I. Concept of cervical spondylosis
Cervical spondylosis is a clinical syndrome in which the cervical spine curvature is straightened or reverse flexed, the cervical spine disc is prolapsed, the vertebral body is unstable, the cervical vertebrae are enlarged or the ligaments are thickened, stimulating or compressing the cervical spinal cord, cervical nerves and blood vessels and producing a series of symptoms. The main symptoms are headache, vertigo, nausea, vomiting, panic, insomnia, neck and shoulder pain or upper limb coldness, numbness, weakness, and muscle atrophy. In severe cases, the spasticity and weakness of both lower limbs, difficulty in walking, or even paralysis of all four limbs, urinary and fecal disorders, and paralysis.
Second, the typology and corresponding symptoms
Cervical spondylosis is clinically divided into 5 types: nerve root type, vertebral artery type, sympathetic nerve type, spinal cord type and esophageal compression type.
1.Nerve root type.
Nerve root type cervical spondylosis has the highest incidence among all types, accounting for about 60%. It is characterized by pain in the neck and shoulder, radiating to the upper extremities or to the occipital region, and accompanied by a feeling of numbness. The symptoms are aggravated by neck activity or increased abdominal pressure. The extent of radiating pain varies according to the nerve root under pressure. At the same time, there can be upper limb weakness and numbness of fingers, and when the head or upper limb posture is improper or suddenly hit the affected limb, severe lightning-like sharp pain can occur.
2.Vertebral artery type.
Due to degenerative changes of the hook vertebral joint and subluxation of the atlantoaxial joint, the vertebral artery is compressed and the blood supply to the vertebral basilar artery is impaired, which is mainly manifested as vertigo attacks when the head and neck are moving, especially when the head and neck are rotated. Seizure vertigo is the characteristic of this disease. In severe cases, sudden collapse may occur, but consciousness is generally clear, accompanied by nausea, vomiting, tinnitus or loss of hearing, and black haze in front of the eyes.
3. Sympathetic nerve type.
The stimulation of degenerative changes of cervical discs, compression of sympathetic nerve fibers in the neck, causing a series of reflex symptoms, clinical manifestations of dizziness, blurred vision, tinnitus, tachycardia, panic, chest tightness, shortness of breath, pain in the precordial area, etc. (cervical heart syndrome), easy to mix with cardiovascular disease, should pay attention to differentiation. x-ray film with instability or degeneration, negative vertebral arteriogram.
4. Spinal cord type.
Spinal cord type cervical spondylosis accounts for a small percentage (about 10%). The main manifestations are unstable walking, numbness of the limbs, and difficulty in urination and defecation. Cervical disc herniation, ligamentous hypertrophy and ossification or other causes cause cervical spinal stenosis, spinal cord compression and ischemia, causing spinal cord conduction dysfunction. Some patients start with the onset of the disease in the upper extremity and progress to the lower extremity; some start with the onset of the disease in the lower extremity and progress to the upper extremity. Most of the patients can be relieved by regular conservative treatment and cervical traction, and only a very small number of patients need surgical treatment. The key is early detection and early treatment.
5. Esophageal compression type.
Swallowing with foreign body sensation is very rare in clinical practice. Difficulty in swallowing due to compression of the esophagus by the anterior umbo-like growth of the cervical vertebrae (confirmed by barium examination of the esophagus), etc.
Third, the current status of treatment of cervical spondylosis and acupuncture treatment
1.Oral drug treatment.
It is mainly used for pain relief, local anti-inflammatory and muscle relaxant treatment, and has a clearer efficacy for local soft tissue strain secondary to cervical instability, etc., but it cannot treat cervical spondylosis at its root. For patients with weakness or numbness of the limbs, neurotrophic drugs can also be used to assist in rehabilitation and promote recovery of the compressed nerves.
2. Traction method.
Through the mutual balance between traction and anti-traction, the head and neck are relatively fixed in the physiological curve state, so that the cervical spine curve incorrect phenomenon gradually changes, but its efficacy is limited and only suitable for patients with mild neurogenic cervical spondylosis; and traction is prohibited in the acute period to prevent local inflammation and edema from aggravating.
3.Physiotherapy.
Physiotherapy is the abbreviation of physical therapy. It is the application of natural and artificial physical factors, such as sound, light, electricity, heat, magnetism and other effects on the human body, in order to achieve the purpose of treatment and prevention of disease. However, its effect is also weak and cannot be treated at the root. And often physical therapy is easy to produce burns on the skin. Medium frequency treatment instrument.
4, Chinese medicine acupuncture treatment of cervical spondylosis has a unique curative effect.
Taiyi acupuncture, cervical eight-needle electro-acupuncture therapy, balancing needle therapy, eight-vein rendezvous point therapy and other methods have remarkable efficacy in the treatment of various types of cervical spondylosis. Chinese medicine is applied according to the principle of diagnosis and treatment, and the prescriptions for soothing the tendons and stopping spasm, activating blood circulation and tonifying the kidneys are used for treatment.
Fourth, self-conditioning and precautions
1.Establish the right attitude, master the prevention and treatment of the disease by scientific means, cooperate with the doctor’s treatment and reduce recurrence.
2.Strengthen the exercise of neck and shoulder muscles, do forward flexion, backward extension and rotation of the head and both upper limbs during free time at work, which can relieve fatigue and make the muscles developed and toughness enhanced, thus contributing to the stability of the spine of the neck segment and enhancing the ability of the neck and shoulder to comply with sudden changes in the neck.
3, correct bad posture and habits, avoid high pillow sleep, reading and ambulation work to keep the spine straight. The work should not last for a long time, more than 2 hours of continuous low work, it is difficult to make the high pressure in the cervical intervertebral space in a short period of time to get effective recovery relief, which will aggravate and accelerate the degeneration of the cervical spine.
4, pay attention to the neck and shoulder to keep warm, avoid head and neck weight, avoid excessive fatigue.
5, early and thorough treatment of neck and shoulder, back soft tissue strain, to prevent its development into cervical spondylosis.