Due to incomplete understanding of cervical spondylosis, most people only think of cervical spondylosis when they have symptoms such as stiff neck and shoulder pain, but some patients also present with symptoms such as increased or decreased blood pressure, angina pectoris, changes in heart rhythm, reduced visual field, hearing impairment, and breast pain. These symptoms are sometimes referred to as “cervical blood pressure abnormalities” and “cervical angina”, making the clinical manifestations of cervical spondylosis, which are already complex and diverse, even more confusing, and even many doctors can be confused by the “cunning” symptoms of cervical spondylosis. Many doctors may be fooled by the “cunning” symptoms of cervical spondylosis.
So what other symptoms should be thought of as possible cervical spondylosis?
I. Vision loss
Cervical spondylosis can be manifested as vision loss, intermittent blurred vision, swelling and pain in one or both eyes, photophobia, lacrimation, or even a narrowing of the visual field and a sharp decrease in vision, and blindness can occur in individual patients, but most of them are accompanied by other symptoms of cervical spondylosis, such as neck and shoulder pain and limited neck movement. It is advisable to exclude cervical spine problems when the above-mentioned eye symptoms occur without detecting eye problems.
Second, hypertension or hypotension
Some hypertension is triggered by cervical spondylosis, also known as cervical hypertension. When the lower and middle cervical vertebrae are misaligned, the carotid sinus is stimulated, causing a sudden rise in blood pressure (e.g., when waking up, when lowering the head), but sometimes dropping below the normal blood pressure value. Patients with cervical hypertension have no organic lesions of blood vessels, heart, brain and kidney, and are often accompanied by neck pain and numbness in the upper limbs.
Third, chest pain or arrhythmia
Irritation of the nerve roots in the back of the neck can trigger angina symptoms such as pain in the precordial region, chest tightness and shortness of breath, as well as tachycardia or bradycardia. It is often misdiagnosed when the patient’s neck symptoms are not obvious but the cardiovascular symptoms are more severe. Unlike coronary artery disease, suspected angina symptoms in patients with cervical spondylosis mostly occur after working with the head down for too long, sudden head twisting or head shaking, and patients also feel restricted neck movement and cervical spine with pressure pain.
Cerebral arteriosclerosis or cerebellar disorders
As a result of the hyperplastic change of the cervical spine compressing the vertebral artery and causing impaired blood supply to the basilar artery, the patient may fall due to sudden head twisting and loss of body support during walking, accompanied by severe vertigo or headache, nausea, vomiting, sweating and other symptoms. However, unlike cerebral arteriosclerosis, patients with cervical spondylosis will wake up and stand up soon after the onset of fall due to the change of neck position, without coma and without sequelae. Patients can have their brain MRI and cervical spine MRI checked at the same time when they visit the clinic.
V. Lower limb paralysis or defecation disorder
Due to the stimulation or compression of the lateral bundle of the vertebrae, the lower limbs are impaired in movement and sensation, and patients may experience numbness, pain, and limpness in the lower limbs. After excluding cerebrovascular lesions by head CT, the possibility of cervical spondylosis should be considered.
These specific symptoms of cervical spondylosis are often closely related to the pathological changes of cervical spondylosis. Blood pressure abnormalities are often caused by sympathetic nerve stimulation; angina pectoris is caused by cervical spondylosis stimulating the cardiac sympathetic nerve or involving the 4th cervical nerve root innervating the transverse brain and pericardium; visual impairment is related to autonomic dysfunction and insufficient blood supply to the basilar artery caused by cervical spondylosis; breast pain is caused by involvement of the innervated nerve. However, these symptoms can sometimes be caused by a variety of other conditions, so when considering whether they are caused by cervical spondylosis, we must first analyze and identify them repeatedly after a thorough and detailed medical history, physical examination and the necessary auxiliary tests.
For patients, if these symptoms appear and conventional treatment is not effective, they should be alert to cervical spondylosis.
(l) Hypertension that is ineffective with antihypertensive drugs.
(2) Angina pectoris with a normal electrocardiogram.
(3) Vision loss for which no cause can be found in ophthalmology, etc.
(4) Swallowing disorders that cannot be explained by other causes.
(5) Intractable breast pain.
(6) Speech, hearing and tongue extension disorders with no apparent cause.
(8) Vertigo of unidentified etiology.
(9) Certain gastric and duodenal ulcers and cholecystitis, etc.
(10) Certain dysmenorrhea, individual schizophrenia.
(11) Others such as insomnia, asthma, urinary disorders, constipation, etc.