Osteochondrosis is the most common pathology in which all parts of the spine are affected.In terms of the frequency of lesions, the cervical spine takes second place, second only to the lumbar spine.Treatment of osteochondrosis of the cervical spine is carried out using conservative methods in most cases and depends on the stage of the disease and the severity of destructive processes in the intervertebral discs.Surgical treatment is indicated in 5-7% of patients with persistent disease, ineffectiveness of conservative therapy for 3-4 months, as well as the development of serious neurological complications.
Clinical manifestations of the disease
Osteochondrosis of the cervical spine has many different manifestations.Symptoms depend on the predominance of one or more 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 occipital region of the head.
- Spine - motor and sensory disorders, as well as the occurrence of innervation disorders manifested by trophic changes in the muscles of the upper limbs.
- Radicular - manifests itself with pain in various localizations (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 caused by insufficient blood supply to brain structures (headaches, 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 complaints or the next exacerbation of the disease.In any case, the treatment of cervical osteochondrosis should be prescribed by a doctor only after a mandatory examination of the patient and the necessary laboratory and instrumental studies to exclude accompanying pathology.
After the diagnosis is confirmed, outpatient treatment is prescribed in most cases.Patients with severe neurological disorders, high probability of complications and severe accompanying pathology require inpatient treatment.Conservative treatment of osteochondrosis involves the use of the following methods.
Drug therapy
In order to combat pain, it is necessary to use drugs during the exacerbation of the disease.For this purpose, they appoint:
- Non-narcotic analgesics.Non-steroidal anti-inflammatory drugs are taken orally or parenterally, with mandatory use of local preparations - ointments, gels, balms, rubs.Complex anti-inflammatory therapy helps to reduce swelling of soft tissues, which is the main cause of pain in vertebral syndrome.The period of use of drugs in this group is 5-10 days, sometimes 2 weeks.If there is no effect, paravertebral blockades of anesthetics with hormonal agents are used in the amount of 1-3 manipulations.
- Antispasmodics, B vitamins.In the acute period, in case of severe edema, a short course of diuretics is indicated for 2-4 days.They reduce vascular spasm and improve microcirculation at the site of inflammation.
- If the patient has unbearable pain for a long time, sedatives (peony tincture, valerian root, herbal teas and infusions) to prevent the development of neurosis.
- External warming agents - balms, ointments, lubricants that have a mild irritating effect and contain biologically active substances of plant and animal origin.Drugs with a strong irritant effect cannot be used, as they increase swelling, which can worsen the condition.
Therapeutic massage
Massage is a component of the complex treatment of osteochondrosis.To enhance the effect of drug therapy, it is used for preventive purposes after the exacerbation has been eliminated and periodically during remission.The course of therapeutic massage is 10-14 sessions and is prescribed 2-4 times a year if there is no severe pain.
Massage improves blood supply, lymph flow and relaxes spasmodic muscles of 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 further relapse.
Therapeutic exercise
Physical therapy exercises for cervical osteochondrosis should be performed daily, except for exacerbation of the disease accompanied by severe pain.In case of severe pain, it is necessary to follow a gentle regime that involves maximum limitation of movements in the cervical spine.
Systematic exercise therapy helps to strengthen the neck muscles, which helps to reduce the static load on the intervertebral discs.Exercises are performed smoothly;large-amplitude sudden movements are initially prohibited.Exercises should be started carefully, gradually increasing the load, avoiding unpleasant sensations.
Exercises are done standing or sitting.The most common exercises include:
- turning the head to the sides;
- tilt your head forward and backward;
- raise the shoulders with relaxed or stable arms, keeping them in this position for 15-20 seconds;
- static loads, with a stationary head, alternating tension occurs in the neck flexors and extensors.
Exercises should be repeated 5-7 times, the duration of the lesson is 15-20 minutes.
Traction
To avoid possible complications, traction should be performed in a hospital setting under the supervision of a doctor.The procedure is carried out with extreme caution, and if pain occurs, it should be stopped immediately, because it can lead to an exacerbation of the disease.
During stretching, the elastic tissues of the ligaments of the spinal column are stretched, which causes an increase in the distance between adjacent vertebrae.It increases by 1-3 mm.This is enough 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 is reduced, which causes a partial retraction of the herniated disc and an increase in the intervertebral foramen.
Stretching has a beneficial effect on the intervertebral joints, eliminates subluxations and helps reduce muscle contracture.Immediately after traction, it is necessary to fix the cervical spine using special devices within a few hours.The course of treatment includes 10 to 20 procedures.
Physiotherapy treatment
The use of drug electrophoresis has a good effect.The technique allows the delivery of drugs to the tissues involved in the pathological process.Electrophoresis with non-steroidal anti-inflammatory drugs, hormonal anesthetics and other drugs is used for cervical osteochondrosis.
The use of diadynamic currents helps to improve blood circulation and has a good analgesic and anti-inflammatory effect, helps to reduce the excitement of nervous tissue.When using complex treatment with conservative methods, the initial appearance of osteochondrosis can be treated, provided an active lifestyle, proper and nutritious diet, giving up bad habits.
With an advanced destructive process, proper 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 preservation methods should be tried.Typically, surgical treatment is indicated when therapy fails for three months or more.Also, the development of spinal cord compression, accompanied by severe neurological symptoms that can cause disability in the patient.
Currently, microdiscectomy and endoscopic operations are most commonly used.Manipulation is carried out 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 cut by pressing on the root or spinal cord.Sometimes it is necessary to remove a small piece of a vertebra or remove a ligament.