Cervical Spondylosis

Cervical Spondylosis

Cervical spondylosis, also known as cervical osteoarthritis or degenerative disc disease of the neck, is a condition characterized by age-related degeneration and wear-and-tear of the cervical spine (the vertebrae in the neck region). The condition causes the bones to shrink and dehydrate resulting in bony projections along the edges of bones. It is one of the common conditions that affect the joints, discs, and ligaments of the cervical spine.

Symptoms

There are usually no signs of cervical spondylosis. However, if you experience any symptoms then you may notice –

• Pain and stiffness around your neck
• Dizziness
• Muscle spasms
• Difficulty in walking or moving around
• Grinding sound when you move your neck
• Headaches
• Reduced coordination and balance
• Tingling and numbness
• Numbness or weakness in the arms, hands, or legs
• Loss of bladder or bowel control

In some situations, cervical spondylosis also may result in a narrowing of the spinal canal within the bones of the spine. 

Causes

Cervical spondylosis, also known as cervical osteoarthritis, is a condition that affects the joints and discs of the neck. It is primarily caused by age-related changes in the spine and is more common in individuals over the age of 40. While the exact cause of cervical spondylosis is not yet known, several factors can contribute to its development. Here are some of the main causes and risk factors associated with cervical spondylosis –

1. Age – The natural aging process leads to wear and tear on the spine. Over time, the discs between the vertebrae may become dehydrated and lose their elasticity. This can lead to the development of cervical spondylosis.
2. Disc degeneration – The intervertebral discs in the neck can degenerate due to age or other factors such as repetitive stress or injury. As the discs degenerate, they may bulge or herniate, causing pressure on the spinal nerves and contributing to the development of cervical spondylosis.
3. Spinal degeneration – The facet joints, which connect the vertebrae in the neck, can undergo degenerative changes. These changes include the formation of bone spurs or osteophytes, which can narrow the space available for the spinal nerves and spinal cord.
4. Poor posture – Chronic poor postures, such as slouching or forward head posture, can put additional stress on the neck and contribute to the development of cervical spondylosis. Improper posture can accelerate the wear and tear on the cervical spine.
5. Bone spurs – The body grows extra bone to make the spine stronger. However, the growth in bones can attack delicate areas of the spine such as the spinal cord and nerves causing severe pain. 
6. Previous neck injuries – Past neck injuries, such as fractures or sprains, can increase the likelihood of developing cervical spondylosis later in life. Trauma to the neck can disrupt the normal structure and function of the spine, leading to accelerated degeneration.
7. Genetic factors – There may be a genetic predisposition to developing cervical spondylosis. Certain genetic traits or variations may make some individuals more susceptible to degenerative changes in the spine.

These factors increase the risk of developing cervical spondylosis, not everyone with these risk factors will develop the condition. Additionally, some people may experience cervical spondylosis without any identifiable cause. If you are experiencing symptoms of cervical spondylosis, it is recommended to consult with a healthcare professional for an accurate diagnosis and appropriate treatment options.

Diagnosis and Tests

To diagnose cervical spondylosis, healthcare professionals typically perform a combination of medical history assessments, physical examinations, and imaging tests. Here’s an overview of the diagnostic process for cervical spondylosis –

1. Medical history – Your doctor will begin by asking you about your symptoms, their duration, and any factors that worsen or alleviate them. They will also inquire about your medical history, previous injuries or surgeries, and any relevant family history.
2. Physical examination – A physical examination allows the doctor to assess your neck and neurological function. They may check for tenderness, range of motion, muscle strength, reflexes, and sensation in your arms and hands. They will also examine your posture and evaluate any signs of nerve compression or spinal cord involvement.
3. Imaging tests – Imaging studies are commonly used to visualize the cervical spine and confirm the diagnosis. These tests include –
   a. X-rays – X-rays provide a basic view of the bones in your neck, helping identify bone spurs, degenerative changes, or abnormalities in the alignment of the vertebrae.
   b. Magnetic Resonance Imaging (MRI) – MRI scans use powerful magnets and radio waves to create detailed images of the soft tissues, such as discs, nerves, and spinal cord. This helps detect herniated discs, nerve compression, and spinal cord abnormalities.
   c. Computed Tomography (CT) scan – CT scans produce cross-sectional images of the neck, providing more detailed information about the bones and the spinal canal. It can be useful in identifying bone spurs and narrowing of the spinal canal.
4. Electromyography (EMG) – In some cases, an EMG may be performed to assess the electrical activity of the muscles and the functioning of the nerves. This test helps determine if nerve compression is present and which specific nerves are affected.
5. Other tests – Depending on your symptoms and the findings from the above tests, additional diagnostic procedures, such as a nerve conduction study or blood tests, may be ordered to rule out other conditions or investigate specific concerns.

It is necessary to consult with a healthcare professional if you suspect you have cervical spondylosis. They will be able to evaluate your symptoms, perform the necessary tests, and provide an accurate diagnosis. Treatment options can then be discussed based on the severity of your condition.

Treatments

The treatment of cervical spondylosis aims to relieve pain, reduce inflammation, improve mobility, and prevent further progression of the condition. The specific treatment options can vary depending on the severity of symptoms and individual circumstances. Here are some common treatments for cervical spondylosis –

1. Conservative management

• Medications – Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may help reduce pain and inflammation. In some cases, stronger prescription medications or muscle relaxants may be prescribed.
• Physical therapy – A physical therapist can provide exercises and stretches to improve neck strength, flexibility, and posture. They may also use techniques such as manual therapy, heat or cold therapy, ultrasound, or electrical stimulation to alleviate pain and improve function.
• Neck immobilization – In acute cases or severe pain, a cervical collar or neck brace may be recommended to restrict movement and provide support. However, long-term immobilization is generally not recommended.
• Lifestyle modifications – Making lifestyle changes, such as maintaining good posture, avoiding activities that worsen symptoms, incorporating regular exercise, and managing weight, can help alleviate symptoms and prevent further deterioration.

2. Medications

• Steroid injections – Corticosteroid injections into the affected area may help reduce inflammation and relieve pain. These injections are usually performed under guidance, such as fluoroscopy or ultrasound.
• Analgesics – In some cases, stronger pain medications or muscle relaxants may be prescribed to manage severe pain and muscle spasms.

3. Surgical intervention

• Surgery is typically considered when conservative treatments fail to provide relief or when symptoms are severe and progressive. The specific surgical procedure depends on the nature and extent of the spinal cord or nerve compression. Common surgical interventions include –
• Decompression surgery – This involves removing the bone spurs or herniated discs that are compressing the spinal cord or nerves.
• Spinal fusion – In some cases, fusion surgery may be performed to stabilize the spine by joining two or more vertebrae together using bone grafts or implants.
• Artificial disc replacement – This procedure involves replacing the damaged cervical disc with an artificial disc, maintaining motion at that level of the spine.

Treatment plans should be tailored to individual needs, and healthcare professionals will consider factors such as the severity of symptoms, overall health, and patient preferences. It’s recommended to consult with a healthcare provider to determine the most appropriate treatment approach for cervical spondylosis.

Outlook

The outlook for individuals with cervical spondylosis varies depending on the severity of the condition, the effectiveness of treatment, and individual factors. While cervical spondylosis is a chronic condition that cannot be completely cured, most people can effectively manage their symptoms and lead a normal life with appropriate treatment and self-care.

With proper treatment and lifestyle modifications, many individuals experience a reduction in pain and improvement in function. Physical therapy exercises and stretching can help strengthen the neck muscles, improve flexibility, and alleviate symptoms. Medications, such as NSAIDs and muscle relaxants, can provide relief from pain and inflammation. In some cases, steroid injections may be beneficial for short-term pain relief.

For individuals who require surgery, outcomes can vary depending on the specific procedure performed and individual factors. Surgical interventions such as decompression surgery or spinal fusion can effectively relieve pressure on the spinal cord or nerves and improve symptoms.