Cervical Spondylosis
Neck pain is common in people older than 50 years, and may be a natural consequence of aging. Like the rest of the body, the bones in the neck (cervical spine) progressively degenerate with increasing age.
Over time, arthritis of the neck (cervical spondylosis) may result from bony spurs and problems with ligaments and disks. The spinal canal may narrow (stenosis) and compress the spinal cord and the nerves to the arms. Injuries can also cause spinal cord compression. The pain that results may range from mild discomfort to severe, crippling dysfunction.
Symptoms
Cervical spondylosis can lead to chronic pain and stiffness in the neck that may radiate into to the upper or lower extremities (radiculopathy or myelopathy)).
- Neck pain and stiffness (may be worse with upright activity)
- Numbness and weakness in the arms, hands, and fingers
- Trouble walking because of weakness in the legs or loss of balance
- Grinding or popping sound or sensation in the neck when moving
- Muscle spasms or headaches (may originate in the neck)
The condition can cause irritability, fatigue, and sleep disturbances, and impair the ability to work.
Diagnosis
The doctor will take a complete medical history to rule out other conditions that cause symptoms similar to cervical spondylosis. The doctor will also perform a complete physical examination. Radiography (X-rays) and other diagnostic imaging tests may also be performed so the doctor can see inside the body.
Medical History
The doctor will ask about any illnesses or chronic conditions. What is the exact location of the neck pain? When did the problem begin? What does the pain feel like? Has your neck been injured before? Have you previously been treated for neck pain?
Physical Examination
The physical examination involves identification of tender spots along the neck and an evaluation of neck motion in various directions. The doctor may also test the patient’s reflexes and the function of nerves and muscles in the arms and legs. The doctor may ask the patient to walk.
Imaging
X-rays and/or magnetic resonance imaging (MRI) studies may show bone spurs and other abnormalities and reveal the extent of damage to the cervical spine.
In some patients, additional tests are needed before a diagnosis is made. Sometimes, the doctor may refer the patient to a neurologist for evaluation.
Treatment
Nonsurgical Treatment
Symptoms of cervical spondylosis may last for several months or become chronic. If symptoms are mild, the doctor may recommend a variety of nonsurgical treatments.
- Rest. A soft cervical collar or neck brace may be used to limit neck motion and relieve nerve irritation.
- Medication. The doctor may prescribe nonsteroidal anti-inflammatory medications (NSAIDs) or other non-narcotic pain relievers to relieve pain and reduce swelling.
- Physical therapy. A cervical traction device, hot and cold therapy, or active exercise program may help relieve symptoms. Exercises may include neck strengthening, neck and shoulder stretching, and aerobic exercises. Patients may also receive gentle massage and perform activities to improve posture.
Nonsurgical treatment may take away most of the symptoms, but it does not treat the underlying cause. Follow-up visits are necessary so the doctor can check if symptoms have gotten better, worse, or have stayed the same.
Surgical Treatment
Surgery may be necessary for patients with progressive neurologic symptoms or severe pain that does not improve with other treatments.
Surgery may remove bone spurs or disk material (decompression) and provide lasting pain relief.