Cervical spondylosis is a common disease based on degenerative changes of cervical discs, followed by pathological changes of cervical disc herniation, osteophytes and ligamentous hyperplasia, which stimulate or compress the adjacent nerves and blood vessels and cause corresponding clinical symptoms. Its incidence is about 10-15% in adults, more men than women, about 3:1, often after middle age, about 25% of people over 50 years old, and about 50% of people over 60 years old have suffered from cervical spondylosis. Therefore, you may find that many of your friends or colleagues around you are complaining about neck discomfort, and you may find yourself a member of the “cervical spondylosis group”. How does cervical spondylosis come about? What are the symptoms, how should I treat and prevent it?
A. Cervical spine aging is the basis, “buried in hard work” is an accomplice
The cervical spine is located between the more fixed thoracic spine and the head, prone to strain, especially the 4-6th cervical vertebrae are more mobile. Degeneration is more likely to occur. Cervical spondylosis in the pathogenesis of many factors affecting the pathological process is complex, the pathogenesis of a variety of causes, mainly the following aspects.
1, cervical aging degeneration: with age, the human body gradually aging, skin wrinkles, hair graying, similarly, the cervical spine and intervertebral disc will also undergo degeneration, secondary to cervical disc protrusion, osteophytes and ligamentous hyperplasia pathological changes, stimulation or compression of adjacent nerves and blood vessels and cause the corresponding clinical symptoms of a common disease.
2, chronic strain injury: all kinds of activities that exceed the normal physiological range of activity are causative factors of cervical spondylosis, such as: long-term low head workers, poor labor posture, inappropriate pillows. The cervical spine is in flexion for a long time, forcing the nucleus pulposus to be displaced to the posterior side of the intervertebral disc, making the fibrous ring there thin and easy to rupture. At the same time, the posterior joint capsule and ligaments are relaxed by long-term stretching, and muscle tension decreases, thus accelerating the degenerative changes of the cervical spine.
3, trauma: on the basis of intervertebral disc degeneration, strenuous activities or uncoordinated movements cause cervical spine trauma, which can easily induce cervical spondylosis.
4, congenital cervical spinal stenosis: congenital cervical spinal stenosis due to the small mobility of the spinal nerve in the spinal canal, once the cervical degeneration and hyperplasia occurs, it is easy to produce severe spinal cord compression and occur spinal cord type cervical spondylosis.
5, cold, damp: especially on the basis of intervertebral disc degeneration, affected by cold, damp factors, can cause increased local muscle tension, muscle spasm, increase the pressure on the intervertebral disc, so that the disc protrusion induced cervical spondylosis.
6, pharyngeal inflammation: smoking, tonsillitis or chronic pharyngitis causes edema and exudation of soft tissue around the posterior pharyngeal wall and cervical vertebrae, weakening elasticity and triggering or aggravating cervical spondylosis. In short, the basic cause of cervical spine pathogenesis is the natural aging of intervertebral discs due to ageing. With the accelerated pace of life and work, people are “working hard” from morning to night, working long hours, or using computers, maintaining a single posture, so that the muscles, ligaments, fascia, joint capsule and other soft tissues are under long-term tension, so that the muscles of the neck are fatigued beyond the physiological load, thus accelerating the occurrence of cervical spine disease. . This is also the main reason why cervical spondylosis is getting younger and younger.
Second, clinical symptoms are complex, and the type of diagnosis should be subdivided
The clinical symptoms of cervical spondylosis are complex and diverse, and in clinical work, cervical spondylosis is often divided into the following types in order to facilitate diagnosis and treatment.
1.Neurogenic type: It is the most common type in clinical practice, manifesting as pain or soreness, swelling pain, pins and needles-like or burning pain in the neck, shoulder and back, limitation of neck movement, and upper limbs may have sinking, weakness, numbness, loss of grip strength and muscle atrophy.
2.Spinal cord type: It is the most serious type clinically, manifesting as numbness of upper and lower limbs, muscle weakness, unstable gait and easy to fall, “stepping on cotton”, and even poor urination, difficulty in urination, weakness in defecation, constipation, and tetraplegia.
3.Vertebral artery type: manifested as dizziness, headache, nausea and vomiting, tinnitus, etc., mostly transient or cervical spine in a certain posture, when the head leaves that position, the symptoms can disappear or improve significantly.
4.Sympathetic nerve type: manifested as panic, pharyngeal obstruction, chest tightness and shortness of breath, increased blood pressure and excessive sweating.
5.Cervical cervical spondylosis: Patients often feel that the neck is easily fatigued and cannot read, write, watch TV and movies for a long time; the neck is “tight” and “stiff” after waking up in the morning, and it does not move well or makes noise when moving.
6.Mixed type: The patient has both the clinical manifestations of the above two or more types of cervical spondylosis, but the manifestation of one type is dominant.
Third, there are many conservative treatment methods, and the reasonable choice of them shows the power
The treatment methods of cervical spondylosis can be divided into two categories: non-surgical treatment and surgical treatment. According to statistics, about 90% of cervical spondylosis patients can be cured clinically through non-surgical treatment, and only a few cases need surgery. The following methods can be used according to different conditions.
1.Tui-na massage therapy: It can relieve the tension and spasm of the neck and shoulder muscles, improve local blood circulation, loosen the nerve roots and soft tissue adhesions to relieve the symptoms, which is a more effective measure to treat cervical spondylosis. Tui Na treatment is performed 1-2 times a day. Spinal cord cervical spondylosis is a contraindication to massage because the cervical spinal canal of this type of patient is narrowed and the cushion gap of the spinal cord in the spinal canal is reduced, so improper manipulation may cause immediate paralysis of the patient. Therefore, the spinal cord type cervical spondylosis is better treated by surgery.
2, cervical traction therapy: traction therapy can not only limit the neck activities, but also make the neck muscles fully relax and rest, so that the disordered or dislocated intervertebral joints can be restored to normal, which is one of the effective methods to treat cervical spondylosis. However, spinal cord type cervical spondylosis is a contraindication to traction therapy and in principle should not be used.
3.Physiotherapy: In the treatment of cervical spondylosis, physiotherapy can relieve the tension and spasm of neck and shoulder muscles, improve local blood circulation, and relieve the symptoms by reducing edema of nerve roots and soft tissues. Commonly used physical therapy methods are the following: ion guide method, ultra-short wave method, paraffin therapy, other methods such as fried coarse salt and hot water bags, electric mattress, etc.
4, peri-collar: restrict the activity of the neck in the acute period of cervical spondylosis, which is conducive to the decreasing inflammatory edema of the cervical spine tissue in the acute period, and has better effect on the unstable cervical spine.
5.Acupuncture: select acupuncture points according to meridians and keep acupuncture for better treatment. The treatment can be divided into treatment courses according to the condition.
6.Closure therapy: divided into painful point closure method and acupuncture point closure.
7.Chinese herbal medicine: Chinese medicine such as cervical rehabilitation, root pain leveling, cervical relief particles, etc.
8.Western medicine therapy: (1) anti-inflammatory and pain relieving agent: it can well inhibit the progress of inflammation and relieve pain; (2) muscle relaxant: it has good effect on treating muscle spasm caused by neck and shoulder pain; (3) neurotrophic medicine: it can improve the damaged nerve repair.
Fourth, surgical treatment is not terrible, and safety issues should not be worried
The treatment of patients with cervical spondylosis should first be non-surgical. The majority of patients can be relieved or cured by non-surgical treatment, and only 10% of patients need surgical treatment. These patients are ineffective after regular non-surgical treatment, and the symptoms of nerve root or spinal cord compression are gradually aggravated or recurrent to the extent that they seriously affect work and life. For example: 1. Spinal cord type cervical spondylosis with spinal cord compression symptoms constantly aggravated or suddenly intensified must be treated with surgery as early as possible. Otherwise, with the prolongation of the disease, the compressed nerve degeneration necrosis, resulting in irreversible neurological dysfunction. 2, a small number of neurogenic cervical spondylosis has severe muscle atrophy or severe pain, the use of non-surgical therapy is ineffective for a long time, and the compressed nerve is accurately localized. At present, the technology of surgical treatment for cervical spondylosis is relatively mature, especially the large number of successful clinical surgery cases at home and abroad in the past 30 years have proved the safety and therapeutic effect of surgical treatment. Patients with severe cervical spondylosis should see a spine specialist or orthopedic surgeon at the hospital, do not be afraid of surgery, and delay the best time for treatment and regret for life.
Five, the key to prevention and treatment depends on persistence, work and rest combined with diligent exercise
For middle-aged and elderly friends, after suffering from cervical spondylosis, do not be nervous, should maintain an optimistic spirit, establish the idea of fighting hard with the disease, cooperate with doctors to reduce recurrence, while reading books on cervical spondylosis, using scientific means to prevent and treat the disease: 1.
1, adjust the sitting posture, activities of the neck: To prevent the occurrence of cervical spondylosis, the most important thing is to sit correctly, so that the neck and shoulders relax, maintain the most comfortable and natural posture, do not shrug your head, talk, read books to look at the front. To keep the spine straight. When reading a newspaper or working for about 1 to 2 hours, let the head and neck move around several times, gently and slowly, so as to achieve the maximum range of motion in each direction. So that the cervical joint fatigue is relieved. The head and neck should be moved forward and backward several times.
2, head up to see far, head up to look at the moon: when a long time to see things at close range, especially in a low state, both affect the cervical spine, but also easy to cause vision fatigue. Therefore, whenever the case is too long, should look up into the distance for about half a minute, like “look at the moon”. This can eliminate fatigue, but also conducive to the health of the cervical spine.
3, choose a good pillow, sleep a good sleep: “high pillow hide worry”, the pillow can not be too high, too hard or too low. “Pillow should pillow neck”: sleep not to sleep prone, the neck should be in full contact with the pillow and keep slightly back, do not pillow on the back of the head, so that the cervical spine forward flexion, suspension. Those who are used to lying on their sides should make the pillow the same height as the shoulder.
4, prevent cold and humidity, avoid injury: prevent wind and cold, humidity, avoid the wind and cold attack at midnight, early morning bath. Cervical spondylosis patients often have a close relationship with the wind and cold, humidity and other seasonal climate change. Wind chill causes local vasoconstriction and reduced blood flow rate, which hinders tissue metabolism and blood circulation. Do not blow cold wind on the head and neck in summer, and wear a scarf or a high-collared sweater in winter to prevent wind and cold in the neck. Avoid and reduce acute cervical spine injury, such as avoiding lifting heavy objects, preventing flash and contusion when working or walking.