Mr. Wang was an exemplary teacher in a middle school. He had worked hard for 30 years and was highly respected and had numerous students. However, unfortunately, one night six months ago, he accidentally fell heavily, resulting in complete paralysis of his limbs and incontinence of urine and stool.
Perhaps we all find it strange why a mere fall would cause Mr. Wang to be paralyzed. This must start with the chronic neck pain that Mr. Wang had 30 years ago.
Thirty years ago, after graduating from college, Mr. Wang, with full of enthusiasm for his work, boarded his dream three-foot podium and began his career as a teacher. He loved his job and worked for many years, working continuously for hours every day and preparing lessons had become his habit. He soon became an idol for students and a role model for teachers to learn from. He gradually developed a sore neck and painful symptoms due to the heavy workload, and his condition was so severe that he could not sleep at night. In order not to affect his work, he did not spare time to go to the hospital to see a doctor. He endured, endurance is the sign of his tenacity, but also a good way to exercise his will, in this way, he endured pain work for more than 3 years.
One day after 3 years, Mr. Wang felt a little dizzy, especially when he got up and lying in bed vertigo worsened. That’s when he had to go to the hospital. After examination, the doctor diagnosed vertebral artery type cervical spondylosis. After applying cervical collar fixation and bed rest, his dizziness was reduced and he went back to his beloved podium; however, the dizziness never completely disappeared.
One day, 10 years later, Mr. Wang felt numbness and weakness in his left hand, and it was only after repeated persuasion from his wife that he stepped into the hospital door once again. After the orthopedic doctor’s examination and film, he found cervical spine osteophytes and diagnosed cervical spondylosis of the nerve root type, so he started cervical traction treatment. His wife also went to a Chinese medicine clinic to buy her husband herbs to eliminate bone spurs and decocted medicine for him every day. Mr. Wang’s hand numbness gradually reduced.
One day, 25 years later, Mr. Wang found that he had weakness in urination, a feeling of stepping on cotton on the bottom of his feet when walking, a heavy head and light feet, and his whole body was as light as drunkenness. Only after his wife and daughter repeatedly urged him to go to the doctor again. However, this time he was stunned by the doctor’s diagnosis of spinal cord cervical spondylosis. CT and MRI examinations proved that there was a large amount of osteophytes and ligament calcification in Mr. Wang’s cervical spinal canal, and the spinal canal was severely narrowed, and the spinal cord had been compressed and deformed like a candy cane. The doctor recommended him to have surgery as soon as possible. However, due to the fear of the high risk of surgery and the fear of affecting his work, he refused surgical treatment and returned to the lectern.
One day, 30 years later, the unfortunate story at the beginning of our article finally happened, when a mere fall put him in a wheelchair. Although the doctors operated on him in time, he still had not recovered the sensory and motor functions of his limbs for half a year because of the damage and necrosis of his spinal cord, and he was still incontinent.
Many patients with cervical spondylosis have a similar experience to Mr. Wang.
Doctors believe that Mr. Wang’s paralysis is a necessity. Because, like most people, he never did prevention for the disease; because after suffering from a mild type of cervical spondylosis, he never adhered to scientific, standardized and systematic treatment. Together with the fatal weakness of the traditional treatment method for cervical spondylosis itself, he, like many patients and even some doctors, had many misunderstandings in every aspect from prevention, treatment to rehabilitation.
The magpie’s treatment of the untreated disease has become a good story for thousands of years. Prevention of cervical spondylosis is more important than treatment. If Mr. Wang can combine work and rest, actively adjust his life posture and rhythm, and choose the right treatment method, he can effectively prevent the occurrence of cervical spondylosis.
Treatment to improve muscle strength and endurance is the fundamental method to treat cervical spondylosis
In terms of the pathogenesis of cervical spondylosis, the traditional concept has always focused too many eyes on the intervertebral disc, believing that all types of cervical spondylosis are caused by the intervertebral disc; that as long as there is no problem with the intervertebral disc, there is no problem with the cervical spine; and that only when there is a problem with the intervertebral disc, there is a problem with the cervical spine. This concept has been inherited to this day.
Unlike the traditional view, we believe that cervical spondylosis is the result of a multifactorial and multi-pathway synthesis. Tissue structures including muscles, ligaments, intervertebral discs and bone joints are subject to strain and aging, that is, degenerative changes. Moreover, the occurrence and development of the disease is also in line with the same light to heavy, gradual pattern. Therefore, it is incorrect to place all the blame on the intervertebral disc. We should understand cervical spondylosis in an integrated, dynamic and holistic manner.
In the early stages of cervical spondylosis, degeneration of the intervertebral discs may occur, but the more important responsible tissues should be the muscles and ligaments. Due to factors such as prolonged ambulation, sleeping on a high pillow, indulging in computer desk, and strong work pressure, the muscles around the cervical spine will become strained, resulting in a decrease in strength and endurance, which in turn leads to neck pain under the action of inflammatory and pain-causing mechanisms; if the pain does not heal for a long time, cervical cervical spondylosis will be formed. At the same time, the ligaments will be degenerated and relaxed, and the static stability of the bone and joint structure will be reduced, and the physiological curvature of the cervical spine will be lost, and even mild intervertebral instability will occur.
Because the strain of the muscles around the cervical spine, the decrease of muscle strength and endurance is the main mechanism of cervical cervical spondylosis, so only the treatment method to improve muscle strength and endurance is the fundamental method of treatment; if left alone or treated inappropriately, the disease will be prolonged, recurrent and gradually aggravated, leading to the occurrence of other types of cervical spondylosis.
Traditional treatments such as drugs, massage, acupuncture, traction and physiotherapy are all passive treatments, none of which can improve the strength and endurance of the muscles around the patient’s cervical spine, so these treatments can only relieve the symptoms but not the root.
Just as we must eat when we are hungry to replenish our energy, to improve the muscle strength and endurance around the cervical spine, we must allow patients to perform active resistance exercise on their own. We call this treatment “active resistance exercise therapy” and have applied it clinically with satisfactory results.
We emphasize that in order to have a healthy cervical spine, we should prevent cervical spondylosis and nip it in the bud. And to achieve the purpose of preventing and eliminating cervical spondylosis, you must first have healthy muscles. Otherwise, both prevention and treatment amount to empty talk. Why are traditional treatments for cervical spondylosis ineffective? The answer lies in the lack of attention to the strength and endurance of the muscles surrounding the cervical spine.
We can divide all the treatments for cervical spondylosis into two categories, one is the patient’s passive acceptance of the treatment given by the doctor, including drugs, traction, massage, physical therapy and other treatments, collectively known as passive treatment; the second category is the treatment method that allows the patient to take the initiative to exercise, called active treatment. In particular, the treatment method that allows patients to exercise their muscles against certain resistance is called “active resistance exercise therapy”, which belongs to the category of active treatment. Clinical practice proves that long-term active resistance exercise can reshape muscle structure, enhance muscle strength and endurance, and improve muscle movement function, which can fundamentally treat cervical spondylosis, and the method is simple and easy to promote. Active resistance exercise method is an ideal method to prevent cervical spondylosis, and it is also the best treatment method for cervical cervical spondylosis, vertebral artery cervical spondylosis and other types of cervical spondylosis.
If the period of cervical cervical spondylosis is not treated reasonably, it may gradually deteriorate in the direction of vertebral artery type cervical spondylosis, nerve root type cervical spondylosis and spinal cord type cervical spondylosis.
The period of cervical cervical spondylosis is the best time for treatment, and it is completely curable if the exercise of the muscles around the cervical spine is strengthened during this period; if the best time for treatment is lost or improperly treated, cervical cervical spondylosis will occur on the basis of muscle weakness, decreased endurance, ligament strain relaxation and intervertebral disc degeneration, which will stimulate the blood vessels supplying the brain and lead to vertigo and develop into vertebral artery cervical spondylosis. If intervertebral joint loosening and ligament strain damage calcification occur on the basis of muscle strain, weakness, decreased endurance and intervertebral disc degeneration, osteophytes will occur; if the proliferating bone spur occupies the nerve channel and compresses the nerve root, symptoms such as limb numbness and weakness will occur. This is neurogenic cervical spondylosis; if osteophytes and ligament ossification compress the spinal cord, it will produce weakness, sensory impairment, urinary and fecal dysfunction and even paralysis of the limbs, and at this time, it has developed into spinal cervical spondylosis.
It has been proved that many patients with cervical spondylosis regrettably lost the best time for treatment due to their own negligence or unreasonable choice of treatment, and developed into a very serious stage of cervical spondylosis. This is exactly what Mr. Wang experienced.
For vertebral artery type cervical spondylosis, it is most likely to be misdiagnosed as hypertension, Meniere’s syndrome and other diseases. Even after a clear diagnosis, the traditional treatment is to apply cervical collar braking. However, this passive treatment often leads to atrophy of the muscles around our cervical spine, which can make the cervical spine more unstable and make vertigo worse.
Therefore, the traditional passive treatment method still has fatal flaws in the treatment of vertebral artery type cervical spondylosis. Methods such as medication, traction, braking, massage, and physical therapy have been impatiently administered by some physicians, and patients are happy to enjoy these gentle and comfortable services. Undoubtedly, the patient’s muscles will remain weak and the cervical spine will remain unstable, resulting in dizziness for the patient and more “dizziness” for the doctor.
On the contrary, if full attention is paid to the application of active resistance exercise therapy during this period, the muscle strength and endurance around the patient’s cervical spine can be effectively improved, so that the unstable cervical spine tends to be dynamically stable, which is the only way to fundamentally treat vertebral artery cervical spondylosis in a more effective and conservative manner and effectively prevent further development of the disease.
Neurogenic cervical spondylosis is a relatively common cervical spondylosis, and most of the traditional treatments for neurogenic cervical spondylosis also choose drug therapy and cervical traction, which are passive treatments. Among them, cervical traction can reduce nerve compression and relieve the symptoms of limb numbness. However, excessive weight and prolonged traction can make the ligaments more relaxed and the vertebrae more loose from each other, making the disease more prone to recurrence and aggravation. Unfortunately, this type of heavy, prolonged traction therapy is still widely used; in contrast, treatments that can be used to improve muscle strength and endurance are hardly ever used in clinical practice. It is no wonder that patients’ cervical spondylosis has been repeatedly attacked and aggravated. Therefore, clinical practice proves that the traditional methods of treating neurogenic cervical spondylosis still have fatal shortcomings.
Spinal cord cervical spondylosis is one of the most serious cervical spondylosis, which develops on the basis of the above-mentioned types of cervical spondylosis. At this point, the spinal cord is already damaged by compression and must be treated with surgery as early as possible to remove the harmful factors and prevent paralysis from occurring. Of course, surgery is also a passive treatment method. After surgery, muscle function training is still an important part in the rehabilitation of cervical spondylosis, but unfortunately, this part is not taken seriously by patients or even doctors.
Promoting active resistance exercise therapy
We emphasize here that it is time to reconceptualize the pathogenesis of cervical spondylosis and not to neglect the critical and important link of the neck muscles. It is important to recognize that the fatal flaw of passive treatment methods lies in the fundamental failure to improve muscle strength and endurance. We should strongly advocate and promote treatments that can improve muscle strength and endurance —- active resistance exercise therapy. Only preventing muscle strain and improving muscle function is the key to preventing cervical spondylosis. Only by strengthening active resistance exercise and improving muscle strength and endurance can we fundamentally cure cervical cervical spondylosis. Only by strengthening muscle function and improving its dynamic stability can patients with vertebral artery-type cervical spondylosis obtain more satisfactory results; and only then can patients with neurogenic-type cervical spondylosis not have recurrence and aggravation of their disease.
In conclusion, in the traditional treatment methods of cervical spondylosis in the past, passive treatment has been dominant, while active movement treatment has been neglected. Therefore, we call for the prevention, treatment and rehabilitation of cervical spondylosis, we must say goodbye to passive treatment and attach importance to active resistance movement. Only in this way can cervical spondylosis be nipped in the bud, the incidence of cervical spondylosis be reduced, the cure rate of cervical spondylosis be improved, and the incidence of paralysis caused by cervical spondylosis be reduced to a minimum.