Treating Cervical Spondylosis With Physiotherapy
“Physiotherapy for cervical spondylosis mainly aims at relieving pain supporting the neck and restoring the full range of movement of the neck”
A Degenerative Condition
The cervical spine is composed of seven vertebral bodies, intervertebral discs, associated joints and ligaments. Also known as degenerative spondylosis, cervical spondylosis is the most common progressive disorder of the cervical spine.
Cervical spondylosis refers to the degenerative condition of the cervical spine that occurs as a result of degeneration of the intervertebral discs and facet joints that are the connecting structures between the vertebrae meant for transmission of external forces and which also allows mobility of the cervical spine.
As a result of the degeneration, the space in between the vertebrae is reduced and later on, this results in the formation of bony outgrowths in the periphery called osteophytes. This condition is followed by the involvement of the posterior intervertebral joints, causing pain in the posterior part of neck and upper back.
Disturbance Caused By Cervical Spondylosis
- Pain : usually the pain occurs on the site of the cervical spine that is affected. In case of the upper cervical spine, it leads to headaches, if it is the mid cervical region, it results in neck pain and it in the lower cervical region, it leads to radiating pain in the shoulder girdle and arm that can be unilateral or bilateral.
- Muscle spasm and tightness : as a protective response to pain.
- Limitations of movement : the condition restricts neck movements.
- Postural disturbances : a forward chin along with a bent upper back posture, is maintained to ease the pain.
- Muscle weakness and altered sensations : these symptoms are the result of when a nerve is compressed by the degenerating structures; the muscles that are supplied by the involved nerve root, gets affected and weakened.
How Physiotherapy Helps
Physiotherapy for cervical spondylosis mainly aims at relieving pain, supporting the neck and restoring the full range of movement of the neck. Educating the patient about postural correction and strengthening neck muscles is also a part of it.
Heat Modalities
Heat can be effectively used to reduce pain. Superficial application of moist heat packs and a deep heat transfer by ultrasound therapy may prove effective in reducing pain.
Soft Tissue Technique
Therapeutic massage techniques like kneading, wringing and skin rolling can be very helpful in relieving the tightness of the muscles.
Support
A neck collar to support the neck during activities is very helpful in keeping the neck steady and thus, relieving pain. Even while sitting and lying down, the neck should be well supported with pillows. A butterfly pillow flattened in the middle where the head rests and the elevated ends that supports the head on the sides, is the best choice for the people afflicted with cervical spondylosis.
Postural Awareness
Keeping the neck straight and chin tucked in with a straight back should be consciously maintained to avoid any posture related stress on the neck muscles.
Free Active Exercises
Once the pain is tolerable, exercises should be initiated and the person should gradually move to an advanced stage depending on the condition of the problem. It is also advised to perform free active movements of the neck and shoulder every day. Some exercise include:
- Neck flexion and extension: Moving the neck upward and downward
- Neck side flexion: Bending the neck towards the shoulder
- Neck rotations: Moving the neck while trying to look backwards
Static Neck Isometrics
The word isometric muscle contraction refers to the force exerted by the muscles without changing its length to improve muscle strength and endurance. The pressure can be applied by the physiotherapist or by the patient, but one should make sure that during all the movements the shoulder girdle should be stable to avoid any trick movements.
Static Flexion
Place both the hands on the forehead and try to push the neck against the resistance of the hands without moving the head forward. Hold the position for about 10 counts, rest for a few seconds and then repeat.
Static Extension
Place both the hands at the back of the head, apply a mild resistance with the hands and press the head against it. Hold this position for 10 counts, rest for few seconds and repeat.
Isometric Lateral Flexion
Place the right hand on the right side of the head, above the ear, Resist with the hands when the head tries to push sideways. Hold this position for 10 counts, then rest for few seconds and repeat. Continue with the same procedure for the left side.
Hydrotherapy
Neck movements and strengthening exercises when done in a temperature controlled pool can be of great help to relieve pain, reduce spasms and strengthen neck muscles with ease.