Orthopedics-Online

Chronic cervical spine syndrome

definition

A chronic cervical spine syndrome describes a clinical picture in which there are constant or recurring symptoms over a long period of time, which originate in the neck and shoulder area.

In addition to pain and restricted mobility, the irritation of nerves can cause a wide variety of symptoms.

Cervical spine syndrome can have different causes and the individual complaints are also not the same.

In the chronic cervical spine syndrome, a complete cure can often no longer be achieved.

The aim of treatment is therefore usually to relieve symptoms and deal with the disease as well as possible.

Causes of chronic cervical spine syndrome

The chronic cervical spine syndrome is a not clearly defined complex of various symptoms that can occur in different constellations and forms.

Due to the various possible causes of a chronic cervical spine syndrome, there are also various options for the doctor to code the present clinical picture according to the ICD-10 catalog of diseases.

If the doctor suspects signs of aging or if these are proven by imaging, the diagnosis is classified in the M47 category as a so-called degenerative cervical spine syndrome.

In many cases, however, a muscular tension is the cause, so that coding according to M62 as myogelosis in the cervical spine area can take place.

Category S13 coding is appropriate for sprains or strains of joints and ligaments in the neck area as the cause of chronic cervical spine syndrome.

If no clear cause can be identified but there are suitable symptoms of the syndrome, a diagnosis according to M53 can be made as another disease of the spine.

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Symptoms of chronic cervical spine syndrome

Since the chronic cervical spine syndrome is an inconsistent disease complex with partly very different causes and connections, the possible symptoms are diverse.

Most people have only some of the symptoms, but new ones may appear and others may subside as the disease progresses.

Most people with chronic cervical spine syndrome have frequent pain in the neck or shoulder area primarily.

These can radiate, whereby they are often perceived in the back of the head. In addition, many sufferers suffer from restricted movement of the cervical spine due to muscular tension and poor posture.

Since it is actually the most flexible part of the spine, restrictions there can affect the entire musculoskeletal system.
Some people who suffer from chronic cervical spine syndrome therefore also report an unsteady gait.

Other common symptoms are

Dizziness,
Nausea,
Visual disturbances and
Drowsiness
Furthermore, some people suffer from discomfort in the arms or hands. N
tingling or numbness can occur.
In some cases there is even muscle weakness in the arms.

However, since such symptoms can also indicate other causes such as a herniated disc in the cervical spine, such newly occurring symptoms should be clarified by a doctor's visit.

Radicular symptoms

Radicular symptoms are

Pain,
Numbness,
Tingling or
Symptoms of paralysis,

which can be traced back to the impairment of a particular nerve or a nerve root.

The nerve fibers leave the spinal cord in pairs between the vertebral bodies and supply the body in segments. In addition, the nerve tracts combine to form nerve cords, each of which is responsible for certain areas of the skin with regard to sensations (sensitivity) and movements due to muscle tension (motor skills).

If the symptoms are clearly radicular, it is suspected that there is a herniated disc, which is causing a nerve root to be detached

Brutality

Brachialgia is pain in the arm that is triggered by irritation of the nerve plexus (brachial plexus) from which the nerves of the arm originate.

In a chronic cervical spine syndrome, this plexus can become irritated due to tension in the neck muscles, for example.

In addition to arm pain (brachialgia), there can also be abnormal sensations in the arms or hands such as numbness or tingling.

Brachialgia in chronic cervical spine syndrome usually occurs on one side, but can also exist on both sides if the plexus is irritated on both sides of the body

diagnosis

The diagnosis of a chronic cervical spine syndrome can be made if the person concerned repeatedly suffers from the typical symptoms of a cervical spine syndrome over a period of several months or years.

In addition, there must be no evidence of other treatable causes of the symptoms such as inflammation or a bony injury.

The severity of the pain and tension can sometimes be stronger and sometimes less pronounced or even be absent on some days.

In order to diagnose a chronic cervical spine syndrome, no further examinations apart from the targeted physical examination and a medical consultation are usually necessary.

In some cases, a diagnosis using a blood sample or an imaging procedure such as an X-ray of the cervical spine is useful in order to rule out other possible causes of the symptoms

The treatment

As with the acute cervical spine syndrome, active exercise measures are the main focus of treatment in the chronic form.

Since a chronic cervical spine syndrome is often no longer completely cured, the treatment goals are usually the best possible way of dealing with the symptoms and alleviating the symptoms.

The person concerned should integrate regular physical activity into everyday life. Various sports are suitable, such as swimming, Nordic walking or yoga.

Strengthening the muscles by attending a back school also has a positive effect.

Learning relaxation techniques is also highly recommended.

Medicinal relief from pain or tension, on the other hand, should be the exception.

Long-term use of pain relievers carries many dangers and can even cause pain itself.

In the case of a chronic condition such as the cervical spine syndrome, not only the purely biological aspects of the complaints should be considered.

Both psychological and social factors have an important influence on the development and perception of symptoms.

When treating chronic cervical spine syndrome, support in these areas may be important. Problems or stress in the psychological or social area should be recognized and addressed at an early stage and, if possible, addressed.

The duration of a chronic cervical spine syndrome

A distinction is made between the acute and chronic cervical spine syndrome, whereby the acute can also change into the chronic form.
In contrast to many other diseases, there is no uniform definition of the duration from which one speaks of a chronic cervical spine syndrome.

In the case of back pain in general, symptoms of more than twelve weeks are considered to be chronic.

If the duration is between four and twelve, there is an intermediate form that is referred to as subacute. With a chronic cervical spine syndrome, a cure can often no longer be achieved. The aim of treatment is then usually to relieve and control the symptoms and improve the quality of life.

Degree of disability (GdB)

In the case of a chronic cervical spine syndrome, no general degree of disability can be determined.
The degree is primarily erect

the extent of the restricted mobility,
any spinal deformation or instability that may be present
as well as from the number of affected spine sections.

If there is neither restricted mobility nor instability, the degree of disability in chronic cervical spine syndrome is zero.

In the case of minor functional limitations, a maximum degree of disability of ten is usually specified. The maximum value of 100 is usually only available in the event of inability to walk or stand, which is usually not caused by a chronic cervical spine syndrome alone.

In principle, all gradations are possible between these extremes.

Can chronic cervical spine syndrome be cured?

Once a cervical spine syndrome has become chronic, often no complete cure can be achieved and the affected person suffers from the symptoms sometimes more and sometimes less.

The goal in the treatment of a chronic cervical spine syndrome is therefore no longer healing, but rather the best possible relief and control of the symptoms.

This is achieved through various factors such as

learning relaxation techniques,
regular physical activity and
the occasional use of pain relievers.

In the case of chronic complaints, social and psychological influencing factors often have a major influence on the development and perception of complaints, so that the best possible handling of the symptoms is sought through support with these aspects.
In some cases, after a while, symptoms can be eliminated and a cure can be achieved.

Sick leave

In the case of a cervical spine syndrome, the doctor often issues a certificate of incapacity for work (“sick leave”) for a few days.
This is necessary if the cause of the complaints can be traced back to work or if the symptoms are expected to worsen as a result of further work.

However, the sick leave should definitely be used to specifically contribute to combating the causes of the cervical spine syndrome through physical activity.
In no case should you just take it easy on your body in such a case. Frequent and long-lasting sick leave with a cervical spine syndrome should generally be avoided, as this tends to make the symptoms chronic.

You can read more about sick leave under: Cervical spine syndrome - effects and consequences

Inability to work and early retirement

A chronic cervical spine syndrome and other diseases of the spine are among the most common causes of early retirement.

However, most applications for reduced earning capacity due to back problems are initially rejected by the German Pension Insurance.

Often, several rehabilitation measures have to be carried out first and lengthy medical assessments must be carried out. Even in the case of a cervical spine syndrome, it is strongly recommended to take active measures early on in order to prevent long-term inability to work.

An important aspect is the regular implementation of a career-balancing and individually suitable exercise program.

An application for early retirement should only be considered if, despite all efforts and the best possible social and psychological support, there is no prospect of maintaining the ability to work.

You usually get support from your family doctor.

The continuation of the topic can be found here: Cervical Spine Syndrome - Effects and Consequences

Pseudoradicular symptoms

Pseudoradicular symptoms in chronic cervical spine syndrome are referred to as radiating pain or abnormal sensations such as tingling or numbness in the shoulders or arms, the distribution pattern of which cannot be clearly assigned to the supply area of individual nerves or segments.

In contrast to the radicular symptoms, pseudoradicular symptoms do not arise from the localized impairment of an individual nerve or a nerve fiber, but rather from unspecific irritation of nerves, for example through muscle tension in the neck.

Further complications of the cervical spine syndrome can be found at: Cervical Spine Syndrome - Effects and Consequences