What is cervical spondylosis?
First, we must understand what spondylosis is.
Most joints in our body are made up of the end of two bones that articulate with each other inside a joint capsule. When the joint surfaces undergo wear the joint is described as being arthritic. The way the bones in the spine relate to each other though is more complex.
The spine is made up of building blocks called vertebrae. These relate with adjacent vertebrae through a combination of the intervertebral discs, which act as shock absorbers, and facet joints that articulate at the rear. These vetebral segments are stabilised by ligament structures just like any other joint. Because of this unique makeup when degeneration occurs in the spine, we refer to it as spondylosis.
Cervical spondylosis is a condition that affects the bones and discs in the neck. It is caused by the wear and tear of the spine over time and is more common in older adults.
Symptoms of cervical spondylosis
The majority of people with cervical spondylosis have no symptoms or at most report the occasional neck pain and stiffness, otherwise known as cervicalgia. This can be associated with a headache. A common trigger for this is prolonged sitting in front of a computer screen.
In more advanced cases you may experience numbness or weakness in the arms or legs as nerves of the spinal cord get impinged. See cervical nerve impingement.
Diagnosing cervical spondylosis
If you suspect your symptoms are the result of cervical spondylosis, it is important to seek a doctor's opinion. Your doctor can carry out a physical examination and may order imaging tests, such as x-rays or MRI, to confirm the diagnosis and determine the extent of the condition. Having this information helps your doctor be able to safely recommend the course treatment that is most suited to you.
Treating cervical spondylosis
There are several ways to manage cervical spondylosis:
- Physical therapy: exercises and stretches strengthen the muscles in the neck and improve the range of motion.
- Medication: pain relievers and nonsteroidal anti-inflammatory drugs can help to reduce pain and inflammation.
- Hot or cold packs: applying heat or cold to the neck can help to reduce pain and stiffness.
- Injection intervention: image-guided steroid injections targeting the most likely source of the symptoms. Take note that I said "most likely source" because there can be more than one cause of neck pain happennig at the same time.
- Surgery: a decompression procedure to create space to allow nerves to pass freely or a vertebral fusion to stop painful surfaces from rubbing against each other.
Some people will get temporary relief from chiropractic or osteopathic manipulation techniques but take note that these therapies are not without risk and should only be carried out by experienced practitioners. Make sure you are aware of potential complications of manipulations and your practitioner explains these before you agree to undergo treatment.
Risks from cervical spine manipulation include spinal cord injury, nerve compression, and stroke. So, in my opinion, do not have your neck manipulated if you know you have bony changes, are experiencing pins and needles or tingling in your arms or legs, or you recently developed sudden severe neck pain and an accompanying headache.
Red Flag!
If you are experiencing severe neck pain, weakness or numbness in the arms or legs, or difficulty walking this could be a sign of inflammation of the spinal cord known as cervical myelopathy.
Cervical myelopathy can be caused by:
- long-standing compression of the spinal cord from a degenerative spine or bulging disc
- a quick and aggressive movement of the head in an already degenerative spine such as from a traumatic fall or an aggressive neck manipulation
- or rarer causes like tumors, infections, or an autoimmune reaction.
It is important to seek medical attention right away. These symptoms may be a sign of a more serious condition and require urgent attention.
