What is Cervical Spondylosis?
Cervical spondylosis is usually an age-related condition that affects the joints in your neck. It develops as a result of the wear and tear of the cartilage and bones are of the cervical spine. While it is largely due to age, it can be caused by other factors as well. Alternative names for it include cervical osteoarthritis and neck arthritis.
One feature of the degeneration is that the edges of the vertebrae often develop small, rough areas of bone called osteophytes. Also, over many years, the discs become thinner. This degeneration is a normal ageing process which can be likened to having 'wrinkles in the spine'. In many people, the degeneration does not cause any symptoms. For example, routine X-rays of the neck will show these features (osteophytes and disc thinning) in many people who do not have any symptoms.
However, in some people, the nearby muscles, ligaments, or nerves may become irritated or 'pressed on' by the degenerative changes. So, cervical spondylosis often causes no problems but can be a cause of neck pain, particularly in older people
What Are the Risk Factors for Cervical Spondylosis?
Ageing is the major factor for developing cervical osteoarthritis (cervical spondylosis). In most people older than age 50, the discs between the vertebrae become less spongy and provide less of a cushion. Bones and ligaments get thicker, encroaching on the space of the spinal canal.
Another factor might be a previous injury to the neck. People in certain occupations or who perform specific activities -- such as gymnasts or other athletes -- may put more stress on their necks. Poor posture might also play a role in the development of spinal changes that result in cervical spondylosis.
What Are the Symptoms of Cervical Spondylosis?
The symptoms of cervical spondylosis include:
- Neck stiffness and pain
- Headache that may originate in the neck
- Pain in the shoulder or arms
- Inability to fully turn the head or bend the neck, sometimes interfering with driving
- Grinding noise or sensation when the neck is turned
Symptoms of cervical spondylosis tend to improve with rest. Symptoms are most severe in the morning and again at the end of the day.
If cervical spondylosis results in pressure on the spinal cord (cervical stenosis), it can put pressure on the spinal cord, a condition called cervical myelopathy. Symptoms of cervical spondylosis with myelopathy include:
- Tingling, numbness, and/or weakness in the arms, hands, legs, or feet
- Lack of coordination and difficulty walking
- Abnormal reflexes
- Muscle spasms
- Loss of control over bladder and bowel (incontinence)
Another possible complication of cervical spondylosis is cervical radiculopathy, when bone spurs press on nerves as they exit the bones of the spinal column. Pain shooting down into one or both arms is the most common symptom.
Physiotherapy Rehabilitation Program
- Immobilization of the cervical spine is the mainstay of conservative treatment for patients with cervical spondylosis. Immobilization limits the motion of the neck, thereby reducing nerve irritation. Soft cervical collars are recommended for daytime use only, but they are unable to appreciably limit the motion of the cervical spine. More rigid orthoses (eg, Philadelphia collar, Minerva body jacket) can significantly immobilize the cervical spine (see Special Concerns). The patient's tolerance and compliance are considerations when any of the braces are used. A program of isometric cervical exercises may help to limit the loss of muscle tone that results from the use of more restrictive orthoses. Molded cervical pillows can better align the spine during sleep and provide symptomatic relief for some patients.
- Mechanical traction is a widely used technique. This form of treatment may be useful because it promotes immobilization of the cervical region and widens the foraminal openings.
- The use of cervical exercises has been advocated in patients with cervical spondylosis. Isometric exercises are often beneficial to maintain the strength of the neck muscles. Neck and upper back stretching exercises, as well as light aerobic activities, also are recommended. The exercise programs are best initiated and monitored by a physical therapist.
- Passive modalities generally involve the application of heat to the tissues in the cervical region, either by means of superficial devices (eg, moist-heat packs) or mechanisms for deep-heat transfer (eg, ultrasound, diathermy).
- Manual therapy, such as mobilization, may provide further relief for patients with cervical spondylosis. Mobilization is performed by a physical therapist and is characterized by the application of gentle pressure within or at the limits of normal motion, with the goal of increasing the ROM. Manual traction may be better tolerated than mechanical traction in some patients.