Cervical Spondylosis
What is Cervical Spondylosis?
Neck pain is extremely common. It can be caused by many things, and is most often related to getting older. Cervical spondylosis is the degeneration of the joints in the neck. It becomes increasingly more common as people age. More than 85% of people over age 60 are affected.
Like the rest of the body, the bones in the neck (cervical spine) slowly degenerate as we age. This frequently results in arthritis. Arthritis of the neck is called cervical spondylosis. Although it is a form of arthritis, cervical spondylosis rarely becomes a crippling or disabling type.
Causes of Cervical Spondylosis
Disk Degeneration and Bone Spurs
In the spine, arthritis can result as the disk degenerates and loses water content. In children and young adults, disks have high water content. As we get older, our disks begin to dry out and weaken, which is the cause of cervical spondylosis. This problem causes settling, or collapse, of the disk spaces and loss of disk space height.
As the facet joints experience increased pressure, they also begin to degenerate and develop arthritis, similar to the hip or knee joint. The cartilage that covers and protects the joints wears away.
If the cartilage wears away completely, it can result in bone rubbing on bone. To make up for the lost cartilage, your body may respond by growing new bone in your facet joints to help support the vertebrae. Over time, this bone overgrowth — called spurs — may narrow the space for the nerves to pass through (stenosis).
Risk Factors
There are several factors that increase your risk for cervical spondylosis. The following have all been linked to higher risks of neck pain and spondylosis:
- Genetics – if your family has a history of neck pain
- Smoking – clearly linked to increased neck pain
- Occupation – jobs with lots of neck motion and overhead work
- Mental health issues – depression/anxiety
- Injuries/trauma – car wreck or on-the-job injury
Symptoms of Cervical Spondylosis
Pain from cervical spondylosis can be mild to severe. It is sometimes worsened by looking up or down for a long time, or with activities such as driving or reading a book. It also feels better with rest or lying down.
Additional symptoms of cervical spondylosis include but are not limited to:
- Neck pain and stiffness (may be worse with activity)
- Numbness and weakness in arms, hands, and fingers
- Trouble walking, loss of balance, or weakness in hands or legs
- Muscle spasms in neck and shoulders
- Headaches
- Grinding and popping sound/feeling in neck with movement
Treatment
Nonsurgical Treatment
Physical therapy: Strengthening and stretching weakened or strained muscles is usually the first treatment that is advised. Your physical therapist may also use cervical (neck) traction and posture therapy. Physical therapy programs vary, but they generally last from 6 to 8 weeks. Sessions are scheduled 2 to 3 times a week.
Medications: Several medications may be used together during the first phase of treatment to address both pain and inflammation. These medications include acetaminophen (for mild pain), non-steroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants (cyclobenzaprine, carisoprodol).
Other nonsurgical treatments include soft collars; ice, heat, and massage; steroid-based injections (cervical epidural block, cervical facet joint block and medial branch block) and radiofrequency ablation.
Although less invasive than surgery, steroid-based injections are prescribed only after a complete evaluation by your doctor. Before considering these injections, discuss with your doctor the risks and benefits of these procedures for your specific condition.
Surgical Treatment
It is uncommon for people with only cervical spondylosis and neck pain to be treated with surgery. Surgery is reserved for patients who have severe pain that has not been relieved by other treatment. Some patients with severe pain will unfortunately not be candidates for surgery. This is due to the widespread nature of their arthritis, other medical problems, or other causes for their pain, such as fibromyalgia.
People who have progressive neurologic symptoms, such as weakness, numbness, or falling, are more likely to be helped by surgery.
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