Osteochondrosis is the most common pathology of the spine, in which all parts are affected.In terms of the frequency of changes, the cervical spine ranks second, only after the lumbar spine.In most cases, the treatment of osteochondrosis of the cervical spine is carried out by conservative methods and depends on the stage of the disease and the severity of the destructive processes of the intervertebral discs.Surgical treatment is recommended in persistent disease, in the ineffectiveness of conservative therapy for 3-4 months, and in the event of severe neurological complications in 5-7% of patients.
Clinical manifestations of the disease
Osteochondrosis of the cervical spine has many manifestations.The symptoms depend on the predominance of one or more syndromes, which develop as a result of the effect of the pathologically changed structure of the spinal column on the spinal cord, its roots or vertebral arteries.The clinical picture of the disease is determined by the following syndromes:
- Vertebra - manifests itself in pain of varying intensity and duration, which is localized in the neck or the occipital region of the head.
- Spinal - the occurrence of innervation disorders, which are manifested in motor and sensory disorders, as well as trophic changes in the muscles of the upper limbs.
- Radicularis - manifests itself in pain of different localization (upper limbs, chest and abdominal organs), requires a differential diagnosis with many diseases of the internal organs and the cardiovascular system.
- Vertebral artery syndrome is characterized by the development of vestibular disorders resulting from insufficient blood supply to brain structures (headache, hearing loss, tinnitus, dizziness, short-term loss of consciousness).
How to treat cervical osteochondrosis?
The reason for seeking medical help is the first appearance of complaints or the subsequent worsening of the disease.In any case, the treatment of cervical osteochondrosis can only be prescribed by a doctor after a mandatory examination of the patient and the completion of the necessary laboratory and instrumental tests to exclude concomitant pathology.
After confirmation of the diagnosis, outpatient treatment is prescribed in most cases.Patients with severe neurological disorders, with a high probability of complications and severe concomitant pathology, require inpatient treatment.Conservative treatment of osteochondrosis involves the use of the following methods.
Drug therapy
It is necessary to use medicines to overcome the pain during the aggravation of the disease.For this purpose, it is prescribed:
- Non-narcotic pain relievers.Non-steroidal anti-inflammatory drugs must be taken orally or parenterally, with the obligatory use of local preparations - ointments, gels, balms, rubs.Complex anti-inflammatory therapy helps to reduce the swelling of the soft tissues, which is the main cause of the pain of spinal syndrome.The duration of drug use in this group is 5-10 days, sometimes 2 weeks.If there is no effect, paravertebral blockade of anesthetics is used with hormonal agents in the amount of 1-3 manipulations.
- Antispasmodics, B vitamins.In the acute period, in the presence of severe edema, it is recommended to prescribe diuretics in a short course of 2-4 days.They reduce vasospasm and improve microcirculation in the inflammatory focus.
- Sedatives (peony tincture, catnip, herbal teas and infusions) to prevent the development of neurotization if the patient suffers from prolonged unbearable pain.
- External warming agents - mildly irritating balms, ointments, rubs containing biologically active plant and animal substances.Drugs with a strong irritant effect should not be used, as they increase the swelling, which can lead to an aggravation of the condition.
Therapeutic massage
Massage is an integral part of the complex treatment of osteochondrosis.It is used after the cessation of exacerbation to consolidate the effect of drug therapy, and periodically during remission for prophylactic purposes.The therapeutic massage course consists of 10-14 sessions and is prescribed 2-4 times a year in the absence of severe pain.
The massage improves blood supply, lymph outflow, and relaxes the spasmodic muscles of the neck and collar area.Thanks to this, the nutrition of the cartilage tissue of the intervertebral discs improves, which prevents the process from progressing and reduces the risk of subsequent relapses.
Therapeutic practice
Physiotherapy exercises for cervical osteochondrosis should be performed daily, except for exacerbation of the disease, which is accompanied by severe pain.In case of severe pain, a gentle regimen should be followed, which includes maximum limitation of cervical spine movement.
Systematic exercise therapy helps to strengthen the neck muscles, which helps to reduce the static load on the intervertebral discs.Exercises are performed fluidly;high-amplitude sudden movements are initially prohibited.The exercises should be started carefully, gradually increasing the load, avoiding the occurrence of unpleasant sensations.
The exercises are performed in a standing or sitting position.The most common exercises include:
- turning the head to the side;
- tilting the head forward and backward;
- raising the shoulders, with relaxed or fixed arms, holding in this position for 15-20 seconds;
- static loads, alternating tension occurs in the flexors and extensors of the neck with the head still.
The exercises must be repeated 5-7 times, the duration of the class is 15-20 minutes.
Traction
To avoid possible complications, traction should be performed in a hospital environment under the supervision of a doctor.The procedure is carried out with the utmost caution, and if pain occurs, it must be stopped immediately, as this can lead to an exacerbation of the disease.
During traction, the elastic tissues of the ligaments of the spinal column are stretched, which leads to an increase in the distance between adjacent vertebrae.Increases by 1-3 mm.This proves to be sufficient to reduce, and in some cases completely eliminate, compression when the root or artery is compressed by disc herniation or osteophyta.During the procedure, the pressure inside the intervertebral disc decreases, causing partial retraction of the hernial protrusion and enlargement of the intervertebral foramen.
Traction has a beneficial effect on the intervertebral joints, eliminates subluxations that have developed in them, and helps reduce muscle contractures.Immediately after traction, it is imperative to fix the cervical spine with special devices for several hours.The treatment course consists of 10-20 procedures.
Physiotherapy treatment
The use of medical electrophoresis has a good effect.The technique makes it possible to introduce drugs into the tissues involved in the pathological process.For cervical osteochondrosis, electrophoresis is used with non-steroidal anti-inflammatory drugs, hormonal anesthetics and other drugs.
The use of diadynamic currents improves blood circulation, has a good pain-relieving and anti-inflammatory effect, and helps reduce the excitability of nerve tissue.If we use complex treatment with conservative methods, the initial appearance of osteochondrosis can be cured, provided that we maintain an active lifestyle, proper and nutritious diet and giving up bad habits.
With an advanced destructive process, proper treatment and lifestyle make it possible to achieve long-term remission.In some patients, it is impossible to achieve improvement with conservative treatment;in such cases, they resort to neurosurgical methods.
Surgical treatment
Before surgical treatment of cervical osteochondrosis, all available canning methods should be tried.Surgery is usually recommended if treatment fails for three months or more.As well as the development of spinal cord compression in the patient, which is accompanied by severe neurological symptoms that can lead to disability.
Currently, microdiscectomy and endoscopic surgeries are most commonly used.The manipulation is performed with microsurgical instruments and a 10x microscope, which allows for a clear view of the compressed areas of the spinal cord.Excision of part of the hernial extension that presses on the root or spinal cord.Sometimes it is necessary to remove a small fragment of a vertebra or cut a ligament.