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Andrzej Kondratiuk, M.D., Ph.D.
Pain of the Cervical Spine
Exercises and rehabilitation
The importance of cervical vertebrae for your body
Symptoms and complications of cervical vertebrae degeneration
How we move our heads - the basic information on proper functioning of cervical vertebrae
How to perform exercises in line with the natural mobility of cervical vertebrae
How to relax the neck muscles
Exercises and physiotherapy to perform at home, recommended by a physician specialising in rehabilitation and manual therapy
Pain of the Cervical Spine
Andrzej Kondratiuk, M.D., Ph.D.
2024
Edition 2
Copyright ? by Andrzej Kondratiuk
No part of this book may be reproduced or distributed in any way, electronically or mechanically, and in particular copied, recorded and stored in data collection and retrieval systems, without the written permission of the copyright owner.
Copyright ? for the English translation: Magdalena Wajda-Kacmajor
Andrzej Kondratiuk, M.D., Ph.D. - doctor of medical science, specialist in medical rehabilitation, palliative medicine, manual therapy, spa medicine
The recommendations presented here are meant for persons with a doctor-diagnosed degeneration of the cervical vertebrae, after other diseases causing similar symptoms have been excluded. This guide is meant for information purposes only, it does not constitute medical advice and cannot substitute for medical diagnosis and treatment. The author is not responsible for any negative effects or consequences resulting from the application of the advice contained in the book.
Table of contents
Are you performing the exercises correctly? ---8
Introduction --- 9
1. The cervical spine
The anatomy of cervical vertebrae --- 11
The first vertebra - the Atlas (C1) --- 13
The second vertebra - the axis (C2) --- 13
C3-C7 vertebrae - standard cervical verterbrae---15
The cervicothoracic junction --- 16
2. Joints of the cervical spine
The atlanto-occipital joints (C0/ C1)---18
Movement of the atlanto-occipital joints ---19
The atlanto-axial joints (C1/ C2)---20
Movement of the atlanto-axial joints ---22
Range of mobility in the cervical joints ---24
Mobility of the standard cervical vertebra --26
3. Degeneration of the cervical vertebra ---28
Most frequent causes and risk factors of cervical vertebrae degeneration---29
Degeneration of the intervertebral discs ---30
Exercises for advanced discopathy---32
Degeneration of the intervertebral joints ---35
Degeneration of the vertebra ---36
Proliferative changes---37
Sclerosis---38
Osteophytes and syndesmophytes---39
Consequences of cervical vertebra degeneration ---42
Neuralgias of the neck and shoulder girdle---43
Scoliosis of the cervical spine---45
Incorrect head position---46
Spondylolisthesis and vertebrae instability---50
Main symptoms of cervical vertebra degeneration ---53
4. Not every movement is a good one---54
Full forward head tilt ---54
Backward head tilt---56
Exercises with pressing the head with the hand---58
Rotation of the head ---63
5. Starting positions for cervical spine exercises---65
Position for the lateral cervical spine tilt---66
Position for the lateral and backward tilt of cervical vertebrae and upper thoracic vertebrae---67
Position for the rotational cervical vertebrae movement---68
Position for straightening the cervical and thoracic sections of the spine---69
Position for exercises of lower cervical vertebrae---70
Position for the forward tilt of cervical vertebrae ---71
Lying down position for the lateral cervical spine tilt---72
Lying down position for the rotational cervical vertebrae movement---73
6. The sequence of preventive exercises---74
7. Preventive exercises for cervical vertebral degeneration ---80
Self-massage of the spinal muscles---82
Rotation exercises of shoulder joints---83
Exercises for the shoulders and chest---84
Exercise to straighten the thoracic spine---85
Mobilization of the transverse process ---86
Backward head movement---87
Nodding head movement---88
Cervical vertebra traction with supported head---89
Lateral tilt of the cervical spine, with stabilized head---90
Forward tilt of the C3-C7 vertebrae---91
Passive lateral tilts of the upper cervical vertebrae, with supported head---92
Passive forward tilt of the cervical vertebrae, with supported head---93
Lateral tilt of the cervical vertebrae, with head supported on hand---94
Forward tilt of the cervical spine, with stabilized head---95
Neck traction while standing up, supported on a chair---96
Rotational head movement---97
Forward tilt of the upper cervical vertebrae, with supported head---98
Neck traction supported on a chair---99
Exercises for the upper cervical vertebrae ---101
Lying down mobilization of the cervicothoracic junction ---101
Lying down lateral cervical spine tilt---102
Lying down rotational head movement---103
Cervical strain relief position---104
8. Home physiotherapy---105
TENS currents---105
Bioptron therapy---108
Infrared lamp---111
Heat treatments---112
Localized cryotherapy---114
Therapeutic mat with acupressure spikes---116
Cupping---119
Stabilization of the cervical spine - soft neck collar---122
Are you performing the exercises correctly?
As the anatomy of the cervical spine is extremely complex, it is very important to control the strength and range of motion. If you lean your head in any direction without support, the neck muscles and ligaments will have to bear its weight. This causes significant tension of the muscles and stretching of the ligaments. When performing the exercises, you are not able to define precisely the angle by which you should flex or twist your head, or the neck. Therapeutic recommendations usually lack precision. What extreme position is recommended? How much should the neck flexion angle be? What should the plane of movement be? How to boost or stop the movement using your breathing or eyesight? This means you are performing the exercises practically without any control.
The solution to this problem is offered by exercises presented in this guide, which:
limit the movement to its physiological range,
enable you to perform the movement within the proper plane,
control the head position,
stabilize the sensitive joints of upper cervical vertebrae.
Introduction
The cervical vertebrae are more than just elements of the osteoskeletal system. Disorders and diseases of the cervical spine affect the whole body. Your eyesight, hearing and balance can deteriorate. The flow of blood to the head is reduced, which results in vertigo and tension-induced pain. Pressure on nerve roots causes the numbing and weakening of arms and legs. Cervical discopathy impairs the work of the heart and lungs, and disrupts the functioning of the autonomous nervous system.
Preventing spinal degeneration should be mandatory in our times when we work hard and get little rest. First of all, you need to focus on increasing the mobility of the vertebrae. This is aided by maintaining the correct posture and by preventive exercises.
But before you begin therapy for your cervical spine, you need to learn what to look for, what movements are not recommended, and what movements can actually cause harm. Because the anatomy of the cervical spine is complex, not every movement of the neck and head is a good movement.
Positions described in this guide solve this problem by supporting and stabilizing the head. Each movement is applied only to a selected section of the cervical spine, the head is not used as a lever, and the range of motion of the cervical spine is controlled.
This guide will present you with scientific information on:
the importance of cervical vertebrae for your whole body,
the symptoms and complications of cervical vertebrae degeneration,
how we move our heads - the basic information on proper functioning of cervical vertebrae,
how to perform exercises in line with the natural mobility of cervical vertebrae,
how to relax the neck muscles - exercises and physiotherapy to perform at home, recommended by a physician specializing in rehabilitation and manual therapy.
The guide contains:
141 drawings and photographs,
22 exercises that mobilize the whole cervical spine,
8 correct positions for neck exercises,
4 forbidden head movements,
7 steps to health - the sequence for performing cervical spine exercises,
6 methods of at-home physiotherapy.
1. The cervical spine
What is the difference between cervical vertebrae and other vertebrae? How are they connected with the head? How do they work together with the occipital bone during head movements? Do they move all together, or in sequence? Are some of the vertebrae more mobile than others?
In this chapter you will learn about the anatomy of the cervical vertebrae. This is very important because it will allow you to do the exercises correctly.
The anatomy of cervical vertebrae
Cervical vertebrae are marked with the letter C - from the Latin word cervix, meaning the neck. The cervical spine consists of seven vertebrae: C1-C7. Their basic functions include: allowing movement and proper positioning of the head, protecting the spinal canal, correcting posture, and providing nerve supply to the upper limbs, neck and head. The mobility of the cervical vertebrae is much greater than that of the other parts of the spine. The vertebrae are smaller and more susceptible to injury and degeneration. They need protection and proper anterior flexion (physiological cervical lordosis).
This is made possible by the strong ligaments and fasciae of the spine and shoulder girdle, which form a strong and flexible shield. The ligaments connect the vertebrae - both among each other and with the occipital bone. Chapters 1 and 2 present the appearance and anatomy of the vertebrae, joints and ligaments of the cervical spine.
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