Osteochondrosis in the cervical spine is an osteochondrosis intervertebralis, which can be distinguished from osteochondrosis dissecans. Osteochondrosis intervertebralis refers to a disease of the spinal column in which overloading of the spinal column leads to degeneration of the vertebral body and intervertebral disc. The height of the intervertebral disc decreases, changes in bone tissue (sclerosis) occur and bony attachments to the vertebral body, top and bottom plates can form. The clinical picture manifests itself through painful movement restrictions, a deformation of the spine with muscle tensions and often occurs with age. Osteochondrosis dissecans is a bone-cartilage formation disorder that particularly affects the joints of the extremities.
Therapy
Since it is a degeneration of the spine that cannot be cured, the therapy is primarily symptomatic and is intended to prevent further damage. 1) First and foremost is the pain therapy. Pain can be reduced by means of non-cortisone-containing anti-inflammatory drugs.
Strong muscle tensions can also be relieved with medication. 2) Application of heat can also be helpful to detonate tension. In the case of nerve lesions or severe therapy-resistant pain, injections in the vertebral joints or near the nerves can relieve the symptoms.
3) Gymnastics and posture training at pain-free intervals are of great importance and are especially important to counteract the progression of the disease. 4) In case of severe pain, short-term immobilization of the cervical spine by means of splints can be considered. However, the cervical spine is of course responsible for head movement and immobilization in this part of the spine is difficult and requires major restrictions in the activities of everyday life. A rest and relief is nevertheless indicated after acute stress or in case of severe pain. 5) In advanced stages a stabilizing, straightening surgery may be considered.
Contents of physiotherapy
In physiotherapeutic treatment, a precise diagnosis is first made, which defines an “actual condition” of the patient. In the following, objectives are set for the maintenance and improvement of mobility. The therapy consists of pain-relieving techniques, mobilizing techniques and posture training in order to make the patient aware of the posture and load on his or her cervical spine in everyday life.
Mobilizing techniques can originate from the field of manual therapy or, for example, from counteracting mobilization. There are passive techniques with which the therapist mobilizes the patient and there are active techniques where the cooperation of the patient is required. The aim is to maintain and improve the mobility of the vertebral joints and surrounding structures as much as possible.
Also important are pain-relieving exercises and techniques. For this purpose, light movement exercises are available, which the patient can also perform at home. Stretching exercises can relieve pain, but passive techniques performed by the therapist can also be used.
These include fascial techniques, trigger point therapy and massage grips. A specific exercise program should also be developed for the patient, in which he or she learns to strengthen muscle groups that are too weak and to stretch shortened muscles. A mobilizing exercise program, which is regularly carried out outside the therapy, is necessary to prevent the progression of the disease. Posture in everyday life and at work or under stress is also controlled and improved in physiotherapy for osteochondrosis of the cervical spine.
All articles in this series:
