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Most commonly known as a military neck a straight or forward curve of the neck is abnormal and may cause an unkind progression of symptoms leading ultimately to cervical disk degeneration.
Reversal of cervical lordosis explained
The anatomy of the neck features a lordotic curvature in its typical and healthy state. This means that the cervical region has a gentle curvature with the open end of that curve facing the rear of the body. The base and top of the curve will be further posterior than the mid point, which will be further anterior.
When the lordosis is straightened, the neck becomes more upright and linear. This is more common than the next progression of atypical curvature, which is the subject of this article.
Actual reversal of curvature means that part or all of the cervical spine develops a kyphotic profile, with the open end of the curve facing anteriorly. Usually, this reversal is extremely mild, but is still very abnormal. What we now see is the middle of the curve being positioned posterior to the top and bottom.
In essence, picture the letter c and now turn it backwards: This is the shape of a reversed cervical lordosis.
Reversal of cervical lordosis causes
The spinal curvature in the neck is constantly in flux to some degree.
Congenital conditions and developmental conditions can have lasting effects on the natural degree of curvature typically demonstrated from patient to patient. These circumstances may be explainable due to injury or degeneration, or may be idiopathic:
Scoliosis can affect the normal lordotic curvature in the neck.
Cervical spondylolisthesis is a major source of reversed lordotic curvature.
Severe disc pathologies can facilitate a gradual loss or reversal of cervical lordosis.
Vertebral irregularities, such as wedging, can definitely contribute to lordotic alteration.
Traumatic injury, including vertebral fracture, can create the ideal circumstances for a reversal of lordosis to take place.
Severe neck muscle spasms can actually reshape the spinal curves, although these are usually temporary expressions and not actual structural conditions.
Effects of reversal of cervical lordosis
The neck is designed to curve in order to balance the spine, absorb stress, distribute force and provide proper movement of the head. When this curvature is diminished or reversed, symptoms may result, although this is not an inherent part of any altered lordotic condition.
Patients may experience stiffness and tension in the neck. Pain may be present and may even be severe in rare cases. Neurological dysfunction is possible in extreme cases, since the neuroforamen might not align properly, thereby causing a cervical pinched nerve.
In the worst circumstances, central spinal stenosis in the neck might affect the viability of the spinal cord, possible enacting the most dire of symptoms throughout the body.
Patients will also be more prone to injury, since the normal shock absorption qualities of the typical curvature have been lost.
While all these effects are certainly possible, they are not usual. In fact, a great majority of patients have minor symptoms or even no symptoms at all from mild reversed lordotic curvatures.
The pathology leading to a neck curve reversal (cervical kyphosis shown below right) may be inspired by a multitude of conditions as follows:
Post head injury
Poor sitting/working postures
Congenital spinal curvatures
Degenerative cervical discs (a form of osteoarthritis that can either be the cause of or the result of a cervical kyphosis)
Compression fracture of vertebral body
Infection of the cervical spine
Anatomy: straight vs. Curved
I've always heard that it was good to stand up straight.
stand upright, stick your chest out and hold your shoulders back! otherwise you're going get widows hump.
Are these expressions as familiar to you as they are to me? one might think that having a curved neck goes against what we heard from parents and teachers as we were growing up, but the reality is that there is a little bit a truth in both. Maintaining good posture throughout our lives is crucial to both the health of our spine and vital organs. On the contrary, a special type of curve called a lordosis is a good thing, both in the neck and lower back.
When we look at a person from the back their spine should be truly straight, so that the left and right sides of one's body is symmetrical. However, when we view a person from the side, the front and back of their body is different and this is reflected in a coinciding curvature of the spine. Both the lower back and neck are hollowed out (concave) and the mid or thoracic spine is protrudes (convex). Thus there is an alternation of curves functioning to provide stability, shock absorption and aid in propulsion. A straight spine would be very stiff and not flexible. Imagine the plight of a pole vaulter with an inflexible pole.
Nature's design of our spine and rib cage facilitates breathing and offers protective and supportive framework for vital organs. Spinal disks are shock absorbers and because they are in the front of the spine, lordotic curvatures keep them from having to bear weight. Kyphosis or loss of such curvatures bears weight upon the disks, leading to their ultimate degeneration. This process of deterioration is a form of osteoarthritis and in the spine is known as degenerative spondylosis.
Although most physiotherapists or conservative orthopedists can recognize a cervical curve reversal upon viewing the patient's posture, a definitive diagnosis may be obtained via a standing lateral (side view) x-ray of the neck. Cause can often be determined by corroborating a comprehensive history, a thorough examination, x-rays and questions about sleep, work and lifestyle.
In my professional career I found that the majority of young adults presenting with cervical kyphosis either had a whiplash or were stomach sleepers from an early age. For desk jockeys 40-60 years of age, many hours of sitting with their head flexed forward almost dictates the fate of developing kyphosis. In prior years I considered cervical kyphosis a job hazard for the careers of accountants, attorneys and often teachers because of years spent with their head in a book or paperwork. However, the digital age offers some relief in that respect. A well-planned, ergonomically-friendly office can do wonders for protecting the spine in the sedentary worker.
Treatment for cervical curve reversal (kyphosis)
During my chiropractic practice I had the opportunity to note a good percentage of correction toward a more normal lordosis (noted on x-ray) for 70% of patients under my care. This was almost always consistent with those patients that followed all recommendations and were model participants in their own care. Here is the recommended treat plan:
Spinal manipulation of stiff and fixated spinal segments by a qualified physio
Flexibility exercises for flexion and extension of cervical spine
Resistance exercises for flexors and extensors of the neck
Learn the Alexander technique for maintaining good posture (hint: the basic philosophy is to sit and stand like you were hanging by a string from the vertex of your skull. Liken it to a puppet on a string).
Elimination of stomach sleeping
Avoid standing on your head, although some yoga postures may be beneficial
Use of orthopedic neck pillow while sleeping.
Beet juice: apart from being a nutritional powerhouse, beet juice is a great source of nitric acid. The latter helps with blood flow in the body. A smooth blood flow, on the other hand, helps the brain in functioning properly. A study has found that people who consume beet juice have an increased circulation in the white matter resulting from an increased brain activity. This juice is sweet in taste and can be consumed every alternate day.
Berry smoothies: acai is a fruit which has a south african origin and hits the top of the list when it comes to brain assisting food. It increases the flow of the blood and dilates the blood vessels. However, this is extremely expensive. Berries also have a similar effect on the brain, but they are less powerful in nature. What can be done is to mix a little ingredient of acai in frozen berries juice and drink the same every day. Frozen berries retain the freshness and the nutritional benefits. This drink will improvise your brain and increase blood flow in the body.
Pomegranate juice: pomegranate is a great antioxidant and it very aptly limits the free radicals from damaging the brain cells. Antioxidants are also credited with increased blood flow and protection of the heart. A healthy cardiovascular system is synonymous to an increased brain function. What is surprising is the fact that pomegranate has more antioxidant content compared to red wine and green tea. Pomegranate juice can be consumed daily during the morning or afternoon.
Carrot juice: carrot is known for its healthy components that are beneficial for the eyes. Recent studies have revealed that they are great for the brain too. Like other colored vegetables, they are a great source of antioxidant and have a high content of beta-carotene. Carrot juice can reduce the inflammation of the brain cells and improve memory. Carrot juice is not at all bitter and the same can be consumed every alternate day after your meal.
Cocoa: a harvard study revealed that two cups of cocoa on a daily basis greatly helps a person in improving memory. Cocoa contains flavanols that keep the blood pressure normal and relaxes the blood vessel linings. Cocoa is also known to be a great antioxidant agent that limits the free radical to affect the brain cells. Cocoa should not be overloaded with sugar and should be consumed hot before starting your day.
The uterus or womb, is a muscular structure and is held in place by ligaments and pelvic muscles. If these muscles or tendons become weak, they cause prolapse and are no longer able to hold the uterus in its place.
Uterine prolapse happens when the uterus falls or slips from its ordinary position and into the vagina or birth waterway. It could be complete prolapse or even incomplete at times. A fragmented prolapse happens when the uterus is just hanging into the vagina. A complete prolapse depicts a circumstance in which the uterus falls so far down that some tissue rests outside of the vagina. Likewise, as a lady ages and with a loss of the hormone estrogen, her uterus can drop into the vaginal canal. This condition is known as a prolapsed uterus.
Risks: The risks of this condition are many and have been enumerated as follows:
- Complicated delivery during pregnancy
- Weak pelvic muscle
- Loss of tissue after menopause and loss of common estrogen
- Expanded weight in the stomach area, for example, endless cough, constipation, pelvic tumors or accumulation of liquid in the guts
- Being overweight
- Obesity causing extra strain on the muscles
- Real surgery in the pelvic zone
Symptoms: Some of the most common symptoms of prolapse involve:
- Feeling of sitting on a ball
- Abnormal vaginal bleeding
- Increase in discharge
- Problems while performing sexual intercourse
- Seeing the uterus coming out of the vagina
- A pulling or full feeling in the pelvis
- Bladder infections
Nonsurgical medications include:
- Losing weight and getting in shape to take stress off of pelvic structures
- Maintaining a distance from truly difficult work
- Doing Kegel workouts, which are pelvic floor practices that strengthen the vaginal muscles. This can be done at any time, even while sitting down at a desk.
- Taking estrogen treatment especially during menopause
- Wearing a pessary, which is a gadget embedded into the vagina that fits under the cervix and pushes up to settle the uterus and cervix
- Indulging in normal physical activity
Some specialists use the following methods to diagnose the problem:
- The specialist will examine you in standing position keeping in mind you are resting and request that you to cough or strain to build the weight in your abdomen.
- Particular conditions, for example, ureteral block because of complete prolapse, may require an intravenous pyelogram (IVP) or renal sonography. Color is infused into your vein, and an X-ray is used to view the flow of color through your urinary bladder.
- An ultrasound might be utilised to rule out any other existing pelvic issues. In this test, a wand is used on your stomach area or embedded into your vagina to create images of the internal organ with sound waves.