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Cervical Spondylosis:
Symptoms, Causes, Risk Factors, Diagnosis & Treatment

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1.What is Cervical Spondylosis?

Cervical spondylosis is a common, age-related disorder of the cervical spine that is located in the neck region. This condition is also known as neck arthritis or cervical osteoarthritis. With age, the cervical discs gradually face wear and tear resulting in the breakdown of the structure. The fluid present between the cervical discs is lost which makes the spine stiffer, leading to cervical pain. This results in changes in the bones, discs, and joints at the spine of the neck.

As a result of the fluid dehydration and degeneration of the discs and cartilage in the surrounding area, abnormal growth or spurt of bones called osteophytes can occur leading to the narrowing of the passage from where spinal nerves exit, causing a related condition called cervical spinal stenosis.

What is Spondylosis?

Spondylosis is an umbrella term that is used to describe any degeneration of the spinal cord. Spondylosis symptoms involve acute pain in the neck and back in old-age. Cervical spondylosis is prevalent among middle-aged and elderly people with more than 85% of people older than 60 years being a victim of this disorder that causes cervical neck pain. Early cervical spondylosis can also occur but it is rare.

Spondylitis vs Spondylosis

Spondylitis and spondylosis both affect the spinal cord but there is a basic difference between the two. The meaning of spondylitis is that it is the inflammation of one or more typical cervical vertebrae leading to pain in the spine. Cervical spondylosis mostly refers to any kind of degeneration of the spine. So, even though the effects of both the diseases might be similar, their origin and cause are completely different. Understanding the difference between spondylosis and spondylitis is important because it helps the doctors determine the course of treatment and the right medications for the patient.

What is cervical lordosis?

Every person has a normal curve of the spine which is known as lordosis. The loss of cervical lordosis refers to the situation in which a person’s spinal curve arches abnormally and in an increased way inward. This can lead to excessive pressure on the spinal cord that causes pain, discomfort, and extreme numbness. The loss of cervical lordosis is often one of the contributing causes of severe cases of cervical spondylosis.

What is Cervical Vertebrae?

Cervical vertebrae of the spine are the thinnest and most delicate bunch of seven bony rings present between the base of the skull and the thoracic vertebrae at the trunk.

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2.Symptoms of Cervical Spondylosis

Cervical Spondylosis

Cervical spondylosis symptoms can vary from person to person and the extent of cervical spine pain depends on the age of the affected person. Some of the common spondylosis symptoms are:

  • Excessive stiffness at the neck leads to symptoms of cervical pain in neck
  • Heavy cervical spondylosis headache that may originate at the main cervical spondylosis pain areas of the neck
  • Pain in the shoulder and arms that results in the inability to move the hands
  • Failure to properly turn the head around due to extreme pain
  • Spondylosis symptoms show grinding noise or sensation when attempts are made to turn the neck around

With enough rest and proper sleep, cervical pain symptoms tend to improve. The symptoms of cervical pain are maximum in the morning and then again at night before bed.

If osteophytes cause cervical stenosis in the cervical bone, then it puts excessive pressure on the spinal cord leading to a condition called cervical spondylotic myelopathy. The myelopathy meaning is nothing but it refers to any disease of the spinal cord. The onset of this secondary condition can result in the following symptoms of spondylosis:

  • A feeling of abnormal tingling, numbness, and weakness in the peripheral regions like the arms, hands, feet, and legs
  • Lack of balance and coordination which leads to walking and movement difficulties
  • The spondylosis neck bone leads to abnormal reflexes and causes random muscle spasms
  • The occurrence of incontinence or the loss of control over one’s urinary bladder and bowel movements

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3.Cause of Cervical Spondylosis

The normal wear and tear of the bones in the spinal cord are the main cervical spondylosis causes that result in degenerative spondylosis. Other possible causes of cervical pain can be the following:

  • Bone Spurs or Abnormal Outgrowths of Bones called Osteophytes:

As the spine degenerates and becomes weaker due to old age, the body responds by growing new and extra bones to make the spine stronger. This abnormal formation of bones or cervical osteophytes is called bone spurs. These extra bones can put pressure on the spine, such as the nerve and the spinal cord in the cervical region leading to a bad case of cervical disc disease.

  • Dehydrated Spinal Discs:

The spinal cord is made up of tiny bones called vertebrae which consists of small fluid-filled discs. The fluid in between the bones is thick and acts like pad-like cushions that absorb the shock of heavy activities like lifting, twisting and other movements. With age, the fluid can get dehydrated leading due to a condition called disc desiccation. This causes the bones to rub against each other during activities that cause neck spondylosis and results in acute pain in the dangerous space of the neck.

  • Herniated Discs:

In this condition, spinal discs develop cracks in them that result in leakage of the fluid present between them. This internal cushioning material that leaks out can press against the spinal nerves and bones resulting in numbness of the arms and severe pain.

  • Injury:

Any sort of neck injury due to an accident can lead to the onset of mild cervical spondylosis which accelerates the aging process of the cervical spine.

  • Stiffness of the Ligament:

Ligaments are bands of fibrous connective tissue that connects bones and cartilages together. With age, these ligaments can become stiffer that affects the overall neck movement leading to a cervical problem at the neck.

  • Excessive Stress and Overuse:

People who are employed in sectors that require heavy liftings like construction work and more prone to develop neck spondylitis and spondylosis. From an early age, this kind of job puts extra pressure on the neck and spinal cord leading to early lumbar spondylosis and symptoms of cervical spondylosis.

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4.Risk Factors of Cervical Spondylosis

The greatest risk factor of cervical spondylosis is aging and hence, it cannot be absolutely prevented from happening. But there are certainly other factors that can accelerate the onset of this condition. Such factors include:

  • Neck injury due to an accident
  • Work-related stressful activities that require heavy physical actions like heavy lifting
  • Poor posture which means going through the same neck movements or holding your head in an uncomfortable position for a prolonged period of time, especially for people who work desk jobs. This is called repetitive stress.
  • Genetic factors and family history
  • Smoking
  • Being overweight and inactive for a long period of time

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5.Steps to Prevent Cervical Spondylosis

There are certain cervical spondylosis home treatment measures that can be applied to prevent this condition. These home remedies for cervical pain involve:

  • Keep good care of the neck and shoulder region. Avoid loading heavy objects on the head or neck. Do not sleep on a high-pillow.
  • For people with desk jobs, pay attention to the posture you generally tend to follow during work. Make sure to stretch enough in between your work hours. The straightening of your cervical spine is important throughout the day. Lean back your head once in a while.
  • Swimming is considered to be a relaxed exercise for cervical pain. Make sure to swim often and perform general physical activities. Do not be inactive for a long period of time. Exercise for cervical spondylitis is advised for people suffering from symptoms of spondylitis in the neck.

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6.Diagnosis of Cervical Spondylosis

Cervical Spondylosis Diagnosis

How to cure cervical pain? This depends on how well the disease is diagnosed in the first place. Making an accurate diagnosis of the condition involves ruling out other potential factors that can cause neck pain in general. On the basis of the results of tests, the doctor may refer the patient to an orthopedic specialist or a neurologist for further cervical spondylosis treatment. Diagnosis tests include:

1.  Physical Examinations:

The first set of physics tests to determine the proper course of spondylosis treatment includes testing the reflexes of the patient and check for the presence of muscle weakness and deficits in the sensory nerve function. For cervical spondylitis treatment, doctors also run tests to determine the range of neck movement and the general state of the overall walking movement to understand cervical treatment necessary. All these tests help the doctor understand if the spinal nerves and cords are under any sort of extra pressure. To confirm the diagnosis of cervical spondylosis, doctors will order imaging tests and nerve function tests.

2.  Imaging Tests:

  • X-Ray Imaging - To check for the presence of bone spurs and other abnormal growth of spinal bones
  • Computed Tomography (CT) Scan - To obtain detailed images of the cervical region
  • MRI Scan - This procedure involves the use of radiowaves that help the doctor determine the presence of pinched nerves
  • Myelogram - In this case, an injected loaded with a tracer dye is used to highlight the areas of the c spine, Coupled with CT Scan or X-Rays, doctors can find better images of the affected areas.

3.  Nerve Function Tests:

  • Electromyogram (EMG) - This test is used to determine if the nerves of the body are functioning in a normal way. EMG records the passage of nerve signals in the body by measuring the electrical activity of the nerves.
  • Nerve Conduction Study - By placing electrodes on the skin, the doctor studies the speed and strength of the signals sent by the nerve endings in the body.

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7.Treatment and Management

Spondylosis treatments mainly focus on how to cure cervical spondylosis permanently, pain relief and lowering the risk of extensive damage to your vertebrae. Treatment for cervical spondylosis include:

Physiotherapy Exercises for Cervical Spondylosis

On the onset of cervical pain symptoms and treatment, physiotherapy for cervical spondylosis is a great way for pain relief. With the help of a trained physical therapist, you can learn all the exercises for cervical spondylosis. This bunch of cervical pain exercise includes cervical spondylosis exercises to help stretch and strengthen the muscles of the neck and shoulders.

Certain forms of exercises for cervical pain involve the use of neck traction - a form of cervical spondylosis physiotherapy treatment that uses weights to help increase the space between the cervical joints and reduce the pressure forming on the cervical discs and nerve roots.

Medications

Commonly administered medications for the treatment of Cervical Spondylosis are:

  • Muscle relaxants - The best medicines for cervical spondylosis are targeted towards treating muscle spasms. Medicines such as cyclobenzaprine are useful in relaxing the pressurized muscles of the neck and cervical region.
  • Narcotics - Doctor prescribed narcotics such as hydrocodone help for instant pain relief
  • Anti-seizure medications - Anti-epileptic medicine for cervical pain - medicines such as gabapentin help to reduce and remove the pain caused due to damage of the nerve
  • Steroid administration - Cervical pain medicine may also involve the administration of steroid injections such as prednisone to reduce the occurrence of tissue inflammation and effectively reduce pain. For mild pain, corticosteroid medications have proved to be helpful
  • Non-steroidal drugs - Such drugs prescribed by the doctor such as diclofenac are anti-inflammatory and can hence reduce the pain caused due to cervical spondylosis
  • Antidepressants have also proven to be helpful in relieving severe neck and shoulder pain
  • Certain homeopathic medicine for cervical spondylosis is also available for people suffering from acute cervical spondylosis

Home Remedies for Cervical Spondylosis

Various home treatment options are available to help ease the pain of cervical spondylosis. Firstly, patients who are suffering from this neck pain disease are advised to take enough rest during the day and keep proper care of their posture. People who acquire spondylosis at an early age normally do so because of bad study habits.

The home treatments that can help relieve pain include the following:

  • Over the counter pain medicines - Administration of medicines that can be bought over the counter often help patients with pain relief. Such medicines contain Ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol) that work great towards tackling pain due to spondylotic changes of the spine.
  • Heat and cold treatment help provide relief and also works in relaxing the sore muscles of the neck and shoulders. Using a heating pack or a cold pack can be a good home remedy for cervical spondylosis
  • Chiropractic manipulation that can help in order to control events of more severe pain due to cervical spondylosis
  • Wearing a neck collar for cervical spondylosis helps limit movement and provides support for the neck and shoulders. However, these neck collars should not be worn for a longer period of time as it can cause muscle weakness.
  • Several people opt for ayurvedic medicine for cervical spondylosis and patanjali medicine for cervical spondylosis to cure their ailment

The Need for Cervical Spondylosis Surgery

Cervical spondylosis is not progressive even though patients might have to live with severe pain for long periods of time all their life as it is a chronic condition. Cervical Spondylosis Surgery is only advised by doctors in rare cases when other forms of treatment do not help to ease the pain. For people who suffer from a progressive loss of function in the arms, hands, and legs, surgery may be required to fix the defect at the source point. This is because any form of compression at the cord may result in permanent functional disability.

In cases of the surgery, the main goal is to remove the areas or sources that have been applying extra pressure to the spinal cord and nerve endings. Some extensive forms of surgery may also involve the insertion of implants or bone grafts to add stabilization. Doctors also perform a fusion of the degenerated discs as a cure for cervical spondylosis.

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8.Road to Recovery and Aftercare

Cervical spondylosis is not uncommon among people who have crossed their 60s. Early diagnosis of this disease can help doctors recommend a conservative line of treatment to help ease the pain. Though this condition is not reversible, with proper care, home remedies, and lifestyle practices, patients overcome the stiffness and discomfort.

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9.Cervical Spondylosis FAQs: All your concerns addressed

Q.  What is cervical pain?

  1. Cervical pain is the stiffness and discomfort felt at the neck region by patients suffering from cases of cervical spondylosis, cervical spondylitis, cervical lordosis and similar other diseases that affect the spinal cord at the neck.

Q.  What is the difference between cervical and lumbar spondylosis?

  1. Cervical spondylosis occurs at the cervical vertebrae near the neck. Lumbar spondylosis causes the lower lumbar region of the vertebrae to face severe pain.

Q.  What is cervical spondylitis?

  1. Spondylitis symptoms are because of the inflammation in any of the joints in the vertebrae of the spine. Contrary to cervical spondylosis, spondylitis pain occurs due to this inflammation and not the degeneration of the spinal cord discs.

Q.  Are cervical spondylosis and cervical spondylitis serious?

  1. Both these conditions can cause stiffness, discomfort and severe pain in the neck region. But they are nor progressive and show symptoms slowly over time. With proper care and timely corrective surgery, patients can cure themselves of cervical pain.

Q.  Can cervical spondylosis cause a stroke?

  1. Though uncommon, a cervical attack can happen to people who suffer from cervical spondylosis. A transient ischemic stroke occurs because of the presence of abnormal bone spurs or osteophytes that can block blood vessels supplying blood to the brain. Such attacks often happen unexplained and can be the main reason for shock among the patients. With immediate treatment, cervical attack improves within 24 hours.

Q.  Can cervical spondylosis cause fainting issues?

  1. Cervical spondylosis is another factor that can contribute to neck-related dizziness or fainting among people suffering from the condition.

Q.  What happens in patients with cervical spondylosis?

  1. Patients suffering from cervical spondylosis face spinal cord compression that usually leads to a lack of function of the spinal cord. Because the tissue of the spinal cord is damaged, patients are more susceptible to spine injury and may lose movement capabilities. In such serious cases, surgery may be necessary.

Q.  What happens if cervical spondylosis is not treated?

  1. If timely treatment is not administered, the condition can become serious in some patients. The increased degeneration and inflammation of the vertebrae can result in the bones fusing with each other which, in turn, leads to extra stiffness and rigidity of the spine. Patients can lose their movement ability with a decreased range of motion like the inability to bend, twist or turn.

Q.  What are the usual risk factors that can lead to cervical spondylosis?

  1. Cervical spondylosis occurrences are quite normal among the elderly. The risk factors include normal wear and tear of the cervical spinal cord after a certain age with time. There are other factors that can accelerate the occurrence of cervical spondylosis. These factors include severe neck injuries due to an accident, work habits like desk jobs that require people to sit in a certain posture for a long period of time and other jobs that involve heavy lifting and physical activities.

Q.  What is the best treatment for cervical spondylosis?

  1. Various over the counter and prescribed medications are available in the market that help reduce the pain of cervical spondylosis. Physiotherapy and regular exercise are also helpful for such patients. The use of devices such as neck traction and neck collar help ease the pain in many cases of mild cervical pain. In certain rare situations, doctors may advise the patients to undergo surgery too.

Q.  What is cervical lordosis?

  1. Cervical lordosis meaning is that it refers to the normal curve of the spinal cord. Loss of cervical lordosis meaning is referred to as the condition in which the cervical curve arches too far inward. Cervical lordosis loss causes severe pain, discomfort and affects the patient’s ability for normal movement of the neck and shoulders.

Q.  Is cervical spondylosis dangerous?

  1. Cervical spondylosis is a common occurrence as people age. It won’t have any symptoms in most people. Many won’t even be aware of the changes that may be happening in their neck.

    Although cervical spondylosis usually won’t cause any disability, the changes in the spine may compress the spinal cord or the nerve roots attached to it m. As a result, the individual may feel weak or clumsy in their legs or hands.

Q.  What are the dos and don’ts in cervical spondylosis?

  1. Cervical spondylosis can be prevented. Below mentioned are a few simple dos and don’ts that anyone can follow to avoid chronic neck pain.
    • Maintain a good posture at all times. The neck must be in a neutral position so that the head is well balanced directly over the spine.
    • Keep your shoulders down and back in a relaxed position. Try setting an alarm every forty-five minutes to check in on yourself and fix your posture.
    • Try to manage stress levels. Stress may increase the perception of pain and further promote poor positioning and tension in muscles.
    • If you have a desk job, set your workstation in a way so that the computer screen is at your eye level and your feet are supported on the floor.
    • Don’t roll your neck to relax. This creates unnecessary grinding in the bones. You can instead stretch your neck from side to side slowly and hold the position for ten seconds for each side.
    • Make sure that you don’t bend your neck for more than ten minutes when you are reading a book, or looking down at a smartphone or computer. Change your position to keep looking straight.
    • If the neck pain lasts for more than two weeks, you need to seek professional care.

Q.  Can cervical spondylosis cause paralysis?

  1. Cervical spondylosis produces symptoms when the spinal cord or the spinal nerve roots are compressed. This leads to jerky or spastic leg movements and walking becomes unsteady. It may also decrease the sensations in the neck. The neck may be painful and become less flexible. The individual may feel exaggerated reflexes in the leg, and sometimes, the muscles may contract involuntarily.

    In severe cases, the compression may impair bladder and bowel function. If the spinal cord is severely damaged from the neck trauma, it may paralyze all the four limbs suddenly.

Q.  What kind of doctors treat cervical spondylosis?

  1. Cervical spondylosis can be treated by many different specialities of physicians, which may include family medicine doctors, internists, neurologists, rheumatologists, neurosurgeons, general practitioners, orthopaedists, and pain management specialists. Non-physician health-care practitioners who can treat spondylosis include
    • physician assistants
    • nurse practitioners
    • physical therapists
    • massage therapists
    • chiropractors

Q.  When should someone seek medical care for cervical spondylosis?

  1. Spondylosis is diagnosed by plain film X-ray, CT scan, MRI scan. Most of the people will have already gone through these diagnosis procedures after being ordered by their primary doctor. Re-evaluation or medical care may be necessary in the following situations.
    • If the prescribed treatment fails to manage the pain
    • In case an acute nerve dysfunction develops causing weakness in one or more limbs. It is important to visit your doctor if you feel your leg is weak and you can’t flex your foot or ankle.
    • Loss of bladder or bowel control during the time when acute back or neck pain has set in. Inability to start or stop urinating is a serious nerve dysfunction. It should be evaluated at the emergency department immediately.
    • Saddle anaesthesia. The term is used to describe numbness in the groin area or the bottom part that would contact a saddle. This again needs emergency medical care.
    • If back or neck pain is associated with weight loss or fever greater than 100-degree Fahrenheit.

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