Neck pain not to be confused with circulatory problems

By Lim Yang-sun

It is common for middle-aged and elderly individuals to experience numbness in their hands and feet, as the degenerative progression accelerates. Many regard such symptoms as being caused by blood circulation disorders, and they are left untreated.

However, in a myriad of cases, such symptoms are not caused by blood circulation, but by pressure on spinal nerves.

Cervical disc problems, such as herniated discs, and ossification of the posterior longitudinal ligament are two representative conditions that cause numbness in the extremities.

While many are aware of the herniated disc problem, ossification of the posterior longitudinal ligament is rather unknown by the public, so it is important to understand what this is and how to treat it.

Are all spinal problems caused by discs? A stiffened ligament can put pressure on spinal nerves.

Located between the nerves of the posterior vertebrae and spinal canal, the posterior longitudinal ligament vertically connects the vertebrae. As the posterior longitudinal ligament stiffens due to calcareous deposits, it puts pressures on the nerves. This results in various disorders, such as pain, numbness, weakening of the muscle, and hypoesthesia.

Herniated discs produce similar symptoms to ossification of the posterior longitudinal ligament in that the nerve is being pressured and causes pain and other related problems.

While a herniated disc pressures the spinal nerve through protrusion, ossification of the posterior longitudinal ligament pressures it due to stiffening.

Ultimately, this narrows the spinal canal and impinges on the nerve. Many equate spinal problems to only disc herniation; however, it should be noted that this is not the sole cause of problems to spines ― ligaments can also pose a multitude of issues to the spine.

The causes of the ossification are still unclear; however, the occurrence rate is higher among Asians due to genetic factors, alongside obesity and diabetes. In addition, the occurrence is higher among males than female, and the middle-aged male group showed the highest rate compared to other groups. It is common to experience this disease in the cervical area, but it may also occur in the thoracic and lumbar. Many times, it involves problems in two to five vertebrae.

In the early stages, the patient experiences mild pain and pressure around the neck; then this progresses to the shoulders and arms, while decreasing muscle strength. If the symptoms are left untreated, then the condition can worsen and cause loss of lower extremity muscle strength or bowel disorders. While these symptoms show gradual progression, in some cases the symptoms start off mild and progress rapidly after mild trauma.

They can be confused with palsy, ultimately missing the right time for treatment

If there are no symptoms of paralysis and there is only the pain, then conservative treatment measures such as medication, injections or physical therapy can be effective in improving the patient’s condition. However, if the patient experiences paralysis, then surgical treatment, a laminoplasty that enlarges the narrowed spinal canal, is necessary.

Among the elderly, this disease is often confused with palsy; thus, the right treatment is not always identified. If the appropriate treatment is not performed, then this can cause permanent loss of sensation.

If cognitive and language capabilities stay normal, but the patient experiences paralysis in certain parts of the body, then ossification of the posterior longitudinal ligament should be considered as a possibility.

The writer is the spine specialist at Bumin Hospital Seoul in Gangseo District.