Cervical Spondylosis

OH THAT PAIN! Long hours in front of a computer is not good for your neck. Photo: G.R. N. Somashekar

Cervical Spondylosis is a result of sedentary occupations like working in front of a computer, or in a call center, or doing desk jobs, teachers, drivers, (pilots, and couch potatoes are all prone to it.

Individuals suffering from this condition complain of pain in the nape of the neck radiating into shoulders, chest or dorsal region and sometimes associated with numbness of the fingers or hands.

Our spine consists of vertebrae starting with atlas holding above the skull and down till the sacrum. The vertebrae below the atlas bone in the region of the neck are called Cervical vertebrae. Also this is the most mobile portion of the whole of the spine and hence is more prone to this condition. The vertebrae are held in space by the flexible discs between them which are made of cartilage and are spongy in nature.

Degenerative condition

Cervical Spondylosis is a degenerative condition of the cervical spine caused by degeneration of the vertebrae and the flexible cartilage thereby narrowing the foramen or the space through which the spinal cord traverses. This narrowing causes pressure and thereby inflammation of the nerves. The spinal ligaments too lose their elasticity and could buckle into the spinal canal further increasing the pressure on the nerves. The degeneration can produce several conditions of the spinal cord and the nerve roots. Bony ridges called osteophytes can form due to arthritic like degeneration thereby reducing the spaces between the vertebrae causing difficulty in movement of the neck. Sometimes the shock-absorber like disc between the vertebrae tend to push out through the spaces and cause nerve compression causing symptoms like radiating pain down the upper limbs.

How does it all happen?

Computer professionals tend to look at the computer with the hands on the table for long hours every day which leads to degeneration of cervical vertebrae.

People tend to watch television taking the support of a high pillow and the uneven position puts pressure on the discs between the cervical vertebrae.

Drivers at the wheel with constant jerks and unconscious movement of the neck at sudden turning of the head lead to a similar degeneration.

Sportsmen too are not exempt as footballers heading the ball, boxers exchanging punches and batsman staring awkwardly at the incoming cricket ball do enough to encourage degeneration and leading to spondylosis.

Cervical Spondylosis is one of the diseases of Arthritis which tends to occur at a very early age.

Though the advent of this problem used to be in the thirties, as time is passing by we tend to see more patients even in their early twenties with the same problem.

Women are also prone during the menopausal age due to decrease in hormones leading to weakening of the bony structures.

Symptoms

Chronic pain in the neck which can get worse on motion of the neck. Pain radiating along the shoulders, arms, forearms till the fingers. Sometimes pain radiates into the dorsal region or into the chest and this muscular pain if occurring in the left chest may confuse the patient with a heart-attack!

Muscle weakness along the upper limbs. Numbness along the course of upper limbs or sometimes just of the fingers. Stiffness of the neck limiting the movement. Recurrent episodes of headache.

Vertigo is also one of the troublesome features.

Investigations

Clinically, the typical pain and radiation would offer enough clues about the diagnosis but an X Ray of Cervical Spine usually helps in the diagnosis. It would clearly show the degeneration of the vertebrae and if there is any formation of osteophytes.

Sometimes the degeneration of the bones may well be an indicator of a condition like osteoporosis.

An MRI of cervical spine would reveal if there is any impinging of the osteophytes onto the spine or if there is any constriction of the spine.

A blood test for calcium would also be helpful.

Prevention Regular movement of the neck backwards and sideways, each movement above five times and done twice a day would take about two minutes and prevent occurrence of Cervical Spondylosis.

High pillows to be avoided while lying down.

Neck area should be rested at regular intervals in individuals with occupational risk.

Homoeopathy can relieve the pain, muscle spasm and also address the cause of all this by allaying degeneration of the vertebrae. Arnica would be the remedy in cases of pain due to over-exertion or due to an injury to the cervical spine. Rhus tox helps in cases of muscular rheumatism and relieves stiffness of the neck etc. Ruta would be the remedy if osteophytes are impinging on the nerves. In cases where degeneration is evident Calcarea phos and Calcarea flour are indicated. Gelsemium helps in the typical pain in the nape of neck.

Sangurinaria will relieve pain radiating into the shoulders especially the right.

Chelidonium is the remedy when pain is referred mostly into the shoulder and scapular region mostly the right. Spigelia helps to relieve pain radiating into the left chest region. Gnaphalium would help for patients with numbness as a predominant symptom. Conium is a remedy which would allay vertigo of any nature and more so in cases of Cervical Spondylosis.