similar device, but in the form of a roller. Thanks to the tingling of the thorns, skin receptors are irritated, which leads to more active blood flow to the affected area.

Some patients note a decrease in pain in the neck after using the Kuznetsov applicator, as well as an increase in performance, improved sleep quality and restoration of neck mobility. But if you have skin lesions in the affected area or vascular diseases, you should not use a needle applicator.

Degrees of cervical osteochondrosis

The choice of treatment method for osteochondrosis directly depends on the stage of the disease that is diagnosed in a particular patient. It is customary to subdivide 4 stages of osteochondrosis, the division is conditional, since some symptoms may move from one stage to another or not appear at all.

1st degree

The initial stage of the problem, at this stage, if pain is felt, it is often attributed to stress or other disorders (improper sleep, prolonged exposure to an uncomfortable position). The patient may experience slight stiffness and limited movement, especially sudden movements. If you seek treatment for cervical osteochondrosis at this stage, you can eliminate the symptoms at home. To completely get rid of the problem, you can limit yourself to special exercises and attending physiotherapeutic procedures. For prevention, it will be useful to start leading an active lifestyle (it is enough to take 20 minute daily walks in the fresh air), adjust your diet (exclude too fatty, fried, salty foods, give preference to fermented milk products, fruits and vegetables, foods with sufficient calcium and microelements, necessary for the restoration of connective and cartilage tissue).

2nd degree

The pain intensifies and begins to become permanent. Sudden movements and turns bring discomfort; the patient experiences severe headaches and begins to notice that he is very tired from everyday activities. Often patients become absent-minded because they only think about pain. Some people experience numbness in certain areas of the face.

3rd degree

Hernias begin to develop in the area of damaged discs, which causes dizziness and weakness in the arms. Not only does the head and neck hurt, the pain gradually spreads to the entire shoulder girdle.

4th degree

A characteristic process is the destruction of intervertebral discs, replacement of “empty spaces” with connective tissue. This leads to pinched nerves, the pain becomes unbearable and does not go away without taking special medications. The patient experiences dizziness, especially with sudden turns of the head and changes in body position, ringing appears in the ears, sleep is disturbed, the quality of life is greatly deteriorated, and disability is possible if left untreated.

Physiotherapeutic treatment

Physiotherapy is indicated outside of the acute inflammatory process. It allows you to consolidate the achieved treatment results and further improve the patient’s condition. As a rule, a course of 10-15 procedures is prescribed, selected separately for each patient. It could be:

Electrophoresis - involves the use of electric current to ensure deeper penetration of the indicated drugs.
Magnetotherapy – helps to activate blood circulation in the area of influence and stimulates the course of metabolic processes. Additionally, magnetic therapy sessions have an analgesic effect and help eliminate swelling.
Laser therapy has an anti-inflammatory, vasodilating effect, which leads to a decrease in the severity of pain.
Ultrasound therapy is a method of physiotherapy based on the positive effect of ultrasonic waves on the body. They help reduce the sensitivity of nerve endings and also have an anti-inflammatory and analgesic effect.
Diadynamic currents – procedures lead to a reduction in pain, improve tissue nutrition, have a positive effect on muscles and help eliminate inflammation.

Treatment of cervical osteochondrosis

The doctor selects the appropriate treatment method for the patient depending on the stage of the disease. Most often, drug treatment of cervical osteochondrosis is used in combination with physiotherapeutic procedures. In advanced cases, surgery may be required to remove overgrown connective tissue and bone spurs.

Conservative treatment

Most often it is based on taking certain medications. Drug treatment helps reduce pain, get rid of muscle tension, and localize inflammation. Non-steroidal anti-inflammatory drugs and painkillers are used.

Often, the doctor includes chondroprotectors in the prescription. This group of drugs activates the restoration of damaged tissue in the area of intervertebral discs.

These drugs are prescribed in the form of injections or tablets. Good therapeutic results are demonstrated by ointments based on NSAIDs. They are rubbed into the damaged area, relieving pain within 10-20 minutes. The main advantage of ointments is the local effect on the painful area and minimal impact on other organs.

Drugs for effective treatment of osteochondrosis: release form

To treat osteochondrosis, agents for external and internal use are used. The choice of drug release form depends on the patient’s habits and lifestyle, concomitant diagnoses and stage of the disease.

Tablets and capsules

Tablets and capsules for osteochondrosis are the most popular form of release. They have high bioavailability and systemic effects on the body.

The tablets should be taken directly with meals, usually 2 times a day.

The main disadvantage of tablets (especially non-steroidal anti-inflammatory drugs) is that they act directly on the mucous membrane of the digestive system. Such drugs are not recommended for chronic use due to the risk of inflammation and stomach ulcers. They must be taken under the supervision of a doctor.

Treatment with drugs for osteochondrosis can only be started after consultation with a doctor.

Powders

Some medications for osteochondrosis are available in sachet form (a portion of powder in a paper bag for a single dose). Crystalline preparations are very well absorbed and easy to use - you need to take them only once a day, diluting them in about ½ glass of warm water. The effect of taking them comes a little faster. Powder preparations are easier to dose and contain fewer additional components. But not all patients like the need to prepare the mixture and its taste.

Ointments, gels, creams and solutions for compresses

Products for external use are excellent for local anesthesia, relieving inflammation and swelling. They are considered much safer for the body than tablets, since they do not come into contact with mucous membranes and are absorbed into the blood in small quantities. Local preparations do not have a cumulative effect, are easy to use and, as a rule, do not require a prescription. They can be used continuously, not in courses. Among the external forms of release, it is worth highlighting the patches - they are simply attached to the affected area of the spine, they can be worn under clothes all day.

Ointments, gels and creams are the best drugs for osteochondrosis for patients who have contraindications to taking tablets (with steroidal and non-steroidal anti-inflammatory components) from the heart and endocrine system.

The main disadvantages of this form of release are:

low bioavailability (about 5% of the active substance overcomes the natural barriers of the skin);
the possibility of local allergic reactions due to too frequent use;
help to completely get rid of symptoms only in the early stages of the disease.

Please note that ointments with NSAIDs should be used with caution, especially if the patient has ulcerative-erosive lesions of the stomach and intestines. Their active ingredients, even in small quantities, block the enzyme that protects the mucous membranes of the gastrointestinal tract. They also reduce the natural production of enzymes responsible for relieving inflammation.

External products should be rubbed in with vigorous circular movements up to 6 times a day. And compresses (for example, with dimexide) - keep 1-2 times a day for about 10 minutes.

Solutions for injections

Medicines for intravenous and intramuscular administration have maximum bioavailability and reduced impact on the mucous membranes of the gastrointestinal tract, since the active substances enter directly into the blood.

Injectable medications for osteochondrosis can quickly stop the exacerbation of the disease, relieve pain, swelling, and restore the sensitivity of nerve endings. Injections are an excellent alternative to oral medications for those with lactose intolerance. After all, most NSAIDs in tablets (for example, meloxicam) are lactose-containing drugs.

For particularly severe back pain, the drug is injected as a blockade - directly into the nerve. The effect of such an injection lasts up to 3-4 weeks, but the procedure must be carried out by a qualified medical professional due to the proximity of the blockade site to the spine.

The main disadvantage of injection solutions is the need to administer them with an injection or dropper (usually in a hospital). Like other groups of medications, solutions with NSAIDs can only be used as prescribed by a doctor to avoid side effects.

Drugs for the effective treatment of osteochondrosis must be used strictly according to the regimen prescribed by the doctor.

Physiotherapy

Physiotherapeutic procedures pursue a number of goals:

Localization of the inflammatory process;
Relieving muscle spasm;
Pain relief;
Launch of regenerative processes;
Increasing general and local immunity;
Restoring the normal position of nerve fibers, eliminating compression and pinching.

Most often, the following procedures are prescribed for cervical osteochondrosis:

Shock wave therapy. Using a special device, the acoustic wave is directed directly to the cartilage tissue of the spine that has been damaged. As a result, metabolic processes are launched, salt and calcium deposits are destroyed, which interfere with the normal movement of joints and vertebrae. The procedure is characterized by a cumulative effect, often the first results become noticeable only 2-3 months after the start of treatment.
Acupuncture. Acupuncture is often used to treat and prevent cervical osteochondrosis. It is important that the procedure is performed only by a qualified doctor, otherwise you may not only experience a lack of effect, but also a worsening of the current condition. The essence of the procedure is that special needles are installed on biologically active points, forcing the body to start metabolic processes and stimulate the production of natural painkillers.
Massage. The main goal is to reduce pain and improve blood circulation in the damaged area of the cervical spine. With proper massage, the muscles acquire the lost tone, and as a result, it is possible to eliminate the risk of relapse of osteochondrosis in the future. When attending the first massage sessions, the patient encounters severe pain; it is important not to stop treatment due to pain, but to go through all the procedures prescribed by the doctor.

Surgery

It is mainly prescribed in advanced stages of the disease, when the use of medications and visits to physiotherapeutic procedures does not bring any results. The indication for surgical intervention is catastrophic narrowing of the spinal canal.

Modern surgical techniques allow the patient to be discharged from the hospital within 3-5 days and begin outpatient treatment of the symptoms of cervicothoracic osteochondrosis. Over the next three months, the patient undergoes rehabilitation.

Physiotherapy

A correctly chosen set of exercises for osteochondrosis can not only improve the patient’s general condition, but also speed up the process of treating the disease. There are several effective exercises:

Turns and tilts the head in different directions. The exercise is performed in a sitting position, it is important not to jerk, all movements should be smooth with a gradual increase in the number of repetitions and the amplitude of the inclination.
Tilt the head to the sides with resistance. Body position - sitting at the table, one elbow stands on the table, while the palm presses on the temple. Tilt your head towards your hand, creating slight resistance.
Shoulder lift. Raise your shoulders as high as possible and hold in this position for a while.
Self-kneading of the back of the head and neck with your fingertips. It is important that the movements are soft and do not cause pain. You can perform self-massage in any comfortable position.

It is important not to treat cervical osteochondrosis at home without consulting a neurologist; a set of exercises must be agreed upon with the attending physician.

Types of drugs

Due to the fact that modern pharmacology offers a large number of drugs for the treatment of osteochondrosis, it is necessary to know which of them really help with diseases of the cervical spine. Of course, only the attending physician will be able to determine which drug is best suited in a particular case, so self-medication is highly not recommended. Below are the main groups of drugs used for cervical osteochondrosis.

Nonsteroidal anti-inflammatory drugs

The main task of anti-inflammatory drugs is to relieve swelling and inflammation in muscle tissue. They can also help relieve pain. The most common drugs in this class include Naproxen, Indomethacin and Ibuprofen.

NSAID groups

Vascular agents

Prescribed to prevent the development of migraines, speed up metabolic processes and improve blood flow to the brain. The peculiarity of vascular drugs is that they have virtually no contraindications, with the exception of individual intolerance to individual components. But, despite the absence of contraindications and side effects, self-medication is still not recommended. Most often, from the class of vascular drugs, doctors use Trental and Eufillin.

"Eufillin"

Muscle relaxants

Used to restore muscle tone in the neck area. Muscle relaxants actively release nerve endings that can be pinched due to osteochondrosis. There are quite a lot of drugs belonging to the group of muscle relaxants, but not all of them help with cervical osteochondrosis. “Sirdalut” and “Mydocalm” are rightfully considered the most effective.

Muscle relaxants

Analgesics

Effective drugs used in medicine to treat osteochondrosis. They have an analgesic effect on the body. Often, patients, faced with a pronounced pain syndrome, decide to start using analgesics on their own, but this cannot be done due to the possible excess of the dosage. Among all the painkillers used to treat cervical osteochondrosis, the most effective are Baralgin, Analgin, Amidopyrine and others. In rare cases, doctors resort to narcotic analgesics. As a rule, they are used for serious complications of pathology.

"Analgin" - release forms

Chondroprotectors

The main task of this group of medications is to restore cartilage tissue damaged during the development of cervical osteochondrosis. To achieve the maximum therapeutic effect, treatment courses are required, that is, chondroprotectors are used for a certain period of time (about 4-6 weeks), after which a pause is made for several weeks. The active components of this group of drugs are glucosamine and chondroitin - they affect the patient’s body, accelerating the regeneration of damaged tissues. Most often, when treating cervical osteochondrosis, doctors prescribe Structum and Chondroxide.

Chondroprotectors

Vitamin preparations

As an addition to drug treatment, doctors often prescribe vitamin complexes. They are prescribed taking into account the clinical picture of the patient, his current condition and the lack of certain substances in his body. Below are the most common vitamin supplements prescribed by doctors.

Table. Vitamin complexes for cervical osteochondrosis.

Name of the drug, photo	Description
"Ascorbic acid"	An effective vitamin remedy that almost everyone is familiar with. The drug contains a large number of vitamins and minerals that have a positive effect on the functioning of the brain.
"Cyanocobalamin"	The peculiarity of this drug is its anti-inflammatory effect on the body. In addition to nourishing cells with useful substances, Cyanocobalamin promotes the regeneration of affected tissues.
"Pyridoxine"	Due to the large number of useful substances contained in this drug, its regular use helps improve the functioning of all internal organs and systems. This allows you to speed up the healing process.
"Thiamin"	Prescribed to accelerate regeneration processes in bones and cartilage that were damaged during the development of cervical osteochondrosis.
"Retinol"	Another vitamin preparation that is successfully used in the treatment of cervical osteochondrosis. Its therapeutic effect is to restore spinal cord tissue, as well as strengthen it.

Prevention

The main rule of preventive measures is that they must be comprehensive and observed on an ongoing basis. This is the only way they will bring the expected results. Prevention is indicated for people who are at risk.

Watch your posture. The ideal body position is that the head and back are on the same line. Always make sure that your shoulders are straightened, your stomach is pulled in, and your chest is raised. The gait also plays a role - it should be springy and smooth. Never give yourself any slack; at the initial stage, it is important to discipline yourself; in the future, correct posture will become a habit.
A properly organized workplace. When working, the shoulders should be relaxed; constant tension in the lumbar girdle has a direct impact on the cervical spine. The basic requirements are a chair with a comfortable back and armrests, a monitor at eye level, a keyboard below the elbows (the angle between the shoulder and forearm is about 120 degrees). While working, make it a habit to take a break every 40-50 minutes and perform basic stretching exercises.
Correctly adjust the car seat. Many motorists are faced with osteochondrosis of the cervical spine due to the fact that they adjust the driver’s seat not according to the rules, but in a way that is comfortable for them. Correct body position in a chair - the entire spine touches the back, not just the shoulders. It is advisable to purchase special lumbar pillows that will help support the body in the desired position. When driving for a long time, it is important to go out into the streets after 1.5-2 hours and warm up.
Watch your diet. Problems with the cervical spine are often associated with the fact that the patient eats incorrectly. Dangerous foods that increase the risk of osteochondrosis include: white bread, baked goods, sweets, dishes high in salt and sugar, fried and fatty foods. The main danger is refined sugar - the substance helps wash calcium out of the body. Include legumes and nuts, foods high in protein, seasonal vegetables and fruits in your daily diet. Low-fat fermented milk products - kefir, fermented baked milk, cottage cheese, natural yoghurts - will also have a positive effect. If you have a problem with excess weight, visit a nutritionist.
Daily physical activity. Treatment of cervical osteochondrosis at home with the help of physical exercise is an excellent preventative against spinal diseases. It is important to do the exercises at an easy pace, without exceeding the permissible load. If you don’t have time for a full set of exercises, make it a rule to take daily walks.
Massage. Correct techniques restore muscle tone, relieve tension, and trigger metabolic and regenerative processes in the body. It is not necessary to visit specialists; proper massage of the cervical spine can be performed independently.
Proper sleep. During the day, the intervertebral discs experience increased stress; complete relaxation and rest can only be achieved during night sleep. To prevent osteochondrosis, it is important to organize the right place to sleep and monitor the time (at least 8 hours).

Why headaches occur with cervical chondrosis (osteochondrosis)

The constant forced, sitting vertical position of the body, as well as the lack of muscle activity, leads to a monotonous axial load on the spine, which consists of vertebrae connected to each other by discs. Their physiological task is natural shock absorption during loads. Inside the disc there is an elastic nucleus pulposus; it is this that undergoes dystrophic and degenerative changes, loses its capsule and leaks between the vertebrae. Dangerous hernias occur that can penetrate into the space of the spinal canal and compress the tissues of the spinal cord. Additionally, the surfaces of the vertebrae begin to “sag” and destroy each other – “wear off”. Against this background, headaches appear with osteochondrosis, requiring treatment, because pathological processes contribute to the development of inflammation of surrounding tissues, the formation of bone growths that injure tissues, nerve fibers, and blood vessels. The body's response in such situations is pain.

Healing irritation: what other ointments and creams to use for osteochondrosis

Another group of external drugs popular for osteochondrosis works due to the ability to irritate the skin. The skin vessels reflexively dilate and the trophism of the internal organs, which are innervated by the corresponding segments of the spinal cord, decreases. As a result, pain impulses penetrate into the cerebral cortex less well, and pain, accordingly, is more easily tolerated. When applying locally irritating agents, a temporary increase in skin temperature occurs (on average by 1–2 °C for several hours after application). The analgesic effect usually develops within 30–40 minutes and lasts for several hours.

Drugs in this group include a combination of anti-inflammatory dimethyl sulfoxide, camphor, turpentine and two more components that produce a local irritant effect (benzyl nicotinate and nonivamide). When used repeatedly, the product is effective for 10–14 days.

Preparations containing capsaicin, an extract of capsicum fruit, also have quite powerful irritating properties. In addition, capsaicin, the active substance of the extract, has an analgesic effect in diseases of the musculoskeletal system [5]. Capsaicin is contained in ointment and regular tincture of capsicum. There is also a drug that contains a synthetic analogue of capsaicin in combination with a vasodilator; it has an analgesic, warming effect and improves metabolism in the affected area.