How Degenerative Changes Occur in the Cervical Spine

and how to correct them

We will focus on how degenerative changes occur through Movement System Impairment Syndromes, (MSIS). Kulp Physical Therapy and Massage uses a Kinesiopathological model for defining the MSIS and how the dysfunction occurs.

First let’s define Kinesiopathological. Kinesiopathological refers to how movement that is excessive, imprecise or insufficient contributes to the development of pathology.

The MSIS model believes that accessory motion greater than the physiological motion causes the impairment and that accessory motion hypermobility, is the underlying characteristic of degenerative joint disease.

MSIS is a progressive condition that is related to lifestyle that causes degenerative changes in the tissues. It is influenced by a variety of intrinsic, (genetics, sex, age), and extrinsic, (lack of, amount of and type of fitness, work activity), factors.

The Movement Impairment, (hypermobility), is the cause of pain. This hypermobility is influenced by stiffness or relative flexibility of the tissue attached to the adjoining joints. It is also influenced by the joint/joints moving readily in a specific direction contributing to the development of the movement pattern, (becomes habitual). Pain Syndromes are the result of cumulative micro-trauma from stress induced by these repeated movements in a specific direction or sustained alignments usually in a non-ideal position.

Usually overuse or disuse of some muscle groups is a result of these movement patterns and some biomechanical influences. The swayback posture with a posterior pelvic tilt that causes the hip to be extended minimizing the gluteus maximus muscle activity is an example of this.

Movement systems need to be periodically examined beginning at childhood and continuing thru a patient’s senior years to:

  1. Evaluate optimal tissue development
  2. Ascertain the progression of degenerative changes
  3. Determine and guide exercises to maintain health of the musculoskeletal, cardiovascular and metabolic systems

Correcting the movement pattern that is causing the tissues to become painful or irritated is primary. It is not enough just to direct treatment at the affected tissues.

Exercise is not effective unless the exercise limits or corrects the movement at the painful joint and produces the desired appropriate motion at adjoining joints. Guiding exercise for appropriate use can prevent disuse, misuse or overuse of the muscle.

The modification of factors altering the precision of motion, (physiological and accessory), alleviates or reduces tissue irritations and thwarts the painful condition. It creates an optimal environment to reduce factors that cause degenerative disease and in the end, by reducing degenerative disease, you can reduce the patient’s lifetime costs for care of these conditions.

If you have a patient experiencing Cervical Pain, take a moment to think about how physical therapy can help them. Contact us at Kulp Physical Therapy and Massage and talk with Doug or Janelle to help you hone your diagnosis and treatment options/plan. Please contact us at or 585-742-8270 if you’re interested.

This article is written with significant inclusion of information taken directly from the following text.

Sahrmann, SA and Associates. Movement Impairment Syndromes of the Extremities, Cervical and Thoracic Spines, Vol. 1. St. Louis. Elsevier and Mosby. 2011.