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CERVICAL SPONDYLOSIS

What is Cervical Spondylosis?

Cervical Spondylosis, also known as arthritis of the neck, is a health condition in which the disks, ligaments, cartilage, and bones in the neck region. This is age-related where the spinal disks are specifically affected.

The illness cultivates from age-related wear and tear of bones and underlying cartilage. With time signs of osteoarthritis such as bony projections, also called bone spurs, develops at the end of the bones. The disease affects more than 85% of geriatrics above age 60.

What Are The Causes?

The causes of cervical spondylosis include one or multiple of the following.

  • Dehydrated spinal disks 
  • Herniated spinal disks
  • Bone spurs
  • Stiff ligaments
  • Smoking
  • Neck injury
  • Genetics and family history

Symptoms

In most cases, cervical spondylosis shows no symptoms. Over time, symptoms begin to progress gradually and suddenly become extremely severe.

  • Headaches in the back of the head
  • Stiffness of the neck and shoulder
  • Pain in the neck and shoulder region
  • Mild to severe pain makes you unable to move
  • Deficient coordination and loss of bowel control
  • Numbness, weakness, and burning sensations in the arms and legs

Occasionally, the spinal canal within the bones of the spine narrows and the nerve roots passing through may get pinched, resulting in loss or lack of coordination (difficulty in moving limbs).3

Diagnosis

The physician or a physiotherapist will execute careful physical examination of the neck and shoulder, and the extremities (upper and lower). Bending the head forward and to each side will press gently on the neck and shoulder, the doctor will look for redness, tenderness, and swelling to investigate any injury.

Loss of coordination or lack of control indicates damage to nerve roots or to the spinal cord itself. The following modalities are considered for the diagnosis.

Neck X-rays. To identify changes in bone alignment, bone loss, spurs, and sometimes spine tumors.

Computed tomography (CT) scan. Allows for a more detailed view of the spine and bone structure.

Magnetic Resonance Imaging.  Specifically designed to inspect soft tissues such as the nerve roots, cartilage, muscles, and the spine.

  • Spinal compression
  • Herniated disc

Electromyography. Used for the identification of the source and location of pain, and the effects on the nerves.

Treatment Options

Depending on the severity of the condition, doctors and physiotherapists can go for the following treatment options.

Medications. Certain medications are prescribed to alleviate symptoms if any occur.

  • NSAIDs- to relieve pain and inflammation
  • Corticosteroids- prednisolone to decrease pain, if no effect (injection)
  • Muscle relaxants- to relieve spasms (cyclobenzaprine)
  • Anti-seizure medications
  • Anti-depressants

Physiotherapy. Stretch exercises for the neck and shoulder to relieve stiffness and pain. Neck traction involves the use of weight to increase the spaces between cervical joints and relieves pressure on the joints and disks.

Surgery. Surgery is indicated only if the condition does not resolve with physiotherapy and medications (rare cases). Surgical intervention is done in rare cases, if the pain is unbearable, and disturbs normal activities, and quality of life.

References

1. Mayo Clinic. Cervical spondylosis – Symptoms and causes – Mayo Clinic. Mayo Clin. Published online 2020. https://www.mayoclinic.org/diseases-conditions/cervical-spondylosis/symptoms-causes/syc-20370787

2. Aortic Stenosis – Symptoms and Causes | Penn Medicine. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/aortic-valve-stenosis

3. Cervical Spondylosis: Causes, Symptoms, Home Treatments, and More. https://www.healthline.com/health/cervical-spondylosis#treatment

4. Park DK. Cervical Spondylosis (Arthritis of the Neck) – OrthoInfo – AAOS. Am Acad Orthop Surg. Published online 2021. https://orthoinfo.aaos.org/en/diseases–conditions/cervical-spondylosis-arthritis-of-the-neck

5. Cleveland Clinic. Cervical Spondylosis: Symptoms, Causes, Treatments. Published online 2020. https://my.clevelandclinic.org/health/diseases/17685-cervical-spondylosis