Cervical Spondylosis

Cervical spondylosis is a chronic condition that arises due to degeneration of bones and cartilage of the cervical vertebrae, as well as the cushions or cervical disks between the vertebrae. This may also be accompanied by 'spurs' or abnormal growths on the bones of the neck.

As degeneration worsens, one or more of the nerves in the area may get compressed. This can result in pain in that area of the neck as well as the arms, plus altered sensation and weakness. When spondylosis becomes advanced, it can even affect the spinal cord. In such cases, apart from the arms, even legs are affected.

This condition usually starts appearing in women and men once they cross their 40s, and with aging the condition progresses. Those who are above the age of 50 are at a greater risk of getting cervical spondylosis. Although both sexes are affected by it, generally it occurs earlier in men as compared to women.

With aging, there is loss of elasticity and dryness in the spinal disks. Degeneration may result in bulging of a few of the disks, and sometimes even lead to protrusion of the central cartilage through a crack that occurs in the ring surrounding the disk, which is also referred to as herniated disk. The ligaments surrounding it may lose their flexibility, and spurs may form on the vertebrae.

This kind of degeneration may be due to wear and tear all through life. A neck injury in the past may also predispose some people to cervical spondylosis, although aging is the main cause of this degenerative disease. By the age of 60, 85 percent of men and 70 percent of women begin showing evidence of this spinal cord problem on the x-ray.

It can also be caused when minerals like calcium get deposited in the cervical disks, or when ligaments connecting muscles and neck bones get stiff. Some of the other causes of this condition include bad posture, occupational hazard, body type, and lifestyle.

Stiffness and pain in the neck which worsens progressively could be a symptom of cervical spondylosis. The pain could be mild or severe, resulting in debilitation. It may last for many months before it improves, or it could become chronic. Some of the other symptoms are:

• Weakness or numbness in hands, fingers, and arms.
• Pain in the neck that spreads to the shoulders as well as the arms.
• Stiffness and swelling in the neck joint.

• Headache that spreads to the rear side of the head.
• Loss of balance.
• Sudden abnormal reflexes.
• If there is pressure on the spinal cord, weakness, numbness or tingling sensation in the legs.

• If there is compression on the spinal cord, a loss of bowel or bladder control.
• Difficulty walking due to weakening of upper parts of arms and legs.
• Some people may also experience memory loss, sleep deprivation, fatigue and anxiety.

Diagnosis involves two steps. First is a physical examination which is carried out by a doctor. He may ask the person to rotate his head and tilt it towards the shoulders to see if the person is facing any difficulty in doing so.

He may also put a slight downward pressure to see if intensity of pain increases when the person bends his head towards his sides and downwards. Besides these, weakness, and abnormal or reduced reflexes may indicate the prevalence of this condition.

Further confirmation is done on the basis of certain diagnostic tests like X-ray and MRI of the neck, nerve conduction velocity test and electromyogram (EMG) test.

If cervical spondylosis is not treated, the symptoms may either stabilize or reduce, or could become worse. The aim of any treatment is to prevent permanent injury to the spinal nerves and cord and relieve pain.

For Mild Cases

• Wearing a cervical collar or neck brace in the day time in order to lessen the motion of the neck as well as reduce nerve irritation.
• Taking anti-inflammatory drugs that are non-steroidal in order to provide pain relief.

• Application of heat and ice on the affected area for pain relief.
• A physical therapist may also prescribe exercises to strengthen muscles of the neck as well as stretch the shoulders and neck. Water aerobics or walking may also help in relieving the condition.

For Severe Cases

• Hospitalization, involving bed rest as well as neck traction for one week or perhaps two, in order to immobilize the cervical spine completely, and lessen the pressure on the nerves in the spine.
• Prescription of muscle relaxants like cyclobenzaprine or methocarbamol, especially if there are spasms in the muscles of the neck.

• Corticosteroid injections may be administered between the facet joints. A local anesthetic may also be given to lessen the inflammation and pain.
• Physiotherapy exercises with sufficient periods of rest in between therapy sessions.

For Cases Requiring Surgery
In order to relieve pressure on the spinal cord or nerves, when the patient does not respond to conservative treatment, or in case neurological symptoms like weakness in the arms or legs worsen, the doctor may prescribe surgery. The surgical procedure used will be dependent on the underlying condition, like spinal stenosis or bone spurs.

Surgery usually involves removal of affected bones and tissues. There are two approaches to conduct a surgery; anterior approach and posterior approach. When anterior approach is taken up, the doctor conducts the surgery by making an incision in the front part of the neck, whereas, the incision is made on the back of the neck when posterior approach is used.

To reduce the chances of developing this problem of the cervical spine, one can follow the suggestions mentioned below.

• Exercise regularly. Follow a proper routine and stick to it.
• Perform neck exercises to maintain flexibility and strength.

• Take precautions to prevent neck injury. In case you already have neck pain, do not indulge into strenuous activities.
• Maintain correct posture all through the day.
• Move your head in all directions intermittently when working in one position for a long time.

Some people are more prone to develop cervical spondylosis than others. These include:

• People who are overweight and do not exercise regularly.
• Individuals who have had past neck injury or spine surgery.
• Those with jobs involving a lot of bending, twisting, or lifting heavy objects.
• People with slipped disk or severe arthritis.

Spondylosis hampers daily activities of an individual. It is really difficult to perform regular activities with an unpleasant neck pain. Individuals with this problem can relieve themselves of pain by wearing a cervical collar and taking a walk, a hot shower, or over-the-counter analgesics.

It is advisable to consult your health care provider in case you suspect this problem and wish to start practicing any of the above measures.