How effective is homeopathy in cervical spondylosis

Osteochondrosis

Osteochondrosis (osteochondrosis intervertebralis): Signs of wear and tear on intervertebral discs and bony vertebral bodies, which, depending on the extent, lead to back pain and restricted mobility that are often difficult to treat. The main cause of the signs of wear and tear are aging processes, which are favored by obesity and a predominantly sedentary lifestyle. Disc herniation and spinal stenosis with neurological deficits such as paralysis or abnormal sensations threaten as complications.

Therapy is with painkillers, physiotherapy and specific exercises for the back. If conservative measures are unsuccessful or if the disease is very advanced, surgical interventions such as B. the replacement of the affected intervertebral disc with a disc prosthesis or a stiffening operation of the spine.

Leading complaints

  • Persistent lower back pain (when the lumbar spine is affected)
  • Persistent pain in the neck, possibly headache (if the cervical spine is affected)
  • Restriction of movement, difficulty bending down, turning the body or head
  • Relief posture, torticollis
  • Depending on the extent of the degenerative changes, radiating pain into the toes or fingers.

When to the doctor

After 1–2 weeks at

  • local pain with no radiations.

Within a few days at

  • mild persistent numbness in the arm or leg.

Within a day at

  • Paralysis or extensive numbness in the arm or leg.

The illness

Disease emergence

The spine and intervertebral discs are exposed to great stress every day, so a certain amount of wear and tear is normal in old age. The intervertebral disc is affected in two ways: on the one hand, the water content of its gelatinous nucleus, i.e. the "cushion" in the middle of the intervertebral disc, decreases, and on the other hand, cracks form in the surrounding fibrous cartilage ring. The resulting reduction in height of the intervertebral disc disrupts the finely coordinated movements between two vertebrae and leads to increasing damage to the adjacent vertebral bodies. Similar to osteoarthritis, there are additional bony outgrowths on the vertebrae that sometimes rub against each other and cause pain.

Such signs of wear and tear are favored by overloading the spine and intervertebral discs. The intervertebral discs that are compressed during the day normally absorb water at night in order to be able to perform their shock absorber function again the next day. Permanent stress disrupts this regeneration, which means that the intervertebral disc remains compressed and its height is reduced.

The following factors contribute to excessive stress on the spine and its intervertebral discs:

  • Sedentary lifestyle leads to a breakdown of the back muscles. Weak back muscles cannot adequately support the spine and its shock-absorbing intervertebral discs in their supporting role. As a result, the intervertebral discs are increasingly stressed and worn out.
  • Obesity puts heavy strain on the spine and thus also promotes wear and tear on the intervertebral discs.
  • Spinal curvatures like scoliosis lead to unilateral stress on the intervertebral discs and vertebral bodies. The structures then wear out more quickly, especially in the areas that are subject to increased stress.
  • Intervertebral disc surgery and disc inflammation often changes the structure of the disc and its surroundings. As a result, they damage the intervertebral disc directly or indirectly, e.g. B. by an incorrect load.

The intervertebral discs not only cush the entire spine, but also enable rotating, bending and stretching movements. The nucleus of the intervertebral disc (blue spheres) is decisive for its function. This loses much of its shape as it gets older, as the lower row of images shows: On the left, the intervertebral disc of a young person, the nucleus of the disc is clearly visible as a delimited white structure. On the right, however, the intervertebral discs of a 70-year-old with extended, flattened intervertebral disc nuclei and numerous cracks that can be seen as white lines.
Georg Thieme Verlag, Stuttgart

clinic

The lumbar spine is most commonly affected by osteochondrosis. Here the disease manifests itself through pain in the lower back, which becomes more and more severe as it progresses and often leads to an - additionally harmful - posture. Neck pain is typical for osteochondrosis of the cervical spine. If the head is held gently or at an angle, there is also tension and severe headaches. In the further course of osteochondrosis, the affected areas stiffen, making movement more difficult. At this stage the pain often subsides because the bony outgrowths are now fused and can rub less against each other.

Complications

Osteochondrosis is often the basis for other diseases of the spine. For example, previously damaged intervertebral discs promote the occurrence of herniated discs. The bony outgrowths of the vertebral bodies can in turn narrow the vertebral canal and thus cause spinal stenosis. In both diseases, the pressure on the nerve tissue can lead to numbness, abnormal sensations and even paralysis.

Diagnostic assurance

The doctor asks the patient exactly when and where the pain occurs, whether it worsens with exertion and subsides at rest. During the physical examination, he tests pain and tenderness in the spine area by palpating the back. In addition, the doctor examines the mobility of the spine, he lets the patient stretch and bend and turn the head and upper body and tilt to the side.

If osteochondrosis is suspected, an X-ray can help. Both the reduction in height of the intervertebral spaces (as an indication of the reduced height of the intervertebral discs) and the bony outgrowths of the vertebral bodies can be clearly identified. With the help of MRI, it is possible to directly detect the pathological changes in shape of the intervertebral discs.

Note: Numerous researchers engaged in magnetic resonance imaging of lumbar spine in healthy people in the 1980s and 1990s. Regardless of the differences in detail, all studies showed a high percentage of (symptom-free) disc damage of all kinds. If the doctor discovers disc damage on CT or magnetic resonance imaging, he will critically examine the connection with existing symptoms. What is irrelevant for one patient may mean a medical emergency for another. Conversely, the doctor often does not find an equivalent in the CT or magnetic resonance imaging even with the most severe back pain.

Differential diagnoses. Other causes of back pain are vertebral body fractures, facet syndrome, tumors, metastases, or inflammatory changes in the spine.

treatment

As with almost all wear-related diseases of the spine, the main pillars of treatment are the fight against pain and - especially in the thoracic and lumbar vertebrae area - the long-term stabilization of the back by building up supporting core muscles.

Conservative therapy

Medication. To treat the pain, the doctor will prescribe pain relievers and anti-inflammatory drugs such as B. Diclofenac (e.g. Voltaren® or Diclac®) or ibuprofen (e.g. Ibu® or Brufen®). In stubborn cases, short-term injections of pain relievers and anti-inflammatory agents directly into the affected area help.

Physical therapy. Once the acute pain phase has been overcome with the help of medication, physiotherapy begins. The first thing to do is to loosen the muscle tension caused by the pain. For example, heat, red light, fango or massages are used for this purpose.

Active physiotherapy. Once the muscles are relaxed, back-strengthening physiotherapy begins. Targeted exercises help build supportive muscle groups that stabilize the spine. They stretch tense and shortened muscles and thus improve back mobility. They also train coordination and body awareness, which in the long term leads to more back-friendly and healthier movement patterns.

Back school. In addition to gymnastic exercises, the "back school" imparts knowledge about behavior that is gentle on the back. Health insurance companies, physiotherapists and rehabilitation clinics offer courses on this, the costs of which are often covered by the health insurance company. The back school is helpful for chronic back problems if the person concerned uses the techniques they have learned on their own in their everyday lives.

Aids. In some cases, the orthopedic surgeon also prescribes a kind of support corset or corset to relieve the spine.

Operative therapy

Surgery is required if conservative measures do not bring relief, if the disease is very advanced, or if complications arise.

Stiffening operation. Standard surgery is the stiffening of parts of the spine (stiffening operation). The surgeon inserts screws into the vertebral bodies of the affected region and connects them with one another in the longitudinal and possibly transverse directions using rods. In addition to stiffening, individual areas of the spine sometimes also need to be straightened.

Intervertebral disc prostheses. Another therapy option is to replace a worn disc with a disc prosthesis made of metal and hard plastic. The procedure has proven to be safe and sustainable; in contrast to prostheses for large body joints, there is hardly any loosening. Further studies will have to show whether the implantation of intervertebral disc prostheses shows better results in the long term than stiffening. In addition, disc prostheses are out of the question for some patients. If, for example, there is arthrosis of the intervertebral joints in addition to the worn intervertebral disc (such as facet syndrome), the stiffening of this segment remains the treatment of choice.

Note: You can find more information on conservative and surgical treatment of back pain in the article Back pain.

forecast

The prognosis depends crucially on the stage at which treatment is started. In the case of minor complaints in the lumbar spine, patients can often get their pain under control with back training and pain relievers.

If the cervical spine is affected or at an advanced stage, an operation is usually necessary. In many cases, however, restrictions remain here.

Your pharmacy recommends

What you can do yourself

In the case of acute complaints, it is crucial to get moving again quickly and to break the vicious circle of pain - tension - more pain. All variants of back-friendly behavior are recommended for prevention. Anyone who manages to keep the spine flexible and the muscle support functional is half the battle.

Move.

As with most back pain therapy, the motto is: more exercise. However, in the long term, most people only do those types of exercise that they either enjoy or that can be easily integrated into their everyday lives.

  • If possible, go on foot or use the bike. Prefer the stairs to the elevator or escalator.
  • Do you do sports. Sports that are easy on the back and train the core muscles are swimming, aqua jogging, cycling, Nordic walking and cross-country skiing. Make sure you have good equipment (running shoes).
  • If this type of exercise suits you, start weight training at the gym. With competent supervision, you can specifically build up muscles that strengthen your back.
  • If you sit in the car a lot for work, buy a good car seat and use the breaks to walk around, stretch and stretch.
  • When you are in the office, do as much as possible while standing or walking. Such breaks in movement are particularly important in times of stress in order to prevent tension in the neck and back muscles.
  • While sitting, change your position regularly, alternately leaning slightly forward, upright and leaning back.

Workplace ergonomics.

Work chairs with the "dynamic sitting" function make sense. They have a backrest that moves with you and supports your back at the same time. If you find it difficult to change your sitting posture frequently, choose a permanent sitting position that includes an angle of around 120 ° between your back and thighs. What used to be perceived as a sloppy posture has proven in more recent scientific studies to be significantly more back-friendly than a "straight" sitting posture with a right angle in the hip. The correct height of the table and chair is also important for workplace ergonomics. Ideally, the upper and lower arms as well as the upper and lower legs form at least a right angle. If the arms rest loosely on the armrests, this position relieves the shoulder area. Palm rests in front of the keyboard also relax the shoulders while typing, but are also good for the neck.

Work that is easy on your back.

If you do physical work, try to avoid activities that put strain on your back as much as possible. If this does not succeed, carry out the required work in a way that is easy on your back. Lift and carry objects with your back straight and evenly distributed on both arms. Carry heavy loads close to your body and absolutely avoid turning your upper body while standing. Better: crouch down instead of bending down, as far as your knees allow.

Normalize weight.

Reduce excess weight. This not only relieves your back, but also increases the joy of movement and joie de vivre at the same time.

reduce pain

Medication.

Do not hesitate to take pain medication for acute pain. If you are otherwise healthy, there is nothing to prevent you from using over-the-counter pain relievers for a maximum of three days, e.g. B. NSAIDs such as diclofenac (e.g. Voltaren® or Diclac®) or ibuprofen (e.g. Ibu® or Brufen®) or paracetamol (e.g. ben-u-ron®). They help break the vicious circle of pain and tension.

Complementary medicine

Warmth.

Warmth soothes and relaxes the muscles, thereby helping to relieve pain. Warm full baths (calming: lemon balm, lavender; stimulating and stimulating blood circulation: rosemary), warm wraps (hay flower, fango), hot water bottle or warming pillow in bed, blood circulation-promoting plasters (e.g. ABC warming plasters), rubs, for example, have proven to be useful. B. with horse ointment, warming underwear made of angora wool, woolen scarves or a visit to the sauna. Because of the circulatory stress, people with heart disease must first consult their doctor before treating themselves with full baths, diapers or visits to the sauna.

The hot roll is particularly effective: Fold a kitchen towel and two terry towels lengthways. Wrap the kitchen towel width-wise into a tight roll. The other two towels are wrapped around them diagonally so that the whole thing looks like a funnel or like a candy that is only opened on one side. Now pour about three quarters of a liter of scalding water into the roll (be careful of burns!) And wrap the terry towels completely around the now wet inner roll. Check the heat. If the roll is too hot, wrap another terry towel around it. With this hot roller, roll, dab and massage over your back. When the roll gets cooler, take off a sheet of terrycloth.

Cold.

In acute irritation, cold sometimes works better than heat. Cool packs from the pharmacy or crushed ice cubes wrapped in a washcloth and placed on the painful area several times a day for 1–5 minutes have proven effective. To prevent frostbite, it is advisable to wrap the pads in a cloth and avoid direct contact with the skin.

Manual therapies.

In particular, osteopathy and spinal column therapy according to Dorn indicate treatment successes, and there are also reports that acupuncture alleviates the symptoms in many cases. Gentle movement therapies such as yoga, Thai Chi, Qigong and Feldenkrais are recommended for recurring complaints.

In the case of locally limited complaints without radiating pain in the extremities, the same complementary medical methods can also be considered as the measures described in the article back pain.

Further information

Authors

Dr. med. Sonja Kempinski using text excerpts from: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). | last changed on at 16:52


Important note: This article has been written according to scientific standards and has been checked by medical professionals.The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.