Kinesitherapy for degenerative changes in the cervical spine

Presentation of Kinesitherapy for degenerative changes in the cervical spine

Pain in the neck area has different origins. It is most often described as "disc disease" and accompanying "soft tissue damage". This diagnosis is made on the basis of various clinical interpretations, symptoms and syndromes based on modern views on the causes of neck pain.
Recently, many authors (N. Bogduk, A. Marsland, 1988; R. Dussault, V. Nicolet, 1985) considered the problem much more broadly and proved the existence of other potential sources such as zygoapophyseal pathologies, osteophytes.
The etiological factors for obtaining pain syndromes in the cervical spine are many and varied. They can be mechanical, myogenic, neurological or psychosomatic in origin.

Acute and chronic developmental conditions. D. Goldberg et al. (1994) believe that pain in the cervical region with or without cervicobrachial neuralgia can be due to various factors - trauma, cervical arthrosis, arthritis, infections, acute calcifying nucleopathy, tumors.
The spine, as well as the other structures of the musculoskeletal system, are subject to aging, damage, diseases, congenital anomalies, etc. Pathological changes can occur in all structures, but those that are subjected to the greatest mechanical stress are most often affected. These are the skeletal and muscular systems.
Pathological changes develop according to two main mechanisms: 1) excessive stress affecting normal structures, the so-called postural syndrome; 2) normal stress affecting structures with deteriorated mechanical characteristics, the so-called syndrome of dysfunction (R. McKenzie, 1997; N. Popov, 2009). Pathological changes in the cervical spine are most characteristic of C5–C6, followed by C6–C7 and C4–C5. Pathological changes in C2–C3 and C3–C4 are the rarest. M. Matsumoto et all (1998) and Milne (1991) found that the ventral and lateral aspects of the C5–C6 segment were the most common subject of disease changes.

This is due to the fact that this segment has the most pronounced flexo-extensor mobility and is the most loaded of the entire cervical department (J. Dvorak et al, 1991). In peoples who carry heavy objects on the head, the most pronounced degenerative changes are found in the C2–C3 segment. It has been suggested that weight bearing on the head is accompanied by smoothing of cervical lordosis (M. Ioosab et al, 1994). According to V. Zhelev, L. Krajjikova, G. Avramov (2006), the cervical disc herniations accounted for 4–8% of all disc herniations. They are second only to the lumbar.
The clinical picture depends mostly on the anatomic-physiological features of the cervical spine. The two compressive forms of cervical osteochondrosis – cervical disc herniation, cervical spondylosis and spondylarthrosis – represent a neurosurgical problem. Acute injuries can be the result of trauma, abnormal motor activity, poor posture at work or sleep.

Chronic conditions usually develop from incorrect posture, altered muscle tone, etc. V. Mitkov, D. Kostadinov (1969) observed 119 patients with cervical spondylarthrosis and found the following prevalence of characteristic symptoms: radicular symptoms in 49.6%, cerebral - in 30.2%, spinal - in 15.1%, vegetative-dystrophic - in 3.4% and visceral – at 1.4%. The treatment of osteochondrosis of the spine and its cervical region is complex: medication, physical (electro, light, water, warm, balneo), massage and kinesitherapy (treatment by position, extension therapy, physical exercises (Zh. Kolev 1981). Today for the treatment of cervical osteochondrosis, a series of specialized physical therapy methods are used, such as: pressure on trigger points, postisometric relaxation, mobilizing massage, soft tissue mobilizations, special anatomical exercises for the deep neck muscles, etc.