Cervical spine problems, or HWS for short, are no longer uncommon these days. Doctors and physiotherapists are increasingly finding people with an abnormally stretched cervical spine. What exactly is going on there?
Damn, she almost missed the two cyclists when she turned off. Marion B., 42, can break just in time. But the dicey situation makes the tax clerk drastically aware: she urgently needs an appointment with the doctor. She can barely turn her head.
When the "view from the shoulder" only covers a limited field of vision while driving, it is a clear sign that the mobility of the cervical spine is restricted. Not a rarity today - and with our modern way of living and working, clearly a new civilization ailment. Increasingly, doctors and physical therapists are seeing patients in whom the cervical spine has even undergone non-physiological changes due to constant stress. "It has lost its natural curve, has become steeper and more rigid," says Jürgen Förster from the Center for Chiropractic and Osteopathy Dresden. Above all, a one-sided posture for hours in front of the computer, at the laboratory table, or in the hair salon is to blame for such changes. Are digitalization and monotony in job and leisure time increasingly taking their toll?
Our cervical spine (CS) is an ingeniously designed masterpiece of nature
Seven of our 24 movable vertebrae are part of it. The uppermost, C1 (C = cervical or neck vertebra), also called the "atlas", carries our head, just as the eponymous Titan from Greek mythology balanced the heavens on his shoulders. Thanks to an egg-shaped joint between it and the skull, we can raise and lower our heads. We can rotate it because the atlas has a ring into which a bony process of the second cervical vertebra (C2 or "axis") protrudes, forming an axis of rotation. The two vertebrae together are our upper cervical joint, a well-rehearsed team, but one that is quite susceptible to disruption. This is because nerve conduits run toward the spinal cord and brain at this very point. The remaining five cervical vertebrae (C3 to C7), which complete the slight inward curve of the cervical spine, are less mobile. They urgently need strong muscles in the neck to stabilize the neck. But this is often lacking. The result: a so-called cervical spine or cervical syndrome, which is almost always accompanied by pain and tension in the muscles.
Cervical spine syndrome: More than limited flexibility
"Six to eight centimeters deep is our musculature in the neck. If they are strained too much, the superficial muscles tense up first. If the deep ones are too weak, the head becomes misaligned," explains Professor HansRaimund Casser, Medical Director of the DRK Pain Center in Mainz. The specialist for orthopedic rheumatology and pain therapy knows from his practice: With such a muscular imbalance and simultaneous permanent stress, the cervical spine is overstretched, it becomes steeper. "Affected persons can no longer bring the chin to the chest or lift it up, and the ability to rotate is restricted." During X-rays, Hans Raimund Casser has patients specifically stretch their heads forward and far back. He sees that the lower three vertebrae are often so stiff that the upper ones have to move even more. The result: vertebrae shift out of position ("spondylolisthesis"), and the spine becomes more unstable. In addition, from the age of 40 at the latest, the mobility of our spine decreases anyway, because the small vertebral joints undergo degenerative changes. "This is as normal as wrinkles in the skin," says Casser. However, if the muscles are imbalanced, the risk increases that these small joints will become misaligned and completely block movements. Then nothing works at all.
Is excessive smartphone use a trigger of cervical spine syndrome?
Excessive smartphone and tablet use also causes muscular misalignment. "Cell phone neck" is already the striking name for this. Our head weighs around five kilograms. When we look at a display, we tilt it down by 30 to 40 degrees. "Due to the leverage, forces of about 20 kilograms then pull on our neck and neck muscles. That's equivalent to the weight of a crate of water," says Professor Bernd Kladny, head physician of orthopedics and trauma surgery at the specialist clinic in Herzogenaurach. If we also use both thumbs to type text messages and Whatsapp messages, the muscles in the neck and shoulder area are put under additional strain. Anyone who does this for two to four hours a day need not be surprised by unpleasant tension, says the Secretary-General of the German Society for Orthopedics and Orthopedic Surgery (DGOOC). "Due to the self-imposed forward-bending forced posture, the spine collapses and the chest muscles shorten, while other muscles such as the trapezius tense." This muscle, which runs like a triangle from the back of the head to the lower thoracic vertebrae on both sides of the spine, is often involved in tension headaches.
Important: Do something about it as early as possible!
Especially if other symptoms indicate that nerves proximal to the cervical spine are already inflamed elsewhere in the body: A indication could include tingling and numbness in the arms, furriness in the hands, dizziness, tinnitus, and face pain. Neck tension can even disrupt the nerve plexus, which controls our heartbeat. If heart palpitations persist after a cardiologist has ruled out an organic cause, Hans-Raimund Casser recommends checking the cervical spine. "Many people aren't aware of how tense they are." X-rays and magnetic resonance imaging are rarely used because a qualified orthopedist detects muscular imbalances during a comprehensive examination.
If it turns out that vertebral joints have become misaligned...
the first step in therapy is to clear the blockage. Important: Only a trained professional should assist; the risk of injury is extremely significant, especially in the cervical spine, as orthopedist Casser advises. "After that, the musculature must be urgently relaxed using energy techniques to avoid fresh blockages," the specialist advises. A doctor or a properly qualified manual therapist carefully stretches the shorter cords, millimeter by millimeter, at first. It was not a pleasant experience. "The body fights the stretching," Bernd Kladny explains. Nonetheless, it is required. The weaker counterparts can only be strengthened after that.
This requires regular practice, even at home, for which the therapist puts together an individual program. Gentle massages and heat packs can support the effect of active training. Medication and injections can alleviate pain in the beginning if necessary. Rest is taboo if there are no serious neurological problems. Nevertheless, it often takes weeks or even months until the imbalances are corrected. Biofeedback therapy can be helpful. Sensors on the body measure the tension of the muscles and make it visible on a computer screen. In this way, many sufferers can better sense their body and its reaction to stress and learn targeted relaxation techniques to influence it.
An improvement in the long run!
However, to develop in the long run, the workplace must be ergonomically and properly set up. For VDU work, it's common to substitute varifocals with special glasses. It's also critical to train the 150 or so muscles that keep our spine stable and supple daily. And, of course, the "weak spot of the neck" must be taken into consideration. "When people are agitated, they unconsciously draw their shoulders up," says Monika Hasenbring. "You have to become aware of such ritualized actions and make targeted changes." However, she says it is indispensable to bring more movement into everyday life, to compensate for rigid postures through fitness training, to interrupt monotonous sitting for hours as often as possible, and to put cell phones or tablets aside from time to time. "We should finally take breaks seriously again and value them," the psychologist demands. "Because a break gives us fresh energy, and with that, we can work better again right away." And it provides valuable relief for our necks.
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