What is cervical spondylosis?
We often encounter this situation in hospital outpatient clinics: a patient in his 30s in front of us has neck pain, and the doctor says it is cervical spondylosis, and then a patient in his 60s behind us has unstable walking and keeps falling, and the doctor also says it is cervical spondylosis. This situation is very common in our clinic, many people will have such a question, saying why these patients appear to be completely unrelated symptoms, but the doctor said it is the same disease, could it be that the doctor is fooling the patient. Whether the doctor is fooling the patient or not, it requires us to clarify the concept of what cervical spondylosis is.
Cervical spondylosis refers to a syndrome in which the natural degeneration of the cervical intervertebral disc is stimulated by exogenous factors such as strain, wind, cold and dampness, throat infection, etc., resulting in imbalance of the dynamic and static balance of the neck, causing involvement of the neck muscles, nerves, spinal cord and blood vessels, resulting in neck and shoulder pain, radiating to the head and occiput or upper extremities, or in severe cases, spasm of both lower extremities, difficulty in walking, resulting in tetraplegia.
It can be seen that the onset of cervical spondylosis is mainly due to natural degeneration, strain, and other diseases, resulting in the instability of the neck, which affects the function of different tissues such as neuromuscles, blood vessels, and spinal cord, and the various manifestations produced can be called cervical spondylosis.
What are the main manifestations of cervical spondylosis?
Then let’s talk about what are the clinical manifestations of cervical spondylosis, because cervical spondylosis is a very complex syndrome, also known as cervical spine syndrome, which is a general term for cervical osteoarthritis, proliferative cervical spondylitis, cervical nerve root syndrome, and cervical disc prolapse, and is a disorder based on degenerative pathological changes of the cervical spine. Therefore, its main clinical manifestations depend on which tissue structures are affected by the disease.
For example, dizziness induced by irritation of the blood vessels in the neck is a common symptom in patients with cervical spondylosis in which the vertebral arteries are affected. Such patients often experience dizziness triggered by changes in position due to extension or rotation of the neck.
If the cervical spondylosis affects the nerves, the patient should exhibit pain and numbness in the neck, shoulders, upper limbs, or muscle atrophy, etc.
If the cervical spine lesion affects the spinal cord, the patient will mainly experience dysfunction of both lower extremities, and the patient will feel unstable walking, shaking, and in severe cases, incontinence.
When the cervical lesion affects the sympathetic nerve, the symptoms are more complex and varied, and the patient may experience panic, chest tightness, difficulty in breathing, stomach pain or recurrent gastrointestinal discomfort, etc.
What are the factors that generally cause cervical spondylosis?
1, acute head and neck trauma. 50% of medullary cervical spondylosis is related to neck trauma. Some patients with cervical spine osteophytes, cervical disc bulge, soft tissue lesions in the spinal canal, etc. make the cervical spinal canal in a narrow critical state, cervical trauma often triggers the symptoms.
2.Chronic neck strain injury. Long-term head and neck in a single posture position, such as prolonged low head work, prone to cervical spondylosis. Bad posture. Such as lying in bed watching TV, reading books, sleeping with a high pillow, etc.; sleeping while riding in a car, poor muscle protection when sleeping, easy to neck injury when braking. Some of the young white-collar workers are lying on the table at noon to doze off crooked neck, etc.. These are bad posture, easy to cause asymmetric contraction of the muscles on both sides of the neck and shoulder, causing the occurrence of strain injury.
3, chronic infection. The main one is pharyngitis, followed by dental caries, periodontitis, otitis media, etc.
4.Sharp contraction of the neck muscles. In some specific cases, such as sneezing, lifting heavy objects, etc. lead to acute contraction of the muscles of the neck, which aggravates the pressure on the intervertebral discs and leads to the stimulation of the surrounding related tissues.
5.Wind, cold and damp factors. The wind, cold and wet factors in the external environment can reduce the body’s tolerance to pain, which can cause muscle spasm, small blood vessel constriction, slow lymphatic flow, soft tissue blood circulation disorders, followed by sterile inflammation. In particular, the stimulation of excessive temperature difference can induce the occurrence of cervical spondylosis.
6.Developmental dysplasia of the cervical spine structure. Congenital small spinal canal, cervical degeneration, etc. are the basis of some cervical spondylosis causes.
Why do some have to take a film and some have to do MRI and some have to do any vascular ultrasound or vertebral arteriogram or mra?
Sometimes some patients often come to the hospital and say, “Doctor, I have cervical spondylosis and I have heard that MRI is more expensive and better, so I ask for a test, but after taking a medical history and examination, I find that a simple x-ray or vascular ultrasound is all that is needed.
So what exactly is the test for cervical spondylosis? It depends on what part of your structural tissue is affected by the onset of your cervical spondylosis. A simple x-ray examination can understand the sorting status between each bone and bone of your cervical spine and evaluate the degree of disc degeneration by observing the distance between each vertebra and the state of hyperplasia, so it is generally enough to do this examination for simple cervical cervical spondylosis; while if the nerve root type of cervical spondylosis usually has hand numbness and arm pain then you should do neuromyography testing of the upper limbs, which can be very objective to evaluate If it is vertebral artery type cervical spondylosis, which is usually characterized by vertigo and headache, we should do intracranial vascular ultrasound, called tcd, which can clearly see the fast or slow blood flow, and we can also do arteriography MRI, called mra, which can clearly show the travel status and blood flow of the vertebral artery. For spinal cord cervical spondylosis, if the patient feels that the lower limbs are mainly dysfunctional, the doctor should do cervical MRI to understand the degree of damage to the spinal cord in the cervical spine.
How should cervical spondylosis be prevented
The prevention of cervical spondylosis should take measures from both etiology and pathogenesis triggers to effectively reduce the incidence and prevent recurrence in cured patients. Cervical spondylosis is a part of the spine and should be prevented from the spine as a whole.
Prevention is one of the most important elements in preventing the development of cervical spondylosis. It is commonly believed that the intervertebral discs of the spine begin to degenerate after development into adulthood. In fact, the degeneration of each disc varies greatly from person to person. In terms of age, the analysis of 100 cervical spine radiographs of asymptomatic cases suggests that disc degeneration and osteophytes increase with age: in the group under 20 years old, 2/20; in the group 20-29 years old, 2/20; in the group 30-39 years old, 4/20; in the group 40-49 years old, and in the group over 50 years old, 16/20. The most opportunities for spinal trauma are found in infancy and adolescence; therefore, prevention of cervical spondylosis should begin in childhood. Strengthening physical exercise to promote strong and powerful peri-vertebral soft tissues will help to enhance the stability of the spine. Pay more attention to the prevention of trauma and correction of poor posture in work and life. In addition to trauma, common triggers of cervical spondylosis include pillow, cold, overexertion, forced posture work, poor posture and other diseases. The causative factors of cervical spondylosis are complex, but in general, they can be divided into internal (internal factors) and external (acute and chronic trauma) causes, which can be mutually beneficial. Endogenous factors are the basis of the disease. Cervical spondylosis is a chronic multiple disease, prevention and early treatment is very important, once the disease develops to the loss of cervical spine stability or serious hyperplasia, will lead to serious consequences, which is the most worried about paralysis, so for this kind of degenerative disease should be early treatment early prevention. The main preventive measures are to change the bad life and work habits, choose the right bed and pillow, avoid trauma to the head and neck and excessive neck activities.
1, prevent acute head, neck and shoulder trauma: head and neck bruises, bruises and whip injuries are prone to cervical spine and its surrounding soft tissue injuries, directly or indirectly cause cervical spondylosis, so should be actively prevented, once it occurs should be timely examination and thorough treatment. Some trauma is not easy to draw attention to, for example, dozing in a car, encounter emergency brake, head suddenly backward, can cause cervical whip injury; someone angry at random to twist the child’s ears, the child in order to defend and acute twist neck, or with a slap strike the child after the head, etc., can cause cervical muscle and its surrounding soft tissue injury; infants and young children’s neck muscles are still underdeveloped, soft neck, such as premature pick up or hold the child’s posture is not Some adolescent sports do not know the essentials or do not pay attention to the preparatory activities before exercise, such as top bull, head stand, forward roll and ride the neck recreation, etc., can cause sports injuries. Prevention of trauma is a powerful measure to prevent degeneration of the spine. Once trauma occurs, in addition to the treatment of soft tissue injuries, but also timely treatment of cervical small joint dislocation to prevent the development of cervical spondylosis.
2, correct the bad posture in life to prevent chronic injury: chronic strain on the soft tissues of the neck and shoulder is the pathological basis for the occurrence of cervical spondylosis, and the bad posture in life is one of the main reasons for the formation of chronic strain, so correcting the bad posture in daily life is of great importance to the prevention of cervical spondylosis. For example, some people like to lie prone, in order to breathe, can only twist the head to the side, which will occur 1 ~ 4 cervical spine sprain. When the cervical axis is scoliotic and reaches a loss of compensation, symptoms such as dizziness, headache and eye, ear, nose and throat will occur. Due to damage to the normal mechanical imbalance of the cervical spine, will accelerate the degeneration of the intervertebral discs of the cervical vertebrae; someone usually posture is still good, but when reading novels, watching TV, the habit of leaning the head on the bed rails or sofa armrests, resulting in flexion of the neck and back twisting waist, etc., which will cause the spine intervertebral ligament damage to the section of the spine instability; women with children to sleep, often facing the child lying on his side, if the pillow does not fit the height of the body, will set the cervicothoracic vertebrae in forced position, the formation of scoliosis, can lead to spondylosis.
Sleeping in a good position is very important for the health of the spine.
Human trunk, shoulders and pelvic part of the transverse diameter is large, when lying on the side, the spine due to the influence of the mattress and bending, if long-term preference for a side lying position, the spine will gradually side-bending, the lighter wake up stiff back discomfort, the need to get up to resume normal activities, the heavier can develop into spondylosis. Sleep should be mainly supine, side lying as a supplement, to alternate between the left and right, side lying left and right knee slightly flexed opposite. Prone, semi-prone, semi-supine or upper and lower body twisting and sleeping are bad sleeping posture, should be corrected in a timely manner. The head should be placed in the center of the pillow to prevent the pillow.
Pillow: Due to chronic injury or degeneration of the cervical spine and soft tissues of the neck caused by the imbalance of the internal and external mechanics of the spine, compression or stimulation of the cervical blood vessels, nerves and spinal cord cause head, neck, shoulder and arm, upper extremity, middle back, chest pain and other symptoms, and even combined with limb dysfunction and a group of clinical syndromes. There are many factors that trigger and aggravate cervical spondylosis, and the pillow used frequently during sleep is one of the important reasons.
For the average person, at least 1/4 to 1/3 time a day is spent in sleep, therefore, if the pillow is not used properly or do not use the pillow, easy to cause or aggravate cervical spondylosis. On the contrary, if you pay attention to and adjust the posture of the cervical spine in sleep, can also have a preventive and therapeutic effect.
Sleep pillow is an important tool to maintain the normal position of the head and neck that is the physiological curvature, this physiological curve is not only a guarantee of the balance of the external muscle groups of the cervical spine, but also to maintain the state of the physiological structure of the cervical spinal canal indispensable conditions. If the pillow is not properly selected and used, it not only destroys the external balance of maintaining the normal curvature of the cervical spine, but also directly affects the size of the volume and the physiological structure of the local tissue in the cervical spinal canal. Therefore, the height of the pillow must be given great attention.
As the saying goes, “no worries about the high pillow”, but it is not true. Under normal circumstances the physiological curve of the cervical spine is convex, supine position, if the pillow is too low, the head and neck excessive backward, so that the convexity curvature increases, not only the muscle and ligament in front of the vertebral body easily due to excessive tension and fatigue, and can cause chronic injury. At the same time, the posterior tissue of the spinal canal can protrude forward into the spinal canal, increasing the pressure in the spinal canal; excessive head and neck tilt also makes the spinal canal is elongated, the spinal cord and nerve roots in the spinal canal relatively short, in the role of other factors are prone to symptoms. If the pillow is too high, the head and neck are excessively flexed forward, so that the muscles and ligaments behind the vertebral body are prone to strain, triggering or aggravating cervical spondylosis.
Both healthy people, or people with cervical spondylosis, should pay attention to maintaining the physiological position of the cervical vertebrae convexity, in order to prevent or accelerate the degeneration of the cervical spine.
Computer health care
1, due to long-term ambulatory workers and long time continuous low head manual operators, their long time low head will destroy the cervical spine physiological curvature, resulting in cervical spine physiological curvature inversion (reverse bending), so it is appropriate to work regularly rest and moderate head training. People engaged in computer operation, the neck is fixed in a posture for a long time, also easy to lead to strain injury of the neck muscles and ligaments, work should also be regular rest and appropriate activities to enhance the blood supply of the neck muscles and ligaments, enhance flexibility, to avoid cumulative strain injury.
2.Strengthen the neck muscles and ligaments
Active exercise of the neck muscles can effectively enhance the stability of the biomechanical structure of the cervical spine, strengthen the normal physiological curvature of the cervical spine, and promote blood and lymph circulation, which can effectively prevent and reduce cervical spondylosis. According to the survey: the chances of cervical spondylosis attacks decreased by 80% in people with developed neck muscles. However, not all exercise is beneficial, blind, wrong exercise may even bring irreversible and fatal consequences, especially for patients who have already developed cervical spine biomechanical structure instability, should not carry out intense such as head shaking, neck forward, left and right swaying, head down and other exercise. The correct exercise method is: sitting or prone position, both upper limbs straight and placed behind, hands crossed (crossed difficulties can also be not crossed), arms efforts to extend back, while doing their best to lift the head (should be slow), the back of the neck muscles and the muscles between the shoulder blades will try to tense, for 10 seconds and then stop and return to normal position, try to relax the tense muscles, rest for 10 seconds and then perform the above exercise again. This exercise should not be performed in the standing position to avoid falling down due to dizziness. Regularly performing this exercise will effectively promote the recovery of the physiological curvature of the cervical spine and strengthen the relevant muscle strength to enhance the stability of the cervical spine. The neck exercise is prohibited for people with special diseases such as cervical tuberculosis, bone tumor and fracture. In addition, breaststroke must keep the head up position, which is also conducive to maintaining the cervical spine physiological curvature, so often recommended by clinicians, however, cervical spine patients should also pay attention to avoid cold, so before entering the pool should do a full preparation exercise, enter the pool immediately after the breaststroke, stop breaststroke should immediately go ashore to dress, to avoid staying in the pool for a long time and feel cold and wet.
Misconception.
Eliminating bone spurs
In the course of cervical spondylosis, intervertebral disc metamorphosis leads to cervical spine instability, causing a series of related symptoms, but on the other hand, the body through the vertebral body bone proliferation (bone spurs) to increase the contact area between the vertebrae, to achieve stability compensation. If the intervertebral discs had only metamorphosed and not proliferated, I am afraid that the cervical joints of many patients would have worn out and become unusable. In this sense, the presence of bone spurs is a protective response for the body and brings benefits to the patient. This is also the basis for doctors’ preference for conservative treatment for most cervical spondylosis patients. There is no scientific basis for the claims made by some drug sellers that a spur can be eliminated by taking a drug orally or applying it externally.
Taking prevention lightly
Cervical spondylosis is caused by an unhealthy lifestyle and is not difficult to prevent. Medically proven risk factors associated with cervical spondylosis include: ambient temperature and humidity, history of smoking, history of acute and chronic pharyngeal infections, high pillows in soft beds, and working with the head down for more than four hours a day on average. Healthy people should shift the focus of prevention forward, especially adolescents and middle-aged people to avoid high-risk factors for the disease, and it is important to do a good job of self-protection.
Walking backwards, doing yoga and massage can help relieve cervical spondylosis.
Inappropriate gravity massage and reset can aggravate the symptoms and even lead to paraplegia; many movements in yoga can harm the cervical spine if the strength is not controlled; and walking backwards increases the risk of cervical spine damage caused by inadvertent falls.