Cervical Spondylosis ruminations

Just been reading an interesting book.....'The Body In Action ' by Sarah Key. You can look it up on Google and download for free. In the chapter on the neck, the author describes, in explicit detail, the mechanics of the neck and the problems resulting from any malfunctions, not just C/S. She describes cause and effect in a way I've never really encountered before. She also describes the changes which the neck makes in order to counteract any problems. For instance, she argues that osteophytes, the bony spurs which grow in the nerve channels, and are familiar to C/S sufferers, should maybe not be interfered with. She argues that they have been created for a purpose i.e. to stabilise a vulnerable neck, and that they don't cause as much trouble as might be expected if they are removed. This makes good sense to me, and it also suggests that the neck, whilst going through a degenerative process, is also attempting to correct itself as it goes along. It seems that a lot of the aches and pains we experience are more closely associated with corrective processes in tne neck, rather than being direct symptoms of nerve compression.

So, in light of this theory, if I accept that it may be true, what can I expect from my C/S as it continues to degenerate. Any new nerve compression problems might affect my legs, my mobility, or increase the problems I already experience in arms and hands. Any counter measures instigated by the neck might cause further neck stiffness, headaches, shoulder aches etc. However, I can now see these associated symptoms as part of a positive physical reaction to the main problem....i.e. nerve compression.

From my own experiences with 'numb hand' and 'arm pain', I am aware that once the 'numb hand' appeared, 18 months ago, the other associated symptoms ( headaches, stiff neck etc ) seemed to ease off gradually. This suggests that, once full nerve compression kicks in, there is no longer a need for protective adjustments in the neck and thus, associated symptoms abate. It seems that some C/S sufferers, who get full nerve compression from the start, never get to experience these associated corrective symptoms at all. There's no need for the neck to protect what has already happened !

In my case, I experienced 30 years of protective symptoms before full nerve compression actually happened, and, on reflection, I didn't really have a clue how to deal with the associated symptoms. Funny thing is, now that it has resolved into an obvious nerve compression thing ( numb hand ), I find it a lot easier to deal with, to think about, and to take action. Previously, the associated symptoms just distressed and confused me, and it always seemed like the professionals were ignoring or misinterpreting the symptoms I described. That was harder to deal with than what I'm dealing with now, and a lot of the stuff I write about is concerned with unravelling that mess, both for me, and anyone else experiencing similar confusion.

In the book, the author also argues for some strenuous neck exercises to assist the neck as it tries to correct itself. I have to say I'm against this method....but that's another story !

Gerry

Hello again.

This is it. The Final Rumination. There will be closure!

It's over 2 years since these ruminations began, and they've probably run their course by now. However, it wouldn't be right to let them go without a proper summary of what conclusions I've come to.

Firstly, just to re-cap my situation. I was first diagnosed with C/S over 30 years ago. Up until 18 months ago I experienced a range of typical symptoms...headaches, mugginness, stiff neck, frozen shoulders etc etc fairly constantly. Then, 18 months ago, my C/S developed into an actual trapped nerve with the obvious symptom of numb / clumsy hand and arm pain. I couldn't help but notice that the other symptoms eased off somewhat at the same time, and this forced me to consider what was actually happening in the neck, compared to all the advice that I had read or been told. My overview of the C/S condition has changed (evolved ) accordingly and I'm going to try and explain here how I think the condition progresses.

1. C/S should really be re-classified as 2 distinct conditions...Arthritic Based and Injury Based because there are distinct differences.

a: Arthritic Based C/S might degenerate in direct relation to the overal degenerative progress of the general arthritic condition.

b: Injury Based C/S might only degenerate, if at all, through normal wear and tear. I believe this is the version I experience as I have no other arthritic problems besides the usual for my age.

In order to be able to predict the future progress (degeneration ) of the condition it becomes important to be able to make this distinction.

2. Common to both the above is the issue of Pre-Trapped Nerve symptoms and Post-Trapped Nerve symptoms.

a: Pre-Trapped Nerve symptoms include headaches, muggy head, stiff neck, frozen shoulder, pains in shoulder / chest etc.

b: Post-Trapped Nerve symptoms include arm pain, numb hand / leg, loss of power in hand / leg, bowel and bladder problems.

These two symptom groups should be separated because the therapies we need to apply to them are different. Thus the many differing opinions we encounter on this site about how best to treat the symptoms....we are simply not always discussing the same issues.

3. Again, common to all the above, is probably the most important issue i.e. that the neck is continually trying to naturally correct itself and protect itself from future threats. Most of the Pre-Trapped Nerve ( 'associated' ) symptoms seem to result from neck reactions to possible threats and, although persistant and distressing, maybe should be read as warning signs rather than full-on C/S symptoms where a trapped nerve can cause dysfunction in arm, hand or leg. Strangely, in my case, the onset of actual trapped nerve symptoms gave me some relief from the worst 'associated' symptoms, and so, I can say, that my condition improved somewhat in terms of how I felt in general. However, I'm not naive, and I know that it could change again as the wear and tear progresses.

4. My real concern is not what I'm currently experiencing. I am being monitored and advised professionally, although I do think there is a shortage of advice on self-management. My concern is the many years I experienced beforehand where I had no convincing explanation for the symptoms I was then experiencing. It was distressing and depressing and could easily have been handled with better advice and information. I recognise the same desperation in other postings on this site and I suppose, if there has been any purpose to these ruminations, it has been to challenge the professionals, as the first point of contact with C/S sufferers, to re-examine their approach and to try and standardise and maybe improve their advice options.

I realise that determining how the C/S condition will progress ( degenerate ) is difficult, even impossible in many cases, and, as

Welcome to the grand re-opening of the Ruminations Pages...Mark 2.

My name is Gerry. I suffer from a condition where I think that any ideas I have need global exposure. That condition is called 'Deluded'.

Just thought I'd get that out of the way before I started rambling....might help keep the critics at bay !

At this point I'm tempted to list a whole range of symptoms that I experience, and milk whatever sympathy comes my way, but I think I'd rather keep these ruminations on an exploratory and philosophical level. So, be warned. Anyone trying to lower the bar to the gruesome details of their own condition will be duly ignored. My advice is...Open your own page. Of course, anyone wishing to contribute on a more cerebral level is welcome , but only if you are prepared to back up the general vacuousness of my, yet to be, inspired theories. Already it's beginning to look like I make them up as I go along, so perhaps I should call them 'inspired spontaneous vacuous theories'With my previous ruminations I don't believe that I got the recognition that I deserved....so, I'm having another go. Persistent, if nothing else, eh?

Anyway, there seems to have been a lack of input on the C/S pages recently, so why not start afresh. I'll just kick start it with my list of symptoms for today....1: Bored. 2: Bored. 3: Bored to the point of this posting ! Vacuous Theory No 1: \" High quality boredom should never be allowed to result in postings like this\" . Discuss.

[u:9cb23f9819]The Pain / Painkillers issue[/u:9cb23f9819].

As someone who, like many other C/S sufferers, has experienced more than my fair share of aches and pains, I feel an obligation to myself to explore the 'painkiller' issue , and try and rationalise what is actually happening or whether a new approach is warranted.

As affected humans, we tend to percieve pain as something material, something real, which requires an urgent response. This is the purpose of pain, to spur us into immediate action when a threat to our survival occurs. However, the pain itself, is merely a nerve signal, a blinking red emergency light, which points us towards the real threat, usually an injury or an infection. In the modern era we tend to think of our initial response to pain to be something like this...\"I'll get rid of the pain first and then I'll deal with the injury\". The availability of modern 'painkillers' allows us this temporary luxury whilst the body restores itself to a healthy unthreatened status. It wasn't always like this and perhaps we are lucky to live in such an era of luxury 'painkillers'.

However, 'painkillers, as we know them, don't 'kill' pain, or 'numb' pain or 'get rid of' pain. What they do is one of several things. They can encourage our bodies to increase production of natural painkilling chemicals, temporarilly. They can block painful nerve signals from being consciously recognised, temporarilly. They can inhibit the normal cell processes in order to mask the effects of injury, temporarilly. Basically, they help create a false reality which the nervous system doesn't recognise, and therefore the requirement for pain as a warning system is no longer needed, temporarilly.

Of course, the best, most natural, 'painkiller' available is what we already have stored, and continually replenished, internally. Under normal circumstances, these natural painkillers are good enough to help us negotiate minor injuries and infections, and particularly to help us sleep, or rest, painfree, thus aiding recovery. However, they are not designed to completely mask the pain signals, because that would be counter-productive....the warnings are still sdeemed necessary for survival. Also, they are not inexhaustible. With heavy demand they perhaps don't replenish as quickly as they would normally, and that probably explains why the body must rest after more serious injury or infection, so the replenishing process is maximised in the most advantageous environment. It also suggests that the replenishment occurs best when resting or sleeping, but that's another issue which won't be avoided anon.

Under normal circumstances, where occassional illnesses occur, all these processes, using both natural and artificial 'painkillers' , are common to all. When it comes down to chronic conditions with constant or intermittently constant aches and pains, it is possible that a different set of rules need to be applied. The constant demand for natural painkillers can become constantly exhaustive, and the need to boost these limited resources with artificial 'painkillers' becomes ever more demanding. The question here is, does boosting the artificial dosage have any detrimental effect on our ability to replenish natural resources ?

Thid side-effect would be ok for occassional illnesses, where an equilibrium could be gradually restored, but for chronic conditions there is the possibility that our natural replenishment rates decline in direct relation to continued artificial boosting. I can't escape the sense of irony here, where our approach to one chronic condition might lead to the creation of another chronic condition ! It's a bit like smoking to distract from not thinking about the long term effects of smoking....guilty as charged ! Another nightmare scenario might be that, with the depletion of natural painkilling resources, all minor illnesses might become less

\" The play is the thing,

Wherein I'll catch the conscience of the king. \" Hamlet (to himself).

I'm going to run a test on myself. I'm going to try a little perspective transference. I'm going to imagine that I'm a GP, a Phsyio, or a Neurologist and try to visualise my reaction options when confronted with a C/S patient. My own experience with C/S will be the template for that patient, because that's what I'm familiar with. THe purpose of this mental exercise is to try and pinpoint where any shortfalls in treatment might occur.

The textbook overview of C/S is shared by all three...i.e. most C/S cases encountered will be elderly patients, whose C/S has developed through normal wear and tear, or a late onset arthritic condition. A small percentage of patients will be cases of early onset C/S as a result of an injury or an arthritic condition. The recommended therapies are mostly concerned with the majority elderly cases. A 'wait and see' policy is considered acceptable treatment for long term cases.

Firstly, the GP : \" I'm looking at a 30/40/50 year old C/S patient, whose had the Xrays which show degeneration. I'm aware that this could progress at an unknown rate, over many years, until eventually an actual neurological impairment occurs, which will require referring to a neurologist. Until that happens, I'm more or less stuck with the problem of trying to make all the symptoms as tolerable as possible by means of painkilling medications, epidural injections or referrals to the physio.. These are my options and I'm aware that it's going to be a bit of a losing battle, with few satisfying results. The policy is one of 'wait and see' , so I'm just going to have to blindly persevere, despite the patient reporting back continually that nothing is working. The code of practice, which I adhere to, allows me to accept this failure because there are no proven treatments to apply, even if this situation should continue for 30 or 40 years. With a bit of luck, the symptoms might settle down by themselves, or the patient might adopt a sense of resignation over time, and the whole thing might become more manageable for both of us. This is probably the best I can hope for. \"

The Physio : \" The GP has referred this 30 /40 /50 year old C/S patient to me for advice and assistance. I'm more used to dealing with elderly 70 year olds with this condition, where there is a certain inevitability about general deterioration, and I'm aware that the therapies we provide are unproven long term. However, it's probably best all round to assume that the therapies we provide might be useful, if only for the patients sake. It's all we got. There are no signs, as yet, of neurologigal impairment, so, despite the statistical evidence to the contrary, we should persist with something that might help the patient believe there is hope for improvement. From our point of view, we , as physios, would much rather apply proven therapies, but our options are limited, and as such we must assume a support role. A 'wait and see' policy, along with some distracting therapies, might be best. If, or when, a neurological impairment manifests itself, then we can refer the patient to a neurologist. \"

The Neurologist : \" The physio/GP has referred this 30 /40 /50 year old C/S patient to me showing signs of neurological impairment. I've had the patient undergo MRI Scan and EMG tests to determine the extent of the problem, and to pinpoint the problem area in the neck. This has been achieved successfully and we now know what surgery might be needed to help restore full or partial use of the affected limb or bodily function. However, we are aware of the risks of such surgery, and, also, we are not fully aware of how the condition might progress with no intervention. We are more used to dealing with elderly patients, more worst case scenarios, where sur

Hi Gerry I'm a bit concerned that one of the pieces of the advice you give may actually be harmful.

I refer to

\"After rising, have a cup of tea first. Then take 2 nurofen, or similar, and wait half an hour before having a snack / breakfast\"

NSAIDS, of which Ibuprofen/nurofen is one, should [b:c3d66befe4]ALWAYS[/b:c3d66befe4] be taken on a full stomach. My husband very nearly died of a perforated ulcer caused by taking NSAIDS on an empty stomach. We learned this lesson the hard way and I'd hate for anyone else to have to go through it. I realise your intentions are good, but what you suggest is really very dangerous indeed.

I don't wish to cause offence here or upset you, but really felt I must say something

Sarah

Hi Sarah.

It's a good point you're making. Anyone with an existing stomach problem shouldn't really be taking nurofen at all. Also, anyone taking nurofen on a daily basis should folliow your advice...i.e. always on a full stomach. I've had problems with this myself in the past. However, for occassional use, when needed, and where there is no existing problem, I have to say that the way I've suggested seems to me to be the best way to alleviate symptoms as fast as possible. It's not meant to become a regular daily habit. I've found that taking them on a full stomach sometimes dissipates the effect, where a quick result might be needed. That works for me, and then snacking within half an hour seems to help with any possible stomach upsets. There are more appropriate painkillers for anyone with an intolerance to nurofen, and that's something that should be discussed with the GP.

Giving advice is always difficult when dealing with people's differing tolerances. My advice is based on my experience only. I've tried other painkillers...they either don't work for me or they zap me out, and I'm naturally wary of any that might be addictive because they create their own dependancy other than simply relieving pain. It's a bit of a minefield we must negotiate when choosing what suits best. Obviously, where your husband is concerned, my advice falls well short of the mark. I can't envisage every eventuality. But I can say that where anyone is considering taking nurofen regularly, and is unaware of any long term effects, then your advice is more appropriate.

I think we all face the inherent gamble of risking the 'cure' to be worse than the original problem. Another C/S dilemma ! I've tried to tackle this aspect with my 'advice', with the one possible concession to nurofen. If only there was a painkiller we didn't have to worry about ! You may well have spotted the weak link there. I still think, in general, it's ok to suggest occassional use in the manner I've advised, in terms of offering a fairly reliable ( for me anyway ) quick relief method for anyone who has found nothing else works, but perhaps it should come with a proviso warning of the dangers you highlighted.

Looks like I'll have to brush up on my editing skills. Thanks

Gerry

The Crux of the Matter.

If we strip away all the debatable issues concerning C/S, we arrive at one repeating scenario: “ How rough do I feel when I rise each morning “ and “ How do I deal with it “.I used to think that painkillers were always required for the rough days. I now know that this needn’t be so, that other factors come into play. For instance, every morning for the last 2 years I’ve developed the habit of simply sitting, alone, in a very comfortable, large size, fisherman’s fold-up chair, for an hour or two, with a tea or a coffee., regardless of whether I feel rough or not. Basically, I’m waiting for that particular day’s aches to resolve themselves into something I recognise, so I can deal with them, or not.. Only on mornings where there is a headache present will I take any painkillers, in the manner I’ve previously described, and that is usually only about once a week nowadays. It used to be most mornings, but that has changed now.

That hour or two has evolved, from being the worst time of the day, in the past, into an invaluable asset in my daily routines. It’s my thinking time, and it has gradually changed from ‘victim time’ to ‘controller time’ as certain issues became clearer to me. It’s a good time for befriending my C/S problems, when they’re at their worst, getting familiar with how they work their exotic tortures on me, and assessing what the rest of my day might evolve into. I suppose, in the past, I used to think I had to beat the pain, thus the regular painkillers, to have a reasonable day. Now I know that, with a little stoic patience, the aches usually ease down to something manageable…..mostly. And I get the added bonus of being able to think “Why this” “Why that” for what it’s worth.

I’d like to call it an ‘organic’ approach, but if you throw in the coffee and ciggies it tends to lose it’s purist credentials. However, I will say that, despite the aching, it has had it’s magic moments of realisation, something I’ve not been shy about sharing. Also, it has helped put me in some control of a condition, where previously I was just a victim. Turning that psychological corner, as an unexpected even unplanned side event, was a good feeling after years of feeling a bit doomed, and it has opened many doors for studying the dilemmas associated with C/S, almost in an abstract way.

Perhaps there’s an argument for saying that de-personalising the ‘victim’ element in any health condition can help with rationalising it’s causes and effects and thus lead to better self management. I dunno…not sure about that one. What I do know is that the ‘poor me’ element doesn’t really go anywhere interesting, so I’m glad to leave that element somewhere in my past, no doubt still screaming for attention. To be honest, it only ever got the opposite reaction to the intended one, such are the vagaries of the human condition, so, unless I want to rewrite the entire DNA programme for Homo Sapiens, I really shouldn’t expect too much by way of sympathy for a seemingly mysterious health condition.

So, where does that leave me. I’m still a bit achey. I’ve got a low grade threatening headache…..possibly because the weather is a bit overcast. But, in the spirit of the advancement of science, I’ve decided to sacrifice myself for the benefit of the greater C/S community , and not take any painkillers. I might take a wander down to my local canal lock, with my saturday Guardian , and catch up on the long awaited overdue collapse of tabloid journalism in this country ( thanks to the unwavering persistence of Guardian journalists, against all the odds ).

Have a nice day

Gerry

Hi

Couldn't think of a title for this posting.....perhaps...\" To intervene or not to intervene, that is the question \".

One of the most striking features to come out of research into C/S treatments is the very glaring instances of recovery to manageable levels for patients where no surgical intervention has been conducted. This is an area which baffles the professionals. In fact, it throws the shadow of doubt over whether their 'sophisticated' techniques might not be negating the option for natural improvement without any interference. It's difficult because, in the climate of busy hospitals, decisions must be made, and we must have faith in the criteria they apply when making those decisions. The option of leaving it to chance, without intervention, doesn't seem like an acceptable scientific informed option, especially if an improved outcome doesn't occur, when compared to taking the option for accredited intervention / surgery, which may or may not have similar outcomes. At least, the decision makers can feel justified in having chosen the recommended option, even if the outcome is failure.

One thing seems obvious though, and that is that any intervention / surgery will change the dynamics of any activities the neck was engaged in previously, even possibly negating the natural options for recovery which research has shown, can occur. It seems to me that most research into C/S concerns medications and surgery, rather than an investigation into why natural recovery to manageable levels can sometimes occur. The processes involved in these 'natural recoveries' are not well known. It is assumed that the neck's reaction to it's own difficulties sometimes results in positive outcomes. Understanably, it's difficult to define, in each individual case, where degeneration and regeneration cross paths, and forecasting an expected outcome is precarious, if not impossible. Thus the willingness to opt for accepted intervention, despite the doubts. I suppose that, until there is better understanding of the natural processes, then it is assumed satisfactory to have the interventional option as the most reliable foundation for treatment.

However, I have to ask myself.....Is this a trade off between two unknowns, rather than an option for treatment based on known fact. Again, it seems obvious to me that real progress in the treatment of C/S should be concentrated on deciphering and accommodating the processes which occur when 'natural recovery' takes place. These processes occur continuously, on and off, for the long term C/S sufferer. Accepted that this approach may not help the most severe cases, where surgery is perhaps the only option, but we shouldn't discount the many cases of long term C/S where meaningful therapy might produce improvements.

I was hoping to end this posting there, but I see now I'm going to have to explain the term 'meaningful therapy'. I'll keep it simple. Our sleeping arrangements and environment can hugely affect the intensity of the symptoms we experience. Altering, or experimenting with, our normal sleeping arrangements can produce a more tolerable and manageable condition. There's only one rule.....allow 3 days for any changes to mature and then decide 'good' or 'bad'. Then try another change. Most 'associated' C/S symptoms like headaches, stiff neck, shoulder aches, chest pains etc can be minimised with proper sleep therapy. The use of memory foam mattress, or topper, proper cervical pillow (not memory foam) and the exclusion of all draughts are recommended. Sometimes it helps to sleep on a sofa or armchair, as the neck seems to adopt a more restfull upright position as compared to the horizontal lying down position. Real results affecting the intensity of symptoms can be achieved by these means, where all the exercising, as recommended by physios, can easily become counter productive and can exacerbate the symptoms. Once a

\" No Title \"

After 30 years of symptom experiences with Cervical Spondylosis ( C/S ) , I have come away with the impression that the details of my experiences have been ignored by those who should be interested, if they're really seeking improvements. This may sound a little resentful, but it's not. It's merely fact. I have tried to understand the reasons for the advice I was given, and no amount of patronising or condescending, on my part, convinces me that there was a positive purpose to such advice. Ultimately. I am left with the impression that the current approach to C/S is to try to ignore the many 'unpredictable' symptoms, by means of painkillers or fairly useless therapies, until the condition becomes serious enough to warrant surgical intervention, which in itself is risky and 'unpredictable'. This all strikes me as a pretty negative approach to a condition, which might be managed, more successfully, on a day to day basis , with more attention given to explaining why the differing symptoms occur and how we can best deal with them.

When I look up C/S on the Net, and I read the list of associated symptoms, I recognise that I've had them all, many times over, except for the leg myleopathy and loss of balance. Yet to come, maybe. What I don't see are any reasons given, or patterns explained, for the occurance of these varied symptoms, or for that matter, how each of these symptoms should be treated....except for the usual advice...take some painkillers and if that doesn't work, try an upgrade. I don't even detect that that [u:4cad2065ac]they[/u:4cad2065ac] understand the processes involved, so it's not even a case of 'The less we know, the better for us'. It does seem that not too much effort has been put into exploring the details of the symptoms and how best to manage them, and perhaps the painkiller option is as much an outclause for them, as it is for us, in avoiding the real issues. As a result, I've had to do the thinking myself and, rightly or wrongly, I've come to some conclusions about the symptom patterns involved and how they might be better managed in a rational way, without such frequent recourse to medications. Another thing to consider here, in their defense, is that if you haven't yourself experienced the various confusing symptoms, then it must be difficult to even begin to understand the urgency of needing to deal with them, and the medications will help diffuse this awkward situation.

To me, what's lacking here is an attention to detail because the urgency of the situation has no patience for re-analysing the problem. You might say that the availability of the medication option negates the need to rationalise each individual symptom, for both the patient and the doctor, and as such, alternative options remain mostly unexplored. Yet, all science is based on minute attention to detail, on cause and effect, so what is it that makes it so easy to overlook these aspects when dealing with a condition like C/S. I suspect that the changeing unpredictable nature of C/S has influenced a reluctance to deal with the details of the symptoms.

It needn't be so. Each symptom does have it's cause and effect. Each symptom can be dealt with separately. Take recurring headaches and muggy head feelings, for instance. These seem to be caused by muscular adjustments in the neck area, usually when there is a percieved threat of nerve pinching, or following such a threat. They (headaches/muggy) usually resolve after a few days into a more clarified pain in shoulde, arms or neck. To break that down, as a result of some aggravation a nerve is either pinched or is likely to be pinched. The muscles of the neck react protectively, giving rise to stiff neck, headache and muggy head. As this initial response settles down, the real symptom of the pinched nerve reveals itself as a more clarified pain elsewhere. This is a rational analysis of

\"Describing Cervical Spondylosis Symptoms\"

( Or an alternative title for long suffering readers of these postings...\"He just likes posting a lot !\" I've obviously acquired some bizarre ways of humouring myself ! )

I think everyone will agree that it's quite difficult to describe, meaningfully, the aches and pains and psycological effects of C/S. If I were to try and describe it, in layman's terms, by way of comparison, I would probably opt for this description......\" In the morning you feel a bit like someone has beaten you up during the night, whilst you slept, and your mental state is probably something like what women experience with a bad case of PMS / PMT.\" Ok...no need to gang up on me ! I'm not sure exactly what the symptoms of Fibromyalgia, or ME, or MS, or Lupus are, but I imagine they're not much different in essence.

The problem is the unclarified nature of the aches, and the resultant psycological confusion that this creates. With most medical conditions, if you can recognise the connections between injury and pain, i.e. cause and effect, then there is less need to enter a phase of mental confusion whilst trying to figure out what exactly is going on. Add to that the possibility of a headache or a muggy head and you can see the problem with stabilising your understanding.

With PMS / PMT, because of the hormonal changes, any mental attempts to come to terms with the unusual sensations are doomed to failure, simply because the mind has not had time to adjust to the onrush of hormonal changes, and so, a conflict of understanding between mind and body takes centre stage. Also, I should add that the inner turmoil is not obvious to the recipient of the expression of helter skelter emotional outbursts ( I'm in real trouble now ). C/S is a bit similar in that there is no outward sign of injury and therefore it is difficult for another person to rationalise the distress of the sufferer. Although not hormonal, I think that C/S can create a similar conflict between mind and body, possibly because the sufferer can't rationalise it either.

At this stage of exploring the problem, it seems we are left with 2 choices in how we proceed. Do we opt for \" That's just the way it is, what can I do about it \", the flagship excuse of self-victimisation, which helps us to skirt[ PMT Alert! ] around the problem and carry on regardless. Or, do we make a conscious effort to really get to grips with the conflict and try to rationalise why the opposing elements don't mesh together, psycologically, as would be expected normally. The only obstruction to a resolution of understanding is a little bit of ignorance, on our part. Strangley, it's ok to include this ignorance in an equation to help resolve the conundrum, just like it's ok to use symbols in Algebra[ PMT Alert! ], without quantifying specific values, to resolve an equation satisfactorally. The initial equation might look like this...\" My Symptoms + My Ignorance = My Bad Mood[ PMT Alert!!!!]\". THe equation we really want might be...\" My Symptoms + My Accepted Ignorance = Normality\". And, following on from that... \" Normality = Less Confusion in Dealing With Symptoms\". Basically, the sooner we accept and begin to explore our ignorance, the sooner we start to exclude negativities fron entering the equation. It's the unknown elements which disrupt satisfactory conclusions.

So, what do we do with these unknown elements ( our ignorance ) to try and reach better understanding and therefore better outcomes overall. It's all too easy to avoid them, but that just leaves a default solution where negative \" bad moods \" could become the order of the day. On the other hand, if we at least attempt to resolve our ignorance then, at the same time, we are effectively whittling away at the \" bad moods \" on the

Patient v Therapist Relationships

I suppose one of the good things about posting my views on an anonymous forum like this, is the fact that I would never dare expressing them in real time i.e. at the GP's, at the P/therapist's or at the Neurologist's. I simply can't afford to risk alienating professionals who are my gateway to medications, p/therapy or surgery. Whenever I have, in the past, expressed doubts about anything, it has usually ended up in embarassing silences, not good for either party. I've also always got the impression, from communicating on other forums with C/S patients, that they consider these encounters as something of a 'charade' where, no matter how disappointed the patient is with any advice, they should just accept it, because that's all that's on offer. An unlikely situation of the patient patronising the professional !

The patient is aware that the professional's attitude is tempered by their own uncertainties about treatment, although the professional will try to mask this aspect, and, as such, all is forgiveable in an unperfect world. Perhaps it's the attempted masking which makes it all so obvious ! It all works on certain levels, keeping the wheels turning. However, it can also be a systemised denial of patient inclusion, perhaps because it is already assummed that there exists, at the core of treatments for the condition, a presummed inevitability about degenerative processes, and the prospects for improved treatments are inherently bleak.

As C/S patients, we are aware of, and encounter these scenarios regularly. In a way, I suppose, we assume the charade before any treatment, and we don't like to leave a lingering sense of futility behind us when we leave...that could count against us in any future dealings. We don't want to shut any doors. Gradually, we become complicit in the general denial of the usefulness of questionable therapies, or we stop attending. Strangely, either choice will probably have few repercussions on our general well-being, because the therapies don't guarantee improvement, and the lack of therapies doesn't necessarilly mean a worsening of symptoms.

I know the choice that attracts me most, because I have no desire to be a victim on two levels. Once we strip away the supposition that the professionals might hold all the answers where C/S is concerned, we free ourselves to face the dilemmas it creates and perhaps to trying to manage these on a home-based, daily level. It is so much easier to accept our own attemps / failures than it is to accept why advised therapies are not working. And if something does happen to work, it's usually a reward that makes all the effort worthwhile.

One last observation here. The word 'Regenerative' never crops up in any description of C/S. 'Degenerative' is the classic description upon which all theory is based. Some time ago I read a book called 'The Body in Action' by Sarah Keys, which disputes the 'degenerative' overview and seems to make a lot of patient friendly sense. On the downside, I found I didn't agree with her suggested regime for exercising. Can't win 'em all.

Gerry

Hi

Just to wind up the previous posts, which hopefully will have given a little food for thought on the subject of therapies for cervical spondylosis, here’s a little story of recent events which might help put some meat on my speculative theories.

About 4 weeks ago, I was due to have a new kitchen fitted at home, and I had agreed with the chosen fitter to help out where I could with disassembling the old one and helping with collecting the new one from Ikea (of course) and various other tasks. I know my limitations regarding certain types of work (overhead, heavy weights etc) , so I thought that, with care, I could manage without too much aggravation of the neck. So, pre-empting his arrival, I started disassembling the old sink unit. It was awkward, fixings and screws in funny places, and I was a little worried I might have twisted too far. The previous evening I had also helped collect the worktops and units, so I knew I was pushing at the limits.

Anyway, the following morning I woke, and my neck was stuck. Very little movement without searing pain, mostly at top of shoulder blade, to the rear. I apologised to the fitter and said that I wouldn’t be able to assist any more. He knows me, and my C/S problems, so he was understanding. That day was a write off, and that night I slept in my usual memory foam mattress to try and ease it. The next morning it was just the same, so I knew I was perhaps looking at a long recovery, as has happened many times before. However, I know the ropes, and I also saw this as an opportunity to try out different sleeping postures and just see what happens.

That afternoon, I took a nap on my sofa ( easily done because of the fatique ), semi-upright, with hand supporting chin. I woke after an hour and, to my relief, there was little pain, and flexibility had been restored. Something was working. That night I again slept on mattress, and awoke next morning to find the stiffness and pain had returned. So, bearing all this in mind, I decided to try and only sleep on sofa for a couple of days, and see what happened. I pushed the sofa against a bookcase and put some soft pillows in place so I could sleep upright, just leaning to one side. Although I could only sleep for about 4 hours in this position, without slipping down, it worked again. The pain reduced by 80%, and I didn’t feel so fatiqued. After a couple of nights like this I was able to return to mattress and sleep without waking in pain.

In summary, it was quite obvious that horizontal sleeping compounded the symptoms, whereas, upright sleeping almost completely removed the pain and restored normal flexibility. The fact that initially the pain receded with sleeping upright, but then returned after a horizontal sleep, is key to what’s going on. Why this happens has undoubtedly got something to do with how the neck relaxes and reacts when horizontal. Perhaps it detects it’s own vulnerability more acutely and instigates greater reactive protection, accompanied by relative painful symptoms. When sleeping upright ( or semi-upright ) perhaps the neck doesn’t detect the vulnerabilities and so restores itself to normal functioning. So it seems to me, and this is how I will be treating any future mishaps. I could easily have been looking at a week or two, or more, of incapacity, if previous mishaps are anything to go by. Instead, I was in pain for three days and, almost beyond my wildest hopes, it abated…..just like that ! That first little upright nap on the sofa showed me that the symptoms can disappear, almost magically. The fact that the symptoms reappeared next morning just shows me that I was a bit slow in learning the lessons.

I should also add that, throughout all this, my numb/clumsy hand was totally unaffected, which highlights the fact that trapped nerve symptoms ( numb hand etc ) and ‘associated’ reactive symptoms are basically unrelated. The ‘as

HI

Me again.

If anyone is interested I've advanced a few theories on C/S management on another site....'Online Physio'....under the heading ....'Cervical Spondylosis. Delayed Symptoms and how they manifest themselves'.

Gerry

Ps...From ruminations to theories...the quest continues !

Hi Gerry, hope you are keeping well. I can't find the site yopu mentioned could you PM the address to me please.

Sarah