What is cervical spondylosis?
Cervical spondylosis, also known as cervical osteoarthritis or neck arthritis, is a common, age-related condition that affects the joints and discs in your neck. It develops from wear and tear of the cartilage and bones found in your cervical spine, which is in your neck. While it’s largely due to age, it can be caused by other factors as well.
According to the Mayo Clinic, the condition is present in more than 85 percent of people over the age of 60, although some people who have it never experience symptoms.
For some, it can cause chronic, severe pain and stiffness. However, many people who have it are able to conduct normal daily activities.
Cervical spondylosis causes
Unfortunately, the bones and protective cartilage in your neck are prone to wear and tear that can lead to cervical spondylosis. Possible causes of the condition include:
These overgrowths of bone are the result of the body trying to grow extra bone to make the spine stronger. However, the extra bone can press on delicate areas of the spine, such as the spinal cord and nerves, resulting in pain.
Dehydrated spinal disks
Your spinal bones have discs between them, which are thick, pad-like cushions that absorb the shock of lifting, twisting, and other activities. The gel-like material inside these disks can dry out over time. This causes your bones (spinal vertebrae) to rub together more, which can be painful. According to the Mayo Clinic, this process can begin around age 40.
The spinal disks can develop cracks, which allows leakage of the internal cushioning material. This material can press on the spinal cord and nerves, resulting in symptoms such as arm numbness and sciatica.
If you’ve had an injury to your neck, such as during a fall or car accident, this can accelerate the aging process.
Ligament StiffnessThe tough cords that connect your spinal bones to each other can become even stiffer over time, which affects your neck movement and makes the neck feel tight.
OveruseSome occupations or hobbies involve repetitive movements or heavy lifting, such as construction work. This can put extra pressure on the spine, resulting in early wear and tear.
The greatest risk factor for cervical spondylosis is aging. Cervical spondylosis often develops as a result of changes in your neck joints as you age. Disk herniation, dehydration, and bone spurs are all results of aging.
Factors other than aging can increase your risk of cervical spondylosis. These include:
- neck injuries
- work-related activities that put extra strain on your neck from heavy lifting
- holding your neck in an uncomfortable position for prolonged periods of time or repeating the same neck movements throughout the day (repetitive stress)
- genetic factors (family history of cervical spondylosis)
- being overweight and inactive
Most people with cervical spondylosis don’t have significant 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 when:
- tilting your neck backward
Another common symptom is muscle weakness. Muscle weakness makes it hard to lift the arms or grasp 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. These symptoms warrant immediate medical attention.
When to see a doctor
If you have the sudden onset of 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.
If your pain and discomfort start to interfere with your daily activities, you may wish to make an appointment with your doctor. Although the condition is often the result of aging, there are treatments available that can reduce pain and stiffness.
Testing and diagnosing
Making a diagnosis of cervical spondylosis involves ruling out other potential conditions, such as fibromyalgia. Making a diagnosis also involves testing for movement and determining the affected nerves, bones, and muscles. Your primary care physician may treat your condition or refer you to an orthopedic specialist for further testing.
Your doctor will start by asking you several questions regarding your symptoms. Then, they will run through a set of tests. Typical exams include testing your reflexes, checking for muscle weakness or sensory deficits, and testing the range of motion of your neck. Your doctor might also want to watch how you walk. All of this helps your doctor determine if your nerves and spinal cord are under too much pressure.
If your doctor suspects cervical spondylosis, they will then order imaging tests and nerve function tests to confirm the diagnosis.
- X-rays can be used to check for bone spurs and other abnormalities.
- CT scans can provide more detailed images of your neck.
- MRI, which produces images using radio waves and a magnetic field, helps your doctor locate pinched nerves.
- In a myelogram, a dye injection is used to highlight certain areas of your spine. CT scans or X-rays are then used to provide more detailed images of these areas.
- An electromyogram (EMG) is used to check that your nerves are functioning normally when sending signals to your muscles. EMG measures your nerves’ electrical activity.
- A nerve conduction study is used to check the speed and strength of the signals your nerves send. This is done by placing electrodes on your skin where the nerve is located.
Treatments for cervical spondylosis focus on providing pain relief, lowering the risk of permanent damage, and helping you lead a normal life. Nonsurgical methods are usually very effective.
Your doctor might send you to a physical therapist for treatment. Physical therapy helps you stretch your neck and shoulder muscles. This makes them stronger and ultimately helps to relieve pain. You might also have neck traction, which involves using weights to increase the space between the cervical joints and relieve the pressure on the cervical discs and nerve roots.
Your doctor might prescribe certain medications if over-the-counter drugs don’t work. These include:
- muscle relaxants, such as cyclobenzaprine, to treat muscle spasms
- narcotics, such as hydrocodone, for pain relief
- anti-epileptic drugs, such as gabapentin, to relieve pain caused by nerve damage
- steroid injections, such as prednisone, to reduce tissue inflammation and subsequently lessen pain
If your condition is severe and doesn’t respond to other forms of treatment, you might need surgery. This can involve getting rid of bone spurs, parts of your neck bones, or herniated disks to give your spinal cord and nerves more room. Surgery is rarely necessary for cervical spondylosis. However, a doctor may recommend it if the pain is severe and it’s affecting your ability to move your arms.
If your condition is mild, you can try a few things at home to treat it:
- Take an over-the-counter pain reliever, such as acetaminophen or an anti-inflammatory drug such as Advil or Aleve.
- Use a heating pad or a cold pack on your neck to provide pain relief for sore muscles.
- Exercise regularly to help you recover faster.
- Wear a soft neck brace or collar to get temporary relief. However, you shouldn’t wear a neck brace or collar for long periods of time because that can make your muscles weaker.
Cervical spondylosis is a common, often age-related condition that can cause stiffness, discomfort, and headaches related to neck pain. Your doctor may not be able to reverse the condition, but they can often recommend conservative treatments to help you overcome the discomfort and pain.