• Robert@optimalhealthclinic

Osteopathic considerations in the treatment for Cervical Spondylosis.

Cervical Spondylosis is an age-related degenerative condition with both inflammatory and degenerative factors, leading to osteoarthritis of the spine.

Evidence has shown that it starts with degeneration of the intervertebral discs. Age-related

changes in the vertebral body's endplate result in an inability for the intervertebral discs to have sufficient nutritional exchange. As a result, the nucleus pulposus increases in collagen, causing the annulus to no longer absorb compressive load as efficiently.

This leads to an approximation of the zygapophysial joints (ZPJ) and increases mobility in the affected vertebral segments, which leads to increased rotational shearing forces being placed upon the disc, furthering the load on ZPJ. Eventually, approximation of the ZPJ can lead to an unfolding of the ligamentum flavum, particularly when in extension (which should be avoided in individuals with Spondylosis). Eventually, osteophyte (bone spurs) encroachment can occur into the intervertebral foramen, the spinal canal, or even the vertebral artery leading to neurological symptoms.

Commonly hypomobility of the lower cervical spine is a clinical presentation along with the development of a forward head posture and kyphosis of the upper thoracic spine, which can lead to hypermobility of the mid-cervical segments. Therefore, treatment can include a more osteopathic approach, treating the local tissue causing symptoms as mentioned above and a full-body approach. For instance, correcting imbalances of the lumbosacral and pelvic region can improve thoracic kyphosis and forward head posture.

Additionally, muscles span all three regions on the spine, and changes to their length and strength can impact the cervical spine and shoulder complex. Interestingly, treatment of the shoulder complex can play a role in relieving pain within the cervical spine. Evidence has indicated that the muscles that move the scapular (trapeziuses, levator scapula, and rhomboid minor), which also attach to the cervical spine, could add compressive and shearing forces to the ZPJ. Furthermore, these muscles that control movement at the scapulothoracic joint can play a significant role in transferring load between the upper limb and the cervical spine.

To discuss your symptoms and treatment options, please contact us on 07901870166. Kind regards Robert @ Optimal Health Clinic

Reference List

Goodman C, Heick J, Lazaro R (2018). Differential Diagnosis for Physical Therapists Screening for Referral. Missouri USA: Elsevier.

Huether S & McCance K (2019). Understanding Pathophysiology. 7th ed. China: Elsevier.

Levangie P, Norkin C (2012). Joint Structure and Function, A Comprehensive Analysis. 5th Ed. India: F. A. Davis Company.

Magge D, Zachazewski J,Quillen W, Manske R (2016). Pathology and Intervention in Musculsketal Rehabilation. 2nd Ed. China: Elsevier.

Wineski, L (2019). Snell's Clinical Anatomy by Regions. 10th Ed. China: Wolters Kluwer.

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