Spotlight on Cervical Spondylosis – All You Need to Know About Neck Pain

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Cervical spondylosis is a degenerative disorder of cervical spine and cartilage, leading to the compression of spinal nerves. It is also named as cervical osteoarthritis.

Prevalence of Cervical Spondylosis

The prevalence of cervical spondylosis is same in both the sexes, although the degree of severity is more for males.

  • Cervical spondylosis progresses with advancement in age, incidence is more at the age of 50-60 years.
  • Those who have history of trauma in the cervical region.
  • People who carried more weight on their shoulders or heads, it includes laptop bags also.
  • Dancers who involve in repeated twisting and bending.
  • Using computers for prolonged duration.
  • Sitting in improper postures while watching TV, working on laptop or desktop.
  • Driving daily for very long duration.
  • Being overweight and inactive.
  • Repetitive stress in the cervical region due to profession or strenuous exercises.
  • Spondylosis runs in genes. You may have more chance of getting cervical spondylosis, if your parents are suffering with it.
  • Those who have osteoporosis. Minor fracture of spine may occur due to osteoporosis leading to spondylosis.
  • Past history of neck or spine surgery.

 

Causes of Cervical Spondylosis

 

  • Intervertebral disk herniation – Bulging of the disks causes compression on the spinal cord and nerve roots.
  • Disk degeneration – Wear and tear causes dehydration in the disks leading to more bone to bone contact between the vertebrae.
  • Bone spur – Disk degeneration also causes extra growth of bones in abnormal position, pinching the nerves and spinal cord.
  • Stiffness in ligaments – Makes the neck less flexible.

 

Symptoms of Cervical Spondylosis

 

  • Pain- Localised pain in neck, shoulder region or radiating pain from neck till fingers. Pain during coughing, sneezing or laughing.
  • Stiffness- unable to turn the head or bend the neck.
  • Abnormal sensation- Tingling sensation or numbness or feeling of heaviness or pins and needles in upper limbs.
  • Difficulty in gross and fine movements of hands. You may find difficulty in buttoning shirt, etc.
  • Loss of coordination and difficulty in walking.
  • Weakness of arms, hands.
  • Vertigo- Feeling giddy, loss of balance.
  • Muscle spasms.
  • Headache.
  • Abnormal reflexes.
  • Abnormal or clicking sounds while attempting neck movements.

 

Diagnosis of Cervical Spondylosis

 

  • Your physician may do physical examination for neck movements, muscle strength, reflex tests.
  • Neck X-ray and CT scan provides detail information of the cervical bones
  • MRI and myelography specifies the involvement of nerve roots.

 

Management of Cervical Spondylosis

 

  • Bed rest helps to ease pain by reducing the stress in cervical region.
  • Mechanical Traction- It does cervical immobilisation and widening of foraminal space, which minimises the pain.
  • Immobilisation of cervical region- Using cervical collar or braces limits the movement of cervical spine thus reduces nerve irritation.
  • NSAIDs ( Nonsteroidal anti-inflammatory drugs)- reduces pain and inflammation.
  • Muscle relaxants- reduce muscle spasms.
  • Opioids, steroids are administered in moderate-severe pain.
  • Low power laser, diathermy, cold and heat application may help to minimize the pain.
  • Surgery-may also be recommended if you have persistent pain that fails to respond to other treatments.

 

Limitations of Modern Treatment Modalities

 

  • Traction gives only temporary and minimal pain relief.
  • Cervical collar or braces should be worn for whole day, which causes discomfort, reduction in muscle tone leading to neck stiffness.
  • NSAIDs cause adverse effects such as gastritis, renal toxicity, hypertension, liver abnormalities, and bleeding.
  • Opioids may lead to addiction and mood disorders.
  • Muscle relaxants are sedatives that can make you feel dizzy and drowsy.
  • Surgery often doesn’t lead to a complete cure. It may only be able to prevent symptoms from getting worse.
  • Surgery leads to complications like paralysis, nerve damage causing permanent numbness, difficulty in swallowing, hoarseness of voice.

 

Ayurvedic Treatment for Cervical Spondylosis

In Ayurveda, cervical spondylosis is included under Greeva graha, Manya Stambha and apabahuka. Treatment varies according to the stage of disease, chronicity, age of patient, etc. Ayurveda gives you long lasting promising results without any side effects.

Internal Medicines:

Following are the internal medicines you can take to reduce pain, strengthen muscles and nerve roots-

  • Guggulus – Yogaraja guggulu, Trayodashang guggulu, Maha Yogaraja guggulu and Laksha guggulu.
  • Arista’s – Balarishta, Ashwagandharishta and dashamoolarishta.
  • Kashayams – Dhanwantharam kashayam, Rasnasaptakam kashayam, Rasnadi kashayam, Maharasnadi kashayam.
  • Tailas – Gandha taila, Prasaranyadi taila, Ksheerabala taila, Karpasasthyadi taila, Dhanvantara taila, Maha Narayana taila and Kottamchukkadi taila. These tailas are used internally, externally for abhyanga and Nasya.

 

External treatment modalities

  • Lepa – External application of medicated paste or poultice, to relieve pain, stiffness and numbness. It includes Nagardai lepa, Kolakulathadi lepa, etc.
  • Swedana – Application of heat in neck and shoulder region, which induces sudation.There are various types of swedana can be done depending on the symptoms, whether you have dominance of pain, numbness or stiffness. It includes- Valuka sweda, Jambeera pinda sweda, Patra pinda sweda and choorna pinda sweda. Sudation reduces pain,stiffness in ligaments, muscle spasm and improves blood circulation.
  • Abhyanga – Massage with medicated oils. It tones up the muscles and improves blood circulation.Stretching technique followed during massage acts as traction and helps to reduce stenosis by increasing intervertebral space. Thus reduces the nerve irritation.
  • Nasya – Nasal administration of medicines. Nasya mainly strengthens the head,neck region and nerve roots. Relieves vertigo and abnormal sensation.

All these treatments must be done for minimum 7 days and may extend up to 14-21 days depending upon the severity.

Dos

  • Maintain proper sitting posture while working in computer and laptops.
  • Sleep in supine position.
  • Regularly do smooth massaging without putting pressure at home with appropriate medicated oil, under the guidance of an ayurvedic doctor.
  • Attend physiotherapy classes.
  • Practice Isometric and neck exercises to strengthen the muscles.Neck exercise like Flexion, extension, rotation and lateral bending. Exercise should be started only after complete alleviation of  pain. If you work in system for longer duration, do these neck exercises every one hour.
  • Do yoga and pranayama to reduce weight and stress.  But if you are in acute stage of cervical spondylosis avoid yogasana. After complete recovery from pain gradually you can start exercise and yoga.

Yogasanas beneficial in cervical spondylosis – Surya Namaskar, Ardha chakrasana, Pada hastasana, Trikonasana,Bhujangasana, Salabhasana, Vakrasana, Ustrasana, Savasana.

Don’ts

  • Avoid keeping your hands as pillow while sleeping, watching TV, etc.
  • Avoid thick and very hard pillows. Use small, firm pillows.
  • Minimise driving.
  • Don’t use cell phone while driving.
  • Avoid sitting for prolonged duration, take a walk in between.

 

Overcome the complications of cervical spondylosis by correcting your posture while sitting, standing and sleeping. Reducing the stress in cervical region and strengthening your muscles by proper exercise.

Let us know in the comments if this article was helpful for you to understand cervical spondylosis and the best treatment modalities.

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