CERVICAL SPONDYLOSIS

Cervical spondylosis is a degenerative disorder of the neck affecting the discs between the bones in the spine. When this occurs cartilage wears away and nerves are affected causing pain.

SWSI Scoliosis Quiz

Cervical Spondylosis

Cervical spondylosis is a degenerative disorder of the neck affecting soft discs between your vertebrae, or bones in your spine, that serve as cushions between the vertebrae. So basically, the discs get squeezed and that is called cervical spondylosis. Also, the cartilage that lines the vertebrae on each side of the disc would wear away if it were not for the discs. When this protecting cartilage wears away, spurs can form where your vertebrae rub together. On their journey out of the spine, nerves linked to the spinal cord may have less space to travel between the vertebrae.

Cervical spondylosis refers to age-related wear and tear of the neck’s spinal discs. Osteoarthritis symptoms include bony protrusion along the borders of the bones as the discs dehydrate and shrink (bone spurs).  Cervical spondylosis progressively worsens with age. Cervical spondylosis affects around 85% of adults over the age of 60. Some persons with it never show any signs or symptoms. As a result, some people may endure chronic discomfort and stiffness. On the other hand, many people who have it can go about their daily lives regularly. When symptoms do appear, nonsurgical therapies are typically successful.

Cervical Spondylosis Causes

Degenerative alterations in the spine cause cervical spondylosis. These modifications occur in everyone. Furthermore, nearly half of persons in their forties and fifties have worn discs that do not produce discomfort.

Disc Degeneration and Bone Spurs

As people get older, the discs in their spine lose height and begin to protrude. They also lose water content, dry up, and become feeble. The disc spaces settle or collapse as a result of this situation, and the disc gaps decrease. Then the discs’ cushioning properties begin to deteriorate with time. As the strain on the facet joints increases, they deteriorate and develop arthritis, similar to what happens in the hip or knee joint. Therefore, articular cartilage, which covers and protects the joints, wears away. If the cartilage wears away, bone on bone occurs.

Your body may respond by creating new bone in your facet joints to assist support the vertebrae in order to compensate for the missing cartilage. Bone spurs, or expansion of bone, can reduce the area available for nerves and spinal cord passage over time (stenosis). Bone spurs can also cause a reduction in spinal range of motion. Cervical spondylosis develops when the bones and protecting cartilage in your neck deteriorate. Here are a few examples of potential causes:

Bone spurs

Bone spurs result as the body attempts to strengthen the spine by growing more bone. The excess bone, however, can put pressure on sensitive regions of the spine, such as the spinal cord and nerves, causing discomfort.

Dehydrated spinal discs

Discs, which are thick, pad-like cushions between your spinal bones, buffer the impact of lifting, twisting, and other movements. In addition, these discs’ gel-like substance might dry up over time. This causes your bones (spinal vertebrae) to rub against each other more, causing pain. This procedure might start in your 30s.

Herniated discs

Spinal discs can develop fractures, allowing the interior cushioning substance to seep out. This substance can put pressure on the spinal cord and nerves, causing symptoms including arm numbness and discomfort radiating down an arm.

Injury

If you’ve suffered a neck injury (for example, from a fall or a vehicle accident), it might hasten the aging process.

Ligament stiffness

The thick cords that link your spinal bones to one another might stiffen over time, limiting your neck movement and making it feel tight.

Overuse

Repetitive actions or heavy lifting puts more tension on the spine, causing premature wear and tear.

Risk Factors

Old age causes the majority of cervical spondylosis cases.  Unfortunately, patients in their middle and later years become more susceptible. Other variables that might put you at risk for cervical spondylosis and neck discomfort include:

  • Genetics — a family history of spondylosis and neck discomfort
  • Smoking increases neck discomfort.
  • Labor – occupations that require a lot of repeated neck motion and overhead work
  • Anxiety or depression
  • Neck injury or trauma in the past

Cervical spondylosis Symptoms

  • Cervical spondylosis can cause the following symptoms:
  • Neck pain that may spread to your arms or shoulders
  • Headaches
  • When you move your neck, you get a grinding sensation.
  • Your arms and legs are weak.
  • Arms, hands, or shoulders that are numb.
  • The neck is stiff.
  • You’re having trouble holding your footing.
  • Problems with your bladder or bowels

Facts about cervical spondylosis

As previously mentioned, when people get older they can get this condition and recognize it because of the pain. Many others, on the other hand, don’t have any symptoms, and they might not even know that their neck is changing. In most cases, cervical spondylosis does not result in impairment. However, these alterations in the spine might occasionally compress the spinal cord or its nerve roots. Your legs or hands may feel weak or clumsy as a result of this.

Treatments

Nonsurgical Treatment

Most of the time, doctors do not consider surgery as a treatment for Cervical spondylosis, and therefore, physical therapy becomes the primary treatment. Your doctor will most likely prescribe physical therapy as the initial nonsurgical treatment option. Exercises that strengthen and stretch damaged or strained muscles might help reduce pain. Physical treatment may involve posture therapy or the use of traction to extend your neck’s joints and muscles. Physical therapy programs span anywhere from six to eight weeks. Sessions usually occur every two to three weeks.

Medications

Your doctor may prescribe a combination of drugs to relieve both pain and inflammation during the first phase of therapy.

  • Acetaminophen is commonly used to treat mild discomfort.
  • Anti-inflammatory medications (NSAIDs). NSAIDs like aspirin, ibuprofen, and naproxen are often recommended alongside acetaminophen and are considered first-line treatments for neck discomfort. They alleviate pain and swelling and depending on your symptoms, the doctor may recommend them for a few weeks. If you have major contraindications to NSAIDs or if your pain does not go away, you may want to try other pain medications.
  • Corticosteroids are used orally. By lowering inflammation, a brief course of oral corticosteroids can help reduce pain.
  • Muscle relaxants are drugs that relax the muscles. Doctors treat painful muscular spasms with medications like cyclobenzaprine or carisoprodol.

A comfortable cervical collar

This is a cushioned ring that is wrapped around the neck and secured with Velcro. Doctors often recommend wearing a soft cervical collar to reduce neck mobility and relax the muscles in your neck. Because long-term use of a soft collar might weaken the muscles in your neck, doctors recommend wearing it for a short time.

Ice, heat, and other treatments are available

To assist reduce symptoms, your doctor may consider using cold, heat, massage, and other local treatments.

Injections of steroids

Steroid injections provide temporary pain relief for many people. The following are the most popular neck pain procedures:

  • Epidural block in the cervical region. A steroid and an anesthetic drug are injected into the area close to the spinal cord’s covering in this treatment (epidural space). This surgery is commonly performed to treat neck and arm pain caused by a herniated cervical disc, also known as radiculopathy or a pinched nerve.
  • Block of the cervical facet joint. A steroid and an anesthetic drug are administered into the facet joint capsule during this surgery. Facet joints offer stability and mobility in the rear of the neck. These joints are prone to arthritic changes, which can cause neck pain.
  • Radiofrequency ablation and medial branch block. In some situations of persistent neck discomfort, this technique is used. It has the ability to diagnose as well as treat a troublesome joint. A local anesthetic is used to block the nerve that feeds the facet joint during the diagnostic stage of the surgery. If the pain goes away, your doctor may have found the root of your neck discomfort. The next step might use a more permanent pain blocker. This is accomplished by burning the nerves that feed the joint, a treatment known as radiofrequency ablation. An ablation usually provides pain relief for several months. However, if the nerve regenerates, pain may return.

Although less intrusive than surgery, your doctor will only recommend steroid-based injections after a thorough examination. Your doctor will discuss the risks and advantages of steroid-based injections for your particular disease with you.

Surgical Treatment

Doctors rarely suggest surgery for cervical spondylosis and neck discomfort unless your doctor concludes that:

  • A herniated disc or bone is pinching a spinal nerve (cervical radiculopathy), or
  • Compression of your spinal cord (cervical spondylotic myelopathy)

Surgery is more likely to benefit patients with progressive neurologic symptoms such as arm weakness, numbness, unsteadiness while walking, or falling. If you have significant neck discomfort (without nerve compression) that has not responded to nonsurgical therapy, the doctor may recommend surgery. Some individuals with significant neck discomfort, however, will not be surgical candidates. There are many medical reasons including severe arthritis, other medical issues, or other sources of pain, such as fibromyalgia.

If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment.