Headaches for osteochondrosis treatment

Headache due to osteochondrosis of the cervical spine is a frequent occurrence. It is impossible to ignore such pain, as this can be a signal of serious pathologies in the body.

Why does the headache with osteochondrosis

Osteochondrosis is an insidious disease. The disease develops gradually and asymptomatically. When a headache occurs, the process is already at the stage at which the spine in the cervical region is significantly deformed.

The intervertebral discs are erased, the vertebrae begin to protrude and put pressure on the nerve roots. The nerves of the spinal cord become inflamed and make themselves felt with pain in the neck.

Headache begins when protruding vertebrae pinch the nerves of the spinal cord or spinal artery. In this case, blood flow is disturbed, oxygen starvation occurs, spasm of cerebral vessels causes prolonged severe pain in a certain area of ​​the head.

With osteochondrosis of the cervical spine, intracranial pressure may increase, which also provokes a headache. At the same time, patients often complain of related symptoms in the form of dizziness and visual impairment. To choose a remedy for headache with osteochondrosis, it is necessary to undergo an examination.

Types of headache with osteochondrosis

Headache with osteochondrosis is usually compressive and boring, proceeds with attacks. An attack of pain can last from several hours to several days.

Localized pain in the occipital part of the head. Sometimes the pain spreads to the temporal and frontal areas.

A person suffering from headache with osteochondrosis does not tolerate noise, harsh sounds. In bright light, he experiences increased pain and pressure on the eyes. It happens that the eyes are covered with a veil, and there is a noise in the ears.

If there is pain in the area of ​​the shoulders or arms during headaches, this may be a manifestation of osteochondrosis of the thoracic spine.

What to do when the head hurts from osteochondrosis

Headaches in osteochondrosis require a long and thorough treatment. It is necessary to be examined in order to understand at what stage the disease is. Based on the diagnostic results, the doctor decides which treatment procedures are best for the patient.

If you are at home and do not have the opportunity to drive to the doctor, you can get rid of a headache attack and relieve pain in the following ways:

  • Take an antispasmodic in combination with an analgesic. This will help relieve spasm and relieve pain.
  • If the pain spreads to the neck, you can drink an anti-inflammatory non-steroid drug. It will reduce pain and stop the inflammatory process in the muscles of the neck.
  • With pain in the neck, ointments containing warming substances are recommended.
  • Doctors often prescribe neuroprotectors. Such drugs almost always show good effectiveness in pain caused by osteochondrosis.
  • For the treatment of degenerative changes in the spine, chondroprotectors, muscle relaxants and vitamins are recommended.
  • If blood pressure rises at the time of a headache, vasodilator drugs are used.
  • It will be useful to massage the neck, head and shoulders.

The course of treatment with medications will restore the blood circulation of the brain, normalize intracranial pressure and relieve tension in the muscles of the neck. ATTENTION: The treatment should be comprehensive and under the strict supervision of the attending physician.

How to relieve headache with osteochondrosis folk remedies

Previously, when there were no modern painkillers and anti-inflammatory drugs, people saved themselves from headaches with osteochondrosis by various home remedies and herbs.

The healing properties of many natural components have not been canceled, they can be used independently to eliminate headaches. Let’s introduce some of the most popular folk treatment recipes:

  • Take a small onion and cut it in half. Attach slices to temples and hold for a bit. The pain goes away after 15 minutes. This method is very good for migraine attacks. Even some analgesics do not relieve this pain so quickly.
  • Propolis has healing properties and anti-inflammatory effect. Tincture of 20 g of propolis, diluted in 100 g of vodka, will quickly relieve headache. You just need to drip 40 drops on a small piece of bread and immediately eat it.
  • Tea brewed from oregano can be drunk throughout the day. The headache will gradually go away.

Headache treatment for osteochondrosis with neck exercises

With osteochondrosis of the cervical spine with a symptom of headaches, correctly performed gymnastics will significantly improve blood circulation. Simple stretching exercises have a beneficial effect on the condition of the spinal column:

  • muscles are strengthened;
  • the spine acquires its former mobility;
  • posture is restored;
  • blood circulation in damaged areas improves;
  • mood improves, which contributes to an overall increase in tone.

Exercises for physiotherapy exercises should be professionally designed. You can do gymnastics at home, but you should not forget a few simple requirements:

  • sudden movements should be avoided;
  • classes should be carried out regularly, gradually increasing the load;
  • if headaches intensify, it is necessary to reduce the intensity of exercises;
  • It is recommended to do gymnastics every day until slight fatigue appears.

There are several exercises for the neck that are most effective for headaches:

  • You need to sit on a chair, lean back, straighten up and turn your head from side to side. They make movements smoothly, the chin when turning should reach the level of the shoulder. Result: the vertebrae become mobile, the muscles acquire a tone.
  • Sit on a chair straight. Tilting your head forward, you need to try to touch the chin of the chest. This exercise helps stretch the neck muscles. The same thing should be done by tilting your head back. This movement is useful for people with a sedentary lifestyle.
  • Sit at the table, lean on it and palm press on the forehead for a few seconds.
  • In a standing position, straighten your back and raise your shoulders up, linger for a few seconds, a field of which you can inhale and relax the body.
  • In the prone position, put a pillow under the head, preferably not very soft, and press it with the back of the head. The muscles of the neck are trained.
  • It is necessary to lie on your stomach, arms should be stretched forward. Head slowly lean back, stretch, bend for a few minutes and relax. Strengthens and stretches the vertebrae.

Gymnastics can not be performed during an attack of pain in any part of the spine. ATTENTION: Be sure to consult a doctor before performing exercises.

Headaches for cervical osteochondrosis

Headache accompanies many diseases. Interestingly, the brain itself cannot hurt: it does not have pain receptors. They are located in large numbers in the meninges, soft tissues of the head, walls of arteries, and vessels of the base of the brain. It is in these tissues that the headache “lives”.

One of the causes of paroxysmal headaches is osteochondrosis of the cervical spine.

Cervical osteochondrosis

Osteochondrosis is a disease that affects the intervertebral discs. The causes of this ailment are many, among them there are also few that depend on a person, such as a genetic predisposition. But in most cases, this is the result of our neglect of our own body: we eat incorrectly, move a little, do not monitor posture, overload our body.

Similar problems arise in a person who has overcome the thirty-five year milestone. But, like all other diseases, osteochondrosis is getting younger year after year. And now eighteen-year-olds begin to complain of pain in the neck. It is the youth who now spends more and more time at the computer, forgetting that the human body is created for movement. The situation is aggravated by improper nutrition, leading to overweight.

Osteochondrosis headache: treatment

Headaches with cervical osteochondrosis are a frequent and rather painful phenomenon for the patient. They are the result of compression of the vertebral artery by bone processes. The pain is bursting, it intensifies with movements of the head and even eyeballs. Often the pain is accompanied by nausea and vomiting, the patient feels a general weakness in the body. Accompanying osteochondrosis of the cervical spine, headache, pressing, dull, is constantly present. In addition to a headache, a person experiences pain in the region of the heart, under the scapula, in the forearm. Most often, pain is accompanied by numbness of the arm or tingling.

With cervical osteochondrosis, the headache does not stop with analgesics. To alleviate the patient’s condition during a headache attack, warming ointments can be used. By increasing blood flow to the cervical muscles, they will reduce pain. Often with cervical osteochondrosis, the so-called “cervical migraine” appears. In this case, one side of the head hurts, which makes this pain look like a classic migraine.

To relieve a headache during an attack, it is necessary to ensure maximum peace of the cervical spine. If possible, the patient should be put to bed. It is useless to treat a headache with osteochondrosis: it is necessary to cure the underlying disease, then the head will cease to hurt.

Treatment of osteochondrosis of the cervical spine

It is necessary to treat cervical osteochondrosis in a complex, using drug therapy, physiotherapy, therapeutic exercises.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Medication Therapy

With osteochondrosis, drugs are prescribed:

  • relieving inflammation and pain;
  • improving cerebral circulation;
  • relieving muscle tension;
  • vitamins of group B;
  • nicotinic acid;
  • preparations of magnesium, calcium, phosphorus.

Physiotherapeutic procedures:

Alternative therapy:


Since osteochondrosis is most often the result of a sedentary lifestyle, the main preventive measure is gymnastic exercises performed daily.

The set of exercises recommended by doctors is divided into two groups: performed in sitting and standing, and lying down.

1 group of exercises

  1. Putting a palm to the forehead, press on it with your head, while straining the neck muscles. The palm should provide resistance. Pressure duration – 7-10 seconds. Repeat the exercise three to four times. Do the same with your palm to the back of your head.
  2. Place your palm on your left temple and do an exercise similar to the first. Do the same with the right temple.
  3. Tilt your head back a little and, overcoming the tension of the neck muscles, slowly lower it, pressing your chin to the jugular fossa at the end of the exercise.

2 group of exercises

  1. Lying on your back, bend your knees, pull them to your stomach, and then raise your head and try to touch your forehead with your knees. Straighten your legs slowly and rest your head in its original position.
  2. Lying on your stomach, raise your head and shoulders without taking your lower body off the floor.
  3. Lying on your stomach, spread your arms to the sides. Turn your torso to the left, trying to get your left hand with your right hand. Repeat the exercise by turning to the right.
  4. Lie on your stomach, rest your chin in your palm, relax your neck muscles. Turn your head to the left, trying to touch the floor with your ear. Do the same by turning your head to the right.

If you perform the complex of exercises regularly, then your blood circulation in the collar zone and mobility of the cervical vertebrae will improve. But be careful: at the slightest sensation of pain, reduce the intensity of movement. Doctors do not recommend performing circular head movements – such exercises can aggravate the disease.

Prevention of osteochondrosis

For the prevention of osteochondrosis should:

  • from childhood to monitor posture;
  • go in for sports, especially swimming;
  • prevent the accumulation of excess weight;
  • consume foods containing calcium, magnesium, vitamins;
  • working on a computer, follow the recommendations of doctors;
  • Do not carry the load on one shoulder.

Diet with cervical osteochondrosis

The diet of a patient with osteochondrosis has restrictions on the use of salt, liquid, spicy foods, strong tea and coffee. The list of banned products also includes pastries, sweets and carbonated drinks. Forget about mayonnaise and canned goods. There is no benefit from these products, but they bring a lot of harm.

Get used to healthy and wholesome food. Include the following foods in your diet:

  • Containing calcium (dairy products, rye bread);
  • Containing manganese and vitamins A, B, C (fruits, vegetables, herbs, whole grains);
  • Containing copper, iron (nuts, seeds, meat, liver);
  • Containing phosphorus (eggs, fish).

Treatment of osteochondrosis of the cervical spine folk remedies

Folk doctors have their own method for diagnosing cervical osteochondrosis:
It is necessary to take lemon juice and iodine (alcohol solution 10%) in equal quantities and mix them. The resulting mixture is applied in a wide strip (at least 6 cm) to the problem area. After a few hours, in some areas of the skin, the strip will lose color: this indicates a disadvantage in this place. Now you know what place needs treatment. You can treat with the same mixture. To do this, apply it every day on a sore spot until the color on the skin persists for several days. The treatment lasts about three weeks. It is useful at this time to engage in therapeutic exercises. Store the mixture in a cool dark place.

Caution: such treatment is contraindicated at high temperature and in case of iodine intolerance.

In addition to the miraculous mixture, traditional medicine uses herbal decoctions for internal use. Their action is aimed at removing inflammatory processes and swelling.

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  • goat willow bark – 50g;
  • buckthorn grass – 10g;
  • birch leaf – 40g.

Grind herbs, mix. Take half a liter of boiling water 2 tablespoons of the mixture, boil for 10 minutes, insist for an hour and strain. Take a glass of broth twice a day.

  • St. John’s wort – 1 part;
  • elderberry red flowers – 1 part;
  • lime color – 1 part;
  • goldenrod grass – 1 part.

Prepares and accepts a decoction in the same way as the first.

No less popular are alcohol tinctures. They are convenient to store and take. And they act much faster than decoctions.

Cedar tincture:
To prepare cedar tincture, you need to grind the nuts together with the shell and pour them with vodka. The level of vodka should exceed the level of nuts by four fingers. The mixture is infused in a dark place for a week. Then the mixture is filtered and taken in a tablespoon three times a day. Instead of nuts, you can use only the shell. 200 g of shell, crushed into powder, pour a liter of vodka and insist for a month. Then filter and drink 25-30 g on an empty stomach half an hour before meals.

Unusual funds

In life, there are the most unexpected remedies that relieve the patient of osteochondrosis. So, one young woman, having tried all conceivable and inconceivable means, got rid of the disease very quickly, rubbing a sore spot with a sheet of Indian onion at night.

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And some are treated with a shovel from an ordinary shovel. They take a genuine handle, bring it behind its back, and massage the sore spot, rolling a healing tool over it. In one session, you need to do 50 swings up and down. You need to do this procedure every day and gradually the disease will recede. However, this method of treatment is not so strange: it can be attributed to self-massage. True, modern self-massage techniques are more gentle.

Headaches for osteochondrosis of the cervical spine

If a person has a sore neck and head, then it is likely that his osteochondrosis is progressing. For a similar disease, this is a very common phenomenon. You must definitely find out what measures should be taken to improve your condition, if you are familiar with it.

Why cervical chondrosis causes headaches

The disease is characteristic of representatives of the middle age group, although doctors say that it is getting younger every year. Intervertebral discs with osteochondrosis are severely damaged. They slowly but rapidly atrophy, and the vertebrae themselves are covered with processes of bone tissue. The development of headaches with osteochondrosis of the cervical spine has the following reasons:

  1. Muscle spasm. It occurs due to the natural reaction of the body to protect vertebrae that are damaged, that is, to limit neck movements. Echoes of a spasm hit the head, but they will not be able to get rid of ordinary analgesics.
  2. Cervical migraine, which is often confused with osteochondrosis.
  3. Radiculopathy (radicular syndrome).
  4. Vertebral Artery Syndrome. Nerve fibers located near the vertebrae are pinched by bone processes. Arteries are in the same condition. This provokes circulatory disorders of the brain, as a result, the cells receive insufficient oxygen and the person has a headache.

What pains causes cervical chondrosis

Sensations in a patient with such a diagnosis may be different:

  1. Throbbing and burning pain, which from the occipital area gradually changes to the crown of the head and temples and lasts a very long time. This is characteristic of vertebral artery syndrome.
  2. When the occipital nerve is pinched, the back of the head begins to hurt, and then the whole head. If a person moves his neck, then the sensations become more unpleasant, the tension increases.
  3. If the spasm is bursting and crushing the head, then the intracranial pressure most likely has risen due to compression of the arteries in the canals of the vertebrae.

How to recognize severe headaches in osteochondrosis

It is sometimes very difficult to distinguish them from those that are characteristic of other diseases. Headache with cervical osteochondrosis has its own characteristics:

  • occurs suddenly;
  • can last from a quarter of an hour to an indefinite time;
  • headaches with osteochondrosis of the cervical spine intensify when a person moves his neck, eyes (while the head does not spin);
  • it is more often felt in the mornings, because a person has been without movement for a long time;
  • the neck may tingle or numb;
  • does not cause an increase in body temperature;
  • headaches with osteochondrosis of the cervical spine do not completely subs >

Therapy will be symptomatic. You must understand that all the drugs listed below will not cure you of the disease, but only temporarily ease the condition. How to relieve headache with cervical osteochondrosis:

  1. It is necessary to take anti-inflammatory drugs, for example, Aspirin and drugs to improve blood circulation in the brain.
  2. If it is impossible to endure, drink an analgesic: Analgin, Baralgin, Tempalgin, Pentalgin, Ketorol, Ketonal. Antispasmodics will also help: M >

In addition to drug treatment, many other methods are used, up to traditional medicine. If you want to know how to quickly get rid of a headache without pills, try using one of the following tips:

  1. Do special exercises regularly at home or do yoga.
  2. Follow a diet that includes foods that are rich in calcium, magnesium, and vitamins.
  3. Do your own special massage of the cervical spine.
  4. Do warming compresses, grindings. They affect the affected vertebrae, as a result, the compression of the arteries decreases and the headache ceases. For example, boil a leaf of horseradish with boiling water, attach it to the back of the head for the night. This should clear the headache.
  5. Try to sleep on an orthopedic mattress and pillow so that the spine is in the correct position.

How to treat cervical chondrosis

The methods of therapy are selected taking into account the degree of the disease. Its main stages:

    Drug treatment. In the acute period, analgesics and antispasmodics, complex drugs, muscle relaxants, anticonvulsants, non-stero >

The spine is the main supporting structure of our body, which binds together all organs and systems. Therefore, it is not surprising that pathological processes in the vertebrae affect the health of other organs. A striking example of this relationship are headaches in osteochondrosis of the cervical spine.

Cervical Changes

Osteochondrosis is usually called degenerative changes in the cartilage of the intervertebral discs. There are several reasons for this violation:

  • Genetic predisposition.
  • Age. When growing up, the vessels in the intervertebral discs are physiologically absorbed. Their nutrition in adulthood occurs diffusely from nearby vessels. Weak blood flow or malnutrition leads to loss of elasticity and structure of the disc.
  • Loads. Violation of the symmetry of the load distribution on the spine when carrying bags over the shoulder, sitting curled up or staying in unnatural poses for a long time, lifting a lot of weight.
  • Obesity. Improper nutrition and overweight create an additional burden on the spine amid a lack of essential nutrients.
  • Spinal injuries.
  • Diseases of the musculoskeletal system of the feet. For example, flat-footedness does not allow the body to cushion normally when walking, so the spinal column experiences a constant axial load.

To understand whether a headache from cervical osteochondrosis can hurt, you need to find out the essence of violations in osteochondrosis.

The mechanism of the appearance of pain is as follows: at the initial stage, the pathology of the intervertebral disc appears. Inside the cartilage tissue, irreversible changes occur over time, which are accompanied by cracking of its structure. Microcracks of the fibrous ring or its dehydration lead first to a slight prolapse (protrusion) of the medulla and “flattening” of the intervertebral disc.

Cartilage wear leads to a decrease in the distance between the vertebrae, and as a result, they begin to come into contact. From the increased load, bone osteophytes are destroyed. In these places, a violation of the mobility and flexibility of the spinal column develops, and the cartilage tissue is gradually replaced by bone.

Such changes lead to mechanical crushing of not only the roots of the spinal nerves, but also of the blood vessels that carry and remove blood from the head.

From cervical chondrosis, pain, swelling and inflammation around the vertebrae appear. First, the pain is localized along the spine, and then goes to the head area. Since in Latin the cervical is translated as Cervicalis, then the headache caused by osteochondrosis of this area is called cervical.

Cervicogenic headache

Headache with cervical osteochondrosis is vascular or neurological in nature. How your head hurts depends on this.

With a predominance of impaired blood flow in the vertebral arteries, there is a noise in the head, dizziness, hearing impairment, flies in front of the eyes, color flashes against a background of throbbing pain. It occurs reflexively with spasm of the arterial vessels of the neck when they are irritated by bone growths, hernia, arthrosis. Arteries pass through the transverse foramen of the vertebrae to the right and left and are constantly injured by collision of the vertebral bodies. Headache, which occurs in this case, can not be eliminated with drugs.

This syndrome is called “vertebral artery syndrome”, and its manifestations are amplified by turning the head from side to side. Such movements cause compression of the vessels, and the blood flow in them drops sharply.

Also, with cervical osteochondrosis, the head hurts due to the development of hypertension syndrome. It occurs when the venous vessels of the neck are compressed, which carry out the outflow of blood from the head. As a result of a violation of their patency and reflex spasm, intracranial pressure rises. Symptoms that arise in this case are severe, bursting pain, against the background of which nausea and vomiting often occur.

Neurogenic headaches with osteochondrosis of the cervical spine occur when damage to the roots of the spinal nerves of the cervical plexus with osteochondrosis of the vertebrae C1-C7. Pain sensations are localized in the area innervated by these nerves:

  • the front of the neck;
  • long front and side muscles of the head;
  • occipital region and upper margin of the ear conch.

Headaches with osteochondrosis of the cervical spine are most often localized in the occipital part. Usually the nature of the headache is very strong, exhausting with its constancy. The attack can last from six to 10 hours. The patient feels a heaviness or pressure in the back of the head, which can then spread throughout the upper part of the head, like a helmet. An increase in soreness occurs when moving in the cervical spine, dizziness joins it, the so-called cervical migraine develops. Vomiting occurs, which does not bring relief.

Since this disease is quite serious, the choice of tactics for the treatment of this pathology should be entrusted to the doctor.


What to do and how to relieve headache in cervical osteochondrosis?

General recommendations

When the neck or head in the back of the head is sharply ill, it is desirable to ensure peace in this area, it is necessary to create conditions for relaxing the neck muscles and eliminating the block of blood vessels. To do this, take a lying position, preferably on a hard surface. Under the knees you need to put a roller. This helps to relax all back muscles. In the acute period (the first two to four days), it is generally recommended to exclude motor activity and spend it in bed.

Sleeping with cervical osteochondrosis is also recommended on a hard bed, on your back.

During the day, you need to wear fixing devices that immobilize the neck from unnecessary movements – collars or soft corsets.

Treatment for cervical osteochondrosis can be etiological (act on the cause), symptomatic (eliminate pain) or pathophysiological (block the development mechanism).

Elimination of the cause

The etiological treatment for cervical osteochondrosis is based on the use of chondroprotective drugs – chondroitin sulfate, glucosamine, collagen, which stimulate the regeneration of cartilage and restore its functionality. To improve nutrition, vitamins of groups B, A, C, D are also prescribed, trace elements copper, selenium, silicon. This is perhaps the only treatment option that acts on the source when the head hurts with cervical osteochondrosis.

Vitamin and trophic preparations, which are administered in the immediate vicinity of the spine, help to stop degenerative processes in the intervertebral discs and damage to the vertebrae. Injections contribute to the accumulation of drugs in the paravertebral muscles, from which, by diffusion, nutrition of the cartilage and bone tissue occurs. Such drugs include Compligam, Combilipen and Milgamma.

According to indications for osteochondrosis, injections of enzyme preparations (Papain, Lekozyme, Karipazim) can be prescribed, which contribute to the resorption of connective tissue in the area of ​​inflammation and reduce pressure on the nerve roots.

Symptom management

Symptomatic treatment is based on the use of non-steroidal anti-inflammatory drugs or analgesics. It can be piroxicam, indomethacin, diclofenac, ibuprofen, reopirin tablets. It is also convenient and justified to use transdermal patches with NSAIDs (Olfen, Dolobene) for headache in cervical osteochondrosis, which must be attached to the neck. Constant and even flow of medication helps reduce inflammation and swelling around the roots of the nerves of the cervical plexus and, accordingly, relieve headaches in the back of the head.

Sedatives, antipsychotics, and tranquilizers are also used as a means of improving the general well-being of patients suffering from headaches with cervical osteochondrosis. They help to overcome insomnia, nervousness, irritability and anxiety, which is inherent in a person tormented by painful sensations.

When your head hurts from osteochondrosis, you can take tincture of valerian or motherwort on your own. On prescription – antidepressants (amitriptyline), antipsychotics (aminazine) and tranquilizers (carbamazepine, hydazepam).

Blocking the mechanism of the development of the disease

Pathogenetic therapy includes “distracting measures” that can interrupt the pain dominant. Such an action is exerted by the setting of mustard plasters, pepper patch, the use of irritating ointments based on menthol or capsicin, an iodine grid, dry heat.

The treatment of headaches in cervical osteochondrosis also includes the fight against muscle spasm. The muscle relaxants Sirdalud, Tizanidin, Midocalm have such an effect. Features of their action are to block the conduct of excitation in the nerve fibers of the central nervous system. As a result, a reflex muscle spasm in response to pain is blocked, but at the same time muscle strength and ability to move are preserved.

It is possible to eliminate muscle spasm and improve blood circulation with cervical pain not only with the help of medicines. A positive effect is exerted by therapeutic gymnastics, therapeutic massage, physiotherapy (electrophoresis, UV-heating, ozokerite), as well as methods based on psychophysiology.

For example, a psychotherapist A. Kurpatov He believes that the cause of osteochondrosis of the neck is psychological problems, respectively, headache is treated when the patient’s psycho-emotional state is stabilized and stress is relieved. Muscle spasm occurs in response to anxiety. The muscles protect the spine, as it were, but in fact, with its prolonged compression, the vertebrae and the block of vertebral vessels and nerves are gradually destroyed. Accordingly, in order to relieve a headache with osteochondrosis of the neck, it is necessary to relax, change the state of fear and anxiety. Kurpatov offers a system that includes psychological training, exercises for relaxing the cervical spine and breathing practice.

In any case, if the head hurts from cervical osteochondrosis, then it should be treated first.

Morozov Georgiy

Georgy Morozov, rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases.