It is a disease of modern time. Male, Female both suffer from this problem equally. Mostly people belong to a high collar society. Today Cervical Spondylosis and Backache are one of the commonest problem encountered in practice. Nearly 50% of the patients of Orthopaedic department suffer this problem. To treat the patient successfully it depends upon an accurate diagnosis and evaluating the patient individually and giving due consideration of the patients life style. The major group of people who suffer from this problem is of Executives, Teachers, Doctors, Computer operators, Bank employs or mainly those people who have maximum desk work with sedentory habits and lot of mental strain.
Unfortunately since these problems are of a chronic nature the patients run from one physician to another, try many systems of medicines only to go back in despair to their own devices for amelioration of their symptoms. Though this problem can be treated satisfactorily it is advisable to know the preventive aspect of this disease, so as to inculcate a culture of health conciousness and pooper posture which would lead to healthy pain free life.
     Being a biped animal man acquires an erect posture. This aquiring of the erect posture has been the base and has lead to many problems of faulty posture and consequent degenerative disorders of spine leading to pain and discomfort.
In human spine there are two primary and two secondary curves. The Dorsal and Sacral curves are primary where as the Cervical and Lumbar curves are secondary. The Cervical and Lumbar curves have more mobility than the Dorsal and Sacral curves. As such human spine is a kind of pillar on which the whole body structure is supported.
Cervical Spondylosis was firstly described in 1899, but only in 1948 this syndrome was clearly defined by Brain, Bull and Knight. The importance of Cervical Spondylosis has more in the neurological complications it sometimes produces than the bony changes which are product of wear and tear or agening.
     The shape of Cervical vertebrae and intervertibral disc in the cervical region give the cervical spine its characteristic mobility- forward, backward and sidewise movement and rotation. This freedom of movement which culminated in the development of the atlanto-occipital and atlonto-axial joint at its cranial end puts an added strains on the remaining joints of the cervical regions.
          Though the exact aetiology of cervical spondylosis also like few other common diseases is obscure but the degeneration of the Disc,Injury, Trauma, Accidental or Occupational, Faulty Postures, Congenital disorders and psycolocical strain leading to the muscle spasm seem to be the contributing or precipitating factors. Trauma or injury not only does cause cervical spondylosis but could precipitate serious symptoms in a pre-existing cervical spondylosis. The congenital disorders present in a segment of spine restrict the mobility and thus add more strain on the rest of the cervical spine segment causing spondylosis.
     Normally people of middle age and later life from urban white collar society who are more prone to the modern lifes stresses and strains and lead a sedantory life style suffer from this disease. Cervical Spondylosis in a heavy manual worker or a labourer is a rarity. Both sexes are equally afflicted by it.
     A case of cervical spondylosis normally gets one or more signs and symptoms from the group of sign and symptoms of this diease which are,
1)Pain- Naging and annoyingly severe. Pain may be radiating to the upper extremities, Headache normally frontal or occipital headache may be found. Few patients may get pain in the chest and throat also and some get pain on deglutition.
2)Stiffness- It can be acute and chronic, leading in to the restricted movement,and again there may be partial or complete restriction or limitation of the movement.
3)Paraesthesia- There may be numbness and tingling or complete loss of sensation on the affected side.
4)Vertibro-basilar Syndrome- Arising because of cerebro-vascular insufficiency leading into Vertigo,Giddiness, with visual and speech defect.
5)Motor Symptoms- Leading into the weakness of the muscles, wasting of muscles and Fasciculation in severe cases.
6)Cervical Myelopathy leading to Tetraplegia.
7)Miscellaneous Symptoms- They can be blurring of vision, Loss of balance, Palpitation, Shortnessof breath, Pain over the chest and coldness in the hands.
Though in Homoeopathy each patient who may suffer from these symptoms individually or collectively is treated with individual remedy according to his symtomatology.As the clinical picture may be variable.
     Pathologically the symptoms occur due to the compression of one or more nerve roots,as Radicular symptoms, in acute cases there may be abrupt onset of an arm pain.Numbness of one side of the hand or two or three fingers and a diminished reflex, occurs due to osteophytic impegment on a nerve root. In incidious onset, burning or tingling sensation accompanied by pain radiating down the upper limb. In case of cord compression central posterior spurring with hypertrophy of the ligamentum flavum can compress the spinal cord may lead in spastic weakness of legs and posterior column signs(impaired vibratory and position senses and ataxia). A lesion at the 4th and 5th cervical segment may result in an increase in all tendon reflexes, particularly finger jerks. A lesion at the 5th to 6th cervical segments may diminish biceps reflexes, A lision at the 6th to 7th cervical segments diminishes the triceps reflexes on one or both sides.
     The X-Ray of the spine show changes in the cases of cervical spondylosis, but does not indicate the severity of the symptoms. The changes in the X-Ray can be (i) Oblitration of the Cervical Lardosis. (ii) Osteophytes formation both interior and posterior. (iii) Narrowing of the intervertebral foramen. (iv) Diminution of the disc space between C5-C6 or C6-C7 vertebrae. (v) Exaggeration of the Lardotic curve.
Myelogram- The contrast medium in the myelogram is obstructed. In an air myelogram with laminography the compression of spinal cord is visualized.
While treating a case of cervical spondylosis,one should start the treatment after a careful diagnosis and should rule out the other various conditions which may present similar kind of symptoms. These are cervical disc herniation; Diabetic neuropathy; Cervical rib syndrome; Periarthritis; Fibrositis; Arthritis of shoulder; Brachial neuritisand Carpal tunnel syndrome; Vascular conditions as Raynauds condition, Coronary artery disease; Pernicious anemia etc.
     As it is a self limiting disease, patients must be reassured. And must be asked for the adoption of right posture. Physiotherapy is an important part of the treatment., which may include short wave diathermy (SWD), Ultrasonic massage, Cervical spine exercises. And in very selective cases cervical traction. Wearing of cervical collar may be of some help for a short time, but certainly regular use of collar is not advised as part of treatment. Yoga definitely helps, but it should be done under the guidance of some yoga expert.
Homoeopathically as usual each individual case may require different remedy. Still I have found the best results with these few remedies e.g. Rhus Tox; Bryonia; Formica Rufa; Kalmia Latifolia; Calcarea Flouricum; Conium Maculatum; Cocculus Indicus; Gelsemium; Arnica Montana; Ruta etc. in the cases with their individual symptomatology.
General precautions are to avoid using thick pillows, very spongy and Dunlop mattresses, one should not get up with a sudden jerk. Avoid constent forward bending posture for a very long period, and if it is must then give rest to the neck in between for sometime. Avoid unnecessary mental and physical stress and strain.