Degenerative disc disease (low back pain) the cervical spine is the main cause of manifestations of pain in the neck and irradiiruet pain in your hands. Pain events begin to occur in the case in which one or more intervertebral discs in the cervical spine begin to deteriorate due to degeneration.
Predisposition of some people to develop the degenerative disc disease, perhaps, has a genetic component. The trauma can also accelerate, and sometimes cause the development of degenerative changes of the cervical spine.
The treatment of degenerative disc disease of the cervical spine gives good results only when you have a regular character, and it is consistent and systematic. Osteochondrosis of the cervical spine is included in the list of reasons the most common symptoms in patients of working age, which in the long sitting at the computer. Patients often do not pay attention to the pain and not turn to the doctor , which leads to complications.
Risk factors for degenerative disc disease of the cervical
While almost all people sooner or later develop involutional degenerative changes of the cervical spine, there are some factors that may make it more likely, early development of degenerative disc disease or the appearance of symptoms. These risk factors may include:
- Genetics. Some studies of twins indicate that genetics plays an important role, a way of life during the early stage of development of degenerative disc disease of the cervical spine and fast debut of symptoms.
- Obesity. The weight is associated with risk of development of degenerative disc disease (osteoarthritis).
- Structure. This habit can hinder the flow of nutrients in the discs and accelerate their hydration.
- In addition, the trauma of the spine can sometimes start or accelerate the process of degeneration of the cervical spine.
The symptoms
The symptoms of osteoarthritis of the cervical spine can widely vary for different people.
When the back pain becomes symptomatic, pain may develop gradually or appear suddenly. The symptoms may vary from discomfort in the neck before exhausting severe pain radiates to the arm, numbness and / or muscle weakness.
The main symptoms are:
- The pain in the neck. Low intense pain on a background of stiffness in the neck is the most common symptom of osteoarthritis of the cervical spine. However, sometimes the pain can worsen dramatically and last for a few hours or days.
- Neuralgia. This type of pain tends to be acute, or with the sensation of electrical shock that radiates to the shoulder, hand, hand and / or fingers. As a general rule, the neuralgia is heard only on one side of the body.
- The neurological symptoms in the hand, brush and / or fingers. It can be a tingling sensation needles, numbness and / or weakness that can spread to the whole upper limb. These types of symptoms can interfere with daily activities, for example, print, dress up or to hold objects.
- The pain intensifies when you are driving. In general, the pain caused by you degenerative disc, usually intensifies when you are driving and decreases with rest.
- If the pain comes from the same degenerative disc, is, very probably, it will go away on its own in a matter of a few weeks or months. However, other symptoms of degenerative disc disease of the cervical spine often become chronic and require treatment, for example, if the facet joints of the neck also begin to degenerate and / or occurs a compression of the nerve root.
Less common symptoms
Most cervical spine degenerative, the more likely it is that the spine canal narrows and increase the risk of spinal cord compression. If you check the compression of your spinal cord , will develop myelopathy, and symptoms such as:
- The difficulty of the movement of the hands and / or feet
- Problems of coordination and / or balance
- The loss of control of bowel and / or bladder
- Weakness and / or numbness anywhere below the neck
- Rastrellatura pain in the extremities, which can increase when you lean forward
Cervical myelopathy is a serious condition that requires immediate medical care. Usually this condition occurs in people over the age of 50 years.
Diagnostics
The diagnosis of cervical osteoarthritis can be identified on the basis of such data as:
- Medical history. In the first place, the doctor needs to study in detail the symptoms and medical history.
- The physical examination. Then the doctor will perform a physical examination, palpation of the neck and checking the range of motion in the neck. During the test patients can be prompted to perform certain movements and to communicate, increases or decreases the pain in the neck.
- If the pain is intense, or if there are neurological symptoms such as pain, tingling, or weakness in the shoulder, the arm or the brush, then the doctor will probably prescribe the possession of medical imaging .
- Techniques of medical imaging (x-ray, CT, mri, PET). If the doctor determines that to clarify the exact origin of the symptoms, it is necessary to obtain an image of the tissues (discs) then, most likely, will be assigned to magnetic RESONANCE imaging. Magnetic RESONANCE imaging, x-ray or, perhaps, computerized tomography can confirm if there are signs of degeneration, and also to identify other states (such as osteoarthritis or stenosis), which can cause the symptoms.
- After confirmation of accurate diagnosis of degenerative disc disease of the cervical spine, as well as any number of other states, it is possible to understand if Genesis's symptoms and determine an effective treatment program.
State, associated with osteochondrosis cervical spine
Disc degeneration is often accompanied by other pathological states that develop both at the same time, or in some cases, a cause other. The more often you experience the following conditions:
- Hernia cervical spine occurs in the case where the disc degeneration leads to violating the integrity of the ring, fibrous, and occurs diverticulum content beyond the ring. But the herniated disc can appear after the injury , which at the end accelerates the degeneration of the disc and leads to the development of arthrosis of the cervical spine .
- Cervical osteoarthritis. Because, as the degenerative disc and the storage space within the vertebral column begins to decrease, the facets, the joints may start to move abnormally and cause the wear and tear of the cartilage, but also of stimulating the formation of osteophytes cervical spine.
- Cervical stenosis of the spine. This is a condition that occurs because of osteophytes or herniated disc and occurs a narrowing of the spinal canal (where the spinal cord passes) or foraminal holes (where the nerve root).
But you have to realize that sometimes some people already with the birth of a narrowing of the spinal canal and the development of symptoms is not associated with osteochondrosis.
Radiculopathy cervical - the symptoms of pain, tingling, numbness and / or weakness, radiating to the shoulder, hand and brush, may occur when one or more nerve roots zaselyalsya or irritated. If the stenosis occurs in the spinal cord compression herniated disc, or osteophytes, then you can develop myelopathy. Possible symptoms of pain, tingling, numbness and / or weakness can be felt at this level, in the area of the neck, and anywhere below the level of compression. For example, a person may be tingling or weakness in the legs, balance problems, or difficulty with control of bladder and bowel.
In the presence of symptoms myelopathy important to consult a doctor, as the condition may progress, without treatment, can eventually develop paralysis of the limbs, disorders of the functions.
Treatment
Usually, when you see the symptoms due to osteochondrosis cervical spine the adoption of the acts, corrective, aimed at reducing the symptoms. In the first place in the treatment of degenerative disc disease of the cervical spine are used non-surgical treatments.
In rare cases, when pain and symptoms persist or worsen, despite a couple of months of treatment, or if there is danger of injury to the spinal cord, then solved the problem of the operation.
Conservative treatment options
For the treatment of pain in the neck, caused osteochondrosis, the doctor usually recommends one or more of the following treatment options:
- Vacation or a life style change. Some actions can be more painful for the neck, such as the elongation of the neck, forward when you work on your computer. The withdrawal or modification of some activities in the space of a few days or weeks usually reduces the pain. In addition, it is recommended that you maintain a correct posture (instead of the veranda when sitting or bending the neck forward while driving, etc.). The consumption of healthy foods, adequate hydration, and smoking cessation are also useful for the health of the disk.
- Treatment of pain with the help of medications or injections. A certain effect can give the-counter painkillers. If the pain is intense, it can be given stronger pain reliever, such as oral steroids or muscle relaxants or opioids.
The injection, as the facet injection, nerve or epidural block. They may include injection of corticosteroids into a structure to reduce local inflammation:
- Caudal epidural injections
- Injection of compound joints
- Interlaminar caudal epidural steroid injection
- Transforaminal epidural injections
- Selective block of the nerve roots
- Block the branches of the medial
- Ice and heat can be used in the treatment of degenerative disc disease of the cervical spine.
- Physical THERAPY. Most non-surgical programs for the treatment of degenerative disc disease of the cervical spine will include some programs of exercises such as isometric, and tensile strength .The selection of exercises must be executed by qualified expert ( medical THERAPY) , as well as insufficient physical exercise can lead to worsening . In addition ,the exercises must be selected taking into account the individual characteristics of a specific person . In general, increasing the strength and flexibility of the neck can reduce the risk of pain and to a certain extent, slow down degenerative changes in the disc.
- Chiropractic. The cervical spine can be manually adjusted by qualified personnel in the field of healthcare, improve range of motion and / or to reduce the pain. Depending on the symptoms a particular patient should perform a physical examination and / or viewing first-hand the manipulation of the neck.
- Physiotherapy
- Massage
- Acupuncture
- Corethrogyne
The surgical treatment of degenerative disc disease of the cervical
The operative techniques for treatment of degenerative disc disease of the cervical spine are usually treated in two cases:
- There are neurological symptoms, such as constant numbness in the hands and / or weakness, or problems with walking or bowel control. If the neurological symptoms caused osteochondrosis cervical spine, there is the risk of permanent damage to the nerves, and surgery may be recommended to reduce the pressure on the nerves.
- The chronic pain is severe and unresponsive to treatment for at least six months of non-surgical treatment, and the daily activities becomes difficult. Surgical outcomes are expected for patients with chronic pain in combination with other states, such as the instability segments of motion of the neck and / or radiculopathy.
The main surgical techniques for treatment of degenerative disc disease of the cervical spine are:
- Anterior cervical discectomy and fusion (ACDF).
- Disc replacement artificial.
In addition, there are a number of other surgical procedures for the treatment of degenerative disc disease cervical:
- Decompression endoscopic
- Endoscopic foraminotomy
- Decompression percutaneous
- Intra-disk used therapy, electrothermal
- Selective discectomy, endoscopic
- The stimulation of the spinal cord
- Radiofrequency ablation
- Epidural lysis of adhesions
Surgical procedures on the neck, aimed at the decompression of the nerve roots and / or spinal cord and, therefore, the reduction of neurological symptoms such as pain or weakness in the hands, has the tendency to good, durable results - positive, the forecast is 80% to 90% .