The first steps


Suffering from a chronic illness means many appointments and lots of unpredicted problems. Therefore it is extremely important to create structures that keep our lives as simple as possible. One step at a time.

If you are standing right at the very beginning of the diagnostic journey, everything will be confusing, and it is hard to know where to start.

1. Diagnosis

I think a clear diagnosis should be the first step to take, using:

X-ray in flexion, extension and maybe rotational views

Upright MRI

CT in rotation and flexion

or even a combination of two or more.

And if necessary an additional test, like neurovegetative diagnostics. Unfortunately, there are no strict guidelines for the diagnosis of ligamentous instability without bony injury, which is why those instabilities are often missed.

As a little help, there are some angles which could be measured, however, the opinions about what is considered a pathological angle differ largely.

It is often necessary to ask for a second opinion. Four eyes do see more than two.
2. Non-invasive treatment options

As soon as it is clear in which area the cervical spine is damaged, the next step would be to find the right physical therapy.

Unfortunately there is no therapy that works for all of us.

My personal rules for therapy can be found here.
3. Surgical treatment

If no non-invasive treatment leads to improvement or if symptoms even become worse then the last option is surgery.

Again, there are some things to consider before surgery, have a look here.