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Abstract: Patient Zhang, 35 years old, came to our hospital with symptoms of “persistent neck pain, stiffness, and limitation of movement” and was diagnosed with cervical disc degeneration after cervical spine MRI. According to the patient’s specific condition, comprehensive conservative treatment was recommended, and after a period of time, the patient’s clinical symptoms such as cervical pain and stiffness were significantly reduced, and the range of motion of the cervical spine was gradually restored.
Basic information】Male, 35 years old
Disease Type】Cervical disc degeneration
Hospital】Harbin First Hospital
Consultation time】April 2022
Treatment plan】Comprehensive conservative treatment (cervical brace fixation + bed rest + microwave therapy + massage therapy + oral ibuprofen extended-release capsule + cervical muscle exercise)
Treatment period】2 weeks of inpatient treatment and home cervical muscle exercise
Treatment effect】The patient’s cervical pain and stiffness were significantly reduced, and the range of motion of the cervical spine was gradually restored.
I. Initial consultation
The patient, Mr. Zhang, has been working at a desk for a long time. Recently, he has been busy and under great pressure, and he has been experiencing neck pain, stiffness, and restricted movement, intermittently manifesting as numbness of the upper limbs, but the muscle strength of the upper limbs remains normal. The main reason for the above symptoms was the straightening of the cervical spine curvature and the release of inflammatory factors from the cervical intervertebral discs to stimulate the nerves. After detailed communication with the patient according to his specific condition, the patient expressed his willingness to be admitted to the hospital for treatment.
II. Treatment process
Since the patient’s clinical symptoms were mainly neck pain and neck stiffness, he did not have spinal nerve compression symptoms such as limb weakness and severe urinary and fecal dysfunction, and his condition was not serious. Therefore, after communicating with the patient, the patient agreed to comprehensive conservative treatment. During the acute stage, the patient’s cervical spine movement was restricted, and he was immobilized with a cervical brace. He was hospitalized for 2 weeks with bed rest and assisted with microwave therapy and massage therapy to relax the neck muscles and promote the recovery of the physiological curvature of the cervical spine. At the same time, oral ibuprofen extended-release capsules were administered to eliminate the neuroinflammatory response and reduce pain symptoms. After the acute period, under the guidance of the rehabilitation doctor, daily cervical muscle exercises, such as resistance cervical extension and forward flexion training, were insisted on to improve the stability of the cervical spine.
III. Treatment effect
After 2 weeks of comprehensive conservative treatment, the patient’s symptoms of cervical pain and stiffness were significantly reduced, and he was able to complete multi-directional movements such as cervical flexion and extension activities and rotation activities, and the symptoms of cervical strain gradually disappeared, the cervical curvature gradually recovered, the strength of the neck muscles increased, and the stability of the cervical spine was improved. The patient was instructed to carry out cervical muscle exercises at home after discharge.
IV. Notes
The patient’s discomfort gradually disappeared, and as a doctor, we are truly happy for the patient. In daily life, the patient should pay attention to protecting the cervical spine, avoiding long-term low work, playing with cell phones and other bad habits; maintain a reasonable sleeping posture and adjust the pillow height when sleeping; after maintaining a posture for a long time, pay attention to moving the neck regularly so that the neck muscles can get rest, so as not to overwork the neck muscles and cause changes in the cervical curvature. In addition, prepare activities before activities to avoid cervical spine injury. If discomfort symptoms such as pain and numbness appear again in the neck, pay attention to timely return to the hospital for a review to confirm the degree of lesion development so as not to delay treatment.
V. Personal insight
Cervical disc degeneration occurred in this patient mainly due to long-term ambulation, and the age factor also contributes to the accelerated rate of cervical disc degeneration. Therefore, conservative treatment can help patients relieve symptoms in the short term, but whether the condition can remain stable in the long term requires patients to strengthen cervical spine maintenance when living and working. If properly maintained, cervical disc degeneration will slow down significantly; if not, fracture of the annulus fibrosus and nerve compression by cervical disc herniation may occur, eventually leading to serious consequences such as weakness of limbs, difficulty in walking and urinary and fecal dysfunction.