Cervical spine instability - symptoms and treatment
If instability is present, treatment should be comprehensive. Prevention plays a huge role.
Treatment consists of several stages.
Drug treatment:
- non-steroidal anti-inflammatory drugs are intended to relieve inflammation, reduce and cure pain;
- muscle relaxants help reduce muscle spasm and tone, help reduce compression of the nerve roots;
- B vitamins nourish nervous tissue, restoring and protecting it;
- D vitamins and calcium supplements are prescribed to patients with osteoporosis.
Physiotherapeutic treatment.[1][2][5]
It is an effective means of treating pain, relieving inflammation, restoring nerve and muscle tissue. Physiotherapeutic treatment also allows you to deliver a medicinal substance to the lesion using an electric current. In physiotherapeutic treatment the following is used:
- techniques that relieve inflammation: electrophoresis, magnetic therapy, UHF therapy;
- techniques that promote tissue regeneration: laser therapy, mud therapy.
Novocaine blockade[1][2]
It is a method of relieving acute pain by delivering a medicinal substance directly to its source. It is carried out by a neurologist in a medical institution (not at home!) after a special training course. The medicinal substance can be a solution of Novocaine 0.5% or a solution of Lidocaine 2%. You can also add solutions of vitamins or hormones. The composition of the administered substance is selected by the doctor in accordance with clinical indications in the absence of contraindications to the administered drugs. It should be noted that a neurologist should not inject the substance into the intervertebral joints; this procedure can only be performed by neurosurgeons.
Spinal immobilization.[2][3][5]
It is one of the first remedies for exacerbation. It is carried out with a special collar that limits mobility. It is prescribed only by a doctor and is selected strictly individually according to the size of the neck. It is recommended that the selection be carried out in specialized orthopedic salons. The mode of wearing a collar is also recommended depending on the cause of the exacerbation.
Manual therapy.[3][5]
It is a means of mobilizing the vertebrae. It is forbidden to perform during the acute period of injury. Performed by a chiropractor on the recommendation of a neurologist after examination.
Physiotherapy.[3]
It is one of the most effective means of prevention and treatment. The course is developed for the patient depending on the cause of instability, as well as the condition of the spine. The goal of gymnastics is to strengthen muscle tissue (ligaments and muscles). If gymnastics is carried out after an injury or surgery, it is carried out only under the supervision of a neurologist or instructor-methodologist in the exercise therapy room. After training, the course is carried out at home independently.
Reflexology , particularly acupuncture .
It is a means of relieving pain, restoring muscle and nervous tissue, treating associated symptoms: improving blood circulation, improving sleep. It is performed only by a reflexologist using special needles.
Surgery.[1][5]
Is a rare practice. Performed in childhood in case of proven structural anomalies. In adult practice, spinal fusion is more often performed. It consists of implanting a structure made of metal plates and fixing elements. Its task is to prevent excessive mobility of the spine. The operation is used after injuries, discotomies and laminectomies. The last two are performed for spinal hernias.
Causes of pathology
There are many different factors that can provoke pathological mobility of the cervical vertebrae.
There are many causes of cervical instability
The most common ones include:
- mechanical damage to the spine caused by various injuries . The cervical spine is considered the most vulnerable part, since the muscle corset in the neck area is quite weak;
- development of degenerative-dystrophic processes . As a rule, they develop against the background of osteochondrosis of the cervical spine;
- primary or secondary degeneration of cervical discs (deterioration of the statics of the spine, disruption of metabolic processes in the affected area, etc.);
Degenerative changes in the cervical spine - previous spinal surgery . As a result of a violation of the integrity of the supporting complexes, instability often occurs, and excessive physical stress on the back in the postoperative period only aggravates the situation, making instability of the cervical spine more pronounced;
- consequences of cervical dysplasia , as a result of which, during intrauterine development, improper formation of the cartilaginous tissues of the spine occurs.
What is instability
On a note! An inactive lifestyle can also lead to the development of pathology, since in the absence of sufficient load, the muscular corset weakens and the load on the back is distributed unevenly. Do not forget also about previous diseases, such as vertebral fistula, osteoporosis or osteomelitis - all of them can provoke instability of the vertebrae.
X-ray SHOP
Massage pillow for neck and shoulders
Possible complications
Incorrect or untimely treatment of cervical instability can lead to serious complications, for example, arthrosis of the intervertebral joints or cervical osteochondrosis. In this case, the patient experiences pain in the back, which intensifies with physical activity or bending the body.
The disease can have serious complications
Lack of quality treatment can lead to severe headaches, irritability and insomnia, which significantly impairs the quality of life. In this case, visual acuity may decrease, coordination of movements may be impaired, lethargy and general weakness of the body may occur. Sometimes instability of the cervical vertebrae can be completely restored with the growth of osteophytes (bone tissue), but such improvements will lead to a decrease in the mobility of the spine or its complete loss.
Diagnostic features
During the diagnostic examination, the doctor will examine all the patient’s symptoms and complaints. An X-ray of the spine may also be required. Pathological changes in the structure of the cervical vertebrae can be detected during a standard x-ray or using functional studies. We are talking about diagnostic procedures such as myelography, MRI or CT (computed tomography).
Use of CT myelography
Based on the results of the diagnostic procedures performed, the doctor will be able to make an accurate diagnosis and prescribe appropriate treatment. As noted earlier, the earlier the diagnosis is made, the greater the chance of rapid and effective therapy.
Clinical picture
Instability of the spinal column constantly irritates pain-sensitive muscles, ligaments, the fibrous ring and the capsule of the facet joints, forming a chronic pain syndrome.
Pain is located in different locations and has its own characteristics:
- radicular pain: localized in the legs, occurs due to compression of the spinal roots;
- back pain: felt during long walks and flexion-extension, for the same reasons it can intensify. It is often reflected and spreads to the buttocks and thighs.
General recommendations for exercise therapy classes
For each patient, a set of exercises is developed individually by the doctor and may include exercises taken from different techniques. It is impossible to independently choose the optimal mode and intensity of exercise for yourself, since only a specialist can give a correct assessment of all factors and choose those exercises that will only bring benefit and will not cause harm.
The first classes are conducted under the supervision of a specialist in physical therapy. He monitors the correct execution of each exercise, and will also be able to accurately determine the required number of repetitions. This is extremely important, since improper execution can lead to aggravation of the patient’s condition.
In order for the exercises to bring maximum benefit and not cause harm, the following recommendations must be followed:
- Exercise therapy classes are conducted daily, systematically over a long period of time. All exercises are performed comprehensively. Otherwise, you should not expect positive changes.
- Physical therapy is done in the morning and sometimes in the evening. Therefore, you need to make it a rule to set aside time every morning to complete the entire complex. In the morning, patients are usually prescribed to do a set of active exercises, and in the evening, stretching, muscle relaxation and relaxation exercises are recommended.
- Rushing during exercise therapy is not appropriate. Each movement must be performed smoothly, without sudden movements, and must be completed to the end. If any exercise is difficult, you should not simply refuse to do it. In such a situation, it is better to consult a doctor so that he can select an effective replacement that is more appropriate to the patient’s capabilities.
- The load is increased slowly so that the muscles gradually become stronger. If you stay at one level of physical activity, the results achieved will gradually disappear. But an increase in load should be discussed with a specialist and, with his help, determine the available limits of your capabilities.
- Every movement should be confident, but smooth. Jerks, jolts, sudden movements will only lead to aggravation of the patient’s situation, and thoughtless exercises, even with a large number of repetitions, will not give good results.
- Exercise therapy should be approached with caution and without fanaticism. Their goal is not to build muscle mass, but to maintain back health and improve blood circulation.
- The muscles are first warmed up by light exercise or by taking a hot shower.
- Clothing should be light, not restrict movement, made from natural materials and moderately warm, especially if classes are held outdoors.
- The last meal should be at least 1–1.5 before the start of exercise.
- Before engaging in exercise therapy, you should not take painkillers, as they will block the transmission of pain impulses and will not allow the patient to stop in time.
- During exercise, you should maintain even breathing.