Hi
I am a long-term Cervical Spondylosis ( C/S ) patient. I was first diagnosed with C/S by means of Xray at age 30. I am now 60 and for the last two years have displayed the classic C/S symptom of numb / clumsy hand which indicates compressed nerve at C5/C6. Before this particular symptom appeared I had 30years of, what I call, associated C/S symptoms ( headaches, stiff neck, frozen shoulder etc ) indicating neck reactions to percieved threats of nerve compression, but never developing into actual nerve compression until recently.
I believe that my C/S resulted from a car crash I was involved in, aged 10. The problem was not spotted then and it has affected me in various ways ever since. My concern here is that all treatments and therapies I've undergone, both physical and medicinal, simply increased my sense of futility with such methods. I've had neck exercises, traction, collars, painkillers, etc etc, and the less said the better. Over the last few years I have re-considered the whole complex C/S issue and subsequently I have devised an overview of the condition which, although probably not in agreement with the textbook descriptions, makes perfect sense to me. I was never satisfied with the standard descriptions of C/S that I encountered, although the varied symptoms were generally described correctly. What was always missing was an analysis of each symptom and reasons for their intensity or unpredictability.
So, below is my version of a guide list to the varied unpredictable symptoms associated with C/S. Also I include my version of an overview of long-term C/S.
Any relevant comments would be appreciated.
Below is a list of associated C/S symptoms and a guide to how they should be assessed in terms of their relevance to the cervical nerve compression problem.
1: Trapped or compressed nerve in neck: This is the primary cause of all the symptoms. Although not necessarily painful in itself, it’s reaction to it’s own distress is to radiate primary and secondary symptoms throughout the body. Depending on how advanced or degenerated the C/S has become over time, the radiated symptoms can be occasional, on/off, or more permanent.
2: Arm Pain: Mostly resulting from incorrect nerve signals. If there is any associated numbness or tingling, then the arm pain is usually a direct symptom of the trapped nerve in neck, rather than a muscular reaction.
3: Numb / Clumsy Hand: This symptom is a direct symptom of the trapped nerve in neck. Usually, the middle finger can’t be straightened horizontally and there is less grip and power than normal. It needn’t necessarily be painful, but it is awkward to use the hand.
4: Leg Pains: These tend to be a combination of direct symptoms of a trapped nerve and muscular reactions. Normal mobility can be affected.
5: Bladder problems: These are a direct symptom of a trapped nerve. Usually not painful, but can cause discomfort and a need to urinate frequently.
6: Bowel and Sphincter Problems: These are a direct symptom of a trapped nerve. Not usually painful, but will cause problems with bowel movements.
7: Stiff and Aching Neck: This results from protective muscular reaction which limits further aggravation to the nerve.
8: Headaches: Mostly starting at base of skull and spreading throughout the head. These result from stiffening neck muscles and, as such, are a by-product of the protective reactions.
9: Shoulder Aches and Pains: These mostly result from incorrect nerve signals. Usually, there is no real physical problem with the shoulder, but the localised muscles are reacting as though there is.
10: Chest Aches and Pains: As with Shoulder Aches and Pains. Sometimes the pain will be pinpointed and concentrated ( for instance, at centre of shoulder blade ). But this should still be assessed as a reaction to false signals rather than a real physical problem in that area.
11: Frozen Shoulder: As with Shoulder Aches and Pains, except the muscular reaction enters a cycle of reactions which usually doesn’t resolve for several months. Frozen shoulder can come with general arm pain as well.
12: Mugginess and disorientation: As with Headaches, these symptoms are associated with overworked protective muscular reactions in the neck.
13: Lower Back Aches and Pains: These usually result from secondary muscular reactions and adjustments the muscular structure must make to compensate for reactions to other symptoms.
14: Fatigue and Exhaustion: This results from continual protective reactions being overworked and occasionally demanding total rest so that natural resources of painkillers ( dopamine etc. ) and energy levels can be restored . It would usually occur naturally during sleep, but, as the aches and pains still have to be suppressed whilst we sleep, the resources can get depleted and the body demands that they be restored, whether we are sleeping or not. The vulnerability to the risk of further aggravation to the nerve is acute during this phase, because the protective reaction system has temporarily shut down to enable replenishment.
Finally, under normal circumstances ( non- C/S ) we accommodate a fairly negative overview of pain. The implications of pain are that it will most likely worsen if we don’t feel assured that we can treat the injury successfully, This understanding of pain, however, doesn’t always relate to C/S aches and pains because there is usually no physical problem in the local painful areas which might require fixing. A combination of aches and pains, and confusion over how best to react to assist healing, can easily overwhelm the C/S sufferer and disrupt any resolve to adopt proper neck therapies which might help overall. In theory, by not having a proper understanding of the varied symptoms, we allow the overwhelming to happen, and usually end up making irrational decisions about pain treatment and medications, rather than exploring less drastic methods. Putting the distracting pains into perspective should help with interpreting their importance, in remedial terms, and also help with highlighting the need to focus on useful neck therapies.
It is not the intention of this guide to dispute or conflict with professionally held opinions. All opinions explored in this guide should be seen as complimentary only. The intention is to encourage a fuller understanding of C/S symptoms in contrast to the general professional literature and advice which are currently available.
And here's a generalised overview for the C/S condition. I can go into much more detail on specific issues like appropriate non- aggravating therapies, particularly concerning sleeping arrangements, which might minimalise the need for painkillers, but I'll leave that for another time.
1. C/S should really be re-classified as 2 distinct conditions...Arthritic Based and Injury Based because there are distinct differences.
a: Arthritic Based C/S might degenerate in direct relation to the overal degenerative progress of the general arthritic condition.
b: Injury Based C/S might only degenerate, if at all, through normal wear and tear. I believe this is the version I experience as I have no other arthritic problems besides the usual for my age.
In order to be able to predict the future progress (possible degeneration or regeneration ) of the condition it becomes important to be able to make this distinction.
2. Common to both the above is the issue of Pre-Trapped Nerve symptoms and Post-Trapped Nerve symptoms.
a: Pre-Trapped Nerve (' associated ') symptoms include headaches, muggy head, stiff neck, frozen shoulder, pains in shoulder / chest etc.
b: Post-Trapped Nerve symptoms include arm pain, numb hand / leg, loss of power in hand / leg, bowel and bladder problems.
These two symptom groups should be separated because the therapies we need to apply to them are different. Thus the many differing opinions we encounter on how best to treat the symptoms....we are simply not always discussing the same issues.
3. Again, common to all the above, is probably the most important issue i.e. that the neck is continually trying to naturally correct itself and protect itself from future threats. Most of the Pre-Trapped Nerve ( 'associated' ) symptoms seem to result from neck reactions to possible threats and, although persistant and distressing, maybe should be read as warning signs rather than full-on C/S symptoms where a trapped nerve can cause dysfunction in arm, hand or leg. Strangely, in my case, the onset of actual trapped nerve symptoms gave me some relief from the worst 'associated' symptoms, and so, I can say, that my condition improved somewhat in terms of how I felt in general. However, I'm not naive, and I know that it could change again as the wear and tear progresses.
4. My real concern is not what I'm currently experiencing. I am being monitored and advised professionally, although I do think there is a major shortage of advice on self-management. My concern is the many years I experienced beforehand where I had no convincing explanation for the symptoms I was then experiencing. It was distressing and depressing and could easily have been handled with better advice and information.
5. C/S can be seen as a recurring threatening / healing experience with varied symptoms appropriate to both phases. The regenerative activities of the neck, as it attempts to protect from nerve compression, should be the focal point of any therapies employed. The first two questions should always be...'what is the neck trying to do' and 'how do we assist it to achieve it's purpose with the least possible distress'.
I realise that determining how the C/S condition will progress ( degeneration v regeneration) is difficult, even impossible in many cases, and, as such, it creates it's own difficulties in terms of giving standard useful advice. Knowing this, the issue of self-management becomes ever more important in seeking ways to improve the quality of our lives.
Gerry
