CERVICAL OSTEOARTHRITIS OR CERVICAL OSTEOARTHRITIS. CAUSES, SYMPTOMS AND TREATMENT
Cervico-arthrosis is a degenerative arthrosis or arthropathy affecting the cervical spine. Osteoarthritis is a common disease of one or more joints, which begins with local deterioration of the articular cartilage and is characterized by progressive degeneration of the cartilage and secondary inflammation of the synovial membrane. It is most common in older people, over 65 years of age, but can occur earlier.
Cervical spine disease
Discosomatic articulation, called discoarthrosis, affects the intervertebral discs, especially at the C5-C6 and C6-C7 levels, which are the most mobile segments and are located in the zone of maximum lordosis.
A unciform process, called uncoarthrosis, which is associated with the previous one with an involvement of the foramen of conjunction, which are the spaces through which the nerves exit.
Posterior interapophyseal joints, bony proliferations or osteophytes may involve both the foramina and the intertransverse foramina.
In general, the 3 forms of osteoarthritis often present together.
Origin or etiology of cervicarthrosis
According to its causes, cervical osteoarthritis can be divided into:
Primary: When the cause is unknown, although some people have a history of cervical osteoarthritis, it is not known if it is caused by a disease. Predisposing factors are known: age (the older the age, the greater the risk), genetics, gender, obesity, endocrine system (controversy over the role of estrogen)...
Secondary: when it is due to a known previous pathology that damages the integrity of the cartilage or the subchondral bone, or that subjects the joint to excessive loads or friction.
Causes of cervicoarthrosis
Acute trauma: unilateral vertebral dislocation, fracture of the uniform processes, hyperflexion or hyperextension trauma.
Congenital disorders: joint disorders, infections, autoimmune arthritis, metabolic diseases (hyperparathyroidism, osteoporosis).
Alterations caused by cervicoarthrosis
It generally follows a progressive evolution, with several phases:
This is the first stage, as it is the structure most sensitive to the aging process. First, the nucleus pulposus loses water, losing its elasticity and turgidity, which reduces the disc space. The annulus fibrosus loses its elasticity, especially in its thinner posterior part. It therefore becomes a weak area of the annulus through which the nucleus pulposus may protrude or herniate.
Uniform motion is lost in the affected segments of the spine. The edges of the joint react by forming small traction spurs called osteophytes. Unstable segments are more susceptible to trauma, which can lead to sprains and even subluxations of the posterior facets.
Extension of the cervical spine is limited by the anterior fibers of the intervertebral disc, but if the disc has lost its properties, it loses its ability to bear loads, the load will fall on the posterior joints, which are unprepared to bear the load and therefore begin to degenerate, with loss of articular cartilage, destruction of the subchondral bone and formation of osteophytes.
The intervertebral joint loses much of its mobility due to narrowing of the intervertebral space, with the formation of osteophytes from the bony ridges of adjacent vertebral bodies.
Intervertebral disc herniation
As a result of the overall degenerative process, the nucleus pulposus begins to exert pressure on the posterior portion of the annulus fibrosus, which is thinner and already degenerated. The fibers in this region separate, and part of the nucleus herniates, usually in a posterolateral position. This results in a narrowing of the nerve duct of the spinal stenosis and subsequent irritation of the nerve roots.
Symptoms of cervical osteoarthritis
Cervicoarthritis can manifest itself in several types of images (3):
Latent forms: asymptomatic but with radiological findings.
Cervical pain syndromes, (acute and chronic cervical pain syndromes)
Painful syndromes of the upper extremity and thorax, (cervicobrachialgias)
Spinal cord syndromes
We will distinguish between the most typical symptoms of acute and chronic processes:
Acute symptoms are usually the result of a sudden movement or posture held for a long period of time, and usually manifest as acute pain, muscle contracture, and significant limitation of mobility.
The chronic picture presents with dull, referred neck pain of mechanical rhythm and moderate intensity, joint stiffness, muscle contractures, limited mobility, joint cracking and deformity.
As a result of neck pain, various conditions may occur, such as:
Cervicobrachialgia: Osteophytes compress a nerve root, which will lead to alterations in the arm. The intensity of the pain is very variable and can sometimes radiate to the head or thorax.
Encephalic syndromes: vertebrovascular insufficiency and Barré-Lieou syndrome are distinguished.
Myelopathies: Due to osteophytosis on the posterior aspect of the vertebral bodies that closes the spinal canal and compresses the spinal cord, (hard hernia).
Osteoarthritis - Another way to understand its causes
Physiotherapy treatment for cervical osteoarthritis
In treating cervical osteoarthritis or osteoarthritis of the neck, it is important to consider not only the characteristics of the person, but also the cause. In physiotherapy, different elements can be added to the therapies to treat cervical osteoarthritis or cervical osteoarthritis:
By "physical agents" we mean all the tools provided by nature, which we regulate and apply to the body in order to obtain beneficial effects. Among the physical agents most commonly used for cervical osteoarthritis, we can find (these are the most frequently used):
Thermotherapy and cryotherapy
Thermotherapy consists of using high temperatures to produce beneficial effects on the organism, while cryotherapy consists of using low temperatures for the same purpose.
Heat produces the following therapeutic effects:
Analgesia. Pain reduction occurs because the simple stimulus of heat moves along pathways that "trick" the brain into ignoring the painful stimulus. In addition, the increased blood flow cleans the neck area of all those inflammatory and tissue-corrosive substances.
Relaxation. Heat stimulates certain receptors in the muscles that decrease the activity of the muscles when they are activated, so that tension is reduced and the muscles relax. In addition, it Certain types of orthopedic pillows promotes relaxation and loosening of muscles.
Trophism. Muscles gain in fiber and quality because they are nourished by the increased blood supply from heat.
Increased range of motion of the joints. The non-contractile tissues of the muscle soften with the heat, so the range of motion of the joint is increased. In addition, relaxation results in a decrease in tension and thus an increase in the length of the muscle itself.
Cold, on the other hand, produces the following therapeutic effects:
Decreased inflammation. The decrease in temperature reduces blood flow, so that fluids do not accumulate in the tissues of the injury.
Analgesia. Decreased pain at low temperatures is due to decreased nerve conduction which increases the pain threshold.
Neuromuscular rehabilitation. Cold applied to the area of a muscle generates contractions that help the muscle remember what the contraction is.
There are many types of electrical currents, each with a different shape and intensity and different effects on the body. The most commonly used is TENS (transcutaneous electrical nerve stimulation), a form of electrotherapy that reduces pain by acting on the nervous system. Like heat, the current is converted into a stimulus that travels along pathways that "trick" the brain so that the painful stimulus is ignored.
Magnetic therapy is the application of magnetic fields, which have an effect on our body because our molecules are positively and negatively charged. This is particularly useful, for example, to counteract the loss of bone mass (because calcium is charged in such a way that it sinks and generates bone in the presence of a magnetic field), a disorder often linked to cervical osteoarthritis.
Ultrasound is the use of high-frequency sound waves that, when propagated through our bodies, have thermal (like heat therapy) and mechanical effects that restore tissue integrity.
Cervical traction consists of a controlled elongation of the axis of the cervical spine. This traction allows for a passive stretching of the neck musculature which reduces the tension that may exist in the neck muscles.
Exercises, stretching and self-massages
Exercises, stretching and self-massages are excellent tools to rebalance the state of the cervical region, recover the amplitude of the articular movements, strength, proprioception, etc. Watch the following video:
Cervical osteoarthritis - Treatment with exercises, self-massages and stretches
In the following video, we explain about 8 exercises, stretches and self-massages that you can perform step by step at home for the treatment of cervical osteoarthritis.
Cervicoarthritis. Causes, symptoms and treatment
The cervical spine cannot function well if we do not use it properly. That is why it is necessary to include the acquisition of a series of attitudes in the performance of our daily activities. Therefore, it is desirable that the person:
Avoid prolonged postures at work or when doing housework.
Preferably sleep on your back or on your side, as sleeping on your stomach generates excessive tension in the cervical spine. Also, make sure that the pillow is not too large. Certain types of pillows are recommended.
Take measures at work and at home: the neck should not be bent when working on a computer or watching television.
Avoid sudden movements of the neck, etc.
Things to keep in mind
Cervical osteoarthritis is a degenerative condition in which the joints of the spine are affected and occurs more frequently in people over the age of 65.
Cervical osteoarthritis can be divided into primary and secondary osteoarthritis.
The causes of cervical osteoarthritis can be due to acute trauma or congenital disorders.
Cervical osteoarthritis causes a variety of disorders including: instability, disc degeneration, segmental hyperextension, disc herniation, among others. Know it well and take preventive measures to reduce its symptoms.