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Monday, 25 November 2013

Cervical Stenosis with Myleopathy Treatments In Chinese medicine perspective

Musculoskeletal disorders (MSDs) is medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints. A shoulder disorder was found in 27% of subjects, rheumatoid arthritis in 1% and osteoarthritis (OA) of the hand, hip, and knee in five, seven, and 18% of subjects, respectively. Disability was frequent: a walking distance of < 500 m was found in 60% and ADL dependency in 40% of the group. Factors related to one or both of these disability measures included female gender, hip and knee OA, impaired vision, cognitive impairment and neurological disease(1).
V. Cervical Stenosis is defined as a degeneration of the structures of the spine as a result of aging causes of a slowly progressive condition of the cervical spinal cord. Spinal stenosis cause pressure on the spinal cord, which may lead to the symptoms of myelopathy. Cervical spinal stenosis with myelopathy is a common disease in elderly patients of male gender(2)
F. Treatments
F.3. In Chinese medicine perspective
1. Compound Qishe Tablets, Jingfukang, Extractum Nucis Vomicae, etc.
In the review of randomized controlled trials with adults with a clinical diagnosis of cervical degenerative disc disease, cervical radiculopathy or myelopathy supported by appropriate radiological findings. ll four included studies were in Chinese; two of which were unpublished. Effect sizes were not clinically relevant and there was low quality evidence for all outcomes due to study limitations and sparse data (single studies). Two trials (680 participants) found that Compound Qishe Tablets relieved pain better in the short-term than either placebo or Jingfukang; one trial (60 participants) found than an oral herbal formula of Huangqi ((Radix Astragali)18 g, Dangshen (Radix Codonopsis) 9 g, Sanqi (Radix Notoginseng) 9 g, Chuanxiong (Rhizoma Chuanxiong)12 g, Lujiao (Cornu Cervi Pantotrichum) 12 g, and Zhimu (Rhizoma Anemarrhenae)12 g) relieved pain better than Mobicox or Methycobal and one trial (360 participants) showed that a topical herbal medicine, Compound Extractum Nucis Vomicae, relieved pain better than Diclofenac Diethylamine Emulgel.

2. Acupuncture
According to the study of Witzmann A at the Neurochirurgischen Abteilung des Landeskrankenhauses Feldkirch., the treatment of chronic spinal pain is dominated by non-operative procedures. There are three main procedures in this field of treatment: the manual medicine, the therapeutic application of local anesthetics and acupuncture. Acupuncture is the last step of the treatment cascade in out patients in any case, because acupuncture does not only serve as treatment option for pain relief, but also and even more so has an harmonizing effect upon physical and psychological disturbances. It is absolutely necessary for the patient to lie down for 25 to 30 minutes to reach these goals(2).

3. Etc.

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/20091597 
(2) http://www.ncbi.nlm.nih.gov/pubmed/11075429