Therapy

The treatment of the cervical spine syndrome is primarily intended to relax the tense shoulder and neck muscles in order to eliminate the pain. Depending on the severity and extent of the complaints caused by the cervical spine syndrome, the most suitable therapy can be selected from various options. This should be done in consultation with the treating physician or therapist.

Anti-inflammatory and pain-relieving medications can be used for pain therapy, as well as muscle relaxants to relieve the tense shoulder and neck muscles. The so-called wheal therapy has an analgesic effect and relaxes the muscles.A medication (e.g. a local anaesthetic) is injected under the skin at the painful area. Local heat applications have a similar effect, as the muscles are relaxed by heat and tension is released.

Warming plasters, creams and the like are suitable for this. The therapeutic use of baths (balneotherapy) can also provide relief. A manual massage can also provide relief from the symptoms of cervical spine syndrome.

Massages are often combined with heat treatments such as red light radiation or heat packs. However, massages are often not sufficient in the case of recurrent cervical spine syndrome. Here, under physiotherapeutic guidance with specific exercises, the blood circulation in the shoulder and neck area should be improved, tensions removed and the muscles strengthened.

The so-called iontophoresis (stimulation current treatment) offers a therapeutic option for cervical spine syndrome. With iontophoresis, small amounts of muscle-loosening medication are introduced into the subcutaneous tissue with the help of electric current. This stimulation current treatment lasts about ten to twenty minutes and requires frequent repetition in order to achieve a balancing effect (at least six applications).

Stimulation current treatment is not indicated for people with pacemakers or metal implants. Ultrasound treatment is another therapeutic method for cervical spine syndrome complaints. An ultrasound probe, from which inaudible sound waves emanate, is moved over the tense muscle areas by a therapist.

These sound waves cause internal friction in the tissue and generate heat. In this way, a so-called micromassage is produced, which loosens tensions. The long-term success of a therapy for cervical spine syndrome depends above all on the person affected learning how to avoid renewed overloading and finding a suitable compensatory sport that alleviates the symptoms.

The tasks and possibilities of physiotherapy (physiotherapy) essentially cover three aspects in the treatment of acute or chronic complaints of the cervical spine: 1. pain relief and regulation of the disturbed muscle tone (state of tension): This topic is certainly the most important in the first, acute phase of the complaints. The main concern in this early phase of the cervical spine syndrome is to combat the pain problem. In the following, only the physiotherapeutic therapy options will be discussed.

For treatment options within the medical therapy spectrum, please refer to the individual clinical pictures. Often the cause of the complaints lies in an increase in pressure on the intervertebral discs, especially the lower cervical vertebrae. This can also lead to pressure on the nerve roots in the intervertebral space (neuroforamen), which are located in pairs between two vertebrae.

One promising therapeutic method is therefore the manual relief of the intervertebral discs and nerve roots by a carefully executed traction in the longitudinal direction of the head. Another proven method of pain treatment is the relaxation of tense muscles by means of specific massage techniques. Here, the massage of the shoulder-neck area is in the foreground, which is extremely tense in almost all patients with problems of the cervical spine.

A similar effect is achieved by stretching the affected muscle fibers. Stretching by an experienced physiotherapist is certainly more effective here, but good results can also be achieved by stretching yourself. A therapy often used in manual therapy and also in traditional Chinese medicine (TCM) is the “trigger point treatment”.

Here, characteristic pain points are treated with a pressure treatment. In the acute phase of the complaints, it is often advisable to supplement the physiotherapeutic measures with local application of heat (e.g. fango, red light, etc.). Muscle relaxation caused by heat often already leads to an alleviation of the pain.

A maximum relaxing effect can be achieved if a heat application is followed by a relaxation massage, because the tense muscles are already in a relaxed state and are more accessible for therapy. 2. stabilization and targeted build-up of the supporting muscle parts of the cervical spine: this part of physiotherapy in cervical spine syndrome usually only begins when the acute pain has already subsided somewhat.An effective muscular exercise program can strengthen the weakened muscle groups and thus possibly prevent a recurrence of the symptoms, or at least significantly reduce the intensity of pain. A strengthened musculature tires less quickly and is therefore less likely to be overloaded, thus offering better and longer protection for the non-trainable structures of the cervical spine (intervertebral discs, vertebral joints, etc.).

Isometry here means muscle tension, but no visible movement should occur. The origin and base of the muscles do not approach each other. The patient is only given such a high level of resistance that he or she can respond painlessly with his or her individual performance.

Also the axis-fair integration of the cervical spine into the upright body posture should be worked out at the latest in this therapy phase. In this case, axis-appropriate integration means that the head is held straight in extension of the spine. An important principle in strength training of all spinal column areas is that the back is stabilized, i.e. it is only held in place and does not perform any active movement.

The training effect for the back is achieved by making it even more difficult for the trunk muscles to hold on to the body through active movement exercises of the arms. With all complaints of the cervical spine, it should also be considered that the cause of the complaint can be well-founded in other regions of the body. Thus the shoulder region should also be examined with each occurrence of neck pain.

The thoracic and lumbar spine (thoracic spine, cervical spine) must also be examined regularly. Quite a few pain problems of the cervical spine find their actual cause in a disorder of the underlying spinal column sections. 3) Recognizing and eliminating the triggering factors: The third point in the physiotherapeutic treatment of cervical spine syndromes, which is decisive for the long-term therapeutic effect, is the elimination of the disturbances causing them (prophylaxis).

This includes, for example, learning to behave in a way that is appropriate for the back and avoiding particularly stressful movements. This can be illustrated particularly well using the example of sitting posture on the computer. After long periods of sitting, most people adopt an increasingly “crooked” sitting posture.

The shoulders are then often still raised when typing on the keyboard, which leads to the typical tension of the shoulder-neck muscles in almost all patients working at a desk. In order to have a good view of the screen, the cervical spine is often overstretched, which increases the pain problem or can lead to further complaints. A long-term promising physiotherapeutic treatment of the cervical spine syndrome that develops in this way can only take place if such misbehaviour is avoided.

Therefore it is necessary to recognize and eliminate such misbehavior. Often, even minor changes in the working environment or in everyday life can bring about a significant alleviation of the symptoms. For example, the unfavorable positioning of the monitor alone when working at the computer can be the main cause of painful tension in the neck and neck muscles.

Fortunately, a lot has changed for the better in this area in recent years. Many companies today try to make working conditions as back-friendly as possible. The keyword “workplace ergonomics” is becoming more and more important in the prevention of chronic back pain (Back-friendly everyday behaviour-neck school).

In many companies, company physicians help to set up an ergonomic workplace.

Pain relief and control of disturbed muscle tension (muscle tone).
Stabilization and targeted muscle building of the supporting muscle parts of the cervical spine.
Detection and switching off of the triggering factors (prophylaxis)

Osteopathy is a method of treatment that belongs to alternative medicine. The philosophy of osteopathy is that the human being is treated in its entirety and underlying disorders of complaints are treated so that a natural energetic and functional harmony is restored.

In an osteopathic treatment of a cervical spine syndrome, the body and head posture of the affected person is first assessed in standing and sitting positions.The tension of the connective tissue is tested over the entire surface of the body and the tense muscles are felt. In a side comparison, the restriction of movement caused by the cervical spine syndrome is tested. The osteopathic therapy then consists of a combination of head turns, muscle tension by the person affected and precisely defined movements of the cervical spine by the osteopath.

As a rule, each vertebra is treated individually and adjacent joints such as the shoulder are also examined and treated for movement restrictions. In osteopathic treatment, the release of bony blockages is followed by a relaxation of the adjacent soft tissues, muscles, ligaments and connective tissue. The therapy of the cervical spine syndrome is often very lengthy and produces only unsatisfactory results.

For this reason, many patients turn to naturopathic alternatives after failed conventional medical therapy attempts. First of all, it should be mentioned that there have been no meaningful studies on the effect of homeopathic remedies in general. The theoretical principles of homeopathy (such as the principle of potentiation) even contradict current chemical and physical knowledge.

At the same time, the homeopathic remedies on offer are not regulated by the currently valid German Drug Law, but are subject to their own, scientifically unjustifiable regulations. Nevertheless, a whole range of different homeopathic remedies are offered for the treatment of the cervical spine syndrome. Depending on the cause, quality and localization of the pain or tension caused by the cervical spine syndrome, preparations such as Rhus toxicodendron, Actaea racemosa, Arnica or Bryonia are used.

More detailed information on this can be obtained from a correspondingly trained alternative practitioner. Caution is required in any case, however, if the pain becomes acutely worse or worse. In this case, it is always advisable to consult a physician.

Various simple home remedies have been proven to alleviate the symptoms of cervical spine syndrome. Many of them are aimed in different ways at heat treatment of the affected region in order to relieve muscle tension. When taking a shower, for example, warm water can be directed at the neck with a medium-strong jet for about five minutes.

Also suitable is a red light irradiation up to three times a day for about ten minutes each time. Other simple but effective home remedies are movement exercises that should be performed regularly and do not require any additional aids. In the so-called mill circles, the outstretched arms are moved in opposite directions in wide circles while standing and are guided close to the body.

The direction should be changed occasionally. A strong and relaxed back and neck musculature forms the basis for completely healing a cervical spine syndrome and preventing it from developing again. Therefore, sports activity and exercise are strongly recommended for cervical spine syndrome.

However, sports must also be well chosen in the case of spinal problems, since sports that are too strenuous or put too much strain on the spine can otherwise trigger a cervical spine syndrome. For example, breaststroke should be avoided, as this can quickly tense the neck muscles and cause problems in the cervical spine. A suitable swimming method for this is backstroke.

Here the back and the spine in general are strengthened and the neck is relieved. In addition, water sports do not damage the spine joints as it can happen when jogging, for example. Yoga is also very well suited to strengthen the back muscles.

Yoga also helps to reduce emotional stress, which can also be a trigger for tension in the neck and back. Other suitable sports include hiking and walking, but also gentle weight training. In any case, the physical activity should always be adapted to the individual fitness level.

You can find more information on this topic at: Exercises for the cervical spine syndromeEven with the possibilities of self-treatment of the cervical spine syndrome, the symptomatology and the respective phase of complaints is the decisive treatment criterion. First, a few words about the possibilities of pain relief during the acute phase. It should be remembered that the perception of pain is individually different for each person.

What is already unbearable pain for one person can be tolerated relatively well by another.Accordingly, the following advice and the resulting results are naturally perceived differently by individual patients. A “panacea” is also not to be expected, since not every form of treatment has the same effect on all people. The common advantage of all physical and physiotherapeutic therapies is the good tolerability of the treatment forms used.

Unwanted side effects are almost zero. An important group of physiotherapeutic treatment measures for cervical spine syndrome are thermal (heat therapy/cold therapy) applications. In contrast to cold therapy, heat applications (thermotherapy) are used far more frequently in cervical spine syndrome.

This is a form of therapy that is very effective and is well suited for self-therapy at home. The possibilities at home are, for example, the use of various grain pillows (spelt pillows, cherry pit pillows, etc. ), which are heated in the microwave and then placed on the painful areas.

If you have a red light lamp, you can also use it well. Less known, but very effective heat applications are the so-called “hot roll”. Hot water is first poured into a funnel-shaped rolled towel.

Then the painful body regions are dabbed with the wet towel. The advantage over a grain pillow or hot water bottle is that this moist warmth promises greater healing success. The second somewhat forgotten possibility of the heat therapy is to make a compress from cooked potatoes.

The cooked potatoes are somewhat crushed and given into a cloth, which may not be too thick, so that still sufficient warmth comes through (e.g. tea towel, linen cloth). This cloth is then put on the aching body regions and left there for some time. The starch contained in the potatoes extracts metabolic “waste” from the muscles.

The duration and frequency of the various heat applications depends entirely on personal sensations. In principle, there is nothing against daily heat therapy. The application possibilities of the cold therapy (cryotherapy) are rather small with the cervical spine syndrome.

It is only justified in a few exceptional cases, e.g. in an inflammatory overheating of the musculature. In this case a cooling of the musculature should be carried out, but I would like to explicitly and fundamentally advise a “gentle” method. I strongly advise against ice applications or even the use of ice spray.

Minus temperatures are actually no longer used in modern physiotherapy. One possibility of a sensible cold application would be, for example, the therapy with moist cold cloths. Quark packs have been a proven household remedy for years and are a good way to reduce overheated muscles to a physiological (normal) temperature.

Commercially available quark is applied to the inflamed area and covered with a cloth. After about 15-20 minutes the curd is simply removed. If the neck muscles are very tense, it is worth trying to bring about relaxation with a self-exercise based on the principle of pressure point treatment.

This treatment is not very pleasant at first, but is extremely effective for certain causes of pain (e.g. painful muscle swelling). For self-treatment, tennis balls are suitable, which are first placed on the floor. Now you lie on the ground in a supine position and lie down with the tense muscle parts directly on the tennis balls.

This pressure is quite painful and unpleasant at the beginning, but after some time the discomfort subsides and the muscles begin to relax. Especially in acute pain phases, a pure physiotherapeutic and physical therapy may not be sufficient. Here the use of an additional drug therapy is required.

This should always be discussed with your treating physician! Unwanted side effects and complications can be minimized and possible incompatibilities/counter indications can be discussed. In the case of a cervical spine syndrome, medication is often used for short-term treatment.

In most cases, pain-relieving and anti-inflammatory tablets are prescribed. These are intended to contribute to natural activity and movement by alleviating the symptoms, in order to relieve the muscular tensions that usually underlie them.However, painkillers are not suitable as a long-term therapy over a period longer than a few days due to dangerous side effects when taken over a long period of time. Some doctors also prescribe muscle-relaxing medication directly, although its use is controversial in cervical spine syndrome.

The same applies to injecting drugs such as local anaesthetics directly into the muscles of the neck or at the nerve exit points. Today, most doctors advise against such procedures because the effect is only short-term and the treatment is associated with risks such as the danger of inflammation. In the long term, relief of cervical spine syndrome should not be achieved by medication but by sufficient healthy exercise and occasional heat applications.

In the therapy of the cervical spine syndrome are suitable drugs: Have a muscle relaxing effect:

NSAID
Ibuprofen
Diclofenac
Celebrex
Paracetamol
Novalminsulfone
Tramadol
Valoron
Catadolone
Devil’s Claw
And much more.
Mydocalm
Diazepam

The cervical spine syndrome describes an inconsistent combination of different symptoms that can be caused by very different clinical pictures. Therefore, there is no examination that can clearly establish the diagnosis. Instead, the diagnosis is made by first ruling out the presence of another specific clinical picture.

If there are no indications for this, the diagnosis cervical spine syndrome can be made in the case of uncharacteristic complaints in the neck, cervical spine and shoulder region. When presenting the patient to the doctor, the first steps are therefore the most important for the further procedure. On the one hand, during the medical consultation (anamnesis), the doctor will ask exactly which symptoms are present, since when they have existed, what causes them and, if necessary, how they are alleviated.

In addition, a targeted physical examination is carried out, during which the doctor pays attention to possible malpositions, tension and inflammatory reactions. Depending on the findings of the medical history and the physical examination, the physician will decide whether further diagnostics are indicated to clarify or exclude other causes or whether a diagnosis of a cervical spine syndrome can be made. It is also important to inform the physician about your own ideas or concerns regarding the symptoms you have experienced.

An MRI (magnetic resonance imaging) should not be used regularly for the diagnosis of a cervical spine syndrome. A cervical spine syndrome can be diagnosed if there is no indication of a serious cause of the complaints or if there is no specific need for treatment. In such a case, an MRI would normally not show any abnormal findings.

An MRI should only be used if this complex diagnosis is associated with a consequence for the treatment of the patient. This may be the case, for example, if the physician suspects, based on a conspicuous finding in the physical examination, that there is a pronounced herniated disc, which may require surgery, or if, due to an accident, an injury in the area of the cervical spine must be excluded. Often, however, a simple X-ray or computed tomography (CT) is performed first. More about this:

MRT of the cervical spine

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