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Cervical spondylosis is a common type of arthritis that affects more than 90% of people that are 60 years of age or older. This article outlines causes, risk factors, symptoms, diagnosis and treatment for cervical spondylosis.

Cervical spondylosis, a type of arthritic condition, is a common disease that affects the joints and discs in the cervical spine, which is located in the neck. This condition is also often referred to as cervical osteoarthritis or neck arthritis.

Cervical spondylosis is so common that researchers estimate that it is present in more than 90 percent of people who are 60 years or older. Interestingly, the manifestation of this disease varies significantly from person to person. While some people will never experience symptoms, for others it can cause chronic joint pain and stiffness. Many people with the disease are able to conduct everyday activities with little to no problems.

Cause of cervical spondylosis

Cervical spondylosis is known to develop from the wear and tear of cartilage and bones. The main factor that plays a role in the development of cervical spondylosis is age. However, it can be caused by other factors as well including:

  • Bone spurs. The body tries to make extra bone to make the spine stronger, which causes overgrowth of bones. These extra bones can press against areas of the spine that are delicate, such as the brain and nerves, which ultimately results in pain.
  • Dehydrated spinal discs. The spinal bones contain discs between them, which make up cushions that are utilized for absorbing the shock of lifting, and other things. Over time, a material that has the consistency of a gel in these discs can dry out, causing the bones to rub together more, which can be very painful. This issue can occur as early as your thirties.
  • Herniated discs. In some cases, spinal discs can have cracks in them, which causes leakage of cushioning material. This type of material will press down on spinal cord and nerves, leading to symptoms including numbness of the arm and pain that radiates down the arm.
  • Injury. An injury to the neck, such as during a fall or car accident, can accelerate the aging process and increases the chances of developing cervical spondylosis.
  • Stiffness of ligament. The spinal cord is connected by tough cords called ligaments. Over time, these can become stiffer, which affects neck movement and causes the neck to feel tight.
  • Overuse. Often, cervical spondylosis can develop due to an occupation or hobby that involves repetitive movements or heavy lifing, which causes early wear and tear.

Risk factors for cervical spondylosis

There are certain risk factors that contribute to the development of cervical spondylosis. These include:

  • Aging, which is the biggest risk factor for this disease.
  • Neck injuries.
  • Certain occupations, such as construction, which cause extra strain on the neck.
  • Repetitive stress, which refers to holding your neck in the same position for long periods of time.
  • Family history, as genetics play a vital role in the development of cervical spondylosis.
  • Smoking.
  • Being overweight.
  • Being inactive.

Symptoms of cervical spondylosis

While most people with cervical spondylosis don’t display significant symptoms, in some patients the symptoms can range from mild to severe. Symptoms in the case of cervical spondylosis can either develop gradually or occur suddenly. The common symptoms in patients with cervical spondylosis are:

  1. Pain around shoulder blade, and sometimes along the arm and in fingers. This type of pain can increase when a patient stands, sits, sneezes, coughs or tilts their neck backwards.
  2. Muscle weakness.
  3. Stiff neck that worsens.
  4. Headaches in the back of the head.
  5. Tingling or numbness that affects shoulders and arms, and sometimes legs.

Rarely, patients may experience loss of balance, and loss of bladder or bowel control.

Diagnosis of cervical spondylosis

A diagnosis for cervical spondylosis is referred to as a diagnosis of exclusion, in which the physician rules out all other possibilities to settle on a diagnosis of cervical spondylosis. The physician will diagnose you based on medical history, physical exam, and imaging tests.

The physical exam will include a series of tests that evaluate your reflexes, check for muscle weakness or sensory problems, and test range of motion of your neck. The doctor may also watch how you walk, which can help determine if there is too much pressure on the nerves and spinal cord.

If the physician suspects you have cervical spondylosis, then they will order imaging tests such as X-rays (which look at bone spurs), CT scan (which provides for details about the neck), MRI scans (which can help locate pinched nerves), and myelogram (which helps look at certain areas of the spine).

Another type of test can be conducted during the diagnosis is an electromyogram, which checks whether nerves are functioning normally when sending signals to your muscles. Additionally, nerve conduction study can help determine the speed and strength of these nerve signals.

Treatment for cervical spondylosis

Currently, there is no cure for cervical spondylosis. However, treatments are focused on relieving pain, reducing the risk of permanent damage, and helping you lead a normal life. These are the following treatments for cervical spondylosis:

  1. Medications. These can include nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, which help reduce inflammation. Muscle relaxants, such as cyclobenzaprine, which help treat muscle spasms. Narcotics like hydrocodone can provide pain relief. Anti-epileptic drugs can help relieve nerve pain. Steroid injections can reduce inflammation and pain.
  2. Physical therapy. This type of therapy helps you stretch your neck and shoulders. It makes them stronger and helps relieve pain.
  3. Surgery. If the disease doesn’t respond to any of the other treatments, then surgery may be needed. It can involve removing bone spurs, parts of your neck bones, or herniated discs, which can give the spinal cord and nerves more room. However, surgery is generally not necessary for treatment of cervical spondylosis.

  • Lees, F., and JW Aldren Turner. "Natural history and prognosis of cervical spondylosis." British medical journal 2.5373 (1963): 1607.
  • Lestini, WILLIAM F., and Samuel W. Wiesel. "The pathogenesis of cervical spondylosis." Clinical orthopaedics and related research 239 (1989): 69-93.
  • Binder, Allan I. "Cervical spondylosis and neck pain." Bmj 334.7592 (2007): 527-531.
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