Cervical spondylosis is a condition that causes deterioration of the vertebrae, discs, and ligaments in the neck or cervical spine.
Other names are arthritis of the neck, cervical osteoarthritis, or degenerative osteoarthritis.
The cervical spine refers to the seven small vertebrae that form the neck. They start at the base of the skull.
In cervical spondylosis, the edges of the vertebrae often develop bone spurs called osteophytes. Over time, the discs get thinner, and their ability to absorb shock is lost, increasing the risk of symptoms.
Swollen neck joints, called facet joints, can press or pinch nearby nerve roots or the spinal cord itself, resulting in tingling or “pins and needles” in the extremities and sometimes even pain in the limbs.
In some cases, there may be a loss of feeling and coordination. Some people may have difficulty walking.
Most people experience degenerative changes as they get older. The AAOS add that over 85 percent of people over the age of 60 years live with cervical spondylosis.
Fast facts on cervical spondylosis
- Nearly 85 percent of people over the age of 60 years live with cervical spondylosis, but not all of them experience pain.
- A range of neck-stretching exercises can help to relieve stiffness and pain.
- Muscle relaxants, steroid injections, and physical therapy can help ease symptoms. In severe cases, surgical options are also available.
- Symptoms can include weakness and pain. In severe cases, the disc can press on a nerve and cause loss of consciousness and mobility issues.
Cervical spondylosis may be treated with simple neck exercises, under the guidance of a doctor.
A person can ease the symptoms of cervical spondylosis with a few simple neck exercises.
Neck tilt (side-to-side)
These exercises can help to moderate the impact of the condition and alleviate pain or feelings of stiffness. However, they will not cure cervical spondylosis.
Cervical spondylosis occurs because of long-term degeneration and wear-and-tear of the cervical spine. A previous neck injury may also lead to the condition.
Some long-term activities may increase the risk of developing cervical spondylosis, such as carrying heavy loads, practicing martial arts, or being a professional dancer or gymnast.
Some researchers say that there could be a genetic cause because the condition sometimes runs in families.
It usually starts to appear afer the age of 40 years, and it progresses over time. Men usually develop it at an earlier age than women.
Smoking may also increase the risk.
Cervical spondylosis is usually symptomless. When symptoms do occur, they tend to resolve over time, often without treatment. If symptoms occur, treatment can help to reduce the impact.
Muscle relaxants are useful if the person has neck spasms, in which the neck muscles tighten suddenly. Options include cyclobenzaprine and similar muscle relaxants.
Antidepressants, such as amitriptyline, can sometimes help to relieve persistent pain that has not responded to other treatments. Gabapentin is another option.
A steroid injection in the neck may help with very severe pain.
Examples of steroid injections include:
- a trigger-point injection that can be done in a physician’s office
- a facet joint injection
- a cervical epidural steroid injection (ESI), performed under fluoroscopy, with the help of an x-ray
Physical therapy can also help alleviate symptoms.
How can physical therapy help?
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Sometimes, the symptoms of pain and stiffness continue to get worse, and nerve problems can occur.
Surgery may be an option if the person experiences:
- persistent neck pain that radiates down the arm
- a loss of sensation
- muscle weakness
- a loss of bowel or bladder function
If MRI results indicate nerve root compression or pressure on the spinal cord, known as myelopathy, the individual may benefit from surgery.
The surgeon may remove some osteophytes, or protruding pieces of bone, and possibly also portions of a disc to take pressure off the spinal nerve root or spinal cord.
Another type of surgery is cervical fusion. This will reduce pressure on the root joints and the spinal cord.
Cervical spondylosis is a kind of arthritis, and causes symptoms such as pain and stiffness.
In most cases, there is just a pain in the neck, stiffness, and the occasional headache.
Neck pain may spread to the shoulders, arms and hands, and the base of the skull. Moving the head may make the pain worse.
Neck stiffness is more common after a long period of inactivity, for example, after sleeping.
Headaches tend to start at the back of the head and then gradually move to the upper half of the front.
Sometimes, these changes result in a compression of the blood vessels. This can affect the blood supply to the brain, possibly resulting in dizziness and even blackouts.
Other, less frequent, problems may include loss of bowel or bladder function and coordination difficulties.
Arms and legs may become weak, and there may be lack of dexterity. Some people may have dysphagia, or difficulty swallowing, if the bones press against the esophagus.
Alongside exercises, individuals can take some steps at home to relieve symptoms if cervical spondylosis becomes painful.
Most people can use over-the-counter (OTC) drugs that do not need a prescription.
- nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen or naproxen
- acetaminophens, such as Tylenol
People with asthma, liver disease, kidney disease, heart disease, hypertension, or a history of stomach problems should not take NSAIDs. For severe pain, the doctor may prescribe different pain relief medication.
Other options include:
- Regular exercise: This can help speed up the recovery time from bouts of pain.
- A heated pad or cold pack: This can provide pain relief when the neck muscles become sore.
- A soft neck brace: These can temporarily relieve pain if a person wears them for short periods. However, long-term use can result in weaker neck muscles.
These remedies may only work for less severe cases. People with severe neck pain should visit a doctor.
Diagnosis may involve an MRI.
If a person aged over 40 years seeks medical advice for pain or stiffness in the neck, a physician will normally suspect cervical spondylosis.
A number of tests can help to diagnose the condition.
The doctor may ask the individual to make some movements, to check their range of motion.
- moving the head sideways
- moving the head forward and bringing the chin down to the chest
The doctor will test the reflexes in the hands and feet. They may check gait and posture by asking the person to walk a short distance.
They will also test for strength and sensation in both the upper and lower extremities.
An x-ray can reveal any physical damage to the spine, and whether there are any bone spurs.
If the patient has severe, radiating arm pain that does not improve, an MRI test may be useful for looking at the nerve roots, as there could be a herniated disc.
An MRI scan can also help pinpoint exactly where the problem is, and whether surgery is necessary.
A myelogram is another diagnostic test. A health professional will inject a colored dye into the spine. This dye shows in imaging scans, such as x-rays.
A CT scan can help to assess the bony structure of the cervical spine.
Electromyography (EMG) and nerve conduction studies (NCS) can help to assess specific muscles and nerves.
There is no way to prevent cervical spondylosis, but there are ways of controlling the symptoms.
For example, an ergonomic specialist may adjust a person’s workstation to minimize repetitive stress on the neck.
Not smoking, exercising sensibly, and regular stretching are all ways to avoid symptoms.