From the Research
For a patient without the normal curve of the cervical spine, I recommend a comprehensive approach including physical therapy focusing on postural correction exercises, gentle cervical traction, and core strengthening, as this approach has been shown to be effective in managing cervical spine issues and improving quality of life 1. The patient's treatment plan should prioritize conservative management, with a focus on early functional mobilization and adequate analgesia, as outlined in the study by 1. This approach can help prevent chronification and promote healing. Some key considerations for the treatment plan include:
- Starting with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (400-800mg three times daily with food) for pain management if needed
- Using a cervical pillow that supports the neck's natural curve to help during sleep
- Implementing ergonomic modifications at work and home, including adjusting computer monitors to eye level and using proper seating
- Considering referral to a spine specialist for evaluation in persistent cases
- Using heat therapy (15-20 minutes several times daily) and gentle massage to provide symptomatic relief It is essential to note that loss of cervical lordosis can result from muscle spasm, poor posture, or degenerative changes, and addressing it early helps prevent progression to more serious conditions like cervical radiculopathy or myelopathy 2, 3, 4, 5. Patients should be educated that improvement typically requires consistent adherence to therapy and lifestyle modifications over several weeks to months. In terms of specific interventions, radiofrequency ablation (RFA) and epidural steroid injection (ESI) have been shown to be effective in managing cervicogenic headaches and neck pain, with RFA having a lower complication rate and longer duration of pain relief 5. However, these interventions should be considered only after conservative management has been attempted, and under the guidance of a qualified healthcare professional.