Osteochondrosis is the most common pathology of the spinal column, in which all its parts are affected.According to the frequency of injuries, the cervical spine is in second place, second only to the lumbar spine.Treatment of osteochondrosis of the cervical spine in most cases is carried out by conservative methods and depends on the stage of the disease and the severity of destructive processes in the intervertebral discs.Surgical treatment is indicated for persistent disease in 5-7% of patients with no conservative therapy for 3-4 months, and also for 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 changed structures 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:
- Vertebral - manifested by pain of varying intensity and duration, localized in the neck or the back of the head.
- Spine - occurrence of innervation disorders, manifested by motor and sensory disorders, as well as trophic changes in the muscles of the upper limbs.
- Radicular - manifested by pain in different localizations (upper limbs, chest and abdominal organs), requires differential diagnosis with many diseases of internal organs and 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 further aggravation of the disease.In any case, the treatment of cervical osteochondrosis should be prescribed only by a doctor after a mandatory examination of the patient and necessary laboratory and instrumental studies to exclude concomitant pathology.
After confirming the diagnosis, 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 includes the use of the following methods.
drug therapy
During the exacerbation of the disease, it is necessary to use medicines to fight the pain.For this purpose, they define:
- Non-narcotic analgesics.Nonsteroidal anti-inflammatory drugs are taken orally or parenterally, with mandatory use of local preparations - ointments, gels, balms, rubs.Complex anti-inflammatory therapy helps reduce swelling of soft tissues, the main cause of pain in spinal syndrome.The duration of use of drugs of this group is 5-10 days, sometimes 2 weeks.In the absence of effect, paravertebral blockade of anesthetics with hormonal agents is used in the amount of 1-3 manipulations.
- Antispasmodics, B vitamins.In the acute period, in the presence of severe swelling, it is indicated to prescribe diuretics for a short course of 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 neurotization if the patient has prolonged excruciating pain.
- External warming agents - balms, ointments, rubs, which have a mild irritating effect and contain biologically active substances of plant and animal origin.Drugs with a strong irritating effect cannot be used, because they increase swelling, which can lead to a 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 enhance the effect of drug therapy and periodically during remission for preventive 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 neck and collar muscles.Due to this, the nutrition of the cartilage tissue of the intervertebral discs is improved, which prevents the progression of the process and reduces the risk of further relapses.
therapeutic exercise
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, it is necessary to follow a gentle regimen, which means maximum limitation of movement in the cervical region of the 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;Sudden movement of large amplitude is prohibited from the beginning.Exercises should be started carefully, gradually increasing the load, avoiding unpleasant sensations.
Exercises are performed in a standing or sitting position.The most common exercises consist of:
- turning on its side;
- tilting the head back and forth;
- raising shoulders with relaxed or fixed hands, 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, lesson duration 15-20 minutes.
Traction
To avoid possible complications, traction should be performed in a hospital under the supervision of a doctor.The procedure is carried out with the utmost care, and in case of pain, it should be stopped immediately, because it can lead to an exacerbation of the disease.
During traction, the elastic tissues of the ligaments of the spinal column are stretched, which causes an increase in the distance between adjacent vertebrae.It grows by 1-3 mm.This is 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 is reduced, which causes a partial retreat of the herniated protrusion and an increase in the intervertebral foramen.
Traction has a positive effect on intervertebral joints, eliminates subluxation occurring in them and helps to reduce muscle contractures.Immediately after traction, it is necessary to fix the cervical spine using special devices for several hours.The course of treatment includes 10 to 20 procedures.
Physiotherapy treatment
The use of therapeutic 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 excitability of nervous tissue.When using complex treatment with conservative methods, it is possible to cure the initial manifestations of osteochondrosis, provided that you maintain an active lifestyle, proper and nutritious food and reject bad habits.
With an advanced destructive process, proper treatment and lifestyle will allow you to achieve long-term remission.In some patients, improvement cannot be achieved with conservative treatment;In such cases, neurosurgical methods are used.
surgical treatment
Before starting the surgical treatment of cervical osteochondrosis, you should try all available methods of preservation.As a rule, surgical treatment is indicated when therapy has failed for three months or more.As well as the development of compression of the spinal cord in the patient, which is accompanied by severe neurological symptoms, which can lead to disability.
Currently, microdiscectomy and endoscopic operations are most commonly used.Manipulation is carried out using microsurgical tools and a 10x microscope, which allows you to clearly see the compressed areas of the spinal cord.It is carried out by pressing on the root or the spinal cord to excision of the protruding part of the hernia.Sometimes it is necessary to remove a small fragment of the spine or cut a ligament.