Treatment of cervical spine syndrome
How is cervical spine syndrome treated?
The treatment of a cervical spine syndrome usually turns out to be relatively difficult, especially in chronic disease. As different as the causes and courses of the disease, as different as the therapies that should enable the patient to have a symptom-free everyday life. Treatment can be very difficult, especially in the chronic course of the cervical spine syndrome, and often only a combination of different forms of therapy leads to success.
In acute or subacute cases, therapy is usually started with pain medication. For this purpose, preparations from the group of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac. However, if the pain is particularly severe, you sometimes resort to centrally acting pain relievers (Analgesics) back, for example those from the group of morphines, whereby one has to be careful when taking it in order not to trigger addiction. Tilidine or Tramadol (Tramundin®) are often used here.
However, all painkillers should only be taken over a longer period of time in consultation with the attending physician or family doctor, because they lead to side effects such as heartburn or damage to internal organs, which must then be prevented (e.g. with tablets to protect the stomach from over-acidification) .
Especially in the case of strong muscle tension, muscle relaxants are also administered in addition to the painkillers, which loosen the muscles and thereby also relieve pain. These include Sirdalud®, Diazepam, Tolpiseron and Flupirtin. There is also the option of taking antidepressants, which produce a certain pain-relieving effect and thus reduce the use of classic painkillers a little.
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My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
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The spine is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.
The treatment of the spine (e.g. herniated disc, facet syndrome, foramen stenosis, etc.) therefore requires a lot of experience.
I focus on a wide variety of diseases of the spine.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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Further information about myself can be found at Dr. Nicolas Gumpert
Illustration of a cervical spine syndrome
1st - 3rd - cervical spine (cervical spine)
- First cervical vertebra (carrier) -
Atlas - Second cervical vertebra (turner) -
Axis - Seventh cervical vertebra -
Vertebra prominent - First thoracic vertebra -
Vertebra thoracica I - Shoulder corner - Acromion
- Humerus head - Caput humeri
- Shoulder blade - Scapula
- Humerus - Humerus
- Twelfth thoracic vertebra -
Vertebra thoracica XII - Parietal bone - Parietal bone
- Cerebrum - Telencephalon
- Cerebellum - Cerebellum
A - back of the head
B - neck
C - shoulder
D - upper arm
You can find an overview of all Dr-Gumpert images at: medical illustrations
Therapy in general
Besides the drug treatment is especially the case with the cervical spine syndrome physical therapy of great importance. Physiotherapy and manual therapy are available important components in the treatment of cervical spine syndrome. The common goals of both treatment measures are one permanent relief caused by the cervical spine syndrome Pain, by Decrease in muscle tone in tense Musculature, as well as a Stabilization of the cervical spine through targeted building of muscles.
Until 1994, physiotherapy was called physiotherapy. It includes the conservative treatment of the body with the help of so-called Remedies, which are used externally.
The term remedy basically summarizes various substances, materials and processes, which health-promoting effect have. Remedies used in physiotherapy are above all Heat, cold and pressure. Physiotherapy is most commonly found in the treatment of orthopedic diseases Application. Here lies the treatment of Back painThe treatment of cervical spine complaints comes first.
When treating cervical spine syndrome, a distinction is made between short-term and long-term goals. Short term goals mainly include Pain relief, regulation of muscle tension in the neck, shoulder and back area, as well as a Increase in mobility of the head.
Long term goals especially include the Cure the disease, as well as maintaining the ability of the person concerned to work. These goals are achieved using various methods.
Be there active methods, in which the person concerned has to work, from passive methods differentiated. Active methods include, for example, B.movement therapy (back school) and Respiratory therapy. The passive methods include, among other things Massages, thermotherapy (Application of cold and heat), Hydrotherapy (Application of water) and Phototherapy (Use of short-wave light). Physiotherapy is prescribed by the doctor after the diagnosis and, for those with statutory health insurance, is usually financed by health insurance companies.
The Manual therapy is a sub-discipline of physiotherapy. Manual therapy deals with that Recognizing and treating disorders or Blockages in joints in the spine. The goal is Removal of existing blockagesin order to avoid incorrect movement sequences in the joint and the resulting damage. This is done on the corresponding joints apply pressure forcefully and quicklyt, they are "adjusted". Be like that Relieved pain and Fixed movement restrictions. Manual therapy is viewed critically in the area of the cervical spine. In the worst case, if the treatment is carried out improperly, Damage blood vessels in the throat and so to serious clinical pictures, such as one stroke to lead.
Treatment of radical symptoms in the arms / brutalgia
The treatment of radical symptoms in the arms can be carried out in different stages. It is important that it is initially ruled out that there are no tumors or herniated discs that are the cause of the problem. In that case, prompt surgery could be an option. In general, basic pain therapy is usually used at the beginning. NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or diclofenac are often used. In addition, low-potency morphines can also be used for severe pain. The injection of locally effective anesthetics, such as, for example, can relieve pain and also reduce muscle tension. Be lidocaine.The use of muscle relaxants to loosen hardening (drugs that relax the muscles) must be viewed critically and not every doctor advocates it.
In addition to drug therapy, physical therapy and exercise can help. If blockages are the cause of the radicular symptoms, manual therapy is possible. In subsequent steps, acupuncture, heat and cold therapy, and nerve blocks can be used to reduce the radicular symptoms. In the long term, it is important that patients in whom the radicular symptoms are due to tension and blockages caused by incorrect posture make a lifestyle change and carry out regular posture controls and exercises on their own.
Also read the article on the topic: Therapy of cervicobrachialgia
Different treatments for cervical spine syndrome
While massages do not have a greater effect in the treatment of the cervical spine syndrome, at least in the long term, building up muscles with the help of various exercises makes perfect sense. Massages of the neck and neck area provide short-term pain relief. However, stretching or so-called traction, in which the head is slowly pulled in a longitudinal direction, is often somewhat more promising, which is intended to relieve the spine.
The strengthening for muscle building, which should take place in the cervical spine syndrome, is called isometric, which means something like constant volume. The patient should therefore not exert any visible muscle tension, but should exert targeted pressure against a resistance, according to his current performance. A consistent implementation of such measures also serves quite successfully to make the symptoms disappear in the long term, as the entire musculature in the affected area is strengthened.
In addition, with the help of thermotherapy, another field has been found for the treatment of the cervical spine syndrome, where both cold and heat can be used. Cold therapy (for example with cold air) is mainly used to relieve local, superficial pain. Heat therapy (in the form of warm baths, red lights, warm compresses or pillows) is, however, considered by most to be more effective.
Electrical stimulation is also often used. With the help of this so-called Transcutaneous nerve stimulation (TENS) patients can even partially treat themselves. Here, the nerves under the skin are stimulated via glued skin electrodes and the transmission of pain to the brain is to be changed. There is still very little study evidence that this method is effective, but its use has already brought relief to many patients.
The next step in the treatment of the cervical spine syndrome is the somewhat more complex local anesthesia (Local anesthesia), which are more suitable for chronic pain conditions. Here, the person affected is injected with an anesthetic that only has a very limited spatial effect. As a result, a long freedom from pain can often be achieved.
Other, more alternative methods that are increasingly being included in treatment for cervical spine syndrome, but should not constitute an independent treatment due to a lack of proven effectiveness, are, for example, acupuncture or hypnoid procedures.
Another great relief is numbing the nerves that cause the pain to radiate into the arm. The nerves run out of a nerve plexus (= Brachial plexus) between the muscles of the cervical spine and then pull into the arm. In severe cases, a catheter can also be inserted here, through which medication can be administered permanently, as the effect of individual medications is limited in time and must be repeated often. This method is only withheld in severe cases.
The ruff that many people remember is rarely used today. Used very often in the past, it is now only used briefly, if at all, to relieve the cervical spine. Wearing it for too long quickly leads to a weakening of the muscles, which in the case of the cervical spine syndrome should be strengthened. Therefore, in addition to the relief, the muscle building is more important here.
Homeopathy must also not be forgotten as an alternative treatment method. Different homeopathic remedies are used here, depending on the location and severity.
Read more on the topic:
Homeopathics for cervical spine syndrome
How can you best relieve neck tension?
Warmth or cold - which is better?
In the case of a cervical spine syndrome, both cold and heat therapy can be carried out. The principle here is that the patient has to find out for himself what helps him more personally or what feels better about him. If the radicular symptoms are due to a long-lasting inflammation, such as There are rheumatic changes or osteoarthritis in the cervical spine area, then cold helps better here. By using cold packs - which are not allowed to be placed directly on the skin, but are best wrapped in a kitchen towel - inflammatory processes are reduced.
However, if there is tension or hardening due to poor posture or a blockage, then the use of heat is usually better. Warm cushions, heat patches or a visit to the sauna can be good here. The heat releases cramps and the muscles loosen up. As a result, the radicular symptoms in the arm can be greatly reduced or disappear in the meantime. The use of heat and lime should not be continuous. If the symptoms worsen, the use should not be continued.
Exercises
By different exercisesthat too performed at home the discomfort can be Cervical spine syndrome clearly improved become. The target of these exercises is the Muscle building and a Strengthening of weakened muscles. Strong muscles in the neck-, shoulder- and the back area tire later and can Stabilize the cervical spine longer and before Protect overload.
Usually these are so-called isometric strengthening exercises. When doing the exercises, it should be noted that they are in Intensity and duration are adapted to the individual's level of training. It is also important that Regularly stretch your neck, shoulder and back muscles.
Also some sports can have a positive effect on the cervical spine syndrome. This includes above all Swimming and walking. Furthermore, different ones can be used at home Relaxation exercises be carried out to the to loosen tense muscles and so those Relieve discomfort. At the same time, you can do relaxation exercises Stress relieved and so internal tensions are released. Fall under this autogenic training, yoga or the Progressive muscle relaxation according to JacobsenIn Jacobsen's progressive muscle relaxation, the Alternation between tension and relaxation different muscle groups achieve relaxation throughout the body. In addition, this process Increased blood flow.
Just as important as building strong muscles in the neck, shoulder and back area to stabilize the cervical spine and the Relaxation of tense muscles through relaxation exercises, is the Avoidance of postures and movementswhich lead to tension and cramps in the corresponding muscle parts in the first place. This includes above all that Observe a back-friendly sitting posture at work and the Performing back-friendly movements in everyday lifesuch as back-friendly stooping or back-friendly carrying of objects. This will make the Back relieves and the Cervical spine syndrome prevented.
The doctor diagnoses one Cervical spine syndrome and a conservative therapy was chosen numerous exercises available for the patient to alleviate the pain in the back area and to ensure that back pain no longer occurs to this extent. The cervical spine syndrome is mostly painful muscle tension that needs to be loosened. For this reason, numerous exercises aim to loosen up these muscles.
Exercise 1: The patient stands up straight, stretches his arms all the way up, stands on tiptoe and takes a deep breath. As he exhales, he lets his arms drop and swing and his stretched back slide back into its original position.
exercise 2: Sitting on a chair, swing your arms back and forth next to your upper body and repeat this a few times. Then the upper body and head are included in the movement, but the back remains straight. Again, the goal is one Loosening of the back muscles.
Exercise 3: An exercise that can be integrated very well into the everyday and working day is one in which one concentrates on the entire back muscles while sitting and tries to tense and hold them as hard as possible. After several seconds, relax again and repeat these exercises several times.
Exercise 4: A pure stretching exercise is that Tiptoe. Here, the person concerned should walk on tiptoe through a room for several seconds and try to touch the ceiling with their index fingers. This exercise should only be done after the muscles have been initially warmed up.
Exercise 5: This exercise is intended for an appropriate Muscle stretching to care. Here you should use the Quadruped take and then make your back as round as possible. Then return to the original position. Again, only slightly springy movements should be carried out and tearing movements should be avoided.
It is especially important next to the Durationwith which the exercises are performed, including the Number of repetitions. So the person usually has to stay in the end positions for a few seconds, then come back to the starting position and then repeat the exercises a few more times. Without regular repetition and the regular alternation of tension and relaxation, there is no positive effect. Exercise 1 should be repeated a total of five times in a row. The normal physiological posture should then be resumed. This exercise can still be done a few times a day.
exercise 2 should be repeated once and then returned to normal posture. This exercise can also be combined very well with the first one.
The tension-relaxation exercise (Exercise 3) can be integrated into everyday life. Especially with sedentary professional activities, it makes sense to perform these exercises once an hour, in which the back muscles are first consciously tensed and then loosened again. In addition to eliminating back pain, this exercise is also said to have a generally calming and stress-relieving effect.
Exercise 4 should only after the muscles have warmed up sufficiently be carried out as it is too Strains the muscles of the back can come when the body is cold and the exercise is carried out immediately. You should only do this exercise once or twice a day, e.g. Perform before bed after the working day. It is also important that you do not go beyond the limit. One should only stretch so far that there is no pain in the spine area. Tearing and jerky movements should be avoided in all exercises. Rather careful, stretching movements help ensure that the back muscles are slowly but constantly loosened or stretched.
At Exercise 5 the position should be held for approx. 20-30 seconds, after which you can return to the original position. This exercise should not be repeated too many times a day. The recommendation here is once or twice a day.
Regarding the general duration of the exercises, it should be said that the exercises that are part of everyday life, e.g. Workplace can be built in, should be carried out more often a day. Mat exercises or running stretching exercises should only be done 1-2 times e.g. before or after work.
You can find further information under our topic: Exercises against a cervical spine syndrome
Physiotherapy / manual therapy
The physical therapy deals with the extended treatment of muscular functional impairment. With her exercises she attacks where the limits of self-practicable exercises in everyday life are reached. The untrained patient receives from the physiotherapist, among other things above mentioned exercises for incorporation into everyday life.
With regular physiotherapeutic treatment modules, however, the muscles are trained even further: This also happens more often Exercise equipment for use with light weights to train the muscles in the back area accordingly. In addition to classic physiotherapy, you can also Stimulation current applications to relax the muscles or Heating and cooling applications be performed.
Manual therapy is special Handgrip techniquesto identify and assess a movement disorder in the spine.
Then the manual therapy begins, which is also called "Mobilization " referred to as.
In addition to the cervical spine syndrome, this treatment technique also comes into play Head or jaw joints, joints of the arms and legs and joints of the chest and pelvis for use. There are three different techniques for manual therapy. The Traction, the sliding technique and the stretching and relaxation technique.
In the Traction technology The therapist gently pulls the joint surfaces apart to make appropriate Loosen blockages in this area.
In the Sliding technology two joint surfaces are moved parallel to each other by means of special handles. This results in greater freedom of the joints and the corresponding movement in this area can again be carried out more easily.
The Stretching and relaxation techniques ensure that the muscles return to a state that is essential for pain-free movement.
Not all techniques are equally suitable for treatment. The most important thing is to clarify the Contraindications by an orthopedic surgeon.
This is how a traction technique can work with a Herniated disc of the cervical spine have devastating effects. First of all, it may even have to be confirmed by means of an X-ray that the use of physiotherapeutic measures is safe. As soon as this has been clarified, regular physiotherapeutic exercises can be carried out, which may also be paid for by the health insurance company.
Duration of illness
How long the symptoms of the cervical spine syndrome last varies greatly from person to person and so the duration of treatment also varies. The cervical spine complaints often disappear after a few days to weeks with treatment. Various factors, such as stress, can prolong the duration of the cervical spine complaints and thus the duration of the therapy. There may also be irregular changes between cervical spine complaints and symptom-free intervals, making therapies necessary, which primarily provide short-term pain relief.
The cause of the symptoms also plays an important role for the duration of the treatment. The treatment of cervical spine complaints caused by whiplash can be shorter than when the cervical spine complaints have been caused by years of poor posture and back-unjust habits. Long-term relief of the symptoms can only be achieved if the posture is improved and movements that are gentle on the back are learned. The treatment is then often lengthy, as it is difficult to get rid of habits that have been internalized for years. In any case, the co-operation and motivation of the person affected are of paramount importance for the success and duration of the treatment of the cervical spine syndrome.
Read more on the topic: Duration of a cervical spine syndrome
