Thursday, 26 July 2012

Cervical Osteoarthritis

Cervical Osteoarthritis refers back to the degenerative condition of the cervical spine such as the intervertebral joints in between the vertebral bodies and also the vertebral discs. The other terms employed for this condition are

Degenerative disc disease
Degenerative spondylosis
Osteopytosis
Spondylitis deformans
It's very common in persons above Half a century of age and those who have to do work like typing or persons who've to keep the neck in a single position as in reading, writing along with other table works.
It comes down to degeneration of disc leading to, reduced space among two vertebrae, later osteophytes are formed within the periphery. This is followed by involvement from the posterior intervertebral joints leading to pain in the posterior area of the upper limb. Generally, this pain is together with tingling, numbness and radiating anyway.
The osteophytes formed could also compress the cord that will produce weakness of whole from the limb.

Predisposing Factors For Cervical Osteoarthritis
Faulty posture adapted is assigned to wrong habits, anxiety and mental tension.
Occupational stresses causes continous pressure around the cervical segments. The parts of society prone to stress and strain are-
a) Officers, typists yet others working on poorly and wrongly positioned desks and tables.
b) Drivers vulnerable to prolonged driving.
c) Coal miners and divers.
d) Persons involved with occupations including lifting and carrying things on their own head.
e) Practice of holding phone on a single shoulder while talking.
f) Over sleeping awkward positions, using inappropriate pilows.
Built from the body Persons having thick neck having a Dowager's Hump and long backs tend to be prone to spondylosis.
Sites
The segments commonly affected within the cervical region are C4 to T1. Together with these sites, other parts of spine will also be affected due to compensatory adjustments.

Clinical Feature Of Cervical Osteoarthritis
1)Onset: The problem gets precipitated by fatigue, mental tensions, worries, anxiety or depression. It happens gradually due to faulty posture.
2)Pain: The location of pain depends upon the site where the cervical spine is impacted by the pathology.
a) Upper cervical spine- Headache
b) Mid cervical spine- Neck pain
c) Region from C4 to T2- Radiating pain; pain in shoulder girdle, shoulder and arm, either unilateral or bilateral.
3)Muscle weakness: Based on which nerve root gets compressed, the concerned muscles which are supplied by that nerve root gets affected and weakened. Usually, the postural muscles from the neck are weak. They're: upper cervical spine flexors, lower cervical spine extensors and side flexors.
4)Sensation: There occurs paraesthesia which means, pins and needles or altered sensation from the particular dermatome which is given by the impinged nerve root.
5)Nature of pain: Usually referred to as dull, aching pain, sometimes gets exaggerated as sharp, stabbing pain and sometimes occurs as cramping type.
6)Limitation of motion: All the neck movements get limited, often bilateral but is unilateral in the event of acute onset of pain. The movement which gets greatly limited is flexion from the upper cervical spine and extension from the lower cervical spine.
7)On palpation: It's detected that there is lack of mobility of soft tissues together with loss of movements from the accessory intervertebral structures.
8)Muscle spasm: There's spasm mostly of the scalene muscle usually unilaterally. Because the middle and lower fibres of trapezius get lengthened and reduced in tone. Imbalance results resulting in the upper trapezius to bear increased tone and therefore there occurs muscle spasm and muscle tightness.
9)Postural disturbance: The posture gets disturbed in cervical osteoarthritis as follows-

Stress at C5,C6, so tightness of upper cervical spine extensors.
Chin placed forward.
Kyphosis of thoracic spine.
Tight pectorals.
Flattened, sometimes lordotic lumbar spine.
Flexion of elbows and hand.
Backward tilt of pelvis.
Hip flexed and knee flexed.
Ankles dorsiflexed.

10) Cervical spondylosis is generally associated with headache, vertigo and lack of balance which is because of postural changes.
Investigations
The only real investigation which can easily read the diagnosis apart from the the signs of the patient is radiograph. Early and proper diagnosis is essential for Treatment Of Cervical Spondylosis/Cervical Osteoarthritis. The X-ray finding reveals that there's:
Osteophyte formation at the margin from the apophyseal joints
Reduced space between your vertebral bodies
Lipping of the vertebral bodies

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