Osteochondrosis is the most common pathology of the spine, affecting all its parts.In terms of frequency of lesions, the cervical spine ranks second, after the lumbar spine.In most cases, treatment of cervical osteochondrosis is carried out conservatively and depends on the stage of the disease and the severity of the disc-destroying process.Surgery is required in 5-7% of patients with persistent disease, failure to respond to conservative treatment for 3-4 months, and severe neurological complications.
clinical manifestations of disease
Cervical osteochondrosis has multiple manifestations.Symptoms depend on the predominance of one or several syndromes arising from the impact of pathologically altered structures of the spine on the spinal cord, spinal roots or vertebral arteries.The clinical manifestations of the disease are determined by the following syndromes:
- Vertebrae - manifests as pain of varying intensity and duration, located in the neck or occipital region of the head.
- Spinal - occurrence of innervation disorders, manifested by motor and sensory disturbances, as well as nutritional changes in the muscles of the upper limbs.
- Radicular - manifests as pain in different locations (upper limbs, chest and abdominal organs) and requires differential diagnosis with many diseases of the internal organs and cardiovascular system.
- Vertebral artery syndrome is characterized by vestibular disorders (headaches, hearing impairment, tinnitus, dizziness, short-term loss of consciousness) due to insufficient blood supply to brain structures.
How is cervical osteochondrosis treated?
Reasons for seeking medical help are the first time a complaint occurs or the next time a condition worsens.In any case, treatment of osteochondrosis of the cervical spine can only be carried out by a doctor after a mandatory examination of the patient and the necessary laboratory and instrumental studies to rule out accompanying pathology.
Once a diagnosis is made, outpatient treatment will occur in most cases.Patients with severe neurological disease, high likelihood of complications, and severe concomitant pathology require hospitalization.Conservative treatment of osteochondrosis involves the use of the following methods.
drug treatment
Medications are needed to combat pain during progression of the disease.To this end, they stipulate:
- Nonnarcotic analgesics.NSAIDs can be taken orally or parenterally and must be used in topical preparations - ointments, gels, balms, liniments.Complex anti-inflammatory treatment helps reduce soft tissue swelling, which is the main cause of pain in spondylolisthesis.The duration of medication in this group is 5-10 days, sometimes 2 weeks.If this is not effective, a paravertebral block can be performed with a hormonal anesthetic in a dose of 1-3 procedures.
- Antispasmodics, B vitamins.In the acute phase, if severe edema is present, a short course of 2-4 days of diuretics is required.They reduce vasospasm and improve microcirculation in inflammatory foci.
- If the patient suffers from severe pain for a long time, sedatives (peony tincture, valerian root, herbal teas and infusions) can be used to prevent the development of neurotization.
- Topical warming agents - balms, ointments, liniments that have a mild irritating effect and contain bioactive substances of vegetable and animal origin.Medications with strong stimulating effects should not be used as they can increase swelling and thus worsen the condition.
therapeutic massage
Massage is an integral part of the complex treatment of osteochondrosis.It is used after an exacerbation has resolved to consolidate the effects of drug therapy and regularly during remission for preventive purposes.Therapeutic massage sessions range from 10-14 sessions, and are performed 2-4 times per year in the absence of severe pain.
Massage improves blood supply, lymphatic flow and relaxes spastic muscles in the neck and collar area.As a result, the nutrition of the cartilage tissue of the disc is improved, preventing the progression of the process and reducing the risk of subsequent recurrence.
therapeutic exercise
Physical therapy exercises for cervical osteochondrosis should be performed daily unless the condition worsens and is associated with severe pain.If severe pain occurs, a gentle treatment regimen must be followed, which includes maximizing the restriction of movement of the cervical spine.
Systematic exercise therapy helps strengthen the neck muscles, thereby helping to reduce the static load on the intervertebral discs.The exercise went smoothly; large and sudden movements were prohibited at first.Exercise must be started carefully and the load gradually increased to avoid unpleasant sensations.
Exercises are performed standing or seated.The most common exercises include:
- Turn your head to the sides;
- head tilting forward and backward;
- Raise your shoulders, relax or fix your arms, and maintain this position for 15-20 seconds;
- Static loading, head immobilization, alternating tension occurs in the flexor and extensor muscles of the neck.
The exercises must be repeated 5-7 times, and the course duration is 15-20 minutes.
Traction
To avoid possible complications, traction should be performed in a hospital under the supervision of a doctor.The procedure is to be performed with extreme caution and should be stopped immediately if pain occurs as it may worsen the condition.
During traction, the elastic tissue of the spinal ligaments is stretched, causing the distance between adjacent vertebrae to increase.Add 1-3 mm.It turns out that when a herniated disc or osteophyte compresses a root or artery, this is enough to reduce or even completely eliminate the compression in some cases.During the surgery, the pressure within the disc decreases, causing the protrusion to partially retract and the intervertebral foramen to enlarge.
Traction has a beneficial effect on the intervertebral joints, eliminating subluxations that develop in the intervertebral joints and helping to reduce muscle contractures.Immediately after traction, a special device must be used to immobilize the cervical spine for several hours.The course of treatment includes 10 to 20 surgeries.
physical therapy
The use of medicinal electrophoresis has good results.This technology can deliver drugs to tissues involved in pathological processes.For cervical osteochondrosis, non-steroidal anti-inflammatory drugs, hormonal anesthetics and other drugs are used for electrophoresis.
The use of dynamic current helps improve blood circulation and has good analgesic and anti-inflammatory effects, helping to reduce the excitability of nerve tissue.When treated with a combination of conservative methods, the initial manifestations of osteochondrosis can be cured as long as you maintain an active lifestyle, proper and nutritious nutrition, and give up bad habits.
Through advanced destructive processes, proper treatment and lifestyle will allow you to achieve long-term relief.Some patients do not improve with conservative treatment; in these cases, neurosurgery is used.
surgical treatment
All available canning methods should be tried before surgical treatment of cervical osteochondrosis.Usually, surgery is needed when treatment has been unsuccessful for three months or more.and spinal cord compression in patients with severe neurological symptoms that may lead to disability.
Currently the most commonly used are microdiscectomy and endoscopic surgery.This procedure is performed using microsurgical instruments and a 10x microscope, which allows you to clearly see the area of spinal cord compression.Remove part of the herniation that is compressing the root or spinal cord.Sometimes it is necessary to remove a small piece of vertebrae or remove a ligament.