Osteochondrosis is the most common pathology of the spine, in which all its parts are affected.In terms of the frequency of lesions, the cervical spine ranks second, second only to the lumbar spine.Treatment of osteochondrosis of the cervical spine is carried out in most cases using conservative methods and depends on the stage of the disease and the severity of the destructive processes in the intervertebral discs.Surgical treatment is indicated for 5-7% of patients with persistent disease, lack of effect from conservative therapy for 3-4 months, as well as with the development of severe neurological complications.
Clinical manifestations of the disease
Osteochondrosis of the cervical spine has a variety of manifestations.Symptoms depend on the predominance of one or several syndromes that develop as a result of the impact of pathologically changed structures of the spine on the spinal cord, its roots or vertebral arteries.The clinical picture of the disease is determined by the following syndromes:
- Vertebral - manifested by pain of varying intensity and duration, localized in the neck or in the occipital region of the head.
- Spinal - the appearance of innervation disorders, manifested by motor and sensory disorders, as well as trophic changes in the muscles of the upper extremities.
- Radicular - manifests itself with pain in different locations (upper limbs, thoracic and abdominal organs), requires differential diagnosis with many diseases of 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 impairment, 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 next exacerbation of the disease.In any case, treatment for cervical osteochondrosis should be prescribed only by a doctor after a mandatory examination of the patient and the necessary laboratory and instrumental studies to exclude associated pathology.
After confirmation of the diagnosis, outpatient treatment is prescribed in most cases.Patients with severe neurological disorders, high probability of complications and severe accompanying pathologies require hospital treatment.Conservative treatment of osteochondrosis includes the use of the following methods.
Drug therapy
The use of medications is necessary during an exacerbation of the disease to combat pain.For this purpose they describe:
- Non-narcotic analgesics.Non-steroidal anti-inflammatory drugs are taken orally or parenterally, with the obligatory use of local preparations - ointments, gels, balms, rubs.Complex anti-inflammatory therapy helps reduce soft tissue swelling, the main cause of pain in vertebral syndrome.The duration of use of drugs in this group is 5-10 days, sometimes 2 weeks.If there is no effect, paravertebral anesthetic blocks with hormonal agents are used in the amount of 1-3 manipulations.
- Antispasmodics, B vitamins. In the acute period, in the presence of severe edema, the prescription of diuretics is indicated in a short course for 2-4 days.They reduce vascular spasm and improve microcirculation in the inflammatory focus.
- Sedatives (peony tincture, valerian root, herbal teas and infusions) to prevent the development of neuroticism if the patient has prolonged excruciating pain.
- External heating agents - balms, ointments, rubs that have a mild irritating effect and contain biologically active substances of plant and animal origin.Drugs with a strong irritating effect cannot be used, as they increase swelling, which can lead to worsening of the condition.
Therapeutic massage
Massage is an integral part of the complex treatment of osteochondrosis.It is used after elimination of exacerbation to consolidate the effect of drug therapy and periodically during remission for prophylactic purposes.The course of therapeutic massage is 10-14 sessions and is prescribed 2-4 times a year in the absence of severe pain.
Massage improves blood supply, lymph flow and relaxes spasmodic muscles in the neck and collar area.Due to this, the nutrition of the cartilage tissue of the intervertebral discs is improved, preventing the progression of the process and reducing the risk of subsequent relapses.
Therapeutic exercises
Physical therapy exercises for cervical osteochondrosis should be performed every day, except for the aggravation of the disease, accompanied by severe pain.In case of severe pain, it is necessary to follow a gentle regimen, which includes the maximum limitation of movements in the cervical spine.
Systematic exercise therapy helps strengthen the neck muscles, which helps reduce the static load on the intervertebral discs.Exercises are performed without problems;Sudden movements with large amplitude are prohibited at first.Exercises should be started carefully, gradually increasing the load, avoiding the appearance of unpleasant sensations.
Exercises are performed in a standing or sitting position.The most common exercises consist of:
- turning the head to the sides;
- bending the head forward and backward;
- raising the shoulders, with relaxed or fixed arms, keeping them in this position for 15-20 seconds;
- static load, with a stationary head, alternating tension appears in the flexors and extensors of the neck.
The exercises should be repeated 5-7 times, the duration of the lesson is 15-20 minutes.
Withdrawal
To avoid possible complications, withdrawal should be carried out in a hospital setting under the supervision of a doctor.The procedure is carried out with utmost care and if pain occurs, it must be stopped immediately, as it can provoke an aggravation of the disease.
During traction, the elastic tissues of the ligaments of the spine are stretched, which leads to an increase in the distance between adjacent vertebrae.It grows by 1-3 mm.This proves to be sufficient to reduce, and in some cases completely eliminate, compression when a root or artery is compressed by a herniated disc or osteophyte.During the procedure, the pressure inside the intervertebral disc decreases, which causes partial retraction of the hernial protrusion and an increase in the intervertebral foramen.
Traction has a beneficial effect on the intervertebral joints, eliminating the subluxations that have been created in them and helps reduce muscle contractures.Immediately after withdrawal, it is necessary to adjust the cervical spine using special equipment for several hours.The course of treatment includes from 10 to 20 procedures.
Physiotherapy treatment
The use of medicinal electrophoresis has a good effect.The technique allows the delivery of drugs to tissues that are 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 helps improve blood circulation and has a good analgesic and anti-inflammatory effect, helping to reduce the excitability of nervous tissue.When using complex treatment with conservative methods, the initial manifestation of osteochondrosis can be cured, provided that you maintain an active lifestyle, proper and nutritious food and give up bad habits.
With a very advanced destructive process, the right treatment and lifestyle will allow you to achieve long-term remission.In some patients it is impossible to achieve improvement with conservative treatment;in such cases, neurosurgical methods are used.
Surgical treatment
Before surgical treatment of cervical osteochondrosis, all available conservation methods should be tried.Typically, surgical treatment is indicated when therapy has been unsuccessful 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, microdisctomy and endoscopic operations are used more often.The manipulation is performed using microsurgical instruments and a 10x microscope, which allows you to clearly see the compressed areas of the spinal cord.A part of the hernial protrusion is removed by pressing the root or spinal cord.Sometimes it is necessary to remove a small fragment of the vertebra or remove the ligament.