Introduction
Since “cervical spine syndrome” is a collective term for pain in the cervical spine, but does not represent a defined clinical picture, it is difficult to formulate uniform exercises. Depending on the symptom-causing structure, there are different approaches. In physiotherapeutic treatment, the structure should first be defined by specific findings. However, there are typical causes for a cervical spine syndrome, which can be improved quite quickly by simple exercises.
Brief description of the disease
It should be emphasized that the cervical spine syndrome is a description of symptoms and not a clear diagnosis. The term cervical spine syndrome does not provide any information about affected structures or other causes of pain or loss of function in the region of the cervical spine. A cervical spine syndrome often occurs in people who, for example, work at a computer or constantly assume a certain head position.
The main damage to the cervical spine is increased protraction, which is accompanied by the advancement of the chin and thus a stretching of the front cervical muscles and a compression of the upper cervical spine in the rear region. The distance between chin and cervical dimples increases. If you have a cervical spine syndrome because you often find yourself in this position, you should consciously try to avoid this position in everyday life in order to relieve the spine. There are simple exercises that counteract the protraction.
Description of the physiotherapeutic intervention (exercises)
For the first exercise – the retraction – it is useful to initially add a mirror for self-correction. The counter movement to the contraction is performed. The patient stands straight upright, or sits upright on a chair.
Looking forward, he now moves his chin towards the neck as if he wanted to make a double chin. The back of the head and the upper cervical spine stretch out, the spine straightens up. It is important that the movement only comes from the cervical spine and that the upper body remains stable in space.
This exercise can cause a pulling in the back or even radiate into the arms, which is not necessarily bad as long as the symptoms do not worsen. (Please consult your therapist!) The exercise can be done about 10 times in a row and, if it does good, repeated several times a day.
To increase the effect of the retraction, you can manually apply a light pressure with your own hands at the end of the movement. To do this, place the space between thumb and index finger on the chin and keep the forearm as parallel as possible to the floor. At the end of the active movement, gently push the chin further back.
A similar exercise serves more to strengthen than to mobilize the cervical spine, but can also be useful in the case of cervical spinal syndrome. The patient performs a retraction (as above) and can, for example, hold a towel as a resistance with his hands behind his head. The towel should have constant contact with the back of the head and be slightly taut.
Now he performs the movement against a slight pressure. The number of repetitions does not change compared to exercise 1. You can also use the towel at the end of the movement to build up slight pressure against the back of the head and hold the tension with the head.
The result is isometric tension, i.e. the muscles are trained without you seeing any movement. The final position is held for about 5-10 seconds, then the tension is released. The exercise can be repeated about 10 times.
It is important that the towel lies against the lower back of the head, not in the neck. If the patient has symptoms of cervical spine syndrome even while driving a car, this exercise is very suitable. Instead of the resistance of the towel, the headrest can be used very well.
You hold the tension for about 5-10 seconds and then release it again. The exercise can be repeated up to 10 times a day. A further cause of a cervical spine syndrome can also be unfavorable postures of the arms/shoulders.
In everyday life, we tend to work with our hands in front of the body more often, with the shoulders being pulled forward more and more. Tension and stress often lead to an unconscious, cramped lifting of the shoulders. The shoulder and neck muscles tense up and begin to hurt.
Exercises to relieve the symptoms begin with light shoulder circling.In an upright sitting or standing position, the patient lets the arms hang down loosely, sideways on the body and begins to circle with the shoulders. Circling backwards is the most suitable method because the cervical spine syndrome is more likely to occur when the shoulders are pulled forward (protraction) and circling backwards relieves the stressed structures. Circling can also be performed alternately on the right and left side.
The next step is to train one’s own perception of a tense posture and detonate the muscles by tensing the shoulders and then releasing them. To do this, consciously pull your shoulders far towards your ears, hold the tension for a few seconds and then let your shoulders sink again in a very relaxed manner as you exhale, feeling how the distance between your ears and shoulders increases again. The exercise can be performed about 10 times in a row.
Movement is very suitable for loosening the neck muscles, which are often tense in cervical spine syndrome. In everyday life, we often adopt one-sided postures that are harmful to our muscles and joints. The nutritional situation of the musculature is worsened by a lack of movement, resulting in muscle tension and painful restrictions or shortening of the muscles.
Head circling is suitable for mobilization and detonation. You tilt your head to one side, as if you had a telephone receiver between your ear and your shoulder, and then let your head slowly and in a controlled manner circle forward over to the other side. At the ends of the movement, the position can be held briefly.
You may feel a slight stretch. The movement is done in a calm and controlled manner, there should be no dizziness or pain (except for the stretching pain). The gaze remains directed forward during the exercise, the head is not placed in the neck.
Another exercise in cervical spine syndrome, which also serves to relax the neck muscles, is the simple rotation. The patient is in an upright sitting or standing position and now looks over one shoulder as far as possible. Then the patient turns his head to the other side without tilting or bending it, i.e. the gaze runs along a line parallel to the floor to the other side.
The gaze again goes as far as possible over the shoulder to the back. The exercise is also performed slowly and in a controlled manner, there should be no dizziness or pain. A pulling (stretching pain) can occur, however. It is important that the shoulders remain straight during the whole exercise and do not move with it. The movement takes place in the cervical spine, the upper body remains stable.
