The spine is made up of 24 vertebrae which are separated by disks of cartilage that act as shock absorbers that protect the individual vertebrae from hitting each other and suffering damage. There are also ligaments that connect the vertebrae together. When these disks and ligaments become worn out and are unable to function as they should, pain and limited mobility of the neck result. Cervical spondylosis is the medical term for neck pain, stiffness and other associated problems caused by wear and tear of the cervical spine. The condition is usually age related but could also be caused by injury, bad posture or illness. The condition is also known as arthritis or osteoarthritis of the neck.
Your spine keeps changing with age and by the mid-30s the process of wearing down normally begins. By the age of 60, cervical spondylosis is a very common condition, affecting according to some estimates, over 75% of people to some degree or other.
Causes
The common changes in the intervertebral disks that result in cervical spondylosis are given below.
- With the passage of time, the spinal disks wear out and become thinner. The soft tissue has less elasticity and this places pressure on the vertebrae causing pain. The thinning of the disks results in a slight reduction in height in people as they reach advanced years.
- Wear can also cause the spinal disks to crack or tear. This results in the disk bulging out which may place pressure on nearby spinal nerves or tissue and result in pain, numbness or tingling sensation. The condition is known as a herniated disk.
- Osteoarthritis is a disease that causes the degeneration of joints in any part of the body and results in pain and reduced mobility. When the disease affects the cervical spine, the disks wear out faster than would happen with normal aging.
- When the disks start to wear away, the bone tissue of the vertebrae start to rub against each other. This causes the edges to become rough or to develop bony spurs, known as osteophytes. This is a very common condition and may produce no symptoms. However, in some cases, the spurs may press on adjoining nerves or tissues and cause severe pain.
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Symptoms
In many cases, cervical spondylosis produces no symptoms. However, if symptoms do develop, they can include:
- Neck pain, stiffness or the loss of full movement or flexibility of the neck. The pain will often be worse with the movement of the neck.
- A steady, constant soreness in the neck that increases or decreases in intensity depending on the stress placed on the spine.
- Popping or clicking sounds that can be heard when the neck is moved.
- Muscles spasms that affect the neck region.
- Headaches.
- Dizziness.
When the spinal disks get worn out, the canal that the spinal cord passes through may become narrower and increased pressure may be placed on the cord. This condition is known as cervical spondylotic myelopathy (CSM). With CSM, in addition to the symptoms listed above, there could also be:
- Numbness, weakness or tingling in one or both of the legs or arms.
- Unsteadiness on the feet and difficulty in walking.
- Loss of hand function as in finding it difficult to write.
- Loss of bowel and bladder control.
Treatment
If cervical spondylosis is diagnosed early, conservative treatments are often effective. These generally include:
- Physical therapy to stretch and strengthen the spine muscles and improve posture.
- Massage may be effective in relieving the symptoms, but it must be done by a qualified professional. Massage by well-meaning friends or relatives may provide temporary relief from the pain but may result in greater long-term spinal damage.
- The application of heat or ice to the back of the neck could relieve the pain but again, this should be tried only after obtaining your doctor’s approval.
- Oral medication may be prescribed. These could be over-the-counter medications or, if stronger medicines are required, prescription drugs may be advised.
- The use of a brace or soft collar can reduce the stress on the neck and by limiting the movement of the cervical spine, can give the muscles and tendons a chance to rest and recuperate. However, excessive or prolonged use of a collar or brace could cause the muscles to atrophy (waste away) due to non-use. Braces and collars should be used only on the doctor’s advice.
- Injections of steroids or other medication into the neck are another option. The common options here are:
- Cervical Epidural Block: A combination of steroids and anesthetic are injected into the epidural space, next to the covering of the spinal cord.
- Cervical Facet Joint Block: The steroids and anesthetic are injected into the affected joints of the cervical spine.
- Media Branch Block and Radiofrequency Ablation: This procedure is used in conjunction with injection treatment. If the injection effectively relieves the pain, then that identifies the affected area of the spine. Radiofrequency is then used to create sound waves that numb or damage the nerves that are causing the pain. Once damaged, the pain from the nerve is either reduced or eliminated.
- For the most severe cases of cervical spondylosis, including CSM, surgery may be advised. This involves removing the bone spurs and fusing the vertebrae together or removing a portion of vertebrae to create more space for the spinal cord.
Also Read: Herniated Disk: When Is Surgery Needed?
The doctor will do a complete examination before providing a diagnosis of the exact nature and extent of the problem. This will include full physical examination, and often the use of x-rays, CT scans, MRI and other tests.
The complexity of cervical spondylosis and the various causes and effects mean that suspected cases must be examined and diagnosed at a multispecialty hospital with a dedicated orthopedics and spine department where highly qualified and experienced specialists will be available along with the latest diagnostic equipment and technology. This specialized department will be able to provide you with the most effective treatment options to offer the maximum recovery from the ailment.
If cervical spondylosis is allowed to go untreated, then the problem will continue to become worse and the resulting treatments may be longer and more complex. Early diagnosis is essential.