Degenerative disc disease (low back pain) in the cervical spine is the underlying cause of pain symptoms in the neck and irradiiruet pain in his hands. Pain symptoms begin to manifest in the case when one or more intervertebral discs in the cervical spine begin to collapse due to degeneration.
Predisposition of some people to develop osteoarthritis may have a genetic component. Trauma can also accelerate, and sometimes cause the development of degenerative changes in the cervical spine.
Treatment of degenerative disc disease of the cervical spine gives good results only when it has regular character and is consistent and systematic. Osteochondrosis of the cervical spine is included in the list of the most common causes of symptoms in patients of working age who sit long at the computer. Often patients do not pay attention to pain and not seek medical assistance , leading to complications.
Risk factors of degenerative disc disease of the cervical spine
While almost all people sooner or later develop involutional degenerative changes in the cervical spine, there are some factors that can make more likely the early development of degenerative disc disease or the symptoms. These risk factors may include:
- Genetics. Some studies of twins indicate that genetics plays a greater role than lifestyle, with the early development of degenerative disc disease in the cervical spine and the rapid onset of the symptoms.
- Obesity. Weight is associated with risk of development of degenerative disc disease (osteoarthritis).
- Smoking. This habit can hinder the flow of nutrients to the discs and accelerate their hydration.
- In addition, a spinal injury can sometimes start or speed up the process of degeneration in the cervical spine.
Symptoms
Symptoms of degenerative disc disease of the cervical spine can vary widely in different people.
When degenerative disc disease becomes symptomatic, pain may develop gradually or appear suddenly. Symptoms can range from some neck discomfort to debilitating severe pain radiating to the arm, numbness and / or muscle weakness.
Main symptoms:
- Pain in the neck. Low-intensity pain on a background of stiffness in the neck is the most common symptom of degenerative disc disease of the cervical spine. However, sometimes the pain can sharply increase and last for several hours or days.
- Neuralgia. This type of pain tends to be sharp or with a sense of shock radiating to the shoulder in the arm, hand and / or fingers. Typically, the neuralgia is felt only on one side of the body.
- Neurological symptoms in the hand, wrist and / or fingers. You may experience sensations of tingling, needles, numbness and / or weakness which may extend along the entire upper extremity. These types of symptoms can interfere with everyday activities, for example, to print, dress up or hold objects.
- The pain increases with movement. In General, the pain caused by degenerative disk usually increases with movement and decreases with rest.
- If the pain comes from the degenerative disc, it is likely to disappear by itself within 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 in the neck also begin to degenerate and / or there is compression of the nerve root.
Less common symptoms
The more the cervical spine degenerates, the more likely that the spinal canal will narrow and increase the risk of spinal cord compression. If there is spinal cord compression will develop myelopathy and will appear symptoms such as:
- The difficulty of moving hands and / or feet
- Problems with coordination and / or balance
- Loss of control of bowel and / or bladder
- Weakness and / or numbness anywhere below the neck
- Shooting pains in the extremities, which can increase when you lean forward
Cervical myelopathy is a serious condition that requires immediate medical attention. Typically, this condition occurs in people older than 50 years.
Diagnosis
The diagnosis of osteochondrosis of the cervical spine can be set on the basis of such data as:
- Medical history. First, the physician needs to examine in detail the symptoms and medical history.
- Physical examination. Then the doctor will conduct a physical examination, by sensing the neck and checking the range of motion in the neck. During testing, patients can be asked to perform certain movements and indicate increases or decreases pain in the neck.
- If the pain is intense or if there are neurological symptoms, such as pain, tingling, or weakness in the shoulder, arm or hand, then the doctor is likely to prescribe medical imaging .
- Medical imaging (radiography, CT, MRI, PET). If the doctor determines that to determine the exact origin of the symptoms is necessary to obtain image of tissue (disks) then most likely be scheduled for MRI. MRI, x-ray or perhaps CT scan can confirm whether there are signs of degeneration, and to identify other conditions (such as osteoarthritis or stenosis) that can cause symptoms.
- After confirming an accurate diagnosis of degenerative disc disease of the cervical spine, as well as any other bound States, one can understand the Genesis of symptoms and to identify effective treatment program.
Condition associated with degenerative disc disease of the cervical spine
Degeneration of disc is often accompanied by other pathological conditions that develop either at the same time, or in some cases one causes the other. Most often meet the following condition:
- Hernia in the cervical spine occurs in the case that disc degeneration leads to disruption of the integrity of the fibrous ring and protrusion of content occurs outside of the ring. But a herniated disc may occur after injury , which ultimately accelerates the disc degeneration leads to the development of degenerative disc disease of the cervical spine .
- Cervical osteoarthritis. As soon as the disc degenerates and the disc space within the spinal column begins to decrease, the facet joints may start to move abnormally and cause excessive wear of the cartilage and stimulate the formation of osteophytes in the cervical spine.
- Cervical stenosis of the spine. This condition, which occurs due to osteophytes or herniated disc and is narrowing of the spinal canal (where the spinal cord) or foraminal foramen (where the nerve root).
But you have to understand that sometimes some people are already born with a narrowing of the spinal canal and the development of symptoms associated with degenerative disc disease.
Cervical radiculopathy - symptoms of pain, tingling, numbness and / or weakness radiating to the shoulder in the hand and arm can occur when one or more nerve roots are irritated or zaselyalsya. If stenosis occurs when the spinal cord compression by disc herniation or osteophytes, that can develop myelopathy. Possible symptoms of pain, tingling, numbness and / or weakness can be felt on this level in the neck and in any place below the level of compression. For example, a person may be tingling or weakness in the legs, problems with balance or even difficulty controlling bowel and bladder.
If you have symptoms of myelopathy, it is crucial to seek medical help because the condition can progress, and without treatment can eventually develop paralysis of the limbs, and dysfunction.
Treatment
As a rule, when symptoms due to degenerative disc disease of the cervical spine taken curative actions aimed at reducing symptoms. Primarily in the treatment of degenerative disc disease of the cervical spine uses non-surgical methods of treatment.
In rare cases, when pain and symptoms persist or worsen despite several months of treatment, or if there is a risk of damage to the spinal cord, then the issue of the operation.
Options for conservative treatment
To treat neck pain caused by degenerative disc disease, the doctor usually recommends one or more of the following treatment options:
- Vacation or lifestyle change. Some actions can be more painful for the neck, such as neck stretch, forward when working at the computer. Abstinence or change certain activities for several days or weeks generally reduces pain. In addition, it is recommended to maintain correct posture (instead of slouching when sitting or bending the neck forward while driving, etc.). Eating healthy food, proper hydration and Smoking cessation are also helpful for the health of the disks.
- Treatment of pain with medications or injections. A certain effect can give over-the-counter pain relievers. If the pain is intense, it can be assigned to stronger pain medication like oral steroids or muscle relaxants or even opiates.
Injections such as facet injections, nerve or epidural blockade. These can include injection of corticosteroids to a specific structure to reduce local inflammation:
- Caudal epidural injections
- Injection into facet joints
- Interlaminar caudal epidural steroid injections
- Transforaminal epidural injections
- Selective blockade of nerve roots
- Blockade of medial branches
- Ice and heat can be used in the treatment of degenerative disc disease of the cervical spine.
- LFK. Most non-surgical programs for the treatment of degenerative disc disease of the cervical spine would include a specific program of exercises like isometric and stretching .The selection of exercises should conduct a qualified professional ( doctor physical therapy) , as inadequate exercise can lead to deterioration . In addition ,exercises should be chosen taking into account the individual characteristics of a particular person . In General, increasing strength and flexibility in the neck may reduce the risk of pain and somewhat slow down the degenerative changes in the discs.
- Manual therapy. The cervical spine can be manually adjusted by a qualified technician in the area of health to improve range of motion and / or reduce pain. Depending on the symptoms in the individual patient it is necessary to conduct a physical examination and / or visualization before hand manipulation in the neck.
- Physical therapy
- Massage
- Acupuncture
- Corethrogyne
Surgical treatment of degenerative disc disease of the cervical spine
Operative treatment of osteochondrosis of the cervical spine are usually considered 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 neurological symptoms caused by degenerative disc disease of the cervical spine, there is a risk of permanent nerve damage, and surgery can be recommended to reduce pressure on the nerves.
- Chronic pain is serious and does not respond to treatment for at least six months of nonsurgical treatment, and daily activities becomes difficult. Best surgical outcome is predicted for patients with chronic pain in combination with other conditions such as instability of motion segments of the neck and / or radiculopathy.
Main surgical methods of treatment of degenerative disc disease of the cervical spine are:
- Anterior cervical discectomy and fusion (ACDF).
- Artificial disc replacement.
In addition, there are a number of other surgical procedures for the treatment of degenerative disc disease of the cervical spine:
- Endoscopic decompression
- Endoscopic is foraminotomy
- Percutaneous decompression
- Intra disk used electrothermal therapy
- Selective endoscopic discectomy
- Spinal cord stimulation
- Radiofrequency ablation
- Epidural lysis of adhesions
Surgical procedures on the neck to decompression of nerve roots and / or spinal cord and, thus, reduction of neurological symptoms, such as pain or weakness in the hands, tends to the good remote results - the positive forecast is 80% to 90% .