Cervical Spondylosis
(Arthritis of the Neck/Non-specific Neck pain)
Brief Overview
Cervical spondylosis is a general term for wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, signs of osteoarthritis develop, including bony projections along the edges of bones (bone spurs). This condition generally causes pain, stiffness, headaches, numbness, and reduced movement.
Earlier cervical spondylosis was considered a medical condition in which the degeneration of the inter-vertebral disks occurred due to old-age.
Now, this condition is commonly caused due to regularly ignoring ergonomics of our bodies, e.g. working for long hours with computers, wrong postures while performing day-to-day life functions, sports/repetitive injuries such as long hours of playing video games, texting etc.
In cervical spondylosis, the degenerative changes in the intervertebral discs lead to secondary change in the adjacent vertebrae. These changes in the cervical spine may affect one or more nerve roots, the cervical cord at one or more levels or may cause simultaneous damage to the nerve roots and cord.
Your Health Care Professional / Rheumatologist may diagnose Cervical spondylosis by looking at some Presenting Features (Binder, 2007, Mar 10), such as:
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Cervical pain aggravated by movement
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Referred pain (occiput, between the shoulder blades, upper limbs)
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Retro-orbital or temporal pain (from C1 to C2)
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Cervical stiffness—reversible or irreversible
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Vague numbness, tingling, or weakness in upper limbs
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Dizziness or vertigo
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Poor balance
Signs will be considered, such as:
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Poorly localised tenderness
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Limited range of movement (forward flexion, backward extension, lateral flexion, and rotation to both sides)
Your GP/Specialist will also consider other conditions that need to be Differentiated from cervical spondylosis, such as:
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Other non-specific neck pain lesions—acute neck strain, postural neck ache, or whiplash
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Fibromyalgia and psychogenic neck pain
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Mechanical lesions—disc prolapse or diffuse idiopathic skeletal hyperostosis
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Inflammatory disease—rheumatoid arthritis, ankylosing spondylitis, or polymyalgia rheumatica
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Metabolic diseases—Paget’s disease, osteoporosis, gout, or pseudo-gout
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Infections—osteomyelitis or tuberculosis
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Malignancy—primary tumours, secondary deposits, or myeloma
Treatment may include exercise, manipulation, and mobilisation, or combinations thereof and sometimes decompression surgery. The pain aspect may be managed by use of analgesics and corticosteroids.
Ayurvedic View
In Ayurveda, there is a condition called Greeva Graham (stiff neck), which is similar to Cervical Spondylosis.
This is primarily a vata vyadhi (vata disorder) associated with dryness and degeneration of tissues. This leads to decrease in Slashaka kapha which is responsible for for cushioning the discs between the joints as well as overall movement and flexibility.
When degeneration occurs, it leads to spondylosis.
There are two main reasons for vata disorders:
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Tissue depletion (dhatu kshaya)
The vitiated (increased) vata dosha moves erratically and occupies various sites, tissues and organs.
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Obstruction of Vata Dosha
The free mobility of vata is hampered either by the other two doshas (Pitta and Kapha), dhatus (tissues), or malas (waste products of the body). Obstruction may also happen if two types of vata start moving in opposite direction.
This obstruction of Vata dosha may often lead to neurological disorders, including greeva graham (cervical spondylosis), viswachi (cervical brachial neuralgia), avabahuka (frozen shoulder), pakshaghata (stroke), ardita (facial palsy), gridhrasi (sciatica), etc.
Ayurveda mentions the following Causative Factors for Greeva Graham (Cervical Spondylosis):
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Food habits that increase vata dosha, such as intake of dry, light, cold, and frozen foods
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Fasting for extended periods (depending on your constitution)
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Irregular or sporadic mealtimes
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Processed food, sodas, chips, etc.
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Low intake of water or liquids
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Excess pungent taste, chili, curries, etc.
Lifestyle habits that increase Vata Dosha:
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Staying awake at night
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Sleeping during the day
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Excessive exercise or work
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Suppression of natural urges (sneezing, etc.)
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Too much weight bearing on the spinal column
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Walking for long distances
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Bike riding for long distances
Psychological factors that increase Vata dosha:
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Excess stress
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Prolonged grief
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Excessive anger
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Fear and anxiety
Ayurvedic Management for Greeva Graham (Cervical Spondylosis)
The key approach will be to move vata dosha in the proper direction by:
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Snehana (Oleation therapy):
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Internal Oleation - intake of oily substances such as ghee as part of your daily diet
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External Oleation – Abhyanga oil massage
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Swedana (steam therapy) - mild to moderate steam therapy
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Nitya Virechana (mild purgation) with herbal medicine which may be administered before bed to induce mild purgation
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Nasya (instilling herbal oily substance into nasal passage) is good for many disorders pertaining to the head, neck, and senses. The nasal passages are a direct pathway to the brain, and the olfactory cells respond to volatile, water soluble, and lipid soluble substances. Many medicinal oils used for nasya contain these qualities and stimulate the brain through this pathway by inducing the production of neuropeptides, which reduces pain. (Radhika, Jan-Mar 2012)
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Greeva Vasti (retention of medicinal oil) is a retention dough dam made with black gram to hold the medicinal oil over the neck region. Many Ayurvedic oils like Dhanwantaram Oil and Balaswagandhadi Oil help support pain, stiffness and loss of movement associated with Cervical Spondylosis.
As per the published study, Greeva Vasti and Dashamoola Tailam for the management of Greeva Asthi Sandhi Gata Vata (Cervical Spondylosis) produced positive results (Pandey, 2013).
Action of Greeva Vasti explained:
A study was conducted on 10 patients of cervical spondylosis. They were advised Grīvā Vasti with Daśamūla Tailam for 35-45 min duration, for14 days.
Heated medicated oil is retained within the dough ring over the cervical area for a long duration of time (35-45 minutes). To ensure the constancy of temperature, a little portion of oil is taken out and the remaining oil within the wall is mixed with warm oil.
The heated oil helps to improve the space between the two neck bones, leading to relief from disk herniation. This also nourishes disk cartilage and bone to help prevent further degeneration.
The reason behind the selection of Grīvā Vasti is that it comes under direct contact with painful region. In this disease pathogenesis is at cervical-region and is mostly associated with structural changes of the vertebral column. There is derangement in cervical joints and vertebrae,
degeneration of intervertebral disc and lubrication function of Śleṣmaka Kapha is affected, which results in compression, irritation or inflammation of Nāḍi i.e. nerve, resulting in severe pain and muscle spasm. Therefore, local oleation and fomentation is very effective and gives quick results because they act at the site of pathogenesis.
Upon completion of the study, mean score of neck disability index was reduced from 24.2 to 8.3 giving a relief of 65.7%.
Other Ayurvedic therapies useful for reducing Vata Dosha include:
Shirodhara, Abhyanga, Patra Pinda Sweda, Shastika Sali Pinda Swedan or Navarakizhi, and Pizhichil.
Oils useful for external application:
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Sahacharadi taila
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Bala taila
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Mahanarayana taila etc.
Ayurvedic Medicines that might be recommended by your Ayurvedic Practitioner that are helpful in Cervical Spondylosis:
Yogaraja guggulu, Mahayogaraja guggulu, Rasnaerandadi Kashaya, Rasnadi Guggulu etc.
Yogasana for Cervical Spondylosis
It is critical to seek guidance of an experienced Yoga Therapist to know the proper alignment for your condition. There are asanas that are recommended for strengthening of the neck muscles and ligaments.
The benefits of Yogasana are enhanced when applying Maha Narayana Oil before practising.
Marma Therapy
Krikatika marma is useful in frozen shoulder and cervical spondylosis.
Book your Consultation today to discuss your treatment plan.
References:
Ayurvedic View on Cervical Spondylosis is from Dr J V Hebbar MD @ www.easyayurveda.com
Binder, A. I. (2007, Mar 10). Cervical spondylosis and neck pain. BMJ, 527–531.
Pandey, Y. K. (2013). Effect of Greeva Vasti in management of Greeva Asthi Sandhi Gata Vāta (Cervical Spondylosis). Ancient science of life, 71-75.
Radhika, C. K. (Jan-Mar 2012). A randomized controlled clinical trial to assess the efficacy of Nasya in reducing the signs and symptoms of cervical spondylosis. Ayu, 73-77.
