by Erik Dalton Ph.D.
Researchers do not know if impaired muscle function is the primary cause of joint dysfunction, or if the reverse holds true. However, a reflexogenic relationship exists between the deep myofascia and joints. Long-term chronic neck pain seems to be primarily caused by facet-sticking and degenerative joint desease (Fig. 1).
As components of the spinal anatomy begin to degrade over time… bone loss, disc degeneration, and facet joint osteoarthritis place excess stress on the aging vertebrae. The body responds by growing bony nodules called osteophytes, or bone spurs, to compensate for diminished spinal stability. While the word “spur” often leads people to imagine something sharp or pointed digging into a nerve or other tissue, bone spurs are actually smooth and sometimes ‘crusty’ growths that can be mobilized through movement.
Bone spurs are common and do not exhibit symptoms in most cases. However, when osteophytes grow in confined areas adjacent to nerve roots or the spinal cord, nerve compression can occur. Because the uncinate processes are located near the foramina – channels where nerve roots exit the spinal canal – bone spurs that develop at the uncovertebral joints may cause a condition known as foraminal stenosis (Fig. 2). Should this narrowing of the foraminal canal lead to nerve compression, it might produce symptoms such as localized pain, radiating pain, tingling, numbness or muscle weakness.
In the younger population, cervical radiculopathy is usually a result of a disc herniation or an acute injury causing foraminal impingement of an exiting nerve. Disc herniation accounts for 20-25% of the cases of cervical radiculopathy. But in our older clients, cervical radiculopathy is often a result of foraminal narrowing from osteophyte formation, decreased disc height, degenerative changes of the uncovertebral joints anteriorly and of the facet joints posteriorly.
So, what can manual and movement therapists do to help prevent facet jamming and nerve root impingement? I’ve found that in many cases, these chronic-pain generators can be lessened by applying specific soft-tissue decompression and mobilization techniques to maintain “joint play” in the facets and facilitate rehydration of flattened intervertebral discs. In the video below, I demonstrate two basic, but powerful, cervical mobilization routines to relieve “immobilization arthritis” due to facet jamming and bone spur formation.