Due to more and more sedentary or bent activities in everyday or professional life, the cervical spine (cervical spine) is constantly exposed to uneven loads. The typical posture manifests itself in a hunched back, shoulders hanging forward and a head that is laid back or bent forward. The intervertebral discs are no longer subjected to the same central load and the muscles must constantly counteract this.
If the body is no longer able to compensate for the posture due to lack of stability, unpleasant symptoms occur. These pains and problems in the upper section of the spine, the cervical spine, are summarized under the term “cervical spine syndrome”. Causes and symptoms vary greatly. Therapy/physical gymnastics depends on the individual patient. However, special exercises and tips are used to prevent and treat the cervical spine syndrome.
Physiotherapeutic interventions
Before starting therapy/physiotherapy for cervical spine syndrome, all important structures of the cervical spine and its surroundings must first be clinically examined. In physiotherapeutic diagnostics, the so-called “safety tests” are always carried out first to ensure that important stabilizing ligaments are intact and that the brain supply by the A. vertebralis is not disturbed. In order to test the artery, the head is turned to one side as far as possible and placed slightly in the neck (both sides must be tested).
The patient is asked to count up to 10. In this position the artery is compressed, but with normal supply it should allow enough blood to enter the brain despite compression. If the blood supply is disturbed, speech disorders, visual disturbances, drowsiness or nausea may occur during the test.
In this case the treatment/therapy should be stopped and the patient should see a doctor. The second safety test tests the ligamenti (bands) Alaria. For this, the physiotherapist palpates the spinous process of the second cervical vertebra and tilts the patient’s head to the side with the other hand.
The spinous process should rotate to the opposite side during movement. If it does not move, there may be a blockage. The last safety test tests the Ligamentum transversum atlantis, i.e. a band around the first cervical vertebra.
For this purpose, the spinous process of the second cervical vertebral body is palpated again. The head is fixed by the physiotherapist and the spinous process is gently pushed forward. If the ligament is intact, nothing should move here.
If the tests are negative, the active and passive examination of all movements of the cervical spine (extension, flexion, rotation, lateral inclination) can be performed. The movement of the individual vertebral bodies against each other is also tested using manual techniques. During the entire examination, attention is paid to movement restrictions, too much movement and painful movements.
Finally, the surrounding musculature is tested for length and strength. If the nerves are also affected, there are various examinations that test the conductivity and can differentiate the individual nerves (ULNTs). The reflexes should also be tested in this case, as well as the ability to perceive different stimuli (warm, cold, sharp, blunt).
Depending on the results of the examination, physiotherapy for a cervical spine syndrome has different objectives. If an instability is detected, the stabilizing muscles and possibly coordination must be trained. In case of blockages, these have to be released and the range of movement has to be extended.
In the case of tension, the focus is also on mobilization, movement extension and detonation – in other words, relaxation. In case of pain, the structures should first be relieved and the cause of the pain should be found out. If this is due to instability or poor posture, the cause should be worked on after pain reduction.
Nerves can be mobilized so that the ability to glide is restored and finally the cause of the compression is also treated here. The article Mobility of the cervical spine might also be of interest to you in this regard. In the case of blockages, these must be released and the range of movement expanded.
In the case of tension, the focus is also on mobilization, movement extension and detonation – in other words, relaxation. In case of pain, the structures should first be relieved and the cause of the pain should be found out. If this is due to instability or poor posture, the cause should be worked on after pain reduction.
Nerves can be mobilized so that the ability to glide is restored and finally the cause of the compression is also treated here.The article Mobility of the cervical spine might also be of interest to you in this regard. In the case of tensions, the focus is also on mobilization, movement expansion and detonation – in other words, relaxation. In case of pain, the structures should first be relieved and the cause of the pain should be found out.
If this is due to instability or poor posture, the cause should be worked on after pain reduction. Nerves can be mobilized so that the ability to glide is restored and finally the cause of the compression is also treated here. The article Mobility of the cervical spine might also be of interest to you in this regard.
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