Cervical Spine Syndrome: Therapy

A variety of treatments are available, and the effects of each have been poorly studied.

General measures

Resumption of normal physical activities as soon as possible should be a primary goal of the affected person.
Sleep recommendations
- At night, the cervical spine should best be relaxed by a pillow suitable for the neck. This supports the head and neck region and does not allow the neck to bend.
- The best sleeping position is on your back or side. Sleeping on the stomach is to be omitted in any case, as this leads to hyperextension of the cervical spine.
Nicotine restriction (refrain from tobacco use).
Sports, muscle strengthening should be practiced (see below sports medicine).
Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.
- BMI ≥ 25 → participation in a medically supervised weight loss program.

External immobilization with soft ties do not effectively reduce the range of motion (ROM). Rigid ties are more effective in this regard.
CT-guided periradicular therapy (PRT) – form of therapy in neurosurgery, which is used primarily as pain therapy for radicular symptoms (pain originating from the nerve roots in the spine). It is based on the application of a local anesthetic or corticoids directly to the locally inflamed, compressed or stretched nerve root. Indications (areas of application):
- Disc prolapse (herniated disc).
- Disc protrusion (bulging intervertebral disc)
- Neuroforamenstenose (Einingung of the nerve root exit opening).

Sensorimotor insoles – are said to lead to less pain and tension in the shoulders and neck.

Nutritional counseling based on nutritional analysis
Nutritional recommendations according to a healthy mixed diet taking into account the age. This means, among other things:
- Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grain products).
Selection of appropriate food based on the nutritional analysis
See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
Detailed information on nutritional medicine you will receive from us.

Endurance training (cardio training) and strength training (muscle training).
Endurance, strength and coordination training is beneficial for patients with chronic neck pain.
Stretching exercises for the neck and shoulder muscles performed twice daily for a period of 4 weeks on 5 days of the week achieved a reduction in pain in office workers with chronic moderate to severe neck or shoulder pain
Creation of a fitness plan with appropriate sports disciplines based on a medical check (health check or athlete check).
Detailed information on sports medicine you will receive from us.

Balneotherapy (bath therapy)
Manual therapy
Massages
Microwave diathermy – treatment of nonspecific chronic neck pain [therapy offers no additional benefit for the treatment of chronic neck pain].
Physical therapy with endurance, strengthening, and coordination training.
- For patients with chronic cervical spine syndrome after whiplash, counseling and education works as well as physical therapy.
Transcutaneous electrical nerve stimulation (TENS).
Therapeutic ultrasound
Heat treatment including fango packs

Acupuncture, acupressure and cupping can be helpful in treating chronic neck pain.
Alexander Technique – training activity that teaches patients how to avoid unnecessary muscle tension during the day, improve posture and reduce stress.
For chronic neck pain, acupuncture and Alexander Technique were superior to conventional primary care treatment in a randomized clinical trial.Note: Patients with serious damage to the cervical spine or those who had already undergone surgery were excluded from participation.