Cervical Spondylosis Treatment
Medically Reviewed by Dr Sravya , MBBS, MS
Overview
Neck pain due to various reasons and the most commonly seen age-relate condition is cervical spondylosis. About 85% of people over 60 are affect by it. An adult human being has 33 vertebrae, which are interconnect by vertebral discs and facet joints to form the vertebral column (spinal column, spine, or backbone).
So, the vertebral disc is a complex structure made of fibrocartilage, which acts as a shock absorber when you run or walk. The spinal cord runs down inside and branches out through the opening of the vertebral column. So, the spinal cord is a bundle of nerves that connects different parts of the body to the brain. And the seven vertebrae in the neck region are call cervical vertebrae (C1, C2, C3, C4, C5, C6, and C7).
Thus, spondylosis is a condition where there is degeneration of the discs and joints of the vertebral column, causing a reduction in space between the two adjacent vertebrae and leading to compression of a nerve emerging out of the spinal cord. When the seven vertebrae of the neck are involve, hence it is known as cervical spondylosis.
Alternatively, it is known as arthritis (joint inflammation) of the neck, which is the age-relate slow degeneration of your discs and joints in the cervical spine. The cervical spine is surround by nerves, muscles, tendons, and ligaments. Here, let’s see in depth the signs, causes, and best treatments for cervical spondylosis.
What are the causes of cervical spondylosis?
The degenerative changes that occur in the spine as we age are a natural process. Therefore, most middle-age people have worn-out disks without any symptoms. And most middle-age people have worn-out disk without any symptoms. Because, the common reason for the symptoms of cervical spondylosis are following :
- Dehydrated discs: When you get older, the intervertebral disk, which acts as a cushion between the two adjacent vertebrae, can start to dry out and dehydrate. This will lead to a decrease in the size of the disk. It can increase the chance of having more bone-to-bone contact between the vertebrae.
- Herniated discs: The disk is made of a tough and flexible outer ring with a jelly-like center. Cracks can occur on the outer surface of the spinal cord. The soft internal structure can squeeze through it and cause pressure on the spinal cord.
- Bone spurs: When a crack occurs on the disk or when it breaks down, your body may produce extra bone to strengthen the vertebral column. These extra bones, call spurs, can pinch the nerves out of the spinal cord.
- Stiff ligament: Whereas, ligaments are the structures that connect bone to bone. The spinal ligament can become stiff with age. This makes the neck less flexible as you get older.
Who has a risk factor for cervical spondylosis?
- Age: As you get older, the prevalence of cervical spondylosis increases. It is a natural aging process. So, there is 95% more risk for people over 65 years of age.
- Occupation: Jobs in which extra stress is put on the neck, like plumbers or flooring installers; heavy lifting construction workers; keeping the head in an improper position while working on computers; undergoing more vibrations, like bus or truck drivers.
- Neck injuries: Previous Injuries to the neck during accidents can lead to cervical spondylosis.
- Genetic factors: Some individuals with a family history of cervical spondylosis are at high risk of getting the condition.
- Smoking: People with a smoking habit have an increase risk of cervical spondylosis
Common signs and symptoms:
As you age, the years of natural wear and tear occur in the disk cause, you have certain symptoms progressively. The signs and symptoms begin when degeneration of the vertebral column causes compression on the nerve root emerging from the cord, which runs inside the vertebral column. Therefore, the commonly occurring symptoms are:
- Pain in the neck that can travel to the arms or the shoulders
- Headaches
- A grinding feeling as you move your neck
- Trouble in balancing
- Losing control of the bladder or bowel movement
- Weakness in your arms and legs
- Tingling in the arms or hands
- Numbness in your shoulders, arms, or hands
- Stiffness in the neck
How do I diagnose cervical spondylosis?
- X-rays: X-rays provide images of any dense structures, such as bones and their alignments. They provide images of the structures in black and white. It shows the alignment, defects, and abnormalities in the bone. In cervical spondylosis, an x-ray is taken to find out if any common characteristic features are seen. They include reduction in the disc spaces, bony spurs on the upper and lower parts of vertebrae, and calcium deposits in areas of degenerative inflammation.
- Magnetic resonance imaging (MRI) scans It is use to find abnormalities in bones, muscles, nerves, cartilage, ligaments, and tendons. They are an excellent method for finding any structural abnormality due to aging. Also this will help to find out whether your pain in the neck is cause by damage to nerves due to herniate or degenerative disk and help to formulate the best treatments for cervical spondylosis.
- Computerized tomography (CT) scans give a more detail view than a plain X. This will help you have a better view of your spinal cord, spinal canal, and nerve root.
- Myelogram: This is a procedure where a needle is inject into the spinal cord and an x-ray or CT is taken to view the bone and associate structures more clearly. This helps to view the nerve roots, spinal cord, and subarachnoid space.
- Electromyography (EMG): When the nerve sends electrical signals to the muscles, they react in a certain way and give off these signals, which can be measure. This is a test to measure the electrical impulse of the muscle at rest and during contraction. The electrical activity in muscles and nerves is studies here, which will help to differentiate whether the condition is due to muscle or nerve disorder.
Cervical Spondylosis Treatment Methods
- Physiotherapy for cervical spondylosis: This will be one of the non-surgical treatments for cervical spondylosis advise by your physician. Certain exercises help to relieve pain, give strength to the muscles and joints, or weaken a strain muscle, as well as enhance posture. The therapy duration will vary from 6 to 8 weeks. You have to continue the exercises and stretches according to the physician’s advice.
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Medicines for cervical spondylosis treatment should be taken according to a physician's prescription.
(a) Analgesics are pain-relieving medications or painkillers. The most commonly use is acetaminophen.
(b) Nonsteroidal anti-inflammatory drugs (NSAIDs): These are a class of drugs that reduce pain, inflammation, and fever and prevent clots. It's usually prescribe with acetaminophen. NSAIDs such as ibuprofen, aspirin, and naproxen are considere first-line medications for neck pain.
(c) Oral corticosteroids: They help in the reduction of pain and inflammation as a part of cervical spondylosis treatment.
(d) Muscle relaxants can be use to treat painful muscle spasms. They help with muscle tension, pain, and discomfort. Cyclobenzaprine or carisoprodol are commonly use. - Treatment of cervical spondylosis using a Soft cervical collar or brace This is a pad wrap that goes around the neck to limit the motion of the muscles of the neck and adjust the neck to the require position. Therefore, a soft collar is usually prescribe for a short period of time to provide adequate rest and recuperation. Wearing it too long can cause muscle weakness.
- Self-care: Ice, heat, and massages according to the physician's advice will help you relieve your pain while treating cervical spondylosis. Apply heat or cold several times a day for 10 to 20 minutes to relieve pain.
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Injections: Patients who are in severe pain can have anesthetic and steroid injections for short-term pain relief for cervical spondylosis. These are less invasive than the surgeries that are followed by physicians as treatment methods for cervical spondylosis. They include:
(a) Cervical epidural block: In this procedure, the anesthetic and steroid solution are inject into the epidural space (space near the covering of the spinal cord). This is used for neck and arm pain that occurs due to cervical disk herniation. This state of nerve injury due to disk herniation is call pinch nerve or radiculopathy.
(b) Cervical facet joint block: Here the anesthetic and steroid injection are given into the neck joint call the facet, which helps in neck movement and neck stability. The arthritic changes occurring in these joints can cause neck pain.
(c) Medical branch block and radiofrequency ablation: This is a procedure that can be done for the diagnosis as well as the treatment of cervical spondylosis. In the diagnostic part, the anesthetic agent is inject into the nerve supplying the fact joint. If this relieves your pain, your physician will pinpoint the source of the pain. In the treatment part of the procedure, your physician will block the pain by damaging the nerve supplying the joint using a burning technique call radiofrequency ablation. The treatment effect can last up to several months, but pain can occur again if the nerve regenerates. -
Surgery for cervical spondylosis: Spine surgery is a lengthy and complex procedure with widely variable recovery times. These surgeries include removing bone spurs, fusing the vertebrae, or creating spaces for the spinal nerves. Surgeries will not be recommend to you unless you have:
(a) Cervical spondylosis myelopathy: the spinal cord gets compress by the bone.
(b) Cervical radiculopathy: the spinal cord nerve gets pinched by the herniate disk.
(c) Severe neurological symptoms such as numbness, weakness, unsteadiness while walking, or falling while walking.
You can’t prevent cervical spondylosis as it is an age-relate condition, but you can reduce the risk or decrease the symptoms by following. Such as proper posture, staying physically fit, and avoiding any neck injuries or trauma. If you have cervical spondylosis, talk to your specialist physician about the best combination of physical therapy and medications to alleviate the symptoms and treat cervical spondylosis.