"Cervical osteochondrosis" - degenerative changes in the cervical spine

If a person complains of neck pain, it is usually diagnosed as "cervical osteochondrosis. "Some people also attribute symptoms such as dizziness, memory loss, and numbness in their hands to it. This disorder is mistakenly believed to be related to wear and age-related deformation of the discs and other elements of the spine.

How does the cervical spine work?

The neck is made up of 7 vertebrae. Between them is the intervertebral disc, a semi-rigid structure with a dense ring on the periphery and a jelly-like center that acts as a shock absorber. Each vertebra has two joints on the left and right sides, and between the joints project the vertebral surface, which is covered with cartilage. The joints are connected by ligaments and muscles in the back.

Why does neck pain occur?

Typically, neck pain occurs due to awkward movements, injury, or inflammation of any structure in the cervical spine. Additionally, the cause of pain may be overstretching of muscles or ligaments, such as when lifting heavy weights, failing to turn the head, or when arthrosis develops in the joints between facets. "Nerve entrapment" or cervical radiculopathy, specific processes (metastasis, vertebral tumors, cervical meninges) are relatively rare.

26% and 40% of men and women over the age of 30 have experienced neck pain in the past month, with 5% of men and 7% of women feeling this way all the time.

Acute neck pain usually resolves on its own within 1-2 weeks. Most often, chronic pain occurs due to lack of physical activity or, conversely, too much intensity of exercise.However, people often mistakenly refer to unexplained neck pain and discomfort as cervical osteochondrosis and link its development to wear and age-related deformation of the discs and other elements of the spine. But this pain is usually not related to true osteochondrosis.

cervical osteochondrosis

According to the International Classification of Diseases (ICD), osteochondrosis (osteochondrosis) is a group of rare genetic disorders associated with disruption of normal bone development and growth. Generally, osteochondrosis begins in childhood and can be severe: parts of joints or bones become deformed, and sometimes death occurs. With this disease, it is usually not the cervical spine that is affected, but the thoracic spine (lower thoracic spine). Therefore, the main clinical manifestation of osteochondrosis is a significant curvature of the thoracic spine, the so-called thoracic kyphosis.Symptoms associated with thoracic spine injury:

• Difficulty breathing,
• persistent weakness
• unable to breathe fully,
• Pain and burning sensation behind the breastbone,
• Episodes of rapid heartbeat.

Conditions with neck pain

cervical spondylosis

In people over 50, neck pain is often caused by cervical spondylosis, age-related wear and tear on the vertebrae and related structures. With this disease, the discs become dehydrated and flatten, causing increased degeneration in the neck and making many movements painful.But it’s normal for your spine to change as you age. Therefore, its structure begins to wear out after an average of 30 years, and by the age of 60, nine out of 10 people already have cervical spondylosis. However, most people are asymptomatic.

other reasons

Less commonly, neck pain is caused by hypothermia or severe pressure, a herniated disc, or an abnormality in the cervical spine in which bone growths (bone spurs) compress the nerves that extend from the spinal cord.The most common source of pain in the cervical spine and shoulder girdle is overtightening (defense) muscles: the trapezius, the long back muscle of the cervical spine.In addition, the muscles of the cervical spine are closely connected to the aponeurosis (the broad tendon plate that surrounds the head). The muscular elements of the aponeurosis of the occipital, temporal and frontal regions are connected to the muscles of the neck region, so neck pain is often accompanied by headaches. Therefore, neck pain accompanied by headaches after long periods of sedentary work or sleeping in uncomfortable positions is in most cases related to lack of physical activity and incorrect posture and is not harmful to health.The phenomenon of tech neck, also known as tech neck or internet age neck, is related to pain due to uncomfortable postures. Tech neck is the result of constant use of computers and smartphones, so people are forced to bend their necks. In fact, the relative mass of the head increases with forward tilt. Therefore, the average weight of an adult's head in the "upright" position is 5 kg. If the head is tilted forward at least 15°, the load on the neck muscles will be 13 kg, 30° - 20 kg, 60° - 30 kg. Pain may occur due to continued overload, excessive tension, microtrauma, inflammation, fibrosis (overgrowth of connective tissue) in the neck muscles.

Causes of degenerative changes in the cervical spine

Birth or any other spinal injury, spinal developmental abnormalities, postural disorders, muscle dystonia, as well as prolonged immobility, obesity, and some autoimmune diseases can all contribute to the development of cervical spine pain.

• Chronic bedridden condition is a condition in which a person is forced to lie down for more than a month due to an underlying medical condition. As a result, the muscles become weaker - during verticalization, when the load on the muscles increases, they become overly tight. Pain occurs.
• Obesity: Excess weight increases stress on spinal structures and can lead to pain.
• Autoimmune diseases in which cartilage tissue is destroyed (autoimmune arthritis, polychondritis) can also cause neck pain.

Stages of cervical spine degenerative changes

There are four main stages of cervical spine degeneration (destruction):

• Phase I: Thinning of the intervertebral discs and slight discomfort in the neck;
• second stage: The intervertebral disc is deformed and the distance between the vertebrae is reduced. Pain worsens with movement of the cervical spine;
• The third phase: Cartilage and vertebrae rub against each other, resulting in persistent neck pain and limited movement. When the cervical spine is severely deformed, vertebral artery syndrome may occur, accompanied by visual and vestibular disorders and headaches;
• Stage 4: Degenerative changes are obvious, and cervical spine movement is very limited and painful. The neck area can be almost completely immobilized.

Symptoms of degenerative changes in the cervical spine

Most patients with cervical osteochondrosis experience chronic pain and neck stiffness. As the disease progresses, other symptoms may develop (especially if there is compression of the spinal cord roots, vertebral arteries, and adjacent nerve plexuses).Symptoms of degenerative changes in the cervical spine:

• Neck pain that worsens with movement or standing;
• Pain radiating to the shoulder or arm;
• Numbness, tingling, and weakness in the arms and hands;
• Clicking or grinding sounds in your neck (especially when you turn your head);
• Headache;
• Dizziness attacks;
• Impaired motor coordination;
• Loss of bladder or bowel control.

If such symptoms occur, a neurologist should be consulted as soon as possible.

Symptom types of "cervical osteochondrosis"

All symptoms of "cervical osteochondrosis" can be conditionally divided into 3 groups or syndromes: vertebral syndrome, radiculopathy syndrome and vertebral artery syndrome.Symptoms of spinal (spinal) syndrome:

• Neck creaking when moving;
• Can not move;
• Violates the relative position of the vertebrae in the neck;
• Smoothing the natural lordosis or lateral curvature of the cervical spine (only seen on X-ray, MRI or CT).

Symptoms of radiculopathy syndrome:

• Numbness of the fingers on one or both hands;
• Burning pain in the neck that radiates to the arm or arms;
• Neck and arm muscle dystrophy.

Symptoms of vertebral artery syndrome:

• Paroxysmal dizziness until loss of consciousness;
• sudden increase in blood pressure;
• noise in ears;
• Blurred vision or spots in the eyes;
• Loss of balance and nausea when moving the head;
• Headache (severe pain on one or both sides).

Diagnosis of degenerative changes in the cervical spine

To understand the cause of neck pain and diagnose "cervical degenerative changes" (commonly known as cervical osteochondrosis), a doctor needs to perform an examination, study the medical history, and evaluate the results of laboratory and instrumental tests.

Diagnosis and treatment of cervical osteochondrosis are performed by a neurologist.

examine

During the examination, the doctor listens to the patient's complaints, clarifies medical history details, and performs an examination: checking reflexes, muscle strength, sensitivity, and the condition of the vestibular apparatus.With "cervical osteochondrosis", marked areas of muscle atrophy (muscle loss) in the neck area, decreased or increased muscle tone of the long back muscles, and static derangement of the neck area may be observed. A person may complain of soreness when the muscles are palpated, pain may radiate to the head or arms when the head is tilted, and dizziness or headaches may occur. In addition, patients may experience hand movement disorders (weakness), vision and hearing problems.Doctors may also ask patients to walk, stand on one leg with their eyes closed, or touch their nose. This way, the specialist will be able to assess whether motor coordination is impaired and whether there are problems with gross and fine motor skills.

laboratory diagnosis

To assess the general condition of the bones, patients with suspected cervical osteochondrosis were tested for total and ionized calcium in the blood, as well as markers of bone tissue growth and destruction - osteocalcin and osteoprotegerin, alkaline phosphatase.As cervical osteochondrosis progresses and the joints are destroyed, calcium levels may decrease, while osteocalcin and osteoprotegerin increase.Total creatine kinase is also considered a marker of muscle tissue destruction in cervical myositis.In addition, the doctor may want to evaluate blood levels of trace elements involved in the regulation of muscle tone: magnesium, potassium, sodium.

Instrument diagnostics

To determine the cause of neck pain and related disorders, imaging tests are required: radiography of the cervical spine, computed tomography and magnetic resonance imaging, neuroelectromyography.

• Radiography.Using X-rays, you can identify bone deformations, malignant tumors, and degenerative changes in joints.
• Computer and magnetic resonance imagingTests are performed if lesions in the spine, spinal cord, or brain are suspected. Computed tomography scan revealed vertebral hemangiomas and severe deformity of the cervical spine. Magnetic resonance imaging provides additional information for visualization of muscles, roots, and spinal cord.
• Neuroelectromyography- A method of studying the efficiency of impulse transmission along nerve fibers using low-intensity electric currents. The test can be a little uncomfortable. The research helps elucidate the conduction of impulses along roots, nerves, and from nerves to muscles, confirm nerve or muscle damage, and elucidate the nature and extent of the damage.

Treatment of degenerative changes in the cervical spine

The main goals of treating degenerative changes in the cervical spine are to relieve pain, prevent nerve compression in the neck, and restore mobility to the cervical spine.Depending on the severity of the condition, your doctor may prescribe medication, physical therapy, or massage. Surgery may be needed if the nerve is pinched or the joint is deformed.

Drug treatment of degenerative changes in the cervical spine

Neck pain can be relieved with medication.Medications to relieve neck pain and stiffness:

• local anesthetic creams, gels and patches;
• nonsteroidal anti-inflammatory drugs;
• Hormone medications are injected into the affected joint area in the form of tablets or injections;
• Muscle relaxants to relieve muscle spasms;
• Antidepressants can relieve chronic pain.

Non-pharmacological treatment of cervical osteochondrosis

In addition to medication, it is also important for patients with cervical osteochondrosis to perform neck exercises. For this purpose, the person is referred to a physiotherapist for consultation. It teaches how to properly stretch and strengthen the muscles of the neck and shoulders.

Your doctor may recommend a pad or roller with metal or plastic needles. Use 15-30 minutes before bed to relax muscles.

Wearing a Shantz splint (neck brace) is a passive movement therapy that targets the deep muscles of the neck that are difficult to affect with movement. When a person wears a splint, the muscles relax and when the splint is removed, the muscles tense. If you wear the splints for 15-20 minutes a few times a day, you can train and strengthen them.If you have a severe neck injury, wearing it for 2-3 hours only makes sense. Also, you shouldn't lie in it, let alone sleep.

Surgical treatment of cervical degenerative diseases

Typically, surgery is required for patients with severely deformed spines and pinched nerves.During the operation, the surgeon removes pathological components (hernial protrusions, formations, etc. ) or parts of the vertebrae. After such treatment, long-term rehabilitation is required: wearing a Shants splint or a rigid cervical splint, physiotherapy, regular walking, and painkillers.

Complications and consequences of degenerative changes in the cervical spine

Without treatment, the discs gradually wear away and the vertebrae become "erased. "Common complications of degenerative changes in the cervical spine:

• Intractable pain syndrome in the head, neck, and chest;
• Cramps, dyskinesia, and numbness in the hands;
• Frequent dizziness, impaired motor coordination, and fine and gross motor skills.

Prevention of degenerative changes in the cervical spine ("cervical osteochondrosis")

There is no specific way to prevent true cervical osteochondrosis because it is a hereditary disease.In order to avoid non-specific neck pain, which can be mistaken for cervical osteochondrosis, it is important to ensure correct posture and engage in physical activity: the more a person moves, the more the muscles, bones, ligaments and jointsThe better the situation.To maintain physical activity, adults need 150 minutes of moderate-intensity aerobic exercise per week. Brisk walking, swimming, biking, playing tennis, dancing or roller skating are all suitable. Pilates and yoga will help strengthen your muscles.In addition, gymnastics help to avoid excessive tension in the neck muscles and the appearance of pain: tilting the head forward and backward, alternately tilting and rotating each shoulder, as well as sleeping on an orthopedic pillow.Cervical spine injuries should be avoided: do not jump upside down into the water, and wear a seat belt in the car (to prevent cervical sprains in accidents).

Sleeping positions to relieve back pain

Neck and back pain is often attributed to osteochondrosis and may be caused by uncomfortable sleeping positions.When sleeping, the head and spine should be roughly at the same level. This position minimizes additional stress on the neck.If a person mainly sleeps on his back, the height of the pillow should be on average 6-11 cm; for people who sleep on the side, the pillow should be thicker: 9-13 cm, so that the ideal angle is enough. Keeping it between the shoulders and head keeps the cervical spine from sagging and compensates for muscle strain.Moreover, the heavier a person is, the higher the pillow should be. You also need to pay attention to the firmness of your mattress. The softer it is and the more it sag under the weight of the body, the higher the pillow should be. Also, it’s best not to sleep on just one side all the time – this can lead to muscle imbalances.If a person likes to sleep on their stomach, they may be more susceptible to back and neck pain. In fact, it is difficult to keep the spine in a neutral position in this position. To relieve back tension, place a pillow under your pelvis and lower abdomen, and choose a flat pillow under your head, even without sleeping.Additionally, specialized orthopedic pillows are available.

FAQ

1. Where does the pain of "cervical osteochondrosis" radiate?Pain caused by degenerative changes in the cervical spine can radiate to the shoulders or arms and can also worsen with movement or standing.
2. How to relieve dizziness attacks in "cervical osteochondrosis"?To relieve dizziness attacks, you should assume a comfortable position that minimizes the possibility of falling (sitting in a chair with a backrest or lying down) and seek help. After 5-7 minutes, you can try turning your head: during this time the onset of dizziness will most likely pass. If dizziness persists or worsens, nausea, vomiting, or other neurological symptoms (impaired speech, vision, movement, swallowing, sensitivity) occur, call an ambulance as soon as possible.
3. How to sleep correctly with "cervical osteochondrosis"?When sleeping, the head and spine should be roughly at the same level. This position minimizes additional stress on the neck.
4. How long will the deterioration of cervical spine "osteochondrosis" last?On average, worsening of symptoms caused by degenerative changes in the cervical spine ("cervical osteochondrosis") lasts 4 to 7 days. Nonsteroidal anti-inflammatory drugs and muscle relaxants are used to reduce pain. During this time, it is best for the person to remain calm and wear a neck brace.
5. Which doctor treats cervical spine "osteochondrosis"?Diagnosis and treatment of neck pain are performed by neurologists, neurosurgeons, orthopedists and general practitioners.