[Popular Science Lecture] Sometimes dizziness is caused by problems with your cervical spine

In order to ensure the scientific effect of learning health knowledge in the 3rd China Elderly Health Knowledge Competition, the organizers have collected various health science articles suitable for elderly people to learn from various hospitals. We will share them through the "Health Lecture Hall" column. Today, Dr. Shi Liyan from the Pain Department of Beijing Tongzhou District Integrated Chinese and Western Medicine Hospital brought us "Sometimes dizziness is caused by problems with your cervical spine". Elderly friends are welcome to learn.

Dizziness is a common disease among middle-aged and elderly people. The diseases that cause dizziness are relatively complex. The most common disease that causes dizziness is cerebrovascular disease, but 20% of dizziness is caused by cervical spondylosis.

Cervical spondylosis, also known as cervical syndrome, is a general term for cervical osteoarthritis, hypertrophic cervical spondylitis, cervical nerve root compression syndrome, and cervical disc herniation. It is a disease based on degenerative pathological changes. It is mainly caused by long-term strain of the cervical spine, bone hyperplasia, or disc herniation, ligament thickening, which causes compression of the cervical spinal cord, nerve roots or vertebral arteries, resulting in a series of clinical syndromes with dysfunction. It manifests as vertebral instability and looseness; nucleus pulposus protrusion or extrusion; bone spur formation; ligament hypertrophy and secondary spinal canal stenosis, which stimulate or compress the adjacent nerve roots, spinal cord, vertebral arteries and cervical sympathetic nerves, causing a series of symptoms and signs.

Cervical spondylosis can be divided into: cervical type cervical spondylosis, nerve root type cervical spondylosis, spinal cord type cervical spondylosis, vertebral artery type cervical spondylosis, sympathetic nerve type cervical spondylosis, and esophageal compression type cervical spondylosis.

Causes

1. Degeneration of the cervical spine

Degenerative changes in the cervical spine are the main cause of cervical spondylosis, among which the degeneration of the intervertebral disc is particularly important and is the first factor in the degeneration of the cervical structures. As a result, a series of pathological anatomy and pathophysiological changes of cervical spondylosis have evolved. ① Degeneration of the intervertebral disc; ② The appearance of the ligament-disc space and the formation of edema; ③ The growth of bone spurs at the edge of the vertebral body; ④ Degeneration of other parts of the cervical spine; ⑤ The sagittal diameter and volume of the spinal canal decrease.

2. Developmental cervical spinal stenosis

In recent years, it has been confirmed that the inner diameter of the cervical spinal canal, especially the sagittal diameter, is closely related not only to the occurrence and development of cervical spondylosis, but also to the diagnosis, treatment, surgical method selection and prognosis of cervical spondylosis. Some people have severe cervical degeneration and obvious osteophyte hyperplasia, but do not develop the disease. The main reason is that the sagittal diameter of the cervical spinal canal is wide and there is a large compensatory gap in the spinal canal. Some patients do not have very serious cervical degeneration, but the symptoms appear early and are more severe.

3. Chronic strain Chronic strain refers to various excessive activities that exceed the maximum range of normal physiological activities or the local tolerance time value. Because it is different from obvious trauma or accidents in life and work, it is easy to be ignored, but it has a direct relationship with the occurrence, development, treatment and prognosis of cervical spondylosis. The occurrence and causes of this strain mainly come from the following situations:

1. Bad sleeping position. Bad sleeping position will inevitably cause imbalance of paraspinal muscles, ligaments and joints because of its long duration and the inability to adjust in time when the brain is in a resting state.

2. Improper working posture. A large amount of statistical data shows that the incidence of cervical spondylosis is particularly high among people who have a small workload and low intensity of work, but sit down, especially those who bow their heads. These people include houseworkers, embroidery workers, office workers, typists, and assembly workers on instrument assembly lines.

3. Inappropriate physical exercise. Normal physical exercise is good for health, but activities or exercises that exceed the neck's tolerance, such as handstands or somersaults with the head and neck as the weight-bearing support point, can increase the load on the cervical spine, especially without proper guidance.

4. Congenital deformity of the cervical spine. When conducting health examinations or comparative research radiographs on normal people's cervical spine, various abnormalities are often found in the cervical spine, of which obvious bone deformities account for about 5%.

Dizziness is a common symptom of patients with cervical spondylosis. The most typical symptom of many patients is often: when the head turns to a certain position, dizziness suddenly occurs. In severe cases, the head spins and the patient even faints. Some patients also feel nauseous. In acute cases, the patient cannot raise his head. A few patients have symptoms such as double vision, tremor, tinnitus and deafness. Many people are not clear about why cervical spondylosis causes dizziness. In fact, this is a manifestation of vertebral artery type cervical spondylosis, sympathetic cervical spondylosis and mixed cervical spondylosis.

Why does cervical spondylosis cause dizziness?

It is generally believed that the main reason for dizziness caused by cervical spondylosis is that cervical spondylosis stimulates or compresses the sympathetic plexus around the vertebral artery, causing vertebral-basilar artery system or intracranial and extracranial arterial vasomotor disturbances, resulting in dizziness. In addition, the following reasons may also exist:

1Compression of blood vessels

The "vertebral artery" is a very important artery for supplying blood to the brain. When the diseased tissue of the cervical spine compresses the cervical vertebrae, this blood vessel will narrow, causing insufficient blood supply, thereby causing dizziness, especially when the patient turns his head, this compression will be more obvious.

02Muscle Factor

Patients with cervical spondylosis often have symptoms of neck muscle soreness, which is caused by neck muscle spasm. When the neck muscles continue to spasm and tense, it will inevitably lead to obstruction of blood circulation inside the muscles, thereby releasing pathogenic substances such as lactic acid, 5-hydroxytryptamine, and bradykinin, causing dizziness.

03Neural Factors

Cervical spondylosis causes dizziness due to stimulation, compression or stretching of the pain-sensitive tissues in the head. The lesions in the cervical spine stimulate, compress or damage the second and third cervical nerves, causing headaches, especially in the occipital region. The pain can also radiate to the head through the reflex action of the trigeminal nerve nucleus in the medulla oblongata or spinal cord, causing dizziness in patients with cervical spondylosis.

How to determine whether dizziness is caused by cervical spondylosis?

Characteristics of dizziness caused by cervical spondylosis: Generally, this type of dizziness is induced when rotating or flexing the head and neck, or changing body position. If dizziness occurs suddenly in a resting state (during sleep or lying flat), it is mostly unrelated to cervical spondylosis. At the same time, most patients with cervicogenic vertigo have symptoms such as neck pain, stiffness, and decreased mobility. If dizziness is not accompanied by symptoms of local pain in the cervical spine, it is very likely not caused by cervical spondylosis. The head feels heavy and dizzy, as if a heavy object is pressing on it, and you can't lift your spirits. This type of dizziness is often caused by insufficient blood supply to the brain, and most of them are caused by neurological diseases. Feeling dizzy and things around you are spinning, as if you are drunk, this kind of dizziness is called vertigo, and it is often a problem with the ears.

How to treat dizziness caused by cervical spondylosis?

1 Rest In the acute phase, bed rest should be the main method, and sitting activities should be avoided to avoid increasing the load on the cervical spine and aggravating symptoms. 2 Drug treatment Vertebral artery type requires improving blood supply; sympathetic type requires inhibiting sympathetic nerve excitement; patients suspected of having inflammatory reactions should also be given anti-inflammatory treatment. 3 Physical therapy Physical therapy is effective in improving local blood flow, relieving muscle spasms, and improving clinical symptoms. 4 Needle knife, acupuncture, massage and external treatment of traditional Chinese medicine can achieve good results in improving blood circulation in the neck and relieving muscle spasms. 5 Rehabilitation exercises After the symptoms are significantly relieved, neck and back muscle exercises should be increased, such as "five-point support" and "head-hand confrontation", to increase cervical stability. 6 Surgical treatment Surgery can relieve the mechanical compression of the vertebral artery and spinal cord, reconstruct spinal stability, reduce or eliminate sympathetic nerve stimulation, restore the physiological curvature of the cervical spine and reconstruct the stability of the diseased segment.

The following points should be noted in life

1. Avoid and reduce acute injuries, such as avoiding lifting heavy objects, not braking suddenly, etc. Correct bad postures to reduce strain. Do neck exercises every 1 to 2 hours of lowering or raising your head to reduce muscle tension.

2. Avoid cold stimulation. Cold can cause local blood vessels to constrict, reduce blood flow, and aggravate symptoms.

3. Choose a suitable pillow, not too high or too low, to maintain the physiological position of cervical lordosis. The height of the pillow is about 10cm. A pillow with a low middle and high ends in the shape of a gold ingot has a good supporting effect on the cervical spine.

4. In daily life, if you experience neck discomfort, avoid massaging it casually to avoid aggravating the condition.

About the Author:

Shi Liyan, who works in the Pain Department of the Beijing Tongzhou District Integrated Traditional Chinese and Western Medicine Hospital, has been engaged in the pain department for more than 17 years. She is good at acupuncture knife therapy, nerve block therapy, radiofrequency treatment of spinal nerve root pain, low-temperature plasma thermocoagulation therapy, ozone targeted intervention therapy, tendon needle therapy, tendon relaxation needle therapy, and high-tech biological protein implantation therapy. She treats cervical spondylosis, lumbar spondylosis, knee joint disease, shoulder joint disease, stenosing tenosynovitis, carpal tunnel syndrome, calcaneal pain, tennis elbow, intractable headache, dizziness, migraine, and insomnia, joint swelling and pain caused by rheumatism and rheumatoid arthritis, ankylosing spondylitis, and spine-related diseases.