Cervical Spondylosis: Ayurvedic Treatment

Cervical spondylosis is caused by degeneration of bones, discs – cartilage cushion between the neck bones and joints of the neck. This condition is usually found in middle aged people and elderly. It is a wear and tear disease. Neck pain, stiffness, headache, numbness, etc. This is one of the diseases wherein Ayurvedic treatment has very good promise. 

Explanation

Easy explanation of Cervical spondylosis:
The neck bone structure consists of bones stacked one over the other with sandwich of disc cartilage in between. The triangular – circular aperture within these neck bones (cervical bones) paves way for the nerves from the brain to pass through. The branches of these nerves (nerve roots) arising from through the back and sides of these bones form plexus (merge and divide) and form different nerves. This complex arrangement of nerves is called cervical plexus. These nerves spread on the sides to supply to neck, face, back of the head, ears, shoulder and the full length of the arms.

With ageing, the bones and the cushioning cartilage disc starts to lose its strength. This makes the soft cartilage to thin, expand, slip (called herniation of disc), touch and irritate the nerves.

The degenerating discs also becomes flat with brittle edge causing nerve irritation. Nerve irritation leads to symptoms like pain, numbness etc.
The stiffness arises because of lack of cushioning between the neck bones, causing a friction whenever neck is moved.

This condition is also called Cervical osteo arthritis. Another term Cervical spondylitis is used, when the patient has active inflammation (redness, swelling, increase of temperature etc).

It is more commonly found in males of middle age group. People who are under exertion, frequent travellers can end up with trauma on neck bones, leading to spondylosis.
Bad posture is another strong etiological factor which results in the stiffness due to spondylosis.

In Ayurveda, a condition called Greeva graham is explained. – a condition with cardinal feature of stiffness of the neck is explained and it exactly suits with Cervical spondyslosis.
Greeva means neck and Graha refers to stiffness. It is explained as a Vata condition. Increase in Vata leads to depletion of body tissues. (For example, with ageing, Vata increases and body tissues start degenerating.) The dryness and degeneration caused by Vata leads to decrease of Kapha Dosha. Sleshaka Kapha is responsible for cushioning in between bone joints. Hence disc degeneration sets in leading to spondylosis.
Some compare this condition with another disease called Vishwachi  / Apabahuka.

Causative factors

Causative factors for Greevagraha (Cervical spondylosis) :
Food habits that increase Vata Dosha –
Intake of dry, cold/ frozen and light food
Fasting for long period – leads to depleted nourishment and increase of Vata Dosha.
Untimely intake of food
Junk food, Sodas
Less intake of water/liquids
Excess intake of curried food etc

Viharaja (Bad Habits)-
Night awakening
Day sleep
Heavy exercise
Suppression of the urges
Weight bearing in the head, shoulder or neck
Walking for long distances
Bike riding for long distances.

Manasika Hetu (Psychological factors ):
Stress, Grief, Anger, Fear, Loss of interest in work etc

Clinical features

Clinical features of Greevagraha (Cervical spondylosis) :
Pain in the neck
Difficulty in the usual functions of the neck like rotation, flexion, extension etc
Radiating pain to the shoulder, forearm or arm
Muscular spasm
Numbness
Joint stiffness
Fatigue
Headache
Tingling sensation, numbness, weakness in the arms
Difficulty in walking, lack of co-ordination

Line of treatment

Line of Treatment in Greevagraha (Cervical spondylosis) :
Snehana (Oleation): Both internal and external oleation are beneficial.
Swedana (Sudation): Mild to moderate sudation can be carried.

Mridu shodhana (Mild purgation) – with Castor oil  mixed with milk or Aragwadha phala majja (Fruit pulp of Cassia fistula) etc
The above three procedures help to normalise movement of Vata in proper direction.

Greeva basti (Retaining the medicaments in the nape of the neck)
In this procedure, a compound is created around the back of the neck with black gram paste. Medicated oil (Ksheerabala oil, Bala Ashwagandhadi oil etc) is heated and is retained within the compound for a few minutes time.

Logic: The heated oil helps to improve the space between the two neck bones, leading to relief from disc herniation. The oil, along with oral medicines help to improve nourishment of disc cartilage and bone, reversing the degeneration process.
These four form the basic procedures to treat. Other than this, many secondary procedures such as
Shirodhara
Abhyanga
Patrapinda Sweda
Shastika Sali Pinda Swedam/ Navarakizhi
Pizhichil (medicated oil bath) etc are administered to relieve pain, inflammation of muscles and ligaments and to improve flexibility of neck bone joints.

Herbs used

Ayurvedic Vata Pacifying herbs useful in cervical spondylosis:
Castor root (Ricinus communis)
Rasna (Pluchea lanceolata)
Bala (Sida cardifolia)
Atibala (Abutilon indicum)
Prishniparni (Uraria picta)
Shalaparni (Desmodium gangeticum)
Gambhari (Gmelina arborea)
Amalaki (Emblica officinalis)
Ashwagandha (Withania somnifera)
Sahachara (Barleria prionitis)
Guggulu (Commiphora mukul)
Shallaki (Boswelia serrata)
Shunthi ( Ginger) etc

Ayurvedic medicines

Ayurvedic medicines for cervical spondylosis:
Rasnaerandadi kashaya –  used in backache, low back pain, pain in flanks and locked jaw. It is more commonly used in South Indian Ayurveda practice.
Sahacharadi kashaya – Relieves pain associated with neck, hip and low back.
Rasna saptaka kashaya
Yogaraja guggulu – widely used in the Ayurvedic treatment for various types of arthritis
Mahayogaraja guggulu  – It is widely used in the Ayurvedic treatment of joint diseases, skin diseases, piles, sprue, diabetes, gout, fistula, bloating, emaciation, low digestion power, etc
Ksheerabala (Avartita) – useful in reversing tissue degeneration.
Trayodashanaga guggulu – It is widely used in the Ayurvedic treatment of joint pain related disorders.
Dashamoola rasayana – Relieves pain and inflammation
Rasnadi guggulu

Oils for external application: 
Sahacharadi taila
Bala taila
Vishagarbha taila
Mahanarayana taila
Mahamasha taila etc

Formulations from Sahasra Yoga
Rasna Sunthyadi Kashaya

Wholesome diet and habits

Wholesome diet and habits in Greevagraha (Cervical spondylosis) :
Red rice (Rakta shali)
Wheat (Godhuma)
Milk (Ksheera)
Ghee (Ghrita)
Butter (Navaneeta)
Warm water (Ushna jala)
Vishrama (Rest)
Proper position while sitting and lying down (Sukha asana) etc

Unwholesome diet and habits

Unwholesome diet and habits in Greevagraha (Cervical spondylosis) :
All causative factors mentioned above should be avoided.

Instruments that help

Cervical collars:
They help by restricting the movement of neck. Lesser neck movements help to reduce the pain and heal the ligaments faster. They also tend to increase the space between each neck bone, thereby, reducing the extent of disc prolapse (herniation). Lesser the disc herniation, lesser the irritation the displaced disc causes to the nerve, lesser the pain and discomfort.

You can wear the neck collar at least for 2- 4 hours a day. Do not use it for very long hours or throughout the day.

Cervical pillow:

It keeps the neck in a comfortable position while you sleep.

Cervical traction kit with sand bag:

This is an advanced equipment. It helps to widen the gap between the neck bones, thereby replacing the disc in its normal position. It can be used for a period of 1 – 2 weeks. Seek medical advice for more information.

Yoga for cervical spondylosis

Yogasanas for cervical spondylosis:
In the beginning stages, Yoga exercises to strengthen neck muscles and ligaments with Asanas like
Soorya Namaskara, Bhujangasana, Makarasana, Ardha Naukasana and Marjariasana can help.
You will have to seek expert guidance for following them.
The benefits would double if you apply pain relieving oil such as Mahanarayana taila, 10 minutes before practising Asanas.

Greevagraha (Cervical spondylitis) is a health complaint which is increasing day by day in the young adults; lifestyle changes, altered food and habits, work exhaustion, improper sitting posture, excessive travelling etc are the worsening factors for the disease. As the psychological factors are also involved in this complaint it is wise to adopt some relaxing techniques to reduce the pain.
Article by Dr MS Krishnamurthy and Dr Hebbar

Marma Therapy

Pressing and releasing the Krukatika marma is useful for in frozen shoulder and cervical spondylosis.