Cervical spondylosis is a major killer that leads to paralysis. Many people unknowingly suffer from cervical spondylosis, and unknowingly gradually aggravate it, and when they have to go to the hospital for treatment, it is difficult to curb the recurrence and deterioration of the disease, although they go around to the doctor. Why is this? Many people think deeply about it and cannot understand. This article believes that there are four major reasons for the relapse or deterioration of cervical spondylosis patients.
First, excessive attention to the intervertebral disc, ignoring other factors
The traditional view is that the corresponding symptoms and signs caused by the involvement of adjacent tissues (spinal cord, nerves, vertebral artery, sympathetic nerve) due to degenerative changes of the cervical intervertebral disc and its secondary degenerative changes of the intervertebral joints are called cervical spondylosis. This definition states that the intervertebral disc is the culprit of cervical spondylosis. Under the influence of this thinking, the diagnosis, prevention and treatment of cervical spondylosis are focused on the intervertebral discs. It is believed that cervical spondylosis originates from disc degeneration and there is an inevitable causal relationship between disc degeneration and cervical spondylosis; disc degeneration is a prerequisite that must be present for the diagnosis of cervical spondylosis.
Under the guidance of the above theory, many people believe that the cervical spine is healthy when there is no problem with the intervertebral disc and does not need prevention and treatment; the prevention of cervical spondylosis is also mostly limited to the adjustment of posture to prevent disc degeneration. Many people do not pay attention to cervical disc degeneration and secondary osteophytes until they find out that they have them, not knowing that cervical spondylosis at this stage is already heavy and prevention is already relatively late.
The structure of the cervical spine is very complex, with skin and muscles outside, ligaments, bone and synovial joints inside; the joints are further composed of joint capsule, synovium, articular cartilage, etc. The intervertebral discs are located between the bone and the bone, and in concert with the posterior synovial joints play the role of intervertebral joints, forming the motor unit. We can compare the human cervical spine to a cable-stayed bridge, with the bone and intervertebral discs acting as the pile base of the bridge and the surrounding muscles as the cable-stayed cables of the bridge. Problems with any of the cables and piles will lead to instability of the bridge; among the various tissues of the cervical spine, such as bones, joints, ligaments, intervertebral discs and muscles, degenerative changes in any of them will affect the stability of the cervical spine.
Therefore, cervical spondylosis is a degenerative disease of the cervical spine that occurs under the intervention of multiple factors, with the participation of multiple tissues and through a combination of pathways. Its pathogenesis includes both internal and external causes. Internal causes include genetic factors, mental factors, etc.; external causes include the effects of poor lifestyle and poor posture, and the effects of trauma and infection. Degeneration of any one of the discs, muscles, ligaments, bones, joints and other tissues will lead to or aggravate the degeneration of other tissues, forming an intricate situation that leads to the occurrence of cervical spondylosis. Disc degeneration is only an important part of cervical spondylosis, but not the only part.
In recent years, with the development of medicine, other tissues other than the intervertebral discs have received more and more attention, and many experts have conducted in-depth studies on the role of the muscles around the cervical spine and concluded that muscle strain and degeneration are the first to occur in the early stages of cervical spondylosis, followed by degeneration of the intervertebral discs. Therefore, muscular cervical spondylosis (also called cervical cervical spondylosis) is listed as a separate type. Despite this, the importance of the muscles has not been taken seriously by most people. Regarding the treatment of cervical cervical spondylosis, passive therapy is still predominant in China, and few people apply active resistance exercise therapy that can improve the strength and endurance of the muscles for treatment.
The authors’ study proved that the muscles around the cervical spine are the first tissues involved in cervical spondylosis. A controlled study of a normal group versus a group with chronic neck pain showed that patients with chronic neck pain had significantly reduced muscle strength and endurance in the collar and back muscles and experienced significant muscle atrophy, increased muscle gaps, decreased CT values, muscle gaps, and a large infiltration of adipose tissue in the muscle tissue. After treatment with active resistance exercise therapy, the patient’s strength and endurance of the collar and back muscles improved significantly, pain was significantly relieved, and active resistance exercise therapy achieved significant long-term results compared to the traditional passive treatment group.
In summary, the overemphasis on the intervertebral disc and neglect of the role of the muscles, which allows the disease to progress to the point of disc degeneration before attention is drawn to it, is the main reason why the mildest type of cervical spondylosis (muscular cervical spondylosis) cannot be prevented and effectively treated; the muscles are similarly underappreciated in the treatment of other types of cervical spondylosis. Weakness and poor endurance of the muscles around the cervical vertebrae continue to be unimproved as an important reason for the recurrence and deterioration of cervical spondylosis.
Second, it is difficult to stop the development of the disease with only symptomatic treatment
According to traditional theory, cervical spondylosis is divided into different types such as cervical type, nerve root type, vertebral artery type, sympathetic type, spinal cord type and mixed type. Many people are accustomed to mechanically equate their cervical spondylosis with a certain type in the book, but simply cannot see the relationship between the types and the relationship between the past, present and future of this disease. I do not know that the occurrence of cervical spondylosis is a process that endangers different tissues and produces different symptoms from mild to severe.
Cervical cervical spondylosis is the earliest type of cervical spondylosis, with long-term chronic neck pain as the main manifestation; muscle strain, weakness and decreased endurance as the main causes; mild disturbance of the stability of the cervical spine; and reduction or disappearance of the physiological curvature of the cervical spine. At this stage, the main diseased tissue lies in the muscles, and there is no significant degeneration of the intervertebral discs.
If the disease continues to develop, the disc degeneration increases, the cervical instability increases, further endangering the vertebral artery and leading to vertigo, then vertebral artery cervical spondylosis is formed; if the sympathetic nerve is further endangered and the vegetative nerve function is disturbed, then sympathetic cervical spondylosis is formed; if the cervical instability and compensatory osteophytes compress the nerve roots and make the upper limbs numb, then nerve root cervical spondylosis is formed; if the spinal cord is compressed and the limbs are numb and weak If the spinal cord is compressed, causing numbness and weakness of the limbs and urinary and fecal dysfunction, cervical spondylosis is formed.
In short, cervical spondylosis gradually involves muscles, intervertebral discs, intervertebral joints, vertebral arteries, nerve roots and spinal cord from mild to severe, and is a process of gradual loss of stability and compensation.
The ideal is not to suffer from any cervical spondylosis; even if you suffer from cervical cervical spondylosis, it is better to eliminate it in this state so that it does not develop into vertebral artery type, sympathetic type or neurogenic type cervical spondylosis; those who have already suffered from vertebral artery type, sympathetic type cervical spondylosis or neurogenic type cervical spondylosis must be treated actively and scientifically to prevent the development of spinal cord type cervical spondylosis.
Unfortunately, many people do not look at cervical spondylosis from a developmental point of view, but look at the above-mentioned symptoms in isolation and apply only symptomatic treatment without taking any measures to prevent further development of cervical spondylosis. In fact, the disappearance of a symptom does not mean that the disease is cured; on the contrary, after the disappearance of one symptom and before the arrival of the next symptom, it is precisely the developmental stage of the disease. Muscle weakness and decreased endurance are among the main factors that promote the development of cervical spondylosis, and as long as this factor persists, cervical spondylosis will recur or worsen.
In short, the use of symptomatic treatment alone is tantamount to “treating the head when the head aches and treating the foot when the foot hurts”, and it is difficult to inhibit the development of the disease. In recent years, the surgical treatment of cervical spondylosis has made great progress, while conservative treatment has been stuck in this “allopathic treatment” stage, so you can imagine that the result is definitely the recurrence and gradual deterioration of cervical spondylosis.
Third, ignore early treatment and miss the good opportunity for treatment
Chinese medicine attaches great importance to the treatment of untreated diseases, but in the treatment of cervical spondylosis, we should indeed do a profound review. The period of cervical cervical spondylosis is the easiest period to treat and is the golden period of cervical spondylosis treatment, and we can completely eliminate cervical spondylosis in this budding state. Since muscle strain, weakness and decreased endurance are its main causes, only treatment to improve muscle strength and endurance can fundamentally reverse the pathological mechanism of cervical cervical spondylosis and cure cervical spondylosis. However, unfortunately, most people do not pay enough attention to this, but take a laissez-faire attitude; some people only accept traditional passive treatment methods even if they are treated; these methods do not effectively improve the muscle strength and endurance around the cervical spine, but can only relieve the symptoms. It is not known that although the pain is temporarily relieved, muscle weakness still exists, and naturally, recurrence and aggravation of the disease is difficult to avoid.
Therefore, missing the opportunity to cure the mildest type of cervical spondylosis is the main reason for the recurrence and aggravation of cervical spondylosis.
Fourth, favoring passive treatment, the factor of disease recurrence and aggravation persists
The current conservative treatment methods for cervical spondylosis are divided into two categories: passive treatment and active treatment. Among them, passive treatment is that the patient passively accepts the doctor’s treatment of medicine, traction, massage, physiotherapy, acupuncture and braking, etc. Most of the traditional treatment methods in the past belong to passive treatment. These methods are suitable for the treatment of cervical spondylosis in the acute phase to relieve symptoms, especially for pain and vertigo, and have good short-term effects. However, these passive treatments do not improve the stability of the cervical spine. If only passive treatment is received, the patient’s condition is sure to recur and gradually worsen.
Active treatment mainly refers to the patient’s active movement exercise for cervical spondylosis. Active exercise therapy can be divided into active resistance exercise therapy and active non-resistance exercise therapy according to whether it is resistant or not. Active resistance exercise therapy is a treatment method that allows the patient to perform functional muscle exercises against a certain resistance. The authors invented a special device for this treatment method, which has been produced by Qingyang Shengkang Rehabilitation Products Factory and used in clinical practice for six years. Clinical practice has proved that active resistance exercise with special equipment can reshape muscle structure, enhance muscle strength and endurance, and improve muscle motor function. Active resistance exercise therapy is most suitable for the treatment of cervical cervical spondylosis, vertebral artery cervical spondylosis and sympathetic cervical spondylosis, and is also suitable for the adjuvant treatment of neurogenic cervical spondylosis, and is also a more ideal method for patients who need rehabilitation after surgery. Active non-resistance exercise therapy, including our common fitness gymnastics, is good for relieving fatigue and maintaining normal joint mobility, but is far less effective than active resistance exercise therapy for enhancing muscle strength and endurance.
V. Conclusion
In the past, we have focused too much on the intervertebral discs and ignored the role of muscles in cervical spine health; treatment methods have mostly used passive treatment for symptoms rather than active treatment to improve muscle strength; so that most patients in the period of muscular cervical spondylosis have lost the best time for treatment; because of the persistence of the factor of muscle weakness and poor endurance, it also makes cervical spondylosis recurrent and gradually deteriorate. Therefore, we must go beyond the circle of “intervertebral disc” and have a comprehensive understanding of the pathogenesis of cervical spondylosis; we must avoid looking at a certain type of cervical spondylosis in isolation and fully recognize the organic connection between various types of cervical spondylosis; we must realize that the temporary disappearance of a certain symptom is not equal to the cure of the disease, but may be the latent period of a more serious type of cervical spondylosis. We must recognize that the temporary disappearance of a symptom is not a cure, but may be the latent period of a more serious type of cervical spondylosis; the reestablishment of muscle balance, spinal stability and the release of the risk of important tissue involvement are reliable criteria for curing cervical spondylosis.