Cervical spondylosis

Conditions

Cervical spondylosis refers to a wear and tear changes on the discs of the neck. It is related to age. Osteoarthritis is the most common cause of cervical spondylosis.

As the discs shrink with age, signs of osteoarthritis appear, with bony y extensions.

Cervical spondylosis is very common and worsens with age. More than 85% of people over the age of 60 suffer from it.

Most people experience no symptoms. When symptoms appear, non-surgical treatments are often effective.

Symptoms of Cervical Spondylosis

For most people, cervical spondylosis causes no symptoms. When symptoms occur, they usually include pain and stiffness in the neck.

It causes sometimes narrowing of the space in the spinal cord and the nerve roots that run through the spine to the rest of the body. If the spinal cord or nerve roots are pinched, it can lead to:

  • Tingling, numbness and weakness in the arms, hands, legs or feet.
  • Lack of coordination and difficulty walking.
  • Loss of bladder or bowel control.

Causes

As we age, the bones and cartilage that make up the spine and neck gradually wear down. These changes may include:

  • Dehydrated discs. The discs act as cushions between the vertebrae in your spine. By age 40, most people’s spinal discs begin to dry out and shrink, allowing more bone contact between the vertebrae.
  • Herniated discs. Age also affects the exterior of your spinal discs. Cracks often appear, leading to bulging (herniated) discs that can sometimes press on the spinal cord and nerve roots.
  • Bone spurs. Disc degeneration frequently causes the spine to produce additional amounts of bone. These bone spurs can occasionally pinch the spinal cord and nerve roots.
  • Rigid ligaments. Ligaments are cords of tissue that connect bone to another bone. Spinal ligaments can stiffen as you age, making your neck less flexible.

Risk factors

Risk factors for cervical spondylosis include:

  • Age.
  • Craft connected with additional pressure on the neck.
  • Previous neck injuries.
  • Genetic factors. 
  • Smoking. It has been associated with an increase in neck pain.

Complications

If the spinal cord or nerve roots are severely compressed as a result of cervical spondylosis, the damage may be permanent.

Diagnosis of cervical spondylosis

The physical examination includes:

  • Assessing the motion of the neck.
  • Assessing reflexes and muscle strength to determine if there is pressure on the spinal nerves or spinal cord
  • Gait assessment to see if spinal compression is affecting the patient’s gait.

Imaging tests

Imaging tests can provide detailed information to guide diagnosis and treatment. The doctor might recommend:

  • X-ray of the neck which may show abnormalities. Neck X-rays can also rule out rare and more serious causes of neck pain and stiffness, such as tumors, infections, or broken bones.
  • CT scan. A CT scan can provide more detailed imaging, especially of bones.
  • MRI. MRI can help identify areas where nerves might be pinched .
  • Myelography. A dye is injected into the spinal canal to provide more detailed X-ray imaging.

Nerve function tests

The doctor may recommend tests to determine if the nerve signals are traveling correctly to the muscles. Nerve function tests include:

  • Electromyography. This test measures the electrical activity of nerves as they transmit messages to muscles when the muscles are contracting or at rest.
  • Nerve conduction study. The electrodes are attached to the skin above the nerve to be studied. A small shock is passed through the nerve to measure the strength and speed of nerve signals.

Treatment of cervical spondylosis

Treatment for cervical spondylosis depends on the severity of the signs and symptoms. The goal of treatment is to relieve pain, maintain normal activities as much as possible, and prevent permanent damage to the spinal cord and nerves.

Medications

If over-the-counter pain relievers aren’t enough, the doctor might prescribe:

  • Nonsteroidal anti-inflammatory drugs. 
  • Corticosteroids. 
  • Muscle relaxants. 
  • Anti-epileptic drugs. 
  • Antidepressants. Certain antidepressant medications have been found to help relieve neck pain.

Therapy

A physical therapist may ask the patient to perform exercises to help stretch and strengthen neck and shoulder muscles. 

Surgery

If conventional treatments fail or if neurological signs and symptoms – such as arm or leg weakness – worsen, the patient may undergo surgery.

The purpose of surgery may be to:

  • Remove a herniated disc.
  • Remove part of a vertebra.
  • Perform a bone graft.

Lifestyles

  • Regular exercise. Maintaining physical activity will help speed up recovery. People who walk daily are less likely to experience neck and lower back pain.
  • Over-the-counter pain relievers. Ibuprofen, naproxen, or acetaminophen are often enough to control the pain associated with cervical spondylosis.
  • Heat or ice. Applying heat or ice to your neck can relieve sore neck muscles.
  • Minerva. The brace allows your neck muscles to rest. However, a neck brace should only be worn for short periods of time, as it can weaken neck muscles.