Cervical Spondylosis: Causes, Symptoms, and Treatment

Cervical spondylosis is a wear-and-tear condition that affects the neck part of the spine, called the cervical spine. This condition leads to the deterioration of spinal discs and the formation of bony outgrowths known as osteophytes. These changes can lead to compression of the spinal cord or nerve roots, causing pain, stiffness, and other symptoms.

Spondylosis is a condition characterized by age-related degeneration of the spine, resulting from gradual wear and tear over time. It commonly affects the cervical spine, leading to cervical spondylosis. This process impacts the intervertebral discs, vertebrae, and facet joints, potentially resulting in discomfort, restricted movement, and other related symptoms.

Spondylitis vs Spondylosis

While both spondylitis and spondylosis are related to spinal issues, they are different conditions. Spondylitis refers to inflammation of the spinal joints, commonly associated with conditions like ankylosing spondylitis or psoriatic arthritis. On the other hand, spondylosis is a wear-and-tear condition that happens due to age-related changes in the spine.

Symptoms

Cervical spondylosis symptoms can differ from one individual to another. Common symptoms include:

• Neck pain
• Stiffness
• Headaches
• Shoulder pain
• A sensation of tingling or numbness in the hands or arms
• Weakness in the arms or hands

Some individuals may also experience difficulty in maintaining balance or coordination.

Causes

Your spine changes due to decades of regular wear and tear. The discs between the vertebrae start to wear down during middle age. These modifications may include the following:

• Degeneration: The spinal discs in your neck can slowly wear down over time. The discs narrow over time, and the soft tissue loses flexibility. If you or your parents are a little lower in height than you were years ago, this is due to natural disc collapse or settling.
• Herniation: Normal ageing might result in a portion of your spinal disc tearing or cracking. This is known as a herniated disc. Because of herniation, the disc might expand, pushing on surrounding tissues or a spinal nerve. Pain, tingling, and numbness may result.
• Osteoarthritis: It is a chronic condition in which the cartilage in your joints degenerates. Cartilage breaks down faster in osteoarthritis than it does during normal ageing.
• Bone spurs: When the cartilage in your spine’s vertebral joints degenerates and bone tissue scrapes directly against the other bone tissue, impaired bone growths form along the borders of the vertebrae. These growths are frequent as you become older. They frequently have no symptoms.

Risk Factors

Individuals in the following categories have a higher likelihood of developing cervical spondylosis:

• Older Adults: Advancing age is a significant risk factor for cervical spondylosis. As we age, the spinal discs gradually degenerate, leading to the development of this condition
• Smokers: Cigarette smoking has been associated with an increased risk of cervical spondylosis. The harmful chemicals present in tobacco can contribute to the degeneration of spinal discs and accelerate the progression of the condition.
• Family History: Having one or more family members with cervical spondylosis can increase the likelihood of developing the condition. Genetics may contribute to an individual’s risk of spinal degeneration.
• Occupational Factors: Certain professions that involve repetitive neck movements or prolonged strain on the neck are associated with an elevated risk of cervical spondylosis. Examples include painters who frequently look overhead, plumbers or flooring installers who maintain a downward head position, and individuals who work with improper neck posture for extended periods, such as those who stare at improperly positioned computer screens.
• Previous Neck Injuries: A past neck injury, whether from a fall or a car accident, can significantly raise the risk of cervical spondylosis. Trauma to the neck can accelerate the degenerative changes in the spine.
• Heavy Lifting: Performing tasks that require heavy lifting, like construction work, can place significant strain on the neck and heighten the risk of cervical spondylosis.
• Vibration Exposure: Prolonged exposure to vibrations, such as those experienced by bus or truck drivers, can contribute to the development of cervical spondylosis.

Prevention

Although it may not be possible to completely prevent cervical spondylosis, certain lifestyle modifications can reduce the risk and delay its onset.

• Maintaining good posture
• Practicing regular neck exercises and stretches
• Avoiding excessive strain on the neck
• Managing weight
• Quitting smoking

Diagnosis

Your doctor will do a physical check-up to identify what is causing your neck pain or other symptoms. Your signs and severity indicate the strain on your cervical spine. In addition, your healthcare professional may perform the following tests during a physical exam:

• Neck flexibility.
• The doctor may check the strength of your muscles and test reflexes in your hands, arms, or legs.
• Your reflex responses will also be tested.
• Gait (how you walk).
• Neck and shoulder, looking for trigger points.

Cervical spondylosis can sometimes be diagnosed with merely a physical exam. They may also prescribe tests to discover more about what is causing your symptoms. These examinations may involve the following:

• Myelogram or Electromyogram tests
• X Rays
• Computer Tomography (CT) scans
• MRI Images

Treatment

Symptoms do not usually accompany cervical spondylosis. Therefore, you may not require therapy if you do not have any symptoms. When your illness does create signs, most instances may be adequately treated with conservative treatment. Your doctor may advise you to do the following:

• Physical therapy: Specific workouts and stretches may help to alleviate your problems. Physical therapy concentrates on stretching and toning muscles and improving posture. These exercises can be done at home or with support from a physical therapist in a clinic. Your healthcare provider will guide you on how often and for how long you should do these exercises based on your symptoms and condition.
• Ice, heat, and massage may help alleviate your symptoms. YYou may need to try both heat and cold to see which one gives you better pain relief. Apply heat or ice for no more than 20 minutes at a time, several times a day. Some patients may also try massage as an alternative option. Inquire with your healthcare provider if this is a viable solution for your unique situation.
• Soft collar or brace: Your doctor may advise you to use a remedial collar for a short period. This can assist stressed muscles in rest and recovery by limiting neck mobility. However, wearing a brace for an extended period might result in muscular atrophy. Therefore, use a collar only under the supervision of a medical practitioner.

Your healthcare experts may recommend surgery for the most severe cervical spondylosis, such as cervical myelopathy or radiculopathy. Surgical procedures may include removing bone spurs and fusing the vertebrae or making extra room for the spinal cord by removing a section of the vertebrae.

Spine surgery is complicated, and the recovery period can be extensive. Therefore, before evaluating whether surgery may help you, your healthcare professional will assess your symptoms, condition, and general health.

Medications

• NSAIDs: Over-the-counter pain relievers like ibuprofen (Advil) and naproxen sodium (Aleve) reduce pain and inflammation. Prescription-strength versions may be needed.
• Corticosteroids: Oral prednisone or steroid injections help manage severe pain.
• Muscle relaxants: Drugs like cyclobenzaprine (Amrix) relieve muscle spasms.
• Anti-seizure medications: Certain epilepsy drugs help dull nerve pain.
• Antidepressants: Some antidepressants assist in pain relief.

Surgery

Surgical options are considered when conservative treatments fail or neurological symptoms worsen. Surgical procedures may include removing a herniated disc, bone spurs, or fusing sections of the spine.

Home Remedies and Self-Care

Several self-care methods and home remedies can help reduce symptoms and improve movement.

• Applying heat or cold packs: It helps calm sore muscles and lower inflammation.
• Gentle neck exercises and stretches: Improves flexibility and reduces stiffness.
• Maintaining good posture reduces strain on the neck.
• Using ergonomic pillows and supports: Provides better neck alignment while sleeping.
• Incorporating relaxation techniques: Meditation, yoga, and breathing exercises help alleviate tension and pain.
• Regular exercise: Staying active promotes recovery and reduces discomfort.
• Pain relievers: Pain can be controlled using over-the-counter medicines like ibuprofen or acetaminophen.
• Soft neck brace: Provides temporary support but should not be used long-term to avoid muscle weakening.

Who to Consult for Cervical Spondylosis

If you have symptoms of cervical spondylosis, it is vital to seek professional medical evaluation for proper diagnosis and treatment. Depending on the severity of symptoms, one may consult a general practitioner, orthopaedic specialist, neurologist, or physical therapist.

Summary

Cervical spondylosis is a chronic condition that requires long-term management to alleviate symptoms and improve quality of life. By knowing the causes, risk factors, prevention steps, and treatment options, people can make better choices about their health. Additionally, adopting healthy lifestyle habits, practising self-care, and seeking appropriate medical care can help individuals effectively manage cervical spondylosis and live fulfilling lives.

Complications

Cervical spondylosis can lead to serious problems if it is not treated or if it causes pressure on the spinal cord or nerves.

One major complication is cervical myelopathy. This occurs when the spinal cord in the neck is squeezed. It can cause numbness in the hands, muscle weakness, and difficulty with coordination and balance.

Another complication is cervical radiculopathy. This occurs when a nerve in the neck gets pinched. It may result in pain that radiates into the arm, along with weakness and a tingling or “pins and needles” feeling.

In severe cases, nerve or spinal cord damage may cause long-term problems such as loss of sensation, poor muscle control, or difficulty walking. Some people may also develop poor balance or, in rare cases, loss of control over bladder or bowel functions.

If cervical spondylosis is not managed early, it can lead to permanent damage and disability.

What is Cervical Myelopathy?

As your vertebral discs deteriorate over time, your spinal cord may experience increasing pressure as the canal narrows due to arthritis and disc protrusions. This compression might aggravate neck discomfort and other symptoms. This is known as cervical spondylotic myelopathy (CSM).

If you have CSM, you will experience the symptoms of cervical spondylosis as well as the following additional symptoms:

• Weakness, tingling, or numbness in one or both arms or legs.
• Loss of bladder and bowel control.
• Trouble walking (feeling unsteady on your feet).
• Loss of function in the hands, like having problems writing.

CSM-related symptoms may gradually worsen over time. However, if your symptoms persist or substantially impact your life, your doctor may send you to a spine surgeon specialising in treating this illness.

Frequently Asked Questions