Discopathy is damage to the elastic discs located between the vertebrae of the spine. The disease can affect all three areas of the spine – cervical, thoracic, and lumbar. Neck discopathy is the second most common after lumbar. Injuries to it painfully and severely restrict the movements of the neck and head, affecting the shoulders, shoulders, arms.
The role of the discs is like that of springs – they cushion the vibrations during movement and torsion, as well as the pressure on the vertebrae of the spine. It is under constant pressure, as it resists gravity so that you can remain upright. In addition, the discs, along with the intervertebral joints, contribute to the flexibility of the spine.The structure of the intervertebral discs includes a soft core and a protective ring descried as fibrous. In its optimal state, the core is very watery and gelatinous, and the ring is made of densely layered collagen fibers. With age, this structure begins to change as, degenerative processes develop. The nucleus displaces, compresses, and swells the ring, causing cracks and other defects, even rupture. In this way, the core can protrude beyond the area of the disk, and it “flattens”. When the nucleus swells or protrudes, the nerves that exit the spinal cord into the space where the disc is located can be compressed and inflamed.If the discopathy is posterior to the spinal canal, particles from the disc can press on the spinal cord. Nerve irritation then causes pain and immobility. Discopathy usually occurs at an active age – degenerative changes begin around the age of 30 and its progression and manifestations are unique to the individual. With greater physical activity – for example in athletics, it is often a matter of accumulated numerous microtraumas.Damage can also result from severe injury in an accident. A number of everyday factors that are constantly recurring also predispose to the appearance and development of the disease:
incorrect posture when walking
carrying heavy bags over the shoulder
crouching when working at a computer or doing other activities on a desk, table, counter
prolonged unchanged postures such as long-distance truck driving
heavy lifting, etc.
Symptoms of dyspnea in the cervical spineThe spinal cervical region includes 7 vertebrae – from the skull to above the thoracic region. Here the discopathy occurs when part of the disc enters the spinal canal and this causes compression of the spinal cord. The disease has specific manifestations according to the location, because at each level of the vertebrae, the spinal cord and nerve roots are “responsible” for different parts of the body.Neck discopathy most often affects the space between the fifth and sixth, and the sixth and seventh vertebrae, where the tension is greatest.
In these cases, the development of the disease, respectively leads to numbness and pain in the arms, affecting the elbow area; muscle weakness (specifically the biceps); swelling and numbness of the fingers; stiffening of the back of the shoulders and arms, and to some extent on the forearm; and clenching the fist is very difficult.If the discopathy is between vertebrae 2 and 3, symptoms include numbness and decreased mobility of the tongue, headache, problems with head movement, vision problems.Discopathy between the cervical vertebrae 3 and 4 causes pain in the neck, as well as in the clavicle, and there are difficulties in the movement of the head and shoulders. If the injury is on the disc between vertebrae 4 and 5, pain and tingling appear in the shoulder and shoulder area, the deltoid muscle weakens, and the movements of the shoulder and arm are limited, especially when lifting objects.If the discopathy occurs suddenly – say, due to a rupture of the ring on impact, then the pain is severe. But with the gradual development of the disease, the initial symptoms can be perceived as insignificant – neck pain is relatively mild, intensifying with attempts to move the head or shoulders. People often reassure themselves that they “just slept badly” or are “bruised.”However, the duration of the symptoms should suggest that they are not harmless, even if they subside. A doctor should be consulted in any instances of numbness; pain or tingling in the neck, arms, and shoulders; cramps, heaviness, weakening of their muscular strength, limited mobility, and delayed reflexes.
Diagnosis of neck dyscopathy
Discopathy (rupture of the fibrous ring and the exit of the nucleus of the disc) in the cervical area is not the only cause of tingling, pain and restricted movement in varying degrees of neck, shoulders, and arms.Symptoms similar to discopathy can be caused by other diseases related to the structure and nutrition of the discs and vertebrae.
different types of rheumatic diseases
dislocation of the vertebrae due to damaged and altered discs
endocrine diseases, damage to blood vessels and poor blood supply to the discs
inflammation of the discs and vertebrae, tumors and other more common or less common causes.
Therefore, accurate diagnosis is neededThe most accurate diagnosis is made by magnetic resonance imaging. The method is based on radio waves creating a magnetic field. The problem area is scanned with focus on the discs and vertebrae. Their condition is accurately displayed and reveals pathologies of soft and bone tissue.The patient lies on a “table” that slides forward into the scanner and adjusts to the desired area to be imaged. The patient should not move during the procedure. The method avoids X-ray irradiation.Another method of diagnosis is computed tomography, which also accurately shows the ejection or rupture of the disc, the possible displacement of the vertebrae, calcifications, etc. X-rays in various projections are also used to detect degenerative changes. Myelography is less commonly used. It involves the insertion of a contrast agent into the spinal canal and X-ray scanning.Treatment of cervical discopathyThere are different ways to treat neck discopathy. In most cases, it goes away without surgery, surgery is resorted to only in very advanced stages of the disease, which are not affected by conservative methods. The overall goal is to eliminate the pain and prevent it from happening again.
Conservative treatment is especially effective in the early stages of discopathy or when there is still no rupture but swelling of the ring. It includes extra rest, physical activity in a certain mode, painkillers, physiotherapy, and more.Very useful are specialized massages to correct micro-displacements, and to improve blood supply, metabolism, and the flow of nerve impulses transmitted from the spinal cord to the organs.As for drugs to relieve pain and inflammation, a number of non-steroidal drugs are used in conservative treatment – heparin, ketoprofen, ibuprofen, diclofenac. In rare cases, cortisone is injected into the spinal canal, which has a strong anti-inflammatory effect.Kinesitherapy is widely used. According to the diagnosis, a program of recovery procedures and exercises is prepared. Inversion therapy, yoga techniques, etc. are also applicable methods. An auxiliary neck collar made of soft foam, hard plastic or metal can also be used. It supports the neck and holds it in the necessary position during the treatment.Anatomical pillows are often recommended, which keep the neck in the required position during sleep to avoid undue stress on the vertebrae and discs, respectively.Surgery is the last approach when the damage to the disc is too great. If the pain does not go away after conservative treatment and muscle weakness persists, surgery is considered. The main operative method is microdiscectomy, in which the inside of the damaged disc is removed with the help of a microscope and a minimal incision. According to the indications, techniques of minimal intervention are applied, such as coblation, removing of the damaged disc through special electrodes through the skin.