Dorsopathy of the cervical spine: causes, symptoms and treatment

How often do you hear from a person about his health problems, especially when people experience pain? Many "malfunctions" in the body begin to manifest themselves through pain syndromes, disrupting the habitual comfortable way of life. Such ailments include dorsopathy of the cervical spine. It begins imperceptibly, eventually developing into a constant problem of painful painful sensations.

For the convenience of the designation of all pain syndromes associated with the spine, the term "dorsopathy" is introduced. It is collective and includes degenerative-dystrophic lesions of the spine, its muscular apparatus and ligaments. Dorsopathies often involves multiple pathological processes in the spine: osteochondrosis, spondylosis, spondylarthritis, disc herniation( MPD).A characteristic feature of all dorsopathies is pain syndrome.

Risk factors for the occurrence of dorsopathy

Often, dorsopathy occurs in drivers.

• Forced sitting position for a long time( "office syndrome", work at the computer).
• Microtrauma of the spine, obtained in the performance of professional duties( drivers, tractor drivers, athletes).
• Frequent infections( weaken the body's defense mechanisms).
• Diseases of internal organs( cause reflected pain in the spine, lead to the development of muscle spasm).
• Flat feet, varus, valgus deformity stop( uneven load on the spine axis leads to the cervical congestion).
• Psycho-emotional congestion( lack of endorphins in stress causes increased tonus in the muscles of the shoulder girdle and back).
• Too soft seating furniture.

Dorsopathia of the cervical spine is more common in people aged 35-55 years, appears against the background of a gradual aging of the body. At a younger age, its development is associated with congenital developmental anomalies, sports injuries.

Anatomical features of the cervical spine

1. Low muscle mass.
2. The first and second cervical vertebrae form a combined joint, which ensures the rotation of the head.
3. Transverse processes of the vertebrae, which form a channel for the vertebral artery.
4. Vertebral arteries on each side of the spine blood supply the brain( limbic-reticular complex) and the cervical region. When they are compressed, a syndrome of the vertebral artery is formed: headache, neck pain, dizziness, vomiting, noise in the ears or head.
5. Powerful cervical plexus - truncus simpaticus.
6. Thyroid gland.
7. ENT organs.

The disease is based on the defeat of the vertebral-motor segment( PDS).PDS - these are two vertebrae, intervertebral disc, ligamentous apparatus and adjacent neuromuscular structures.

The cervical region is the most mobile part in the spine. When the load is high, the core of the disk dries out and its height decreases. If the MTD is damaged, the vertebrae are fully taken up. Under pressure, they begin to touch the bone surfaces, deform, flatten, there are pathological displacements of the vertebrae relative to each other, on the vertebrae, bone growths( osteophytes) are formed. When the MTD dies down, the intervertebral fissures decrease and squeeze the spinal nerve roots, causing the development of radiculopathy, pain syndromes. The peculiarities of the structure of the cervical spine predispose to compression not only of the nerve roots, but also vertebral arteries and spinal cord. Damage to the anatomical structures of the PDS often occurs with osteophytes, rather than a hernia in the cervical spine.

• In the defeat of bone structures, spondyloarthrosis, deforming spondylosis, arises.
• When the intervertebral disc is damaged - osteochondrosis, hernia of the MTD.
• Muscular imbalance leads to myofascial syndrome.

Through the neck passes the spinal cord, nerve roots, sympathetic trunk, vertebral arteries. All these structures are involved in the work of the brain, heart, lungs.

Symptoms of dorsopathia of the cervical spine

• Cervicalgia - pain in the cervical spine. The pains can be nagging or shooting like "electric shock", amplified with movement and head inclinations, radiating to the occipital region of the head. The source of pain is more often the damaged facet joints, osteophytes. Appear mainly in the mornings, have a one-sided character of localization, are accompanied by muscular tension( defens) on the side of the lesion. The sensation of a crunch in the neck when the head turns.
• Cervicobrahialgia - pain syndrome spreads into the arm, shoulder, may be accompanied by sensitive disorders( numbness, tingling, feeling of "crawling").Pain more often disturbs at night, there is a feeling of "laying hands".Pain syndrome is most pronounced, if you take your hand back. As the process progresses, the volume of movements in the shoulder joint decreases, the muscles become hypotrophic.
• Kranialgia - headaches, mainly in the occipital region. They have a diverse character: from aching to pulsating, can be accompanied by a feeling of nausea. Pain provoked by turns of the head. Most often occur with the syndrome of the vertebral artery.
• Radicular syndromes( radiculopathy) - develop with damage to the nerve roots. They are much less common than lumbar radiculopathy. Characteristic pain in the neck, shoulder up to the fingers of the hand. Feeling of numbness, weakness of muscles( paresis), prolapse of tendon reflexes. Pain is worse when coughing, head movement, especially when tilting.
• Reflex muscular-tonic syndromes occur when the vascular-neural bundle is infringed in the interstitial space between the muscles. Pain and stiffness in the neck bother in the morning, the head is tilted forward and toward the tense muscles. Sometimes numbness in the hand, a sense of "current flow" in the shoulder can be attached.
• Myofascial syndrome is characterized by the presence of trigger points in the muscles. Trigger points are places of painful compaction in the muscles, with pressing on which there is a sharp pain syndrome. The pain in this syndrome is long, blunt, can spread into the arm or shoulder. When examined, a tight cord in the muscle is determined.
• Cervical myelopathy is a lesion of the spinal cord by hernial protrusions of the intervertebral discs, osteophytes or lesions of blood vessels that supply blood to the spinal cord. The disease begins gradually, but, without medical intervention, is steadily progressing. There is weakness in the arms and legs( paresis).Characteristic of the symptom of Lermitt: when turning the head there is a feeling of passing current into the neck, hands, along the spine, legs. Violations up to loss of sensitivity. Hypotrophy of the muscles of the shoulder girdle, arms.

Diagnosis

The computer or magnetic resonance imaging of the spine will determine the final diagnosis.

Only a competent approach to diagnostic measures will allow the correct diagnosis to be made on time.

1. Complete blood test( to exclude or confirm inflammatory diseases of the spine).
2. ECG( myocardial infarction may be concealed under the mask of osteochondrosis).
3. Inspection of a neurologist is mandatory.
4. X-ray of the spine.
5. CT, MRI.

Treatment of

Treatment of dorsopathies is always prescribed by a specialist after the examination of the patient, revealed pathology of the spine, the presence of concomitant diseases.

From conservative methods of treatment use:

1. Analgesics: diclofenac, nimesulide, meloxicam, etc.
2. B vitamins: Vitagamma, Kombilipen.
3. Muscle relaxants: sirdalud, baclofen.
4. Chondroprotectors: Alflutop, chondroitin sulfate.
5. Cholinesterase inhibitors improve neural impulse conduction: neuromidine.
6. Antidepressants are used for radicular pain: amitriptyline.
7. Glucocorticosteroids: dexamethasone.
8. Local treatment( ointments, creams, gels).
9. Blockade of trigger points by anesthetics.

Surgical treatment is indicated for myelopathy, radiculopathy. Absolute indications for surgical treatment are the presence of gross paresis, sensory and pelvic disorders( impaired urination).

Non-drug treatment:

• Bed rest is not recommended for longer than 2-3 days.
• Physiotherapeutic procedures( UHF, electrophoresis, magnetotherapy).
• LFK.
• Orthopedic methods( wearing a shantz collar, especially in an acute period).
• Manual therapy.
• Acupuncture.

Prevention

Proper organization of the workplace, daily physical activity significantly reduces the likelihood of dorsopathy.

The following recommendations should be followed:

1. The back should be straight while sitting, working at the table.
2. Orthopedic pillow.
3. Daily exercise, swimming.
4. You can not throw your head back hard.

Below are some exercises that you need to perform daily:

• Push your forehead against your palm, straining your neck muscles, then pressing your hand against the back of your neck, also straining your neck muscles.
• Press the palm on the left temple, straining the muscles of the neck, then pressing the right temples to the right palm.
• Slow head turns to the right, then to the left, trying to reach the shoulder with the chin.
• The head inclines to the sides, trying to touch the shoulder of the ear.

All exercises are done in several ways.

Conclusion

Timely diagnosis, treatment and preventive measures contribute to a favorable outcome of the disease at the initial stages of development. An integrated approach to treatment - the combination of drug and non-pharmacological methods, helps prevent the development of a chronic process.

Independent elimination of the pain syndrome can be dangerous, since under the "mask of osteochondrosis" can hide oncological diseases, myocardial infarction.

Specialist of the Moscow doctor clinic tells about dorsopathy: