Osteochondrosis is the most common pathology of the spine, in which all parts are affected.In terms of 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 process in the intervertebral disc.Surgical treatment is indicated for 5-7% of patients with persistent disease, lack of effect of conservative therapy for 3-4 months, and also with the development of serious neurological complications.
Clinical manifestations of the disease
Osteochondrosis of the cervical spine has various manifestations.Symptoms depend on the predominance of one or several syndromes that develop as a result of the impact of pathologically altered spinal structures on the spinal cord, its roots or vertebral arteries.The clinical picture of this 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.
- Spine - the occurrence of conservation disorders, which are manifested by motor and sensory disturbances, as well as trophic changes in the muscles of the upper part.
- Radicular - manifested by pain in various localizations (upper limbs, thorax 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 arising 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 occurrence of a complaint or subsequent 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 laboratory and instrumental studies necessary to exclude concomitant pathology.
After confirmation of the diagnosis, in most cases outpatient treatment is prescribed.Patients with severe neurological disorders, high likelihood of complications and severe concomitant pathology require inpatient treatment.Conservative treatment of osteochondrosis involves the use of the following methods.
Drug therapy
The use of drugs is necessary during the exacerbation of the disease to combat pain.For this purpose they set:
- Non-narcotic analgesics.Non-steroidal anti-inflammatory drugs are taken orally or parenterally, with the mandatory 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, an anesthetic paravertebral block with a hormonal agent is used in the amount of 1-3 manipulations.
- Antispasmodic, vitamin B. In the acute period, with the presence of severe edema, the prescription of diuretics in a short course of 2-4 days is indicated.They reduce vascular spasm and improve microcirculation in the focus of inflammation.
- Sedatives (colored peony, valerian root, herbal teas and infusions) to prevent the development of neurotization if the patient has prolonged painful pain.
- External heating agents - balms, ointments, rubs that have a mild irritating effect and contain biologically active substances from plants and animals.Drugs with a strong irritating effect should not be used, as they increase swelling, which can worsen the condition.
Therapeutic massage
Massage is part of the complex treatment of osteochondrosis.It is used after the exacerbation has been eliminated 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 if there is no severe pain.
Massage increases blood supply, lymph drainage and relieves muscle spasms in the neck and collar area.Due to this, the nutrition of intervertebral disc cartilage tissue improves, preventing the development of the process and reducing the risk of subsequent relapses.
Therapeutic exercise
Physical therapy exercises for cervical osteochondrosis should be carried out every day, except for exacerbation of the disease, accompanied by severe pain.In case of severe pain, it is necessary to follow a gentle regimen, which involves maximum limitation of movement in the cervical spine.
Systematic exercise therapy helps strengthen the neck muscles, which helps reduce the static load on the intervertebral discs.Training is done smoothly;Sudden movements of large amplitude are prohibited at first.Exercise must be started with caution, gradually increasing the load, avoiding the occurrence of unpleasant sensations.
Exercises are done standing or sitting.The most common exercises consist of:
- turning the head to the side;
- tilting the head forward and backward;
- raise the shoulders, with relaxed or fixed arms, holding them in this position for 15-20 seconds;
- static load, with the head stationary, alternating tension occurs on the flexors and extensors of the neck.
The exercise must be repeated 5-7 times, the duration of the lesson is 15-20 minutes.
Attractiveness
To avoid possible complications, traction should be done in hospital conditions under the supervision of a doctor.This procedure is performed very carefully and if pain occurs it should be stopped immediately, as it can trigger a more severe disease.
During traction, the elastic tissue of the spinal ligaments is stretched, which leads to an increase in the distance between adjacent vertebrae.It increases by 1-3 mm.This turns out to be enough to reduce, and in some cases completely eliminate, compression when a root or artery is compressed by disc herniation or osteophytes.During the procedure, the pressure inside the intervertebral disc decreases, which causes a partial withdrawal of the hernial protrusion and an increase in the intervertebral foramen.
Traction has a good effect on intervertebral joints, eliminating subluxations that have formed in them, and helps reduce muscle contractures.Immediately after traction, it is important to fix the cervical spine using a special device for several hours.The course of treatment includes from 10 to 20 procedures.
Physiotherapy treatment
The use of medical electrophoresis has a good effect.This technique allows the delivery of drugs to the tissues involved in the pathological process.For cervical osteochondrosis, electrophoresis with non-steroidal anti-inflammatory drugs, hormonal anesthetics and other drugs are used.
The use of diadynamic current helps improve blood circulation and has a good analgesic and anti-inflammatory effect, helping to reduce the excitability of nerve tissue.When using complex treatment with conservative methods, the initial appearance of osteochondrosis can be cured, provided you maintain an active lifestyle, proper and nutritious diet, and give up bad habits.
With the process of destruction far away, 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 surgically treating cervical osteochondrosis, all available canning methods should be tried.Usually, surgical treatment is indicated when therapy is unsuccessful for three months or more.As well as the development of spinal cord compression in patients, which is accompanied by severe neurological symptoms that can cause disability.
Currently, microdiscectomy and endoscopic operations are most often used.Manipulation is performed using microsurgical instruments and a 10x microscope, which allows you to clearly see the compressed area of the spinal cord.Partial removal of the hernial protrusion pressing on the root or spinal cord is performed.Sometimes it is necessary to remove small fragments of vertebrae or remove ligaments.