Articles on spondylosis

Cervical Spondylosis

Vijay Bathina
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 peopleWhat 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 painHeadache that may originate in the neckPain in the shoulder or armsInability to fully turn the head or bend the neck, sometimes interfering with drivingGrinding noise or sensation when the neck is turnedSymptoms 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 feetLack of coordination and difficulty walkingAbnormal reflexesMuscle spasmsLoss 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 ProgramImmobilization 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.

Cervical Spondylosis

Dr. Yogesh Pithwa, Spine Surgeon
What is meant by cervical spondylosis?The term “cervical” refers to the spinal column in the neck region. The term“spondylosis” refers to any ailment of the spine!! The term spondylosisis used loosely for all kinds of neck pain, from the purely innocuous ones to the ones those require surgical intervention. This neck pain may be in the nape of your neck, or very often may be present between the two shoulder blades.What causes cervical spondylosis?Cervical spondylosis can be caused by a slipped disc or a bony overgrowth or a combination of both. What is a slipped disc? Our spine is made up of a number of bones called vertebrae stacked one on top of another. A disc is a soft, gel-like structure present between two adjacent vertebrae. Normally, these discs act like ‘shock-absorbers’ and also allow some movement between the two adjacent vertebrae, giving the spine its flexibility. When this disc slips beyond its normal confines, it can compress the spinal cord or its nerve roots located close by and lead to problems.Why does the disc slip out? Over the years, the disc develops small microscopic tears, which may unite together over a period of time such that with some trivial injury or some innocuous activity, the disc may slip out of its normal confines. As a part of the normal aging process, the spine may develop some extra bone growth, leading to compression of the adjacent spinal cord or its nerve roots leading to pain.How does cervical spondylosis manifest?One of the commonest complaints is neck pain that may be present either at the nape of the neck or between the two shoulder blades. This pain would generally be noted on some kind of neck movement or on coughing or sneezing. Similar to “sciatica” that occurs in the lower back, when the pain starts radiating down into the upper limbs, it is referred to as “radiculopathy”. Another complaint of cervical spondylosis is unsteadiness while walking. This is the most important complaint to note as very often, this complaint gets relegated to the normal aging process in the older population in whom it is most frequently noted.Can any other condition mimic cervical spondylosis?Any compression or problem affecting the nerves after they leave the spinal canal can also lead to pain along the hand. The most common condition that can affect the nerves after they leave the spinal canal is ‘peripheral neuropathy’, a condition wherein the nerves are ‘weakened’ secondary to diabetes, chronic alcoholism, smoking, other forms of tobacco consumption, nutritional deficiencies or other rare causes. A common complaint in patients with peripheral neuropathy is the presence of pain even at rest, pain of a burning nature or numbness in ‘glove and stocking’ distribution i.e. over the hands, just beyond the wrist joints and over the lower limbs, just beyond the knee joints. Additionally, once the nerves leave the spinal cord, they have to travel through a narrow space termed “thoracic outlet” at the base of the neck so as to reach the upper limbs. There may sometimes be compression at this level, leading to pain radiating down into the upper limbs. Neck and back are often termed the mirrors of the mind. Hence, stressful periods are likely to give you some neck or back pain as well! Poor posture is also a common culprit for neck and back pain.How does the doctor diagnose my condition?An accurate history is the most important diagnostic tool. The way the pain started and progressed, specific aggravating and relieving factors of pain, distribution of pain over your body, associated complaints such as weakness or numbness over the upper or lower limbs will be a guide to short listing the possible causes of your neck pain. A very important history relates to difficulty or clumsiness while walking.A detailed clinical examination involving assessment of spinal motion, assessment of your neurology and certain special tests will allow to further narrow down the causes to 2-3 most probable ones. Though this process of history-taking and clinical examination may appear boring and long-drawn, it is the most crucial part towards prescribing the correct treatment to you. So, it is essential to cooperate with your doctor throughout this entire procedure, which gives more information to the doctor regarding your ailment than any other investigation including an MRI.How does the doctor investigate for cervical spondylosis?On the first visit, if your problem is short-lived and there are no major signs or symptoms, you may not need any further investigation. However, if your problem has been present for some time, or if there is some history of trauma, fever, any other major illness, or any notable findings on clinical examination related to neurological dysfunction, you are likely to require some further investigations.Commonly, plain x-rays of the spine may be ordered with or without some basic blood investigations such ashemoglobin, erythrocyte sedimentation rate [ESR], CRP, RA test, serum calcium, phosphorus and alkaline phosphatase.Based on these tests, or sometimes, in the presence of some significant signs or symptoms, you may be asked to undergo MRI scanning. Plain x-rays demonstrate bony features, while MRI demonstrates the spinal cord, its nerve roots, the intervertebral disc between the two bones of the spine. Both these tests are complementary in nature, doing one does not necessarily mean that the other one is not needed.In some cases such as peripheral neuropathy orthoracic outlet syndrome, additional investigation in the form of EMG-NCVtest, to assess the function of each of the various nerves in your limbs may be required. Rarely, a Color Doppler examination of the upper limb blood vessels may be asked for.Is there any non surgical treatment for cervical spondylosis?The treatment would depend on the duration of your problem, presence of similar episode in the past, neurological function, response to previous nonoperative treatment and lastly, the subjective severity of your pain. Various nonoperative means of treatment include painkillers, muscle relaxants, various modalities such as heat and electrical stimulation, cervical traction, activity restrictions, etc. Painkillers will be prescribed to allow a smoother and easier return to normal function. You would generally be prescribed these on a shorter term or on a longer-term tapering program so as to guard against possible over dependence on these agents, as these are associated with significant side effects if used excessively in the long term. These side effects may range from hyper acidity, gastric ulcer, kidney damage, bleeding disorders, constipation, addiction, etc.  In addition, based on individual merit, you may also be prescribed muscle relaxants so as to relax and soothe your neck and back muscles. This is so because whenever you have neck or back pain, your muscles tend to go into spasm[sustained contraction] and hence, lead to pain. It is essential to break this spasm with a muscle relaxant so as to give effective pain relief.Physiotherapy modalities may be used. This consists broadly of passive and active physiotherapy. During acute pain, generally, only passive physiotherapy would be used. This would be in the form of heat or electrical stimulation in various forms such as SWD [short-wave diathermy], TENS [transcutaneous electrical nervestimulation] and IFT [interference therapy]. Cervical traction too, aids in relaxing the aching neck. In severe cases, you may be recommended to get admitted in the hospital for a day or two to get this physiotherapy on a more aggressive note.  After pain relief, you would be prescribed active physiotherapy i.e., spinal exercises. Based on your complaints, your exercise protocol would be decided by the doctor.You would need to have some activity modifications and restrictions to help your spine get back into shape and stay that way!! If you have a job on hand that requires you to sit continuously for hours on end, then you can sit for 15-20 minutes and then get up and walk around for about 5 minutes, gently shrug your shoulders and perform circular movements in the air with your shoulders, first in the clockwise direction and then in the anti - clockwise direction. Bifocal lenses in spectacles would require you to bend your neck backwards while reading which is not a very healthy practice for your neck spine. Smoking interferes with the nutrition of the disc in between the vertebrae and hence, would need to be abandoned forever! Try to sit in a chair that has a high backrest that supports your neck as well. Try to keep the computer at your eye-level. Do not stack up pillows underneath your head so as to be able to read while sleeping! Ideal position to sleep is sideways with a pillow underneath the head just about adequate to fill up the gap between the side of your head and your shoulder. While lying down with the face upwards, use a very thin pillow or just fold a bed sheet and keep it underneath the head. When is surgery essential?Surgery would be indicated when there is no pain relief despite symptomatic treatment as mentioned above or, when there is significant neurological deficit or, repeated episodes of pain so as to get a permanent solution to the problem. What is the nature of surgery?Microdiscectomy is the usual surgery for cervical spondylosis. This is a surgery performed through the microscope so as to make this a relatively safe procedure. When many levels are involved, the surgery may be done from the backside, otherwise, it would be from the front. Is it a major surgery? We were told that we should not get a spine surgery done as it can lead to paralysis! Or, inother words, what are the risks involved? Even if you are walking out on the streets, you never know when some vehicle will come from behind you and knock you over! So, would you stop walking on the street for fear of this risk? Everything in life carries some inherent risk associated with it. The option for surgery would be offered only if the benefits of surgery significantly outweigh the risks. Rather than asking as to what are the risks of going in for surgery, it would be more prudent to ask as to what are the risks and benefits of getting the surgery done as compared to not getting the surgery done? Spine surgery has had a lot of advances in the past decade or two, there are better imaging facilities like MRI, better surgical instruments, surgical microscope to aid vision in the surgery, computer navigation system to further increase the safety level of surgery, better training and information in an overall sense making spine surgery no longer the taboo that it once was! So, if you have a problem that genuinely requires surgery, there is no point in tying yourself down to the bed for days or months on end because ultimately life is mobility and mobility is life! Discuss the details of your surgery and its attendant risks with your doctor to quell any fears and to clear any and every doubt of yours! If you so desire, your doctor can even arrange to give you references of patients who have undergone similar surgeries. Can we replace the disc? In other words, won’t it be harmful to remove the disc? The disc that has slipped out can no longer carry out its normal function, rather, it is causing harm to the body rather than doing anything good! So, trying to replace the disc back into its position is not a viable option. However, it is possible to replace the damaged disk with an artificial disk that would function similar to the natural disk.How is the post operative recovery and rehabilitation?Generally, you will be admitted one day prior to the day of surgery. You will be advised to fast after dinner the previous night. Surgery would generally be carried out the next day morning. After surgery, on the 2nd or 3rd day, you will be made to walk with a cervical collar. You may be discharged after 3-4 days. Sutures [stitches] would be removed generally on the 10th–14th day following the surgery. By this time, you will be walking around and essentially be independent in doing activities of daily life. You will be allowed to take bath 48 hours after the suture removal. For 3-4 weeks, you will be allowed restricted mobilization within the house. During this period, you will be encouraged to increase all your activities in gradual weekly increments. A month later, you will be starting with spinal strengthening exercises. You will have to use the cervical collar for about 1-3 months at all times other than while taking bath. You will not be allowed to smoke for life!Will I be able to return to work after the surgery?Though you would be up and about, walking about within the first ten days following the surgery, you will be allowed only limited mobilization within the house in the first one month following surgery. Thereafter, if you are having a sedentary light job, then you may be allowed to resume work, provided you do not have to travel for a prolonged time on some bumpy road(s). If you were having some job that requires some moderate labor, you would be allowed to resume work up to three months after surgery. If you were involved in heavy manual labor, it would be wiser to seek some permanent job modification in these situations. Staying off work for more than three months post-surgery is not recommended at all.What about alternative techniques such as manipulation, bone setting, homeopathy, acupressure?Death has been reported following violent manipulation of the neck by some people. Hence, it is not at all recommended. As long as no neurological deficit [loss of sensation, weakness or clumsiness while walking] is present, alternative medicines may be tried. However¸ procrastination in the presence of neurological deficit is not recommended.What about newer advances in the treatment of this condition?Microscope allows for the use of both eyes while working, giving binocular vision and thereby, good depth perception that is very essential for the safe performance of these surgeries. This binocular vision is lacking in endoscopic discectomy. Percutaneous laser discectomy has not been proven to be scientifically superior to microdiscectomy. Rather than doing the conventional surgery of fusion at the level of discectomy, it is possible to replace the disk with an artificial one.This would simulate normal spinal function and hence, is a better surgery than the conventional fusion. However, it is costlier than the conventional fusion surgery·.

The Myth About Lumbar Spondylosis

Dr. Uday Bapusaheb Pote, Orthopedist
There are so many patients who walk into my clinic and when asked what problem do they have and they say lumbar Spondylosis.It's actually is a facepalm moment for me. I will tell you why!There are so many misconceptions about the word ‘Spondylosis’.The meaning of spondylosis is degeneration of the vertebral bodies, mainly the lateral, anterior and rarely posterior vertebral bodies. This is seen as osteophytes (extra bony outgrowths from the vertebral bodies). I have shown it in the picture below.Lateral radiograph of lumbar spine showing anterior vertebral body osteophytesAnteroposterior radiograph of lumbar spine showing lateral vertebral body osteophytesThese are generally harmless and do not cause any symptoms, alone. They are usually seen as a chance finding when an Xray of lumbar spine is done. Its presence is of no clinical significance.So, how and why are they formed?Our vertebral bodies have intervertebral discs in between and those disc have a covering called as Annulus fibrosus which protect the spinal cord from direct contact of the disc with the spinal cord.This annulus is constantly under pressure and wear and tear is common. Say for example the knuckles of a boxer- they harden, due to constant pressure on them and subsequent wear and tear. This is how extra skin is formed in the knuckles to protect them from the wear and tear. Similarly, the only hard substance inside our body is bone. So when the annulus undergoes constant wear and tear, our body forms bone to protect or stabilize the vertebral segments.The only part of these osteophytes which may give problem are posterior osteophytes as they will directly press on the spinal cord. But this phenomenon is rarely seen and is generally associated with long standing disc prolapse.Synonyms- Osteoarthritis.Spondylosis is often confused with other terms likeSpondylitis,Spondylolisthesis,Facet joint degeneration,Degenerative disc disease,Diffuse idiopathic skeletal hyperostosis (DISH),All the above have different etiologies, presentations and treatment. They may occur along with and thus complicating lumbar Spondylosis.FAQsWhat age do we get it?There are cases of Spondylosis seen as early as 20 years of age. It is a natural process of aging and is seen in 80% individuals above 40 yrs of age. It is seen in 27-37% of asymptomatic individuals with more male preponderance.Is it activity related?The studies have shown no correlation with increased activity or even obesity.Over activity may cause degenerative disc disease but not Spondylosis.How can I protect myself?Sorry dear you cannot protect yourself. It’s a natural ageing process, and it’s harmless. So why worry.Do they disappear?This is a very intriguing question.Many therapy centres claim that they can make spondylosis disappear. It’s utter NON SENSE. They do not disappear.There is a case where they do disappear.It’s called aortic aneurysm (swelling in the wall of the artery). The vertebral artery is very close to the anterior surface of the vertebral body.CT angiogram showing abdominal aortaAn aneurysm is pulsatile and may erode the osteophyte. If an anterior vertebral osteophyte which was previously seen and has now dissapered, do NOT celebrate—rush to the nearest hospital immediately it’s a time bomb waiting to explode. (read about aortic aneurysms for more info).So do not fall for false claims of making the osteophytes disappear.Can I work out and do exercises?Yes, sure you can. Do any amount of activity you like.">The general principles of back care apply to each and everyone irrespective of the spondylotic changes.What are the complications?There are none.If you have any back pain or radicular pain to your lower limbs, investigate for any other causes for it as previously mentioned, as Spondylosis do not cause these symptoms.I hope this clears the air over Spondylosis.So when asked what problem you have Please DO NOT MENTION SPONDYLOSIS.

Exercises to Put an End to Cervical Spondylosis

Dr. Vishwas Virmani, Physiotherapist
What is Cervical Spondylosis or arthritis neck pain and reasons for neck painCervical Spondylosis which is also known neck arthritis and neck pain, is a disorder in the neck caused because of  wear and tear on the cartilage and later on bones in the neck area. Cervical Spondylosis is result of wear in the cervical spine which suppress the cushions in the disk of the neck. This will result in increased gap on one side and reduced gap on vertebrae or disks in the neck area.Cervical Spondylosis is condition in which the nerve roots are suppressed in the neck and the neck roots later on effect the nerves in the back spine and hip spine in the later stages. Other reasons for cervical spondylosis is could be neck injuries in the past or present, rheumatoid arthritis or any spine surgery in the past. One of the major symptoms of Cervical Spondylosis and neck pain are stiffness in the neck region, low sensation in the neck or back upper shoulder area, weakness in the arms.In later stages cervical spondolysis could also be a cause for slip disk or sciatica and hip arthritis.EXERCISES.....1 Neck Stretching exercise with hand–  Keep your left hand on backside of your hand as shown in picture and try to keep your head to move forward towards arm-pits with support of your hand. Give only gentle pressure with your hand and hold for only 5 seconds and make a set of 10 repetitions for neck side for both right side and left side. This side bending exercise will relieve your neck pain or cervical spondylosis pain.     2 Neck Side rotation exercise with hand– Sit or stand straight, hold your chick with hand . Now move your head towards right shoulders with gentle pressure from your hand without moving head backwards or forward direction, hold for 5 seconds.  Start this exercise your neck on right side and then do left side. Make a set of 10 repetitions for neck side bending exercise to relieve from neck pain or cervical spondylosis.3 Keep a soft ball behind your head , move your head sideways and move your head up and down. Continue with this exercise for 60 sec to 90 sec exercise to get relief from neck pain or cervical spondylosis. Don’t continue with this exercise if you feel over exhausted or exertion. 4  Stand straight and move your shoulders backwards, give proper force with shoulders as much as you can. Try to hold your shoulders back for atleast 5 seconds and make atleast 10 repetitions.These all exercise will give relief from neck pain or cervical spondylosis. Continue with these exercises and see immediate results to cure and get pain relief from neck pain and cervical spondylosis 

Positional Cervical Spondilitis.

Dr. Amita Arora, Homeopath
Dear Readers,With advanced technology, habits of living in comfort zones have given birth to aches and pain in nape of our neck.We use wrong postures while watching T.V,working on desktops,laptops and mobiles for long hours.Unknowingly we are producing harm to our own body and system.Holding cell phones and bending our neck at same side produces lot of traction in muscles of neck.Advancement in technology has brought great revolution in world but with that it has invited lot of problems of health too.We type on laptops for hours and sit for longer durations in one position,this brings on pain, stiffness in neck.Sometimes we get Vertigo along with Cervical pain.MRI reveals the effect or degeneration of Cervical vertebrae.Homoeopathic Medicines arrests the further degeneration and it helps in reducing the Inflammation.Spondilitis is more of inflammation and spondylosis is degeneration of vertebrae.With the help of Homoeopathic Medicines we arrest the stage of inflammation and reduce pain,swelling and stiffness.Its important to discuss your complete case details and your work schedule with your homoeopath and he/she will help you in recovery.Homoeopathic Health: Conium and Gelsimium helps in Cervical problems,and vertigo.But Every Cervical Patient will not recover with Conium or Gelsimium.There are other good remedies which help in healing.A registered homoeopath is the best person to judge your remedy and give you permanent solution.Health Tips: Avoid sitting for too long in one position.Give rest to your eyes and neck every half an hour for 5 to 7 minutes.Shrug your shoulders,rotate in circular movements to ease the muscles.Before going to bed apply Arnica Ointment (Homoeopathic medicine Arnica helps in inflammation and pain) and give HOT fomentation with hot towel.Practice Yoga daily under guidance.(Cervical patients who have Vertigo should avoid Chakrasan. Practice only under guidance.)

Neck Pain

Dr. Apoorva Kumar, Spine Surgeon
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 causesUnfortunately, 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:Bone spursThese 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 disksYour 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.Herniated disksThe 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.InjuryIf 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.Risk factorsThe 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 injurieswork-related activities that put extra strain on your neck from heavy liftingholding 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)smokingbeing overweight and inactiveSymptomsMost 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:standingsittingsneezingcoughingtilting your neck backwardAnother 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 worseheadaches that mostly occur in the back of the headtingling or numbness that mainly affects shoulders and arms, although it can also occur in the legsSymptoms 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 doctorIf 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 diagnosingMaking 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.Physical examYour 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.Imaging testsX-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.Treatment optionsTreatments 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.Physical therapyYour 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.MedicationsYour doctor might prescribe certain medications if over-the-counter drugs don’t work. These include:muscle relaxants, such as cyclobenzaprine, to treat muscle spasmsnarcotics, such as hydrocodone, for pain reliefanti-epileptic drugs, such as gabapentin, to relieve pain caused by nerve damagesteroid injections, such as prednisone, to reduce tissue inflammation and subsequently lessen painSurgeryIf 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.Home treatmentIf 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.OutlookCervical 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. 

What a Pain in the (Lower) Back! Symptoms

Dr. Vishwas Virmani, Physiotherapist
Lower Back Pain: Causes and SymptomsAnyone who has ever suffered from lower back pain will know that it is a living nightmare, which can confine you to your bedroom for days. People over 60 are more likely to suffer from lower back pain due to the degeneration of their spinal joints. If you are experiencing any discomfort in your back, you must get yourself checked,to ascertain the reasons behind your back pain. Here are some common causes of back pain:1. Spinal Stenosis: A common cause of back pain in the elderly is spinal stenosis. This is a condition when there is an abnormal narrowing of the spine, and any small injury can trigger severe pain in the back and legs.2. Spondylosis: This affects older women more than it does older men. Spondylosis is a condition when the lumbar vertebrae degenerate or develop small fractures causing lower back pain.3. Facet joint osteoarthritis: This is a kind of arthritis that affects the spine in the later part of life. This degenerative condition might lead to stiffness, discomfort, pain and other problems.Since lower back pain is a very common complaint among older folk, people find it difficult to differentiate between routine discomfort and a serious condition. So, here is a list of symptoms of lower back pain.1. Severe leg pain while walking2. Relief from lower back pain only while sitting down or an increase in pain due to being seated3. Pain fluctuates between mild to severe4. Gradual increase inlower back pain5. Numbness, weakness, tingling sensation and discomfort in back and legs6. Problems in bowel movement7.  Prolonged back pain accompanied by weight lossIf you are experiencing one or more of these symptoms, visit your doctor for a thorough check up. After all, your spine is the backbone of your well-being!