Cervical Spondylosis Overview
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, bone spurs and other signs of osteoarthritis develop.
Cervical spondylosis is very common and worsens with age. There also appears to be a genetic component involved because some families will have more of these changes over time, while other families will develop less.
More than 90 percent of people older than age 65 have evidence of cervical spondylosis and osteoarthritis that can be seen on neck X-rays. Most of these people experience no symptoms from these problems. When symptoms do occur, nonsurgical treatments often are effective.
Symptoms of Cervical Spondylosis
Most people with cervical spondylosis don’t have noticeable symptoms. If symptoms do occur, they can range from mild to severe and may develop gradually or occur suddenly.
One common symptom is pain around the shoulder blade. Patients will complain of pain along the arm and in the fingers. The pain might increase on standing sitting, sneezing, coughing, or backward tilting of the neck.
Another common symptom is muscle weakness. Muscle weakness makes it hard to lift the arms or hold objects firmly.
Other common signs include:
- a stiff neck that becomes worse
- headaches that mostly occur in the back of the head
- tingling or numbness that mainly affects shoulders and arms, although it can also occur in the legs
Symptoms that occur less frequently often include a loss of balance and a loss of bladder or bowel control.
If you have the sudden onset o numbness or tingling in the shoulder, arms or legs or if you lose bowel or bladder control, talk to your doctor and seek medical attention as soon as possible.
Causes of Cervical Spondylosis
Cervical spondylosis is caused by chronic wear on the cervical spine. This includes the disks or cushions between the neck vertebrae and the joints between the bones of the cervical spine. There may be abnormal growths or spurs on the bones of the spine (vertebrae).
Over time these changes can press down on (compress) one or more of the nerve roots. In advanced cases, the spinal cord becomes involved. This can affect not just the arms, but the legs as well.
Everyday wear and tear may start these changes. People who are very active at work or in sports may be more likely to have them.
The major risk factor is aging. By age 60, most persons show signs of cervical spondylosis on x-ray. Other factors that can make a person more likely to develop spondylosis are:
- Being overweight and not exercising
- Having a job that requires heavy lifting or a lot of bending and twisting
- Past neck injury (often several years before)
- Past spine surgery
- Ruptured or slipped disk
- Severe arthritis
- Small fractures to the spine from osteoporosis
Who is affected of Cervical Spondylosis
Cervical spondylosis is a very common condition. It’s estimated that 9 out of 10 adults will have some degree of cervical spondylosis by the time they are 60 years old (but many will not have any noticeable symptoms).
How is Cervical Spondylosis diagnosed?
Your doctor will generally begin by asking you about your symptoms and looking at your medical history. This will be followed by a physical examination of the body, with a focus on the neck, back and shoulders to find sore spots. The doctor is also likely to test reflexes and watch you walk. An abnormal gait caused by difficulty walking is one of the symptoms.
Other tests that might be done include imaging such as X-rays, computerised tomography (CT) and magnetic resonance imaging (MRI) of the spine. You might also be referred to a neurologist.
Treatment of Cervical Spondylosis
Your doctor and other health professionals can help you manage your pain so that you can stay active.
- Your doctor may refer you for physical therapy. The physical therapist will help you reduce your pain using stretches. The therapist will teach you exercises that make your neck muscles stronger.
- The therapist can also use neck traction to relieve some of the pressure in your neck.
- You may also see a massage therapist, someone who performs acupuncture, or someone who does spinal manipulation (a chiropractor, osteopathic doctor, or physical therapist). Sometimes a few visits will help with neck pain.
- Cold packs and heat therapy may help your pain during flare-ups.
A type of talk therapy called cognitive behavioral therapy may be helpful if the pain is having a serious impact on your life. This technique helps you better understand your pain and teaches you how to manage it.
Medicines can help your neck pain. Your doctor may prescribe nonsteroidal anti-inflammatory medications (NSAIDs) for long-term pain control. Narcotics may be prescribed if the pain is severe and does not respond to NSAIDs.
If the pain does not respond to these treatments, or you have a loss of movement or feeling, surgery is considered. Surgery is done to relieve the pressure on the nerves or spinal cord.