How to treat cervical spondylosis?

(I) traction 1. Indications Cervical traction is often used as the treatment of choice for neurogenic, cervical and sympathetic cervical spondylosis. However, it is not suitable for those with obvious spinal cord compression and obvious segmental instability of the cervical spine in spinal cord-type cervical spondylosis. 2. Methods of cervical traction Generally, cervical traction is performed with a cervical pillow traction belt. (1) posture: position can be taken sitting or lying down, in order to facilitate, more stable sitting position, so that the neck from the longitudinal axis of the torso forward about 10 ° - 3O °, to avoid over-extension. The patient is required to fully relax the neck, shoulder and the entire trunk muscles. The traction position should be comfortable for the patient, and should be adjusted as appropriate if there is discomfort. In patients with vertebral artery type, the anterior tilt angle should be smaller, and patients with spinal cord type cervical spondylosis should take nearly vertical posture, avoiding forward flexion traction. (2) traction weight and duration: commonly used traction weight varies greatly, from the patient's own body weight of 1/10 to 1/5, most of the 6-7kg, the beginning of a smaller weight to facilitate the patient to adapt. Each traction near the end of the patient should be obvious neck stretching feeling, but no special discomfort, such as this feeling is not obvious, the weight should be increased as appropriate. The duration of each traction is usually 20-30 minutes. Traction weight and duration can be made in different combinations, generally shorter duration when the traction weight is larger, longer duration when the traction weight is smaller. (3) Frequency and duration of traction: generally 1-2 times a day, but also 3 times a day, 10-20 days for a course of treatment, which can be continued for several courses of treatment until the symptoms are basically eliminated. (4) If the efficacy of sitting traction is not good, or the patient's symptoms are more serious or weak and can not sit long, can be used in the supine position traction. With pillow cushion to maintain proper posture, traction weight is generally 2-3kg. 2 hours of continuous traction and then rest for 15 minutes, and then traction, traction total time up to 1O-14 hours per day. (5) The use of electric traction equipment can be intermittent traction, is considered to be conducive to relaxation of muscles, improve local blood circulation. Generally, traction for 2 minutes, relax or reduce the weight of traction for 1 minute, repeated for about half an hour. (B) Tuina 1. Role and indications Chinese medicine believes that cervical spondylosis is due to long-term neck strain, qi and blood disharmony, coupled with external wind and cold, blockage of meridians and collaterals due to the treatment of Tuina can harmonize qi and blood, gui wind dispersal of cold, dredge the tendons and collaterals, so as to achieve the role of antispasmodic pain. Tui na is suitable for all types of cervical spondylosis except spinal cord type with severe cervical spinal cord compression. For spinal cord cervical spondylosis, massage therapy is not traditionally advocated as it may aggravate spinal cord damage, but safe and effective traction and massage therapy have been reported in China. Therefore, massage therapy is not necessarily contraindicated for mild spinal cord cervical spondylosis, only that it should be mild and exempt from spinning and wrenching techniques. 2. Methods: Tui na therapy for cervical spondylosis should be a combination of rigid and soft, and should not be rough. Commonly used manipulation procedures are as follows: (1) Repeated palm rubbing, probing and one-finger Zen pushing at the back of the neck, and then pointing, pressing, or holding at some of the acupoints in the neck and shoulder area such as Feng Chi, Feng Fu, Shoulder Nei Yu, Shoulder Wells, Tian Zong, and Wu Pang, and then popping and plucking at the trapezius muscle and the levator scapulae muscle. If it is the nerve root type, the treatment should include the main acupoints of shoulder, elbow and hand; if it is the vertebral artery type, it should include the acupoints of Baihui and Sun in the head and face. Next, use the rotary trigger maneuver. Finally, end with a wipe, percussion, patting method for the end. (2) The implementation of the rotary trigger maneuver, first asked the patient to rotate the neck to the side, the operator's hands were placed on the patient's lower occipital and occipital part of the back of the trend at the same time a little force to rotate the head and neck. At this time, attention must be paid to: 1) the angle of rotation should not be too large; 2) the "clicking" sound that may be made when rotating the neck should not be pursued unilaterally; 3) spinal cord and vertebral artery type cervical spondylosis should not be subjected to rotary trigger manipulation. (Physiotherapy can improve local blood circulation, relax spastic muscles and relieve symptoms. Methods can be selected from high frequency (microwave, ultrashort wave), low and medium frequency electrotherapy (such as TENS, intermittent electrotherapy, computerized intermediate frequency), ultrasound, magnetic therapy and so on. (D) Exercise therapy 1. The role of exercise therapy The exercise therapy of cervical spondylosis is mainly to do medical gymnastics exercises, the purpose and effect of medical gymnastics for cervical spondylosis are mainly twofold: (1) through the relaxation of the neck in all directions, to activate the cervical spine regional blood circulation, eliminate the bruises and edema, and at the same time stretching the cervical ligament, relaxing spasmodic muscles, thus alleviating the symptoms; (2) to enhance the cervical muscles, enhance their ability to tolerate fatigue, and improve the cervical vertebrae's ability to tolerate fatigue. tolerance and improve the stability of the cervical spine, thus consolidating the therapeutic effect and preventing recurrent attacks. 2. Indications and contraindications When the symptoms of all types of cervical spondylosis are basically relieved or in a chronic state, medical gymnastics can be started to promote further elimination of symptoms and consolidation of therapeutic effect. During the acute attack of symptoms, it is advisable to take localized rest, and it is not advisable to increase the stimulation of exercise. Exercise is contraindicated when there are obvious or progressive spinal cord compression symptoms, especially cervical backward movement should be contraindicated. In vertebral artery-type cervical spondylosis, neck rotation should be gentle and slow, and the amplitude should be appropriately controlled.