Cervical Spondylosis Explored
Posted , 10 users are following.
Hi fellow C/S'ers.
I wanted to open a new discussion, to allow some space for those with Cervical Spondylosis (C/S) to simply express their opinions (including my own obviously) on how they think the C/S dynamics, and its progress over time actually results in the changeable symptoms they experience. I have my own ideas about how it all combines to produce the daily struggle we endure, but I'm also aware that opinions differ, and it might be a wise thing to do to consider other opinions, so that I get a more balanced overview. Same for everyone, I suppose.
I've had C/S a long time, over 30 years, and I've many of the different phases that are common to posters on this site, and other sites. One thing that strikes me is that most posters are in different phases of the condition, and although sympathy/empathy are nice things, they don't quite get into the area of finding or sharing suitable solutions for those differing experiences. What seems to be missing is a general overview, common to all, and acceptable to all, which would give a foundation to build suitable solutions upon. Some might even think that there are no solutions, except poossibly medications or surgery....but, I personally, disagree with that, because I reckon that those possible but risky solutions are only relevant to certain grades of C/S.
The one thing that really stands out for me, after experiencing many different types of C/S phases, is that reasonable manageability always seems to return after difficult phases, and I'm inclined to ask questions about that because that is not a common feature of many other chronic conditions. It's like a rollercoaster effect, which in turn plays a bit of havoc with our expectations, and with our default settings for just getting by with the least possible disruption. It adds to the overall problem, by introducing a mindset that can't predict tomorrow's issues. Also, I think that just adds to an undermining of the decisions we might want to make in the present moment, decisions which might affect how tomorrow actually does evolve.
Just going back to the issue of 'phases' which pass, I've come round to seeing that as an attempted 'corrective' dynamic, whereby most of the symptoms we experience probably result from reactions to threats of nerve compression, and that those same symptoms have little to do with bone degeneration except in the sense that the threat to nerves wouldn't happen if there weren't any bone degeneration. I realise that some people with C/S have an underlying arthritic condition which increases degenerative rates, and thus increases symptom potential, but I still think it makes sense that symptoms result from threats to nerves rather than from spinal degeneration (although one causes the other, and the other causes the symptoms). By that definition, I think it's possible that even where there is serious degeneration, it doesn't necessarily mean the symptoms will get worse....unless there is accompanying increase of threat to nerves. Make sense ?
So, just wondering if anyone has an opinion to offer on this, whether agreeable or not, and maybe we can thrash something out to help create a better picture that people can understand.
Comments welcome......
Gerry
0 likes, 55 replies
Gerry_the_neck
Posted
On the understanding that I am exploring approach overviews for neurological conditions, particularly Cervical Spondylosis, I think there’s one issue which creates a tendency for overview error. Most ‘normal’ injuries/diseases manifest as symptoms which are referred to an ‘emergent’ perception in the mind. There is usually a direct correlation between perceived symptoms and actual injury/disease. This correlation, alone, is very reassuring for the patient....it insists on applying treatments to enable and assist healing. The mindset, which accompanies the perceptions, is usually non-contradictive and determined in organising a response.
When it comes to neurological conditions, particularly where there may be a trapped, or even a threatened nerve, what is observed is, first, a referral of symptoms (and their perception) to a different location than the threatened site, before a confused ‘emergent’ perception is created in the mind. The correlation between injury/disease and perception is broken, as perceived intuitively, the subsequent mindset is confused about ‘cause and effect’, and it becomes difficult to construct a meaningful response. I’m also inclined to think that operators have considerable difficulties defining (and treating) referred symptoms in a meaningful way, and have a tendency to write-off referred symptoms as ‘nerve misbehaviour’. Referred symptoms simply don’t react as one would expect from more ‘normal’ injury symptoms. This , of course, carries over to the patient in a ‘best to ignore’ sub-text.
My problem with all that is simple. If we can’t define what proper nerve behaviour ought to be, then we can’t assume that there is any such thing as ‘nerve misbehaviour’. The referred symptoms, and their perceptions, are meant to happen. They happen consistently over the global population, and they are anything but nerve misbehaviour. They most likely are the nervous system’s least threatening method of response to a threat to itself....i.e. a trapped or threatened nerve. By giving a ‘purpose’ to the referred symptoms, which we should be obliged to do for science reasons alone, we would also help settle the patient mindset into a more constructive mode, to help with coping and treating. Any overviews, reflected back onto the patient, because of lack of understanding of unusual nerve behaviour, will undoubtedly have an opposite unsettling effect.
Obviously, the science hasn’t yet caught up with the difficult to define referred symptoms associated with trapped and threatened nerves. The symptoms must have a ‘purpose’....but their behaviour seems to contradict normal nervous system behaviour, and that creates an anomaly in the thinking, which then reflects onto a patient’s consideration of treatment options. Referred symptoms are probably best treated with programmes which enhance and assist normal coping mechanisms....but that option is perhaps being unintentionally undermined by reflected misunderstandings of nerve behaviour when a nerve is, itself, threatened.
michael_b Gerry_the_neck
Posted
Gerry_the_neck michael_b
Posted
Regarding the C/S, I think the operators adopt set patterns of thinking/assessing, based on more straightforward injuries, and that then conflicts with their observations of referred symptoms. And so, they tend towards ignoring, or classifying as nerve misbehaviour which seems to lack reason ......the symptoms we experience are well documented, verified by EMG etc, and consistent with all cases. And still they shrug them off as incidental misbehaviour. Too convenient, if you ask me.
Gerry_the_neck
Posted
Of course, then we have to ask ourselves why they might adopt an overview of convenience. Only reason I can think of is that they already know that the treatments on offer are pretty useless, if not possibly harmful, and therefore it's easier to reduce their sense of engagement as early as possible in the treatment processes. That's one way they can hedge their bets against expected failure ! I knowe that sounds a bit negative, but I reckon I do better progressive thinking than most of what I've come across in my own C/S treatments. I also think there's a tendency towards conveniently overlooking any feedback they get from patients who do submit to treatments. Looks like a cycle of misunderstandings, based on a premise which evaluates nerve behaviour incorrectly. They should listen to us before assuming anything.
Gerry_the_neck
Posted
It’s really quite remarkable that we don’t as yet have a clearly organised definition of the pain event. There are many theories, from Cartesian to emergent, but, perhaps not too unstrangely, these theories seem to remain unchallenged within the small pockets of thinking fraternities which created them. There is an obvious lack of resonance between the theories and the subjective narrative of pain experience. Currently, the most aggressive theories suggest that pain is a psychological ‘emergent’ perception, which doesn’t require a direct link, nor correlation, to an actual threat of injury or disease. In other words, the ‘emergent’ perceptions can instigate themselves, and perpetuate themselves, with no known recognisable cause, and with no known predictive certainty about perpetuity. I am inclined to dispute such an overview because it would seem to relegate pain perceptions into relative insignificance when assessing any patient....’if the pain perceptions have no known origin, and if their fluctuations depend upon patient mindset variations, then there is obviously no pressing requirement for any interference other than attempting to alter a patient’s mindset ’ ! And so, I must ask again....’What is pain, exactly ?’, because I have an intuitive sense that conflicts with that theorised approach.
So, what is the most obvious attribute of a pain event/perception/sensation, besides the more obvious discomfort it causes ? For me, top of the list has to be the manner by which our normally clear and responsive thinking seems to lose its clarity. A confusion is imposed on conscious thought, which highlights the distress, but discourages reaction which might be inappropriate. This may well be the ‘purpose’ of the pain perception, especially if we consider that a hasty reaction might further threaten an already vulnerable situation. If we think of a ‘purposefully’ created pain perception, perhaps originating in the autonomic protective systems, and then manifested in the conscious mind, as a means of restraining conscious reactions, it would seem to tick a lot of boxes about pain perceptions which aren’t normally considered. Generally, we only tend to see pain perceptions as threat warnings, or as signals requiring reactions. So, if we tinker with our overview a little, it’s not too difficult to come up with an almost opposite explanation i.e. that pain is meant to restrain reactions. I don’t think there could be much of an argument against the possible beneficial effects of a restraining ‘purpose’ , thus feeding into the overview perception of pain being a ‘for the good’ essential tool of the autonomic protective systems. We already know that our autonomic systems, the nervous system and the immune system, operate for our benefit, almost perfectly, and without any conscious control or interference, so why not assume that pain perceptions are an integral feature of that same protectively organised structure.
My own understanding of pain perceptions, intuitively observed, incline me towards seeing pain perceptions as some ‘crossover’ event, where, because consciousness requires perceptions to function, and where we have no conscious perceptions of nervous system/immune system operations, there has somehow evolved a need for a restraining element to discourage any inappropriate reactions. Seeing pain perceptions in that light, I think it gives a ‘purpose’ to the pain event which can be rationalised, and would have a beneficial effect on the way patients currently understand and respond to their pain experiences. On the other hand, if we define pain as a variable event, lacking any particular purpose, are we not really just assuming that pain treatments might be irrelevant to the bigger picture of treating recognisable threats. For instance, with neurological painful conditions, where no obvious source has been detected, are we to assume that the patient’s pain narrative should be ignored as ‘possibly consciously invented’ ? The ethics involved in such assumptions flag themselves up automatically, and should be a pointer to re-thinking the entire ‘pain question’.
michael_b Gerry_the_neck
Posted
Also http://en.wikipedia.org/wiki/Fibromyalgia which seems to have at least some crossover with cervical spondylosis symptoms.
Gerry_the_neck michael_b
Posted
At least we have safety in numbers here !