Cervical spondylosis

June 10, 2023

Introduction

            Cervical spondylosis, otherwise called as osteoarthritis of neck is one among the common ailments that affect day to day activities of a person. Studies says  25% of adults under the age of 40, 50% of adults over the age of 40, and 85% of adults over the age of 60 showing some evidence of disc degeneration.

DEFINITION

            Spondylosis, or spinal arthritis, is a medical term for the wear and tear that occurs in the joints and bones of the spine as people get older. Cervical spondylosis refers to these age related changes that occur in the neck (the cervical spine).

Risk groups

• People with sedentary lifestyle
• Aged persons
• IT professionals or people who are using computers and typing instruments for prolonged time.
• People with previous injuries to neck
• People lifting heavy weights regularly
• People maintaining poor postures during sleeping or sitting.

Causes

            Cervical spondylosis is a disease which affects inter vertebral discs of cervical vertebrae. For understanding the pathology, cervical spine anatomy should be understood. The cervical spine contains 7 vertebrae. A spongy gel like substance is situated between two vertebrae called intervertebral disc (IV Disc) which provide a cushioning effect .Cervical nerves are emerging out from  pathways corresponding to spine. In cervical spondylosis, these IV discs and vertebrae are affected in different manner.

Causes can be summarized as below

1. Dehydrated discs: In this condition discs may loss its spongy nature and become dry results in direct bone to bone contact which cause pain.
2. Intervetebral disc prolapse: Sometime IV discs may slip from vertebral space causing compression to nerve roots resulting in pain, numbness and disabilities.
3. Bone spurs: Degeneration of vertebrae sometime results in abnormal growth of bony structure called as spur. This may come in contact with nerve root or spine.

Symptoms

• Pain over cervical region usually increased by  excess movement and strain
• Referred pain : pain may transfer to back of head, shoulders and upper arms
• Stiffness of neck
• Numbness, tingling, or weakness in upper limbs
• Feel of giddiness on sudden movement of head

Investigations

         Radiological image techniques like X ray, MRI or CT of cervical spines will give exact impression about the underlying pathology.

Management

         Usually analgesics are used to reduce pain. NSAIDs are also used to treat cervical spondylosis.

Non medicinal managements include

• Immobilization of neck with help of collars or any other measures to reduce acute pain
• Isometric cervical exercises will help to retain muscular tone
• Mechanical tractions are widely used technique for treating spondylosis.
• Occupational therapies to improve quality of life.
• Lifestyle modifications may involve an evaluation of workplace ergonomics, postural training, neck-school ,stress management etc

if condition not improving with all these measures  surgical interventions may be needed.

AYURVEDIC ASPECTS OF CERVICAL SPONDYLOSIS

            All the degenerative conditions are classified in Ayurveda under vatha vyadhi. Different diseases like  viswachi, manyasthambha and greevagraha etc can be correlated to cervical spondylosis as per Ayurveda.

Etiology

            Ayurveda categorize manyasthambha among 80 diseases caused by vatha. Ayurveda opines vatha dosha will be predominant during old age. Aggravation of vatha results in degeneration of body tissues. In CS, vatha along with kapha stiffens neck (manya) causing pain and disabilities. Due to roughness of vata, vertebrae become dry and rough results in degeneration of discs and vertebrae causing pain. Kapha cause stiffness and disabilities.

Chikithsa

            Aches and pain management is one of the strongest positives of Ayurveda. Aim of treatment to restore bone strength and rehydrate them. But just applying some oils will not give you any benefits. Proper medicines with panchakarma therapies associated with yoga and lifestyle management will be beneficial to a great extend.

Medicines

            Wide range of medicines is available in Ayurveda to manage vatha vyadhis. They will pacificify vatha thus reduce inflammation and pain. When kapha alleviated, stiffness will be reduced. Application of medicinal pastes(lepa) will be highly beneficial to reduce inflammations. Medicated ghee is given to regain the unctuousness.

PANCHAKARMA

            Nasya is the best choice to treat diseases of upper part of body. Nasya simultaneously controls both vatha and kapha. 

Nasya stimulates the brain through olfactory pathway, structures of the Limbic system including Thalamus, Hypothalamus, Hippocampus, Amygdala and parts of the Basal ganglia which  are concentration areas for neuropeptides called nodal points. Nasya can stimulate areas like Amygdala in Limbic system, thus activating neuropeptide pathway  which help to reduce pain.

Nasya with a nourishing drug can induce some nourishment to tissues by impregnating Kapha and reduce degeneration thus reduce stiffness.²

Other treatment modalities include

• Choorna panda sweda(poultice prepared with medicated powders) to relieve stiffness and inflammation
• Pathra pinda sweda(poultice with herbs) , one among the common treatment modality in keraleeya ayurvedic treatment. Researches shows patra panda sweda  has the following effect on cervical spondylosis ³
• It relieves para-vertebral muscle spasm
• Strengthens Para-vertebral muscles
• Strengthens inter vertebral discs
• Helps repair damaged myelin sheath 
• Has a local anti- inflammatory effect 

• Greeva vasthi( pooling of medicated oil over neck region), taila dhara(pouring vatha hara oils over neck region) for giving nourishment effect also reduce dehydration of IV discs⁴.
• Njavara kizhi : Gives back muscular strength, relive spasm and regain tone. Also provide a rejuvanating effect⁵
• Gentle abhyanga(oil massage) also useful to reduce pain but vigorous massages may aggravate the condition.

Precautions to be taken by the patients with cervical spondylosis

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1. Avoid lifting heavy weights and straining neck
2. Take breaks in-between work to give rest to the neck.
3. Adequate water intake should be maintained
4. Regular exercises
5. Weight gaining should be avoided

Conclusion

            Ayurveda provides a complete care for cervical spondylosis. It prevent degeneration of bones also reverses the dehydration of IV discs. Repairing the damaged soft tissues and bone strengthening reverse the pathology involved. Combination of traditional ayurvedic panchakarma treatments with Kerala special treatments like elakizhi, uzhichil,pizhichil etc  offer a multidimensional benefit to patients suffering from cervical spondylosis .

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