Cervical
Spondylosis
Cervical Spondylosis is a condition of degeneration of the
inter-vertebral disks, which advances with advancing age and
which, in course of time, also involves the adjacent vertebrae
and the para-vertebral structures.The elasticity of the inter-vertebral
disks is lost and it predisposes the disks to injury and tear.
It also leads to inflammatory changes which in turn brings
about calcification (deposition of calcium) leading to extra
bone formations called osteophytes in the adjoining structures.
Spondylosis is a specific form of arthritis, which attacks
vertebrae and connecting bone, and ligament structures. The
spines of majority of people above the age of 50 have certain
degree of osteo arthritic changes. But they seldom cause acute
symptoms. Certain precipitating factors like trauma, incorrect
posture of the body, pressure while sleeping and excessive
intake of sour food usually precipitate spondylitis attacks.
In ayurveda this condition is known as Griva Sandhigata Vata.
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What
are the commonly encountered problems relating to the cervical
spondylosis?
Pain in the back of neck, shoulder and arms,hands, back of
the scalp, numbness in the hands,lack of sensation in certain
areas of the hands, difficulty and restriction in the movement
of the neck,Head ache localized at the back of the head &
giddiness on jerky neck movements,stiffness of the neck and
even paraplegia occur due to spondylitis condition. The movement
of the spine generally aggravates the pain of the neck. It
is often associated with loss of memory and sleeplessness.
What are these caused due to?
- Pain in the neck region can be caused by a variety of
reasons. Different centres in and around the cervical vertebrae
are sensitive to pain and problems connected with any of
these regions can cause pain. The Periosteum ( The outer
layer of the cervical vertebrae ), The anterior and posterior
ligaments ( the ligaments which run along the vertebrae
and stabilize them ), The facet joints ( the joint formed
between the sideward protrusions of the vertebrae ) The
para-vertebral muscles are all pain sensitive and any lesions
to the above structures are capable of producing pain.
- Pain, numbness and lack of sensation in the other areas
are produced by problems effecting the nerves that emerge
from the cervical region. By far, the most common cause
of neck pain is the spasm of the para-vertebral muscles
of the neck.
- The main causes of these problems are 1) Spondylosis,
2) Herniated inter-vertebral disks, 3) Fibro-myalgia and
myo-fascial pain syndromes. Though the three refer to three
different entities, they are interrelated and often super-imposed.
What is Herniated inter-vertebral disk?
The inter-vertebral disks are made-up of two concentric layers,
the inner gel like Annulus Pulposus and the outer fibrous Annulus
fibrosus. As a result of advancing age, the nucleus looses fluid,
volume and resiliency and the entire disc structure becomes
more susceptible to trauma and compression. This condition is
called as Dehydration of the disk. The disk then is highly vulnerable
to tears and as these occur, the inner annulus pulposus protrudes
through the fibrous layer, producing a bulge in the inter-vertebral
disk. This condition is named as herniated disk. This can then
cause compression to the spinal cord or the emerging nerve roots
and lead to associated problems.
What is fibromyalgia and myo-fascial pain syndrome?
These are conditions characterized by pain in the muscles following
severe spasm associated with morning stiffness, disturbed sleep,
a feeling of swelling and have clear trigger points. These points
are tender and when palpated produce the typical pain.
Symptoms
of Cervical Spondylosis
- neck pain (may radiate to the arms or shoulder)
- loss of sensation or abnormal sensations of the shoulders,
arms, or legs
- weakness of the arms or legs
- neck stiffness that progressively become worse
- loss of balance
- headaches, particularly in the back of the head ,Muscle
spasms
- loss of control of the bladder or bowels (if spinal cord
is compressed)
- You may feel or hear grinding or popping in the neck
when you move.
- permanent disability (occasional)
- General tiredness and anxiety - can be present.
Cervical
spondylosis vs Ankylosing spondylosis
Even though ankylosing spondylitis and cervical spondylitis
sound similar, they are different. Spondylitis is a term relating
to "wear and tear" and is more common with the people of older
age .Ankylosing spondylosis relates to an inflammatory condition
in which new bone is produced and then leads to fusion. The
vigorous exercise therapy suggested for people with ankylosing
spondylosis might be harmful to those suffering from spondylitis.
Does
Cervical Spondylosis affects other organs
Consequences
Increasing neck pain is a key indication of cervical spondylosis.
It may be the only symptom in many cases. Examination shows
that ability to flex the head to the side and to rotate the
head becomes limited.Weakness or sensation losses indicate
damage to specific nerve roots or to the spinal cord.
The condition gradually progresses with age and the patients
develop diminition in the range of movement in all directions
apart from Myelopathy (Degeneration of the myelin sheath of
the nerves) leading to weakness, atrophy, difficulty in using
the small muscles of the hands and sensory loss in the extremities.
Herniated cervical disk:- Herniation of the cervical disk produces
problems according to the site of herniation and if the bulge
is central it can lead to compression of the spinal cord leading
to de-myalination and to myelopathy charecterised by a feeling
of chillness, loss of bladder and bowel control and generalized
lack of strength of the muscles in the region below the site
of lesion.. If lateral, it may compress the emerging spinal
nerve roots and produce symptoms like pain, numbness, loss of
sensation and reduction in reflexes in the areas innervated.
Fibromyalgia:- This condition only produces the immediate symptoms
and does not lead to other long-term complications. It only
predisposes the patient to injury.
Complications involved in Cervical spondylosis are
- chronicneck pain
- progressive loss of muscle function
or feeling
- inability to retain feces (fecal incontinence)
or urine (urinary incontinence)
- Loss of bladder and bowel control
In extremely severe cases, if the spinal cord is affected,
there will be loss of balance and also loss of bladder and
bowel control.
- Muscle weakness
The muscles responsible for maintaining the neck in erect
position can become weak.
- Sensory loss
The bones of the neck applies pressure over the nerves passing
through them and can causes loss of sensation in the arm
or fingers.
What are the current approaches to treatment of these
conditions in modern medicine?
Fibromyalgia:- Treatment is often difficult
and frustrating. In some patients mild analgesic drugs, heat
and massage yield temporary relief. In patients with trigger
points, massage or local injection with local anesthetics
may give relief. For some patients combination of the above
with treatment of associated psychological disorders is necessary
for long-term relief.
Herniated cervical disk:- Though the management
of herniated disk is controversial, the first step is bed rest.
For those not responding to rest, surgical removal of the bulging
disk followed by fusion of the vertebrae is the only option
in modern medicine. Cervical spondylosis:- Conservative management
comprises of bed rest, cervical traction and use of cervical
soft collar. If patients develop progressive neurological deficit,
surgical removal of the disk with spinal fusion is the only
option in conventional medicine.
What are the long terms consequences of the above therapeutic
approaches? There is no known medical treatment in modern medicine
and the long term success of the conventional therapy is highly
limited. Surgery offers moderate relief but is associated with
the risks of a major surgery involving delicate structures and
vital parts. Apart from the same, it leads to restricted mobility.
Do other systems of medicine offer better modes of
treatment?
Yes. Ayurveda offers a unique concept in the management of
problems of the cervical region.
It offers comprehensive solutions to the problem in all stages.
How does Ayurveda interpret these conditions?
Ayurveda understands the functioning of the body as comprising
of three basic functions, Movement, Change and growth &
stability, which are referred to as the three doshas Vata, Pitta
& Kapha. These functions in a state of equilibrium lead
to health and in-equilibrium to diseases. The disturbance to
any one of these ultimately leads to problems related to all
the three functions. Treatment in Ayurveda is aimed at restoring
the equilibrium through correction of the underlying functional
in-equilibrium. Treatment comprises of three approaches, Elimination
(Sodhanam) of the accumulated toxic products of digestion, metabolism
and the disease process , Pacification (Samanam) and correction
of the entities responsible for altered functioning and Rasayanam
(Rejuvenation) of the bodily tissue to regain and maintain natural
strength and vitality. Vata, the principle of movement is the
predominant function with the skeleto-muscular system and the
nervous system. Problems relating to these systems are predominantly
caused by vitiated Vata. The vitiation of vata is caused by
two mechanisms. One of them is obstruction to vata due to malfunctioning
of kapha and pitta. The other one is increase of vata independently
as in the case of the degenerative problems.
The therapeutic approach to the two types of vitiation are different.
If Vata’s functions are deranged due to Kapha and Pitta,
as in the case of inflammation, correcting them through elimination
and pacification is the method to be adopted. For diseases due
to Vata alone ( the degenerative disorders), the concept is
to use medications which arrest the degenerative processes.
While fibromyalgia is a condition where Vata is deranged due
to Pitta and Kapha, the other two problems are due to Vata alone.
The treatment of cervical spondylosis and herniated disk comprises
of use of medications to arrest the degenerative process.
Natural
Herbal treatment for Cervical Spondylosis
In Cervical Spondylosis,Any external massage is not of much
use. Violent massage with deep pressure is very harmful for
the spondylitis patient. Only gentle massage over the muscles
of the neck and shoulder joints should be applied and for this
purpose Mahanarayan taila is best suited. This gentle massage
can be given 2-3 times a day .In winter season; this medicated
oil should be gently warmed before application.Guggulu, gum
resin extracted from the plant is the best medicine for the
treatment of cervical spondylosis. Ayurvedic physicians for
the treatment of this condition popularly use a compound preparation
named as simhanada guggulu. It is given in a dose of 2-4 tablets,
4 times a day. Usually hot water or hot milk id given to the
patient after the administration of this medicines. This medicine
has slightly laxative effects. For the patient to recover from
cervical ailments, it is necessary that this bowel should move
clearly and regularly. This medicine is very much helpful for
this purpose. For patients having clear motions, this medicines
should be given in a dose of 2 tablets and constipated patients
the dose should be 4 tablets. If the constipation is not relieved
even by taking 4 tablets the dose can be further increased to
6 tablets.At night some medicines should be given to the patients,
which will act as a purgative. Triphala powder is the best medicine
for spondylitis. One teaspoonful of triphala should be given
to the patient, mixed with a cup of warm milk and one spoon
of sugar. In the motions become regular by the intake of simbanada
guggulu, then triphala powder should be given only twice a week
otherwise it can be given every day.Hot fomentation on the vertebrae
of the neck is very useful for cervical pains.In a big handkerchief
about 500gms of salt should be kept over a frying pan till it
becomes tolerably hot. Then this should be applied over the
neck. Care should be taken to see that it should not be too
hot. In that case, it may cause burns. Sometimes patients suffering
from cervical Spondylosis develop some anesthetic patches in
the back, neck, shoulders and arms because of the pressure from
nervous systems .The patient is therefore not able to feel the
quantum of heat applied during fomentation. It should therefore
be the responsibility of the attendant to examine the heat of
the bolus before applying it on the affected parts .This fomentation
should be continued about ½ an hour every day.After fomentation
the affected part should not be exposed to cold wind. In winter
season therefore immediately after fomentation, the affected
part should be covered with some wool engarment. In other seasons
also the affected part should be kept covered with some cotton
garments after fomentation. It is very convenient to take the
fomentation before bedtime. After the fomentation the patient
should go to sleep so that he does not run the risk of exposure.DietSour
things particularly curd, are strictly prohibited. Fried things,
pulses and various preparations of pulses are also contra- indicated
in this condition. Bitter vegetables like bitter variety of
drumstick, neem flowers and bitter gourd are very useful. Wheat
is better than rice for the patient.He should however, avoid
taking refined wheat which is known as maida (flour) and suji
(semolina). To some extent they are constipated and do not help
the patient in the recovery.
LifestyleExposure to cold,cold bath and any violent exercise
of the neck muscles, including pressure, are very bad for the
patients of Cervical spondulosis.Under the impression that this
pain is being caused by some defects in the muscles, people
undertake different types of neck exercises .While reading and
writing ,one should maintain a comfortable posture. Morning
walk gives some relief to the patient, but if it is cold outside
the patient should always use a woolen scarf around his neck
while going out of the house.
Which is the product recommended for these problems?
CERVIRITE, a product drawn from these concepts offers a total
solution to the problems described above. In fibromyalgia
in addition to external massage, Cervirite, offers excellent
relief from the para-vertebral muscular spasms and thereby
alleviates the pain. Regular use of cervirite also helps in
prevention of episodes.
By regular usage,it helps to prevent the loss of elasticity
of the disks thereby reducing the chances of disk herniation
and also in retarding the spondylotic changes by its unique
action. CERVIRITE
thus establishes near total normalcy in the subjects on regular
usage. [Order
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