In Ayurveda, neck pain is known as Grivastambha. Stiffness or rigidity is caused by aggravated Vata Dosha, the ‘biological air’, in the neck. It is commonly known as a ‘stiff neck’. Cervical spondylosis, according to modern concept, is a degenerative disorder.
Incidence in India compared to worldwide
Job related mechanical exposure in both sexes, and psychosocial factors in women, seem independent of each other to play a part in the development of shoulder and neck pain in vocationally active people. The effect of psychosocial factors was more prominent in women, which could be the result of biological factors as well as gender issues.
- An intervertebral disc may be degenerating,
- Constantly watching a far object for a long period of time,
- Heavy exercise to the neck and shoulder,
- Incorrect sleeping and sitting posture.
- Lifting heavy objects on the shoulders or on the head.
- Regular day sleeps,
- The bones, ligaments or joints may be damaged,
- The large nerve roots in the neck that go to the legs may be irritated,
- The large paired neck muscles may be strained,
- The smaller nerves that supply the neck may be irritated.
Signs and Symptoms
In cervical spondylosis pain is presented in two forms:
- Confined to neck only (upper cervical).
- Radiating to the arms (lower cervical).
- In the chronic phase, the patient complains of pain which may be worse at night and after neck movement.
- Morning stiffness is a characteristic feature.
- The disease is exaggerated in cold weather.
- There may be tingling and numbness along the arms. This is due to compression of the nerves by protrusion of the disc.
- Vertigo is common.
- X-rays can reveal spurs on the vertebra in the spine, any thickening of the joints, which connect each vertebrae to another, and can reveal if there is any narrowing of the spaces between the intervertebral discs.
- CT scan of the spine can view and diagnose spinal stenosis, which is the narrowing of the spinal canal.
- MRI scans are best for visualising the intervertebral discs and assessing the extent of disc herniation. The MRI can also visualise all aspects of the spine: the vertebrae, the ligaments, the facet joints, and the nerves.
- Electrodiagnostics: NCV or Nerve Conduction Velocity study or EMG – Electromyography are also used at times to diagnose shoulder, neck, and arm pain and tingling and numbness.
Allopathic Treatment & Side Effects
There is no solution in Allopathic system of medicine to reverse the process of spondylosis as it is a degenerative process. The basic treatment of spondylosis is aimed the treating neck-pain and back-pain which are due to spondylosis. Hence, the treatment of spondylosis is similar to the treatment neck-pain and back-pain.
Available treatments fall into several categories:
- adjunctive therapies (chiropractics and acupuncture),
- minimally invasive procedures such as injections,
- physical therapy,
- self-care exercise,
- Extension ad flexion exercises are recommended.
- For weakness and paresthesias in the arms, Ekangveer Rasa, one tablet, twice a day is given for seven days.
- Gentle massage with Vishagarbha taila is helpful in reducing morning stiffness.
- Mahayograja guggul is the drug of choice of treatment of cervical spondylosis. Two tablets, twice a day, are recommended with hot water.
- Treatment is best by immobilisation of the neck in flexion in a cervical collar.
Ayurveda Clinical Studies
- A preliminary study was conducted on 22 patients diagnosed with Greeva stambha vis-a-vis cervical spondylosis, satisfying the inclusion criteria. Maha Yogaraj Guggulu 500 mg twice-a-day, along with Panchguna taila (for local massage) and Nadi sweda (hot fomentation with decoction of Dashmoola) were prescribed for 7 days. The results were analyzed on the basis of symptomatic improvement using visual analog scale. Improvement was observed in the majority of the symptoms of Greeva stambha vis-a-vis cervical spondylosis, as indicated by a reduction in swelling and spasm provided.
- A study was performed on 10 diagnosed patients of cervical spondylosis on the basis of pathology, and radiology findings. Patients were given Griva Vasti with Dashmoola Taila for a span of 35-45 min duration, for fourteen days. Assessments were analysed on the basis of the neck disability index prior and after the treatment. Statistical analysis was performed with the help of Instat GraphPad 3 using Wilcoxon matched-pairs signed rank test. Relief in neck disability index upto an extent of 65.70%, which was statistically significant (P < 0.01).
- An experimental work was designed to study the efficacy of Nasya in reducing clinical symptoms of cervical spondylosis. Total duration of nasya treatment was twenty-one days. The protocol for the first fourteen days was similar in both the groups (Rooksha Sveda for seven days followed by Patra Pottali Sveda for seven days). During this regimen, 90 ml of Gandharvahastadi Kashaya twice-a-day and Guggulu Tiktaka Kashaya once-a day was administered internally. The study proved that efficacy of the conventional management along with Nasya than conventional treatment alone in reducing the clinical symptoms of cervical spondylosis.
- In all the three groups, nasal administration of Karpasasthyadi proved to be highly efficacious in reducing the clinical symptoms of cervical spondylosis. When compared, it was also statistically proved that nasal administration along with physiotherapy was more effective than either nasal administration or physiotherapy alone in reducing clinical symptoms of cervical spondylosis
- Katyal BS, Kumar A, Makhija R, Devalla RB. Clinical observation on Greeva Stambha (cervical spondylosis) Chikitsa. Ayu 2010; 31(2): 218–222.
- Pandey YK, Shalini, Sharma AK. Effect of Griva Vasti in management of Gr?v? Asthi Sandhi Gata V?ta (Cervical Spondylosis). Anc Sci Life 2013;33(1):71-5.
- Radhika C, Kumar GV, Mihirjan K. A randomized controlled clinical trial to assess the efficacy of Nasya in reducing the signs and symptoms of cervical spondylosis. Ayu 2012; 33(1):73-7.
- Ahmad A et al. The Effect of Karpasasthyadi Taila Nasya, Physiotherapy in Cervical Spondylosis. J. Ayur. Pharma Research 2015;3(3):23-30.