NECK PAIN – CERVICAL SPONDYLITIS

 

NECK PAIN – CERVICAL SPONDYLITIS

Neck termed as “Cervix” means a constricted part of body or organ. Body beauty prefers long neck than short. Neck has its own worth in having cervical spines, spinal nerves, blood vessels, thyroid gland, food tube (oesophagus), wind tube (trachea), voice box (vocal cord) & muscles to have movements of the head. In this golden age, neck is often rewarded with chain or necklace for beauty. Acupuncture and reflexology find health points in favour of having chain in neck like ring in fingers. Neck is one of the most important parts of the body, since

·         It holds the head which has brain

·         It is the condensed pathway of the nerves which emerges from the brain to supply the parts of the body & blood vessels from the heart to supply the brain

·         It gives free movement for the head to look around by remaining as un-fused spines

Even though many things in the neck could cause neck pain, the thing which often goes wrong is spine due to overuse or misuse or non-use. Spine is built for stability and mobility. It is made of supportive small bones which help us to stay erect. Cervical column is the starting point of the spinal column or spines. The degree of rotation of the spines varies with length and the type of facet joints of the vertebras.

As age advances, everything in constant use will have natural degeneration or wear and tear phenomenon due to friction on movements. Like wise, neck is also in no way an exception. In childhood, this wear and tear mechanism is ruled out due to deposition of calcium and growth of the bones, where as in case of adult or aged persons, the occurrence of osteoporosis or osteoarthritis or improper depositions of calcium worsens the condition.  Every one can see people who are able to lift more weight in their head (porters) & a big pot full of water in their head (village ladies). But even a cap or helmet or flower to hood cannot be tolerated in cervical spondlyitis patients. Cervical problem comes as two types, one is inflammatory and another is degenerative due to ageing or disease or arthritis.

Cervical spondylitis is a wear and tear ageing process involving cervical vertebras as age advances or due to overuse. This type of arthritis is most commonly seen in middle age or elderly persons, but can also be seen in youth. It can involve one or more vertebrae. Severe form of spondylitis is Ankylosing spondylosis where inflammatory condition leads to sharp acute pain and new bone formation by calcium deposition to fuse of joint. Here patients are advised for active exercises to avoid fusion.

            Cervical Spondylosis is a secondary degenerative disease condition where damaged inter vertebral discs and vertebra in course of time get ossified in edges forming extra bone called osteophytes. This compensatory undue formation of new bone (osteophytes) occurs in edges which often hinge the spinal nerves for pain. They also cause structural impairment. It can also involve one or more vertebrae. Here patients are advised not to do active exercises since pain, fracture, losing normal curvature of spines & distorted appearances can occur.

PATHOLOGY The vertebras are neatly arranged one after another & transmits spinal nerves thro the central opening & blood vessels thro’ the lateral openings or canal. In total, vertebrae are 33 in no/s. They are separated from one another by inter vertebral discs, which act as shock absorbers or cushions while walking or moving. Cervical or neck vertebras are 7 in no/s, namely C1, C2, C3, C4, C5, C6 & C7. They are held in proper positions with facet joints, ligaments, capsule and muscles of the neck. The cervical spines usually have the curvature in front. The problems of vertebras or discs are referred as Cervical Spondylitis or Spondylosis depending upon the causes. Any problem in spines can reflect in the nerves emerging from them. C5, C6 & C7 are more vulnerable vertebra for degeneration.

 

NECK PAIN INDICATE problems of cervical spines usually, but it can also indicate meningitis or encephalitis (brain fever) thro’ pain and stiffness. So neck pain should not be left casually with out treatment in simultaneous occurrence of fever.

 

INCIDENCES & RISK PERSONALITIES Cervical spondylitis is supposed to be seen in elderly due to osteoarthritis, but in this modern sophisticated world, even youths of 20 ages are also seem to suffer more commonly. This may be due to unused trend or sedentary life. Generally, older age has the higher incidences. Man suffers more commonly than females. The severe inflammatory Ankylosing spondylitis occurs more commonly in youngsters and Cervical spondylosis occurs more commonly in old people. Anyway risk personalities are

·         Aged persons

·         Computer professionals

·         Minute concentrated job oriented persons

·         Persons who constantly work with bending of neck

·         Bike users

·         Travelers who travel long & sleep in sitting position

·         Drivers who keeps the neck in same position for a long time

·         Watching TV in abnormal positions or lying position

·         Habit of keeping neck in one position

·         Telephone operators or persons who often hold the phone by the shoulder against neck with a tilt of head

 

CAUSES – may be primary (by degenerative wear and tear phenomenon) or secondary (by diseased or inflammatory process or injury). Any way, the common causes or triggers are mainly

·         Wrong positions in work or sleep for a long time

·         Complete rest or non use of joints or sedentary or sluggish nature

·         Fall or injury or trauma

·         Violent exercises

·         Diseases of bones

·         Drugs affecting bones

·         Over use of fancies of life like TV, phone, bike, chairs, etc

 

SYMPTOMS usually array of symptoms will alert us to give importance to treat it. If we neglect those, it will lead to permanent damage. Cervical spondylitis can cause different set of symptoms depending upon the involvement of vertebra or disc or both. The main symptoms are

·         Pain in neck which can radiate to back, shoulders & down to hands

·         Early morning stiffness of the neck & shoulder denotes the need of additional support

·         Pain & stiffness can be noted when about to move after while of rest

·         Weakness of hands with numbness & tingling sensations

·         Crackling sounds when moving the neck

·         Occipital headaches with stammering gait or giddiness or lack of concentration

·         Swelling and tenderness of the neck may be noted in spots of inflammation

·         Chest pain sometimes

·         Tilt of neck to any one of the side due to inflammation

·         Restriction of movements of the neck

·         Pain gets more intensified with movements, bending, coughing & sneezing

·         Irritability and sleeplessness due to constant pain

 

COMPLICATIONS often develop if left untreated or maltreated. Also belated treatment will be entertained with irreversible structural changes or damages. The common complications are

·         Degenerative changes can cause permanent deformity of the spines

·         Paralysis of hands or legs due to compression of nerve root

·         Lack of bladder or bowel control depending upon the intensity of the spondylitis

·         Muscular weakness & marasmus (wasting of muscles) of the hands

·         Herniation of inter vertebral (cervical) discs

·         Kyphosis (curvature of spines)

·         Osteophyte changes and calcification which can fuse for immobility of spines

Like wise while caring also, complication can occur. The restricted movements with collar or complete rest will usually cause fusion of the joint or vertebras and results in restricted movements.

 

DIAGNOSIS AND INVESTIGATION - It is better to consult with a doctor for getting examination and treatment. Examination of spines & checking for the force and ability to flex the head in front, backwards, side wards and rotation of the head should be done before starting treatment. The weakness, loss of sensation, stiffness & radiation of the pain of the hands should be intimated to the doctor for proper diagnosis, since the place of numbness or pain or stiffness or radiation may indicate damage to specific spines or specific nerve roots. As for as, investigations concerned, X-rays & CT or MRI has to be done, to arrive at final diagnosis. They often show narrow disc spaces & osteophyte changes - characteristic bamboo spines i.e. with projections (spur). In surgical cases, spino- myelogram is adviced.

 

GENERAL TREATMENT Aiming for relief of pain, generally allopathic doctors initially opt for antibiotics and painkillers. Peptic ulcers patient use to suffer more since they could not take painkillers due to its aggravating nature with ulcer complaints.

Bed rest & cervical collar will be advised for restricting movement and support. But using cervical collar in long run will cause fixation of bones and restriction of the movements. For example - you can notice the same in stiff knee, if it gets POP (Plaster Of Paris) for fracture below knee. In this case, even though knee is free from ailments, non-use for a prolong time makes it stiff which needs exercises for a long time to make it normal. Also it can weaken the muscles due to non usage.

Also now-a-days, people commonly use external applications or sprays like soothing agents which alleviates the pain in minutes. This will temporarily mask the complaints or pain. Also, instantly killing the pain with pain killer tablets or injections or sprays is just like putting off the lights, when you don’t want to see the things around, but surely the day will come to light up, where you cannot switch off the pain.

Finally every physician directs the patient to go for physio-therapy to get relief. Here mainly improvement comes from posture correction, mild gentle exercises, warmth application, short wave therapy, and traction. In any way, treatment should be started at the earliest with proper maintaining of the positions or otherwise crippling of vertebras will get started.

Since there is no known conservative medical treatment available for structural changes or damages, in case of severe pain or sufferings, they do surgery as a last resort. Here, risk of paralysis and development of pain and arthritis in different locations are unavoidable. By surgery they can relieve the nerves which get compressed between the vertebras & do fixation of the affected joint, so that there won’t be any movement in that joint for pain. But this restricted movement of one joint gives strain to other joints since each and every vertebra continues to move in succession one after another during movement. So this joint fixation will complicate other joints, later on.

 

PREVENTION & MANAGEMENT -You can heal yourself, if you do things right i.e. simply doing things perfectly can help in relieving the complaints

Do’s

·         Sleep in straight positions with spreading arms sideward

·         Have a small pillow i.e. not more than 3-4 inches thickness

·         Check for bike shock absorbers often and use smooth roads

·         Sit erect and use neck in erect posture in all your jobs

·         Take rest or move about once in 1-2 hours in case of working in a constant position

·         Rest your wrist in table or elbow in the chair while typing in computer

·         Maintain good posture while reading or working with the computers

·         Always work comfortably in doing any job

·         Wear collar while traveling to avoid pain and deteriorations

·         Wear warm scarf in cold days

·         Warm up slowly to relax the stiffness if any

·         Do simple mild and gentle exercises

·         Take high fibre content diet like vegetables, fruits etc.

·         Take Zinc, Selenium, Omega3 fatty acids to have better heal or relief

Don’ts

·         Don’t put hands under the head while sleeping

·         Don’t lift any heavy weight things or do any strenuous exercises

·         Don’t massage violently with analgesics, since it can aggravate the complaints

·         Don’t use traction or collars or pain killers or drugs continuously

·         Avoid cold exposures & cold bath

·         Avoid citrus fruits, egg, tomato, potato, since they can precipitate pains

 

HOMEOPATHIC APPROACH In this advanced medical world, people go on giving a chance for every system of medicine to get rid of their problem. In cervical problems also they follows the same in aiming for permanent remedy or cure. Whether it is completely cured by Homeopathy?

Homoeopathy is the finger post on the cross roads of healing which directs the way to safest and permanent cure. It is very effective and easy way to attain cure. Homeopathy treatment can reward an effective cure in case of initial period of the disease. In chronic cases or late start of treatment, homeopathy can relieve congestion of the spines and compression of the nerves, if there is no fixation of bones. The homeopathy treatment can also arrest the progressive degenerative changes. In case of well deformed spines, it can only comfort the modern living with temporary management of pain. The Results of Homoeopathy in cervical spondylitis or spondylosis will be marvelous and dramatic compared to other system of medicines or surgical interventions.

At this neck of the moment, one thing every one should accept, we cannot do against nature i.e. if it is due to ageing process, we have to accept the thing, but surely, we can live better without any complaints or pain with proper positioning and homeopathic medicines. Likewise we cannot revert to normal from structural damages in advanced cases and aim for complete cure but we can manage the conditions without pain and symptoms. We can aim for near normal in all other cases. Without treating the actual conditions, if we mask the pain with external applications or pain killers, then it will complicate more lately due to normal usage of neck in spite of pain or complaint which have been masked.

Homeopathic medicines commonly used in cases of cervical spondylitis or spondylosis are Acid flour, Acid phos, Antim-crud, Apis mel, Arnica, Bryonia, Calc flour, Calc phos, Cimicifuga, Causticum, Chelidonium, Colchicum, Gnaphalium, Kalmia, Kali phos, Lachesis, Ledum,  Lycopodium, Medorrhinum, Nat phos, Pulsatilla, Rhododendron, Rhus tox, Ruta, Silicea, Strychinum, Sulphur, Thuja, Zinc met, etc. These medicines should be taken under the advice and diagnosis of a Qualified Homoeopath.