Cervical spondylosis is a common disease, and there are many different types of cervical spondylosis, each with its own characteristics and commonalities. So is “neck pain” whiplash? Do all patients with whiplash have “neck pain”? Can whiplash be ruled out if the neck does not hurt? Today we will introduce the clinical manifestations of different cervical spondylosis.
I. “Cervical” cervical spondylosis
The neck is straight and painful, and there may be pain and stiffness in the whole shoulder and back, and the head cannot be nodded, tilted, or turned, and the posture is slanting. When the neck needs to be turned, the trunk must be turned at the same time, and symptoms of dizziness may also appear. A few patients may have reflex shoulder, arm and hand pain, swelling and numbness, and the symptoms do not worsen when coughing or sneezing.
The “cervical” type of cervical spondylosis is not recognized in academic circles because the common clinical cervical muscle strain can also show symptoms such as soreness, pain and stiffness in the neck, and this condition belongs to the category of soft tissue damage and cervical spondylosis, and it is easy to be confused.
Second, nerve root type cervical spondylosis
1. Neck pain and neck stiffness are often the first symptoms to appear. Some patients also have pain in the shoulder and the medial edge of the scapula.
2.Radiation pain or numbness in the upper extremities. The pain or numbness may be episodic or persistent. Sometimes there is a clear relationship between the appearance and relief of symptoms and the position and posture of the patient’s neck. Neck activity, exertion and deep breathing can cause the aggravation of symptoms.
3. The affected upper extremity feels heavy and has reduced grip strength, and sometimes the object is dropped. There may be vasomotor nerve symptoms, such as swelling of the hand. Muscle atrophy may appear in the late stage.
C. Spinal cord type cervical spondylosis
1. Most patients first experience numbness and heaviness in one or both lower extremities, and then gradually experience difficulty in walking, tightness in various groups of muscles in the lower extremities, slow lifting, and inability to walk fast. Then, when going up and down the stairs, it is necessary to hold the handrail with the upper limbs to ascend the steps. In severe cases, the gait is unstable and walking is difficult. Patients have the feeling of stepping on cotton in both feet.
2. Numbness and pain in one or both upper limbs, weakness and inflexibility in both hands, difficulty in completing fine movements such as writing and fastening, and the tendency to drop objects. In severe cases, the patient cannot even eat by himself.
Patients often feel a belt-like binding sensation in the chest, abdomen, or both lower extremities, called “belt sensation”. At the same time, there may be a burning sensation and cold sensation in the lower limbs.
4. Some patients have bladder and rectal dysfunction. Such as weakness in urination, frequent urination and other urination disorders, constipation. Sexual function is reduced.
Sympathetic cervical spondylosis
1. Head symptoms: such as dizziness or vertigo, headache or migraine, occipital pain, poor sleep, memory loss, difficulty concentrating, etc.
2.Eye, ear, nose and throat symptoms: eye swelling, dryness or teariness, blurred vision, etc.; tinnitus, hearing loss; nasal congestion, “allergic rhinitis”, foreign body sensation in the throat, dry mouth, taste changes, etc.
3, gastrointestinal symptoms: nausea and even vomiting, diarrhea, indigestion, etc.
4, cardiovascular symptoms; palpitations, chest tightness, heart rate changes, arrhythmia, blood pressure changes, etc.
5, facial or a limb sweating, no sweating, chills or fever, sometimes feeling pain, numbness but not according to the distribution of nerve segments or travel. The above symptoms are often clearly related to neck activities, aggravated when sitting or standing, and alleviated or disappeared when lying down.
V. Vertebral artery type cervical spondylosis
1. Episodic vertigo, diplopia with nystagmus. Sometimes accompanied by nausea, vomiting, tinnitus, etc. These symptoms are related to the change of neck position.
2. Sudden weakness of lower limbs and sudden collapse, but consciousness, mostly occurs when the head and neck are in a certain position.
3. Occasionally, there is numbness and abnormal sensation in the limbs. Transient paralysis and episodic coma may occur.
The above are the different clinical manifestations of each type of cervical spondylosis, now we go back to the initial question at the beginning of the article, we can see that it is possible to have cervical spondylosis with “neck pain”, but it is also possible to have other symptoms without “neck pain”, so “Not all patients with cervical spondylosis will have “neck pain”, and if the neck does not hurt, cervical spondylosis cannot be ruled out!