Originally Posted by
gerry the neck
Cervical Spondylosis and Early Morning Self Assessment
This posting is directed more at the C/S patients than at the P/Ts, although I see no reason why the suggested methods couldn’t be advised anyway as part of treatment. It is designed to help the patient deal with the most critical and confusing part of the day, and thus help to create a stable and rational environment for making decisions which will ultimately affect the quality of their day, and subsequent days.
Every C/S patient, without exception, will testify that mornings are the worst time for confusing symptoms. However, what we wake up with is unlikely to last, in that form, for the rest of the day. The symptoms can ease, or they can intensify, depending on what aggravations have occurred, mostly in the 2 preceding days, or even the manner in which we have slept. What we wake up with are the symptoms associated with the muscular adjustments which the neck itself has instigated whilst we slept. I should say here that there may also be actual compressed nerve symptoms evident, but these methods are not directed at them. We have to assume that the neck has read its own needs correctly, and it has applied its own physical therapy to try and ensure its own optimum functioning ability for this particular day. Even though that might mean a stiff neck, or a sore muggy head etc., it is still probably the best result, given a resident vulnerable state. How we react to and accommodate these symptoms is all important to the manner in which the whole scenario pans out throughout the day.
Firstly, we should try and assess if the symptoms may have been instigated, or increased, by our sleeping arrangements. The only way to test this is by altering sleeping arrangements for a few days, and seeing if there are any changes.
Secondly, we should try and assess if there has been any conscious abnormal aggravation to the neck, for instance, a sudden jerky movement, looking overhead, or even lifting of a heavy weight. If something like this has occurred in the previous 2 days, then we can expect residual symptoms to kick in at some stage, and we must deal with them until they ease off.
Thirdly, if we’re satisfied that both of the above didn’t happen, then we must assume that the symptoms we’re experiencing are ‘default’ C/S symptoms, which might occur anytime. This being the case, and all hopefully assessed within 5 minutes of waking, we should now look at how to proceed to manage these symptoms ( and, these same methods apply to the other 2 scenarios as well ). Listed below is a set of self assessment rules to help achieve best results.
1: Allow a half an hour to assess whether the symptoms are tending to ease off or intensify. This will require stoic patience, and no exercising, to give the neck time to fulfil its own instructions and find the position and flexibility which has been allowed to it for that day.
2: If there is a sore muggy head, which is gradually veering towards a headache, it is probably best to consider painkilling meds, always with a snack, as early as possible. Headaches have a tendancy to intensify, if not tackled early, and they have a way of making a tough situation less tolerable.
3: If, after one hour, there is a sensation of easing of symptoms, without meds, then its probably ok to assume that that’s the direction the symptoms are headed, and it should be possible to have a reasonable active day.
4: However, if after one hour, it seems that the symptoms are getting gradually worse, or more clarified, it might be necessary to consider painkillers, and it might also be necessary to re-assess whatever might have been planned for the day, in general. A ready made plan, held in store, for this purpose can be very useful….its easier to change your expectations if you’ve already thought it out in advance.
5: Any symptoms which still persist or intensify after one hour, will not be shifted or eased until you next sleep, or nap. So, that will be your default for the day. Its probably not wise to return to sleeping or napping until later in the day, because, for some reason, returning to sleep, early on, can compound the problems. However, a short nap on a sofa, might work in some circumstances. Be wary, it can go either way. Perhaps a significant feature here is that the neck must achieve its intended goal first before allowing a new sleep to have new effects.
6: Where symptoms have eased off, after one hour, it means that the neck has made its adjustments, and with no further aggravation to the neck during the day, there should be no reason to suspect that the following day will be any different. Unless, of course, an altering of sleeping arrangements should influence this, one way or the other.
7: If, after one hour, a more clarified symptom emerges, for instance…pain in shoulder/arm/chest, headache, stiff neck, them a planned change of sleeping posture should be considered for when you next sleep or nap. This seems to be the only way to shift these symptoms and stop them from entering a repetitive cycle.
8: A general rule here would be to always allow yourself an hour of assessment in the mornings before reaching for any medications, the only exception to this being an intensifying headache.
I should clarify again that these methods are only relevant for ‘associated’ symptoms ( headaches, muggy sore head, shoulder/arm/chest pain, stiff neck) and not for actual compressed nerve symptoms (numb hand/leg, pins and needles, some arm pain, hand/leg pain, bowel/bladder problems etc). But they can help with these symptoms in the sense that, with less ‘associated’ symptoms, the overall manageability is improved.
Gerry
