It has been written and said many times that osteonecrosis of the cervical, cervical and lumbar spine is not a disease. This, if you like, is our "species curse". Humans, as a species, have been bipedal for only a few million years, and even less. This, from the point of view of evolution, is still "midway". It is not known what new anatomical variations of spine development we will arrive in a million years.
Currently, osteonecrosis is the most common disease of the musculoskeletal system that doctors of many different specialties face. Usually these are therapists and neurologists, since with the complication of osteonecrosis a variety of neurological syndromes can occur, which are discussed below.
Osteochondrosis - what is it?
You shouldn't say the words "bone necrosis is common", because this is not true. Osteochondrosis in its purest form is a normal aging process and dehydration of the intervertebral discs, normally, does not cause any complaints. This can be done in older adults who are active, mobile, have good posture and are not overweight. They do gymnastics, swim, avoid heavy lifting, and lead what could be called a "healthy lifestyle".
If we talk about osteonecrosis of any part of the spine, we always mean its complicated course, which causes various complaints and symptoms. And in it, the cervical spine is more vulnerable than other parts. Of course, the cervical region has the least load - only the head, but at the same time, the vertebrae of the cervical region are more mobile than others, and at the same time they have less mass.
All these make cervical lesions with complications of osteonecrosis more obvious. Proximal head leads to headache occurring, which of course does not occur with lesions of the lumbar region. In addition, it must be remembered that it is in the central canal of the cervical vertebra that the spinal cord passes, that it absorbs all the passages below. Thus, with central canal compression syndrome, the patient may experience paralysis of the arms and legs, complete immobility, decreased skin sensitivity throughout the body, and dysfunction of the pelvic organs. All of these can at the moment leave a person with a disability, such as a cervical vertebrae (snoring on the head in unfamiliar small places).
Of course, such complex lesions are not associated with osteonecrosis: the patient is more likely to be bothered by other symptoms. How to treat and cure cervical spondylosis? It is impossible to cure him. To do this, from childhood you simply refuse to move on two legs, and crawl on all fours, or live in the ocean, like a dolphin. Only then will the load on the discs be minimized, or even completely absent.
Only exacerbations of osteonecrosis can be cured, and so you need to know not only their signs and symptoms but also the risk factors.
About risk factors
In the case of the cervical spine, obviously, lifting weights over the shoulders will not play such an important role in the occurrence of pain syndromes as in the lower back. What conditions and diseases can contribute to the development of cervical osteochondrosis symptoms? Here are the most common scenarios:
- The feet are flat, both vertically and horizontally. The spine is a flexible, curved rod. In the event that the arch of the foot does not dehumidify, and while walking is not an "elastic" movement of the spine downwards but rather a blow, this blow with a "wave", like a whip, willgo up. , and is quenched precisely in the cervical region, at the transition of the cervical vertebrae. That's where all the energy goes. Therefore, running on flat feet leads to marked changes in the intervertebral discs.
- Chronic damage. First of all, it is skating on ice in winter, falling back, as well as constantly banging your head against low doorways, which is often seen in people of above average height.
- Wear thick winter hats, high hair ties, and lots of women's jewelry. All this leads to fatigue of the neck muscles, the appearance of chronic spasms, circulatory disorders, and the development of headaches and back pain.
- A sedentary lifestyle, "sedentary" work, the presence of stiffness in the upper chest and cervical spine.
We will not list specific risk factors that occur in sick patients. Quite enough are the reasons for the deterioration in normal, healthy people.
Signs and symptoms of osteonecrosis
Symptoms of cervical spondylosis are varied. Few doctors even know that general prolapse of the abdominal cavity (cystic disease) or liver prolapse, often misdiagnosed as its proliferation, can be caused by cervical osteonecrosis. In this case, the phrenic nerve is irritated and the dome of the diaphragm, contracted, prolapses.
As a result, the liver is "pushed" out of the hypochondrium. But there are other more "normal" symptoms of cervical osteochondrosis - pain and muscle tension. We will not talk about the symptoms of hernia and protrusion of the cervical spine - a separate article is devoted to this issue. Let's talk about clinic happening with "whole" discs, especially since such situations are much more common.
Cervical fibroids cause pain in the neck. Myalgias are manifested by constant, low-intensity aches and pains. It is aggravated by turning and tilting the head. Often accompanied by occipital stiffness.
Headaches in osteonecrosis of the neck almost always have the character of tension headaches. The attack lasts for hours, even days in a row. The pain rises from the neck through the occipital to the temples, and covers the skull like a barrel or helmet. With this pain, the ability to work is not affected, but if lens symptoms are associated with it, they are of a shooting nature and are very painful with head movement.
The "vertebral artery" syndrome
Referring to cervical osteosarcoma, one cannot fail to mention the classic manifestations of cerebrovascular insufficiency caused by cervical osteosarcoma. Its symptoms are vomiting and nausea, dizziness and disturbances in balance. There is noise in the head and in the ears (tinnitus), in severe cases there is a language disorder (emotional disorder), swallowing disorder. More often there are various visual disturbances ("flies"), headaches. Sometimes there are fall attacks, where a person is not unconscious, but falls, and then rapidly rises.
Compression of either vertebral arteries can occur during sleep. In the event that a person simultaneously tilts his head back and turns to the side, the vertebral artery will be pressed against the first vertebra - the map is horizontal, that is, from the opposite side.
If you lie like that for a while, in the morning you are about to get out of bed, you will experience dizziness, nausea, vomiting, gait and balance disturbances. In some cases, "higher-order" disorders also develop - for example, global transient amnesia, in which the patient simply does not remember anything.
Many neurological syndromes and symptoms also arise, which we will only briefly list, indicating their diagnostic reference points, so that the reader of the article can visualize and "try" the symptoms for themselves. This symptom if a neurologist cannot be reached:
- Poor oblique muscle syndrome of the head (usually occurs in patients over 50 years of age, especially in postmenopausal women). There are pain, sensitivity disturbances in the back of the head, along the meninges. A painful, intermittent sensation of nature, both in the neck and at the back of the head, that is constant and increasing in association with prolonged immobility. Increases when turning the head to the healthy side;
- Anterior skin syndrome - manifests itself in patients with additional "cervical ribs".
There are disturbances of sensitivity and "crawling" in the hands, the hands are white and cold, sometimes the hands swell, there is weakness, paralysis of the muscles of the hands, as well as a weakening of the pulse in the wrists. In some severe cases, there may be gradual paralysis or paralysis of the muscles of the hand. The patient cannot drive a car, sleep on his side, cannot lift weights, and work with his arms up high (hanging curtains, plastering). There are also complaints of neck stiffness and pain, forcing head posture in the morning.
- Middle squamous muscle syndrome. First, there are pains in the shoulder, in the shoulder blade area, and then muscle atrophy begins there. Mechanisms involved in damage to the long nerve of the trunk and transverse cervical artery;
- Shoulder levator syndrome (levator clavicle syndrome of the scapula levator). First, pains appear, in the area of the scapula, a "humming" sound. They give shoulder pain, neck pain, often "left wind and sky" pain. A cracking sound is often heard when moving the shoulder blades.
Thus, it is clear that many processes that begin in the neck or in the vicinity of its structures appear "in the periphery", for example, in the area of \u200b\u200bthe hands. This requires a thoughtful and competent approach from the doctor. Nowadays, the diagnosis of complications of osteonecrosis has become much simpler, especially with the introduction of MRI into clinical practice.
Treatment of cervical osteonecrosis
Modern therapy for cervical pain of vertebral origin and associated muscle and compression syndromes provides for short courses of drug therapy. The treatment of acute exacerbation of osteonecrosis of the neck rapidly transitions to a fading exacerbation, in which the main treatments are mobilization and physical therapy.
Ointments and medicines for exacerbations
As you know, "injections", ointments and even blockades have not been canceled. But the neck is home to a large number of nerves, blood vessels, autonomic fibers, sternocleidomastoid muscles. As a result, blockade is performed here less frequently than for acute back or lower back pain. In addition, the thin skin on the neck allows gels, creams and ointments to be absorbed more quickly than in the lumbar spine.
Among the drugs, injectable forms of NSAIDs are used, preferably selective, muscle relaxants of central action, vitamins of group "B".
It should be remembered that if NSAIDs are used, it is imperative to protect the mucosa of the gastrointestinal tract by the use of antisecretory drugs during treatment.
For topical treatment, there are now many ointments, gels and creams that contain NSAIDs, bee and snake venom, as well as cooling and analgesic agents. The main thing is not to use very hot ointments. They can cause increased blood pressure, blushing, and even increased blood pressure in old age. Treatment with ointment is desirable prophylactically, without waiting for the next exacerbation.
About Shants Collar
In the early stages, in the acute stage, it is necessary to protect the neck from unnecessary movements. Shant collars are great for this. Many people make two mistakes when buying this type of collar. They did not choose it according to its size, that is why it simply did not fulfill its function and caused discomfort.
The second most common mistake is to wear it as a backup for a long time. This leads to muscle weakness in the neck and only causes more problems. There are only two markings for the collar with which it can be worn:
- The appearance of acute pain in the neck, stiffness and pain radiating to the head;
- If you're going to do physical work in good health, you run the risk of getting "pulled" in your neck and making it worse. For example, fixing your car when you're lying under it, or washing your windows when you need to stretch out and be in uncomfortable positions.
It is necessary to wear the necklace for no more than 2-3 days, because wearing it longer can cause venous stasis in the neck muscles, sometimes it is necessary to activate it for the patient.
Patient Activation
Kinesiotherapy (dynamic therapy) includes therapeutic exercises, swimming. Gymnastics for cervical spondylosis is not directed at the disc at all, but focuses on the surrounding muscles. Its task is to relieve muscle spasms, improve blood flow and also normalize the flow of veins. This is what leads to decreased muscle tone, reduced pain and stiffness in the back.
Along with massage, swimming, acupuncture sessions, you should buy an orthopedic mattress and a special pillow. Pillows for cervical spondylosis should be made of special materials with "shape memory". Its job is to relax the muscles in the neck and occipital region, as well as to prevent nighttime disturbances of blood flow in the musculoskeletal basin.
Fall is an important period in the prevention and treatment of home physiotherapy products and devices - from infrared and magnetic devices, to the most popular ebonite needles and discs, is a weak current supply during massage that has a beneficial effect on the patient.
What's next?
Statistics show that people in the Mediterranean who regularly and of all ages swim in the sea, the situation of diseases of the musculoskeletal system is many times better.
However, the basis for preventing osteonecrosis, in addition to eliminating risk factors, requires a healthy diet, based on yogurt, plant foods, seafood, fiber and many substances. liquid. This will slow the age-related dehydration of the discs, while maintaining a healthy neck and back into the most advanced years.