I. Cervical spine structure
The spine is often referred to as the “backbone” and plays the role of a pillar in the body. It is composed of a vertebrae, which are connected by about 1,000 ligaments and more than 140 muscles to form a tough spinal column. It is divided into the cervical, thoracic, lumbar, sacral and coccyx vertebrae. There are seven cervical vertebrae, and the task of the cervical vertebrae is to support the head so that a person can raise, lower and turn his or her head.
II. What is cervical spondylosis?
Cervical spondylosis is a series of symptoms caused by degenerative changes in the cervical vertebrae, cervical intervertebral discs and ligaments, resulting in disc protrusion, osteophytes and cervical instability, causing pressure on adjacent tissues and structures such as spinal nerve roots, spinal cord, vertebral artery and sympathetic nerve.
Third, what factors are likely to trigger cervical spondylosis?
1, the age factor: like a machine, with the growth of age, the wear and tear of the human body parts is increasing, the cervical spine will also produce various degenerative changes.
2, chronic strain injury.
(1) poor sleep posture: mainly high pillow, as the saying goes, “no worries about high pillow”, but in fact, high pillow easily lead to cervical strain, accelerating cervical degeneration.
(2) bad habits: long time low head playing mahjong, playing poker, long time leaning on the bed watching TV, etc. are bad habits. The common feature of these habits is that the cervical spine is in a state of flexion for a long time, causing excessive strain on the cervical spine. Some patients with acute aggravation of cervical spondylosis appear after a long time rubbing mahjong.
(3) poor work posture: cervical spine for a long time in a certain position is also prone to cervical spondylosis, such as involving computers, microscopes, carving, embroidery and other staff need to work for a long time with their heads down, and in a flexed neck state, the disc pressure is much higher than the normal position, easy to accelerate the degeneration of the cervical disc.
(4) improper physical exercise: such as acrobats, soccer players, etc. due to long-term strain on the cervical spine, and therefore also prone to cervical spondylosis .
3, trauma: head and neck trauma is likely to induce the production and recurrence of cervical spondylosis, and even combined with fractures and dislocations.
4, cold, moisture: especially on the basis of intervertebral disc degeneration, affected by cold, moisture factors, can cause local muscle tension increases, muscle spasm, increase the pressure on the intervertebral disc, causing damage to the fiber ring.
5, pharyngeal inflammation: When there is acute or chronic inflammation in the throat or neck. Because of the inflammatory edema of the surrounding tissue, it is easy to induce the appearance of cervical spondylosis symptoms.
6, developmental spinal stenosis: spinal stenosis has less cushioning margin for the spinal cord, and is more prone to cervical spondylosis.
7, mental factors: from clinical practice, it is found that bad mood often aggravates cervical spondylosis, and when cervical spondylosis is aggravated or attacked, the patient’s mood is often worse, easily agitated and tantrums.
Fourth, what are the manifestations of cervical spondylosis?
Cervical spondylosis can be classified according to the different areas of pressure as follows
1.Nerve root type: It is most common and mainly manifests as difficulty in neck movement, neck and shoulder pain, weakness of upper limbs, inflexible finger movements, and may be accompanied by headache, dizziness, blurred vision, tinnitus and other manifestations.
2.Spinal cord type: The symptoms are neck and shoulder pain with numbness, weakness or unsteadiness of the limbs, cotton-like sensation, and in severe cases, the symptoms may develop into inability to move the limbs, bed-ridden and unable to urinate and defecate.
3.Vertebral artery type: mainly headache, dizziness, vertigo, and even accidental fall. Sometimes there may be nausea, tinnitus, deafness and blurred vision.
4.Sympathetic type: manifested as migraine, dizziness, nausea, vomiting; blurred vision, tinnitus, deafness, cardiac arrhythmia; abnormal sweating and other manifestations
V. What treatment options are available for cervical spondylosis.
1.Non-surgical treatment
(1) massage and massage therapy: this is the main method of treatment of cervical spondylosis in Chinese medicine, and is also a more effective treatment measure for cervical spondylosis.
(2) cervical spine traction therapy: usually using the occipital jaw cloth belt traction method, there are two kinds of sitting and horizontal, mild patients with intermittent traction, 1-3 times a day, half an hour to an hour each time. In severe cases, continuous traction is feasible, with 6-8 hours of traction per day.
(3) Physical therapy: ultrasound, ultraviolet light or intermittent current or other thermal therapy.
(4) Medication: medication can be chosen to apply some pain relievers, sedatives, vitamins (such as B1, B12,), Chinese herbs, etc., which have certain effect on the relief of symptoms.
(5) Hot and warm compresses: hot towels and hot water bags can be used for local external compresses, the temperature should be maintained at about 50-60℃, 15-20 minutes each time, twice a day. The temperature is too high or too long, can cause peripheral vasodilation and aggravate the symptoms. Acute pain symptoms are not suitable for warm compress treatment.
(6) Bed rest: bed rest can reduce the gravity of the cervical spine and the tension of its surrounding tissues, so that the nerve pressure and reactive edema can be reduced, thus accelerating the relief of symptoms.
(7) Functional exercise: In the acute stage, it is appropriate to rest when the pain symptoms are heavy, and only after the symptoms are reduced and the displaced cervical spine is more stable can the functional exercise of the neck, shoulder and back be started, and the range of neck activities should be smaller when exercising, and the force should not be too violent.
(8) Other: the treatment of cervical spondylosis also has medical measures such as closure therapy, acupuncture, etc. The use of neck brace can limit excessive neck activities and increase the neck support role.
2.Surgical treatment: The purpose is to reduce the compression on the nerve, and the surgical plan is decided according to the source of compression. The compression caused by disc herniation or posterior longitudinal ligament calcification mostly adopts anterior cervical spine surgery, and those with spinal stenosis or multi-segmental lesions can adopt posterior cervical spine surgery to relieve the symptoms. At present, our hospital clinically uses “anterior cervical decompression and internal fixation”.
Sixth, the treatment of the five major misunderstandings
1.Inappropriate repeated traction: cervical traction is one of the more effective methods to treat cervical spondylosis, but inappropriate repeated traction can lead to relaxation of the ligaments attached to the cervical spine, accelerate degenerative lesions and reduce the stability of the cervical spine.
2, repeated blind massage, reset: cervical spondylosis pathogenesis is complex, before doing massage reset treatment must exclude spinal stenosis, serious disc herniation, cervical instability, etc. Spinal cervical spondylosis absolutely prohibit gravity massage and reset, otherwise it is very easy to aggravate the symptoms, and can even lead to paraplegia.
3, do not pay attention to the recovery of cervical physiological bending in the treatment process: blind traction, so that the muscles and ligaments of the neck are in a non-physiological state for a long time, which will cause chronic damage, so attention should be paid to the recovery and maintenance of cervical physiological bending in the treatment process.
4.Exaggerating the effect of surgical or non-surgical treatment methods too unilaterally.
5.Take the prevention of cervical spondylosis lightly. Long-term fixed a posture, easy to cause soft tissue strain on the neck, gradually develop into cervical spondylosis.
Seven, how do we prevent cervical spondylosis in general?
1.Prevention of cervical spondylosis
(1) Read the book about cervical spondylosis and master the prevention and treatment of the disease by scientific means.
(2) Maintain an optimistic spirit, establish the idea of fighting hard against the disease, cooperate with the doctor’s treatment and reduce recurrence.
(3) Strengthen the exercise of neck and shoulder muscles, do forward flexion, backward extension and rotation of the head and upper limbs between jobs or after work, which can not only relieve fatigue, but also develop the muscles and enhance the toughness, thus contributing to the stability of the cervical spine and enhancing the ability of the neck and shoulder to respond to sudden changes in the neck.
(4) Avoid the bad habit of sleeping with a high pillow, which makes the head bend forward and increases the stress of the lower cervical spine, which may accelerate the degeneration of the cervical spine.
(5) Pay attention to the warmth of the neck and shoulders, avoid carrying heavy objects on the head and neck, avoid excessive fatigue, and do not doze off when riding in a car.
(6) Early and thorough treatment of soft tissue strain in the neck, shoulder and back to prevent the development of cervical spondylosis.
(7) Prevent flash and contusion when working or walking.
(8) Long-term ambulatory workers should change their head position regularly and do the exercise of neck and shoulder muscles on time.
(9) Pay attention to the correct posture of the head, neck, shoulders and back, do not shrug your shoulders, talk and read books with a frontal gaze. To keep the spine straight.
2, the choice of beds
Various beds have their own advantages and disadvantages, and with personal residence, climate, living habits, economic status. But from the perspective of cervical spondylosis prevention alone, it is better to choose a bed that is conducive to the stability of the disease and to maintain the balance of the spine. Therefore, it is better to choose a Simmons mattress with elasticity placed on the bed board. It can play an adjusting role with the change of the physiological curve of the spine.
3, the choice of pillow
The pillow is the main tool to maintain the normal position of the head and neck. This “normal” position is to maintain the physiological curve of the head and neck section itself. This weight curve not only ensures the external muscle balance of the cervical spine, but also maintains the physiological anatomical state of the spinal canal. Therefore, an ideal pillow should be in line with the cervical physiological curvature requirements, soft texture, good breathability, low in the middle, high at both ends of the Yuan Bao shape is better. Because this shape can be used in the middle of the depression to maintain the physiological curvature of the cervical spine, can also play a relative braking and fixing effect on the head and neck, can reduce the abnormal activities of the head and neck during sleep.
Secondly, the pillow pistil content selection is also very important, commonly used are.
(1) buckwheat bark: inexpensive, breathable, can always adjust the height of the pillow.
(2) Pu velvet: soft texture, good breathability, can be adjusted at any time the height.
(3) mung bean shell: not only good ventilation, and cool relief, if coupled with the right amount of tea or mint is better, but mainly for summer. Others such as duck feathers are also good, but the price is higher.
Pillow should not be too high or too low, do not “high pillow” to the physiological position is better, generally speaking, the pillow high to 8 ~ 15cm is appropriate, or according to the formula.
(shoulder width – head width) ÷ 2.
Cervical pillow can also play a preventive or therapeutic role.
4, usually can do cervical spine exercise in the office
Eight, cervical spondylosis daily activities guidance
1, the pillow and sleep: the center of the pillow should be slightly concave, the height of 12 ~ 16cm, the neck should be pillowed on the pillow, can not be suspended, so that the head to keep slightly back. Those who are accustomed to side lying position, should make the pillow with shoulder height. When sleeping, do not lie down and read, and do not put your hands above your head for a long time.
2.Avoid over-extension and over-flexion of the neck: Patients with spinal cord cervical spondylosis should avoid over-extension and over-flexion of the neck when washing the face, brushing teeth, drinking water and writing.
3.Some daily activities should be stopped: During the disease, you should stop doing certain activities that over-activate the cervical spine, such as rubbing the glass at high places.