NECK PAIN IN CERVICAL SPONDYLOSIS
Cervical spondylosis is caused by degenerative changes in the bones and joints of the neck along with changes in the intervertebral disks of the neck. This is also a form of wear and tear arthritis or osteoarthritis rather than a disease like condition.
Cervical spondylosis is primarily due to aging. The condition usually first starts after the age of 40 and continues to progress as you age. Men tend to develop cervical spondylosis at an earlier age than women. The condition often leads to myelopathy which is damage to the spinal cord and nerves which produces some of the following symptoms. Cervical spondylosis is the most common condition of the neck that can affect the spinal cord.
Symptoms often develop slowly over time but may start suddenly.
• Neck pain (may radiate to the arms or shoulder)
• Neck stiffness that gets worse over time,
• Loss of sensation or abnormal sensations in the shoulders, arms, or (rarely) legs
• Weakness of the arms, hands, fingers or (rarely) legs
• Headaches, particularly in the back of the head
• May feel irritable and fatigue, disturb sleep and impair your ability to work.
• May feel or hear grinding or popping in the neck when you move.
Less common symptoms are:
• Loss of balance
• Loss of control over the bladder or bowels (if the spinal cord is compressed)
Cervical spondylosis is caused by chronic wearing away (degeneration) of the cervical spine, including the cushions between the neck vertebrae (cervical disks) and the joints between the bones of the cervical spine. There may be abnormal growths or “spurs” on the bones of the spine (vertebrae).
These changes can, over time, press down on (compress) one or more of the nerve roots. In advanced cases, the spinal cord becomes involved. This can affect not just the arms, but the legs as well.
The major risk factor is aging. By age 60, most women and men show signs of cervical spondylosis on x-ray. Other factors like past neck injury, previous spinal surgery, and severe generalized arthritis may contribute to developing spondylosis.
Physical exam – the doctor may identify tender spots along the neck and evaluate your ability to move the neck in various directions. The function of the nerves and muscles in the arms and legs may be tested. Weakness or loss of sensation can be signs of damage to specific nerve roots or to the spinal cord. Reflexes are often reduced. X-ray, CT scan and MRI scans are done to assess the extent of spondylosis. EMG test may help to assess associated damage to the nerves.
Symptoms of cervical spondylosis usually stabilize or get better with simple, conservative therapy. Rest, temporary neck collars, local gels, pain medication are tried initially. If there are any tender areas local steroid injections might help. Physiotherapy to learn exercises which can later be practiced at home.
If the pain does not respond to these measures, there is a weakness in the movement of hands or legs, problems with coordination, beginning of / gradual loss of feeling of bowel or urine, surgery is considered. Surgery is done to relieve the pressure on the nerves or the spinal cord.
Healthy Joint Club says:
Very healthy software engineers in their third decade to elderly beyond 60 years of age suffer from this very common condition, and very rarely it is associated with any serious underlying problem. People are worried that they got ‘spondylosis’ even when they get a whip of pain in the neck. Young people may not realize that it is simply due to pain from a ‘tired muscle’ of the neck which is overworking to hold their head facing the monitor for more than 8 hours a day. Simple and appropriate neck and upper back exercises are all that is needed to keep your neck muscles in fit condition. Some amount of wear and tear which invariably starts in the middle age may contribute to the neck pain later but that does not make the sufferer a ‘patient of neck pain’ and certainly no need to feel that they must suffer from it for the rest of their lives.