Cervical spondylosis

Description

Cervical spondylosis is a general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, signs of osteoarthritis develop, including projections of bone along the edges of bones (bone spurs).

Cervical spondylosis is very common and worsens with age. More than 85% of people over the age of 60 are affected by cervical spondylosis.

For most people, cervical spondylosis causes no symptoms. When symptoms do occur, nonsurgical treatments are often effective.

Symptoms

Most people do not experience symptoms. When symptoms do occur, they typically include pain and stiffness in the neck.

Sometimes, cervical spondylosis results in a narrowing of the spinal canal within the bones of the spine (vertebrae). The spinal canal is the space in the interior of the vertebrae in which the spinal cord and the nerve roots that pass through to reach the rest of the body. If the spinal cord or nerve root is pinched, you may experience:

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

When to see a doctor

Seek medical attention if you experience a sudden onset of numbness or weakness or loss of bowel and bladder control.

Causes

As people age, the structures that form the spinal column and the neck gradually develop wear and tear. These changes may include:

  • Dehydrated discs. The disks act as shock absorbers between the vertebrae of the spinal column. For the 40 years of age, the majority of the people of the disks in the column to begin the drying and shrinkage. As the disks become smaller, there is more bone-on-bone contact between the vertebrae.
  • The herniated disk. The cracks also appear on the outside of the discs of the spine. The soft interior of a disk can squeeze through these cracks. Sometimes, it exerts pressure on the spinal cord and nerve roots.
  • The bone spurs. As the discs break down, the body can produce more amounts of bone in a misguided effort to strengthen the spine. These bone spurs can sometimes pinch the spinal cord and nerve roots.
  • Stiffness of the ligaments. The ligaments are cords of tissue that connect bone to bone. The spinal ligaments can stiffen with age, making the neck is less flexible.

Risk factors

Risk factors for cervical spondylosis include:

  • Age. Cervical spondylosis occurs commonly as a part of aging.
  • Of the occupation. Jobs that involve repetitive movements of neck, awkward positioning or a huge overload of work put additional strain on the neck.
  • The lesions in the neck. Previous neck injuries appear to increase the risk of cervical spondylosis.
  • Genetic factors. Some people in some families will experience more of these changes over time.
  • The habit of smoking. The habit of smoking has been linked to increased pain in the neck.

Complications

If cervical spondylosis severely compresses the spinal cord or the nerve roots, the damage may be permanent.

Cervical spondylosis

Diagnosis

Your health care provider will likely start with a physical examination that includes:

  • Checking the range of motion in the neck
  • Test your reflexes and muscle strength in order to find out if there is pressure on the spinal nerves or the spinal cord
  • Seeing a walk to see if the compression of the spinal cord is affecting your gait

Imaging tests

Imaging tests can provide detailed information to guide diagnosis and treatment. Examples include:

  • X-ray of the neck. An x-ray can show changes in the spine such as bone spurs, that indicate cervical spondylosis. X-ray of the neck can also rule out common and more serious causes of neck pain and stiffness, such as tumors, cancer, infections or fractures.
  • Magnetic resonance imaging (MRI). The use of radio waves and a strong magnetic field, the magnetic resonance imaging can produce detailed images that can help identify the areas where the nerves can be pinched.
  • Computed tomography (CT) myelography. In this type of computed tomography (CT) scan, a dye is injected into the spinal canal to provide more detail of image. This test makes it easier to see the details of the spinal cord, the spinal cord and nerve roots.

Tests of nerve function

You may need tests to determine if the nerve signals traveling properly to your muscles. Nerve function tests include:

  • Electromyography. This test measures the electrical activity in the nerves as they transmit messages to the muscles when the muscles contract and at rest.
  • The nerve conduction study. Electrodes are placed on the skin over the nerve to be studied. A small shock is passed through the nerve to measure the strength and the speed of the nerve signals.

Treatment

The treatment of cervical spondylosis depends on its severity. The goal of treatment is to relieve pain, help maintain your usual activities as much as possible, and prevent permanent injury of the spinal cord and nerves.

Drugs

If non-prescription pain relievers are not enough, your healthcare provider may prescribe:

  • Nonsteroidal anti-inflammatory drugs. nonsteroidal anti-inflammatory drugs (Nsaids) such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), are commonly available without a prescription. You may need prescription-strength versions to relieve the pain and inflammation associated with cervical spondylosis.
  • Corticosteroids. A short course of oral prednisone may help relieve the pain. If your pain is severe, steroid injections may be helpful.
  • Muscle relaxants. Certain medications, such as cyclobenzaprine (Amrix, Fexmid), can help to relieve muscle spasms in the neck.
  • Anti-seizure medications. Some epilepsy medications can relieve the pain of damaged nerves.
  • Antidepressants. Certain antidepressant medications can help to relieve the neck pain of cervical spondylosis.

Therapy

A physical therapist can teach you exercises to stretch and strengthen the muscles of the neck and shoulders. This can be one of the best treatments for pain and stiffness. Some people with cervical spondylosis benefit from the use of traction, which can help provide more space within the column, if the roots of the nerves are being pinched.

Surgery

If conservative treatment fails, or if the neurological symptoms, such as weakness in the arms or legs — get worse, you may need surgery to create more space for the spinal cord and nerve roots.

The surgery may involve the removal of a herniated disc, bone spurs or part of a vertebra. A segment of your neck may need to be merged with bone grafts and hardware.

Self-care

Mild cervical spondylosis could respond to:

  • The Regular exercise. The maintenance of the activity that's going to help speed up the recovery, even if you have to temporarily modify some of his exercises because of neck pain. The people who walk daily are less likely to experience neck and low back pain.
  • Pain medications you can buy without a prescription. Ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others) is often sufficient to control the pain associated with cervical spondylosis.
  • Heat or ice. The application of heat or ice in the neck can relieve the pain of the muscles of the neck.
  • Soft neck brace. The bracket allows the neck muscles to relax. However, a neck brace needs to be worn only for short periods of time due to which, eventually, may weaken the muscles of the neck and cause stiffness in the neck.

Alternative medicine

Chiropractic adjustments can help to relieve the neck pain and stiffness. The chiropractor may manipulate the spine, or massage to relieve the symptoms. The treatment is usually done after the x-rays of the cervical spine have been completed.

Both the massage therapy and acupuncture are being studied for the treatment of neck pain. Some of the first results suggest that both may be useful.

Preparing for your appointment

You may be referred to a physical therapist or a doctor who specializes in disorders of the spine (orthopedics).

Here's some information to help you prepare for your appointment and know what to expect.

What you can do

  • Write down your symptoms and when they began.
  • Write down your key medical information, including other conditions.
  • Write down key personal information, including any major changes or factors of stress in your life.
  • Make a list of all your medications, vitamins or supplements.
  • Find out if someone in your family has had similar problems.
  • Ask a family member or friend to accompany you, to help you remember what you learn during the appointment.
  • Write questions to ask during the appointment.

Questions to ask your doctor

  • What is the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • What treatments are available?
  • I have other health conditions. How can I best manage them together?

In addition to the questions that you have prepared, do not hesitate to ask other questions that arise during your appointment.

What to expect from your doctor

Your health care provider is likely to ask a series of questions. Be prepared to respond to them can make the time to go over points you want to discuss it in depth. You can ask:

  • Where exactly your neck hurt?
  • Has had previous episodes of similar pain that in time would disappear?
  • Have you experienced changes in your bladder or bowel control?
  • You've experienced the sensation of tingling, or weakness in the arms, hands, legs, or feet?
  • Do you have difficulty walking?
  • What self-care measures that have been tried, and some of them helped?
  • What are your occupation, hobbies, and recreational activities?
  • Have you ever had a whiplash or another neck injury?
Symptoms and treatment of Cervical spondylosis