Cervical Spondylosis 'Delayed' Symptoms. How C/S Symptoms manifest themselves.

[gerry the neck]

Hi Physiofi

Thanks for this posting. You probably won't be aware of what it means to me that there are others thinking along the same lines...especially regarding sleeping postures being at the heart of C/S associated symptoms, and possibly other neck conditions like whiplash. I've posted quite a lot on patient forums but I've always found that there was a reluctance from patients to overcome their medications dependancy and try to view the problem from a different perspective. The two therapies don't necessarilly have to conflict, if applied sensibly. Ideally, I would hope that someone with professional qualifications starts exploring the sleeping postures ideas, but I also realise that probably means explaining them as rationally as possible before anyone would want to risk applying them in real time. If anyone was interested I would be prepared to provide an easy guide to helpful sleeping postures and sleeping arrangements. These are methods that work better for me than medications (although they're still necessary in an emergency) or other physical therapies I've experienced over many years. It would be a shame to think that the next generation of C/S patients must endure many years of disappointments before figuring out what works best. I realise that change can take time, so, initially the battle is for the hearts and minds of those who matter.

Gerry

[gerry the neck]

Cervical Spondylosis ( C/S ): Sleeping Posture Therapies Explained



Following on from recent posts, I’ve decided to post a brief description of sleeping posture therapies which could be used by anyone wishing to test or explore further their usefulness in reducing the intensity of various ‘associated’ C/S symptoms. The simplicity and non-aggravational nature of these therapies means they can be used in conjunction with other physical therapies, with medicinal therapies and even with post op therapies, to achieve results sooner than current practices might predict.

To begin with, I’ll explain my C/S condition, which I’ve had, with various symptoms, for 30 years. About 2 years ago I was diagnosed with ‘multilevel degeneration’ from C3 to C7, and stenosis occurring mostly at C5/C6. This manifested as numb/clumsy hand, arm pain and reduced power in right arm and hand. At present there is little or no pain with this symptom, except occasional cramping, usually first thing in the morning, on waking. Previous to this diagnosis, I had 28 years of ‘associated’ symptoms ( headaches, stiff neck, frozen shoulders etc etc ) which I found much more difficult to deal with when compared to the actual trapped nerve symptoms which I now experience. I also still experience ‘associated’ symptoms, but to a lesser degree than before, and I put that reduction down to the sleeping posture therapies I have adopted. The idea that sleeping posture therapies can greatly affect the intensity of symptoms is key to the overall goal of rendering the whole C/S condition more manageable on a daily basis.

So, here’s a brief description of equipment used and sleeping postures required.

A) Bedding: I use a memory foam / sponge hybrid mattress ( one third M/F; two thirds sponge ), which I got direct from a manufacturer. I find sleeping on the floor best, with suitable insulation underneath mattress ( carpet or cardboard or both). It’s important to stay warm when asleep, as body temperature is inclined to drop and aches can set in. I find it uncomfortable to try and sleep on a normal raised bed, perhaps because of mild vertigo sensations. On top of mattress, m/f side up, I also use an opened up regular sleeping bag, as extra direct insulation, before my normal bed linen is placed. This system takes care of all shoulder-downwards aches, which were a constant feature with normal mattresses in the past.

B) Pillows: I use a variety of pillows, for various purposes, listed below.
1: Cervical Ortho Pillow. This is a normal feather or sponge pillow which has been stitched in such a way that there is a ridge around the outside and a soft raised section in the middle. The outside ridge reduces where the neck would meet the pillow. It’s best use is for breaking the pattern of cyclical headaches and muggy sore head feelings. Once the pattern is broken, it is usually ok to revert to a normal pillow. Probably best to say here that, when changing pillows, it can take a couple of nights for any adjustments to become noticeable, and it may even be uncomfortable until the changes occur.

2: Soft Feather Pillow. This is my normal pillow, which I wrap a cotton sheet around several times, just to soften the contact between head and any spikey feather ends. This is a good pillow for the head to sink into and it allows the neck to find it’s optimum position of least resistance. It is important for figuring out those limited positions where the neck is completely relaxed, because that will be instrumental in determining which reactive symptoms will kick in next morning. Find the right position and next days symptoms can be greatly reduced.

3: I also use a flatter feather pillow sometimes, and place it at 45 degrees across the other pillow. This allows me to nestle the shoulder into the point where the two pillows meet, and with no real height adjustment, the head can loll forwards with no strain. This can sometimes be a useful position, again mostly for headaches or muggy head. Being able to assess when the neck is most comfortable, that is, when there is no conscious awareness of any stiffness, is all important, and it will help achieve best results. It also means that the head is unlikely to shift from this position during the night, with resulting reactions next day.

4: Memory foam pillows are usually too resistant for finding these comfort zones, and are probably best avoided.

C) Sofa: This is a bit more difficult because of the need to obtain a sofa which can be slept on comfortably, and with arms at a suitable height and soft enough to allow a good sleep. The use of the pillows can be helpful here to adjust arm heights to suit. It will vary from person to person and might require some trial and error / success before determining what works best. But it is important, in that a sofa allows more upright postures when sleeping, and it is effective in breaking the patterns of cyclical aches which sleeping in a horizontal bed can be responsible for. A good test for a sofa would be that a person can stretch out fully, with no hindrance, that the arms and cushions are soft enough, and that the head, when placed on the arm, seems to be in it’s most natural position in relation to the shoulder. Appropriately positioned pillows can all help to make an unsuitable sofa more user friendly. The best thing about using a sofa is that even a one hour nap, with suitable pillow support, can completely alter the intensity or placement of the symptoms. When used properly, instant relief can be achieved. Sleeping in a bed is unlikely to achieve such results, in fact it can compound the problem by helping develop cycles of repetitive aches. Being prepared to switch between bed and sofa, when necessary, should probably be the first step in adopting sleep posture therapies.

Sleeping Postures: The theory behind sleeping posture therapies lies in the fact that the neck will restore it’s own painfree flexibility, depending on whether it perceives if there is an imminent threat to the nerve roots, which it is designed to protect, or not. If the neck assesses (when asleep) that it is in a comfortable state, with minimal threat of nerve compression, then it will automatically lessen it’s protective reactions and thus lessen any resultant symptoms. Finding the optimum sleeping positions to achieve this can mean a certain amount of trial and error / success. But, if I was to say that two months of experimenting might result in reasonable control of the intensity of all future ‘associated’ symptoms, does it start to sound attractive ?

A) Horizontal Sleeping: Horizontal sleeping, on a mattress, can be part of the cause of the extended cyclical nature of headaches, muggy sore head, frozen shoulder and arm / shoulder blade / chest pains. Breaking the cycle is all important, and having the option of using a sofa, where a more upright sleep can be achieved, can do this. Once the cycle is broken, it’s usually ok to revert to horizontal sleeping again. It might only take a couple of nights of adjustments to relieve a long standing problem.

B) Upright or Semi-Upright Sleeping: This can be experimented with using a sofa with soft pillow support. For some reason, perhaps because of the way in which the neck reads it’s own vulnerabilities when sleeping upright, certain symptoms, which just seem to get worse with horizontal sleeping, can completely disappear with a short nap on a sofa in this position. Different postures will suit different reactive aches and pains, so, again, it’s a learning process for each individual case. The resulting effects can be assessed after each sleep, or nap, and the same postures used for future reference. With frozen shoulder, or arm pain, it is also important to find the most comfortable position for the offending arm or shoulder when sleeping ( frozen shoulder….best with arm tucked into ribs ; arm pain…best with arm draped over head ). Again, the key is in finding the postures where the least resistance or pain is felt, as this will help to break the repetitive cycle of reactions. The general beneficial effects can be better assessed with minimal use of medications, because any medications will disguise and confuse a proper assessment of results.



That’s it, so far. All very simple really. But the difference it can make to achieving a better quality of life for C/S patients, is what its all about.



Gerry