Spondylosis (Cervical) – Symptoms, Causes and Treatment

Cervical spondylosis, often referred to as arthritis of the neck, describes the wear and tear on the cervical spine. Individuals with this condition may experience symptoms such as neck pain, stiffness, or discomfort. While healthcare providers cannot cure cervical spondylosis, they can help manage the condition and prevent it from worsening. Additionally, there are steps you can take to protect your neck and maintain its health.

What is cervical spondylosis?

Cervical spondylosis is a broad term that refers to the gradual wear and tear affecting the cervical spine, which consists of the seven vertebrae in your neck. Over time, the various structures in the spine, including the discs, joints, and ligaments, start to break down due to aging. This condition is sometimes referred to as osteoarthritis of the neck or simply neck arthritis because it involves the same degenerative processes that occur with arthritis in other joints.

People with cervical spondylosis often experience symptoms like neck pain, stiffness, and discomfort. In more severe cases, the condition may lead to nerve compression, causing symptoms like numbness, tingling, or weakness in the arms and hands. While cervical spondylosis cannot be cured, healthcare providers can help manage the symptoms through a range of treatments, including physical therapy, medication, and sometimes surgery, to prevent the condition from worsening.

How common is cervical spondylosis?

Cervical spondylosis is extremely common and is largely considered a normal part of the aging process. As we age, our spines naturally begin to wear down, and this typically starts in a person’s 30s. By the age of 60, about 9 in 10 people show signs of cervical spondylosis, even if they aren’t experiencing noticeable symptoms. The condition is more common in people who have physically demanding jobs or a history of spinal injury, but it affects nearly everyone to some degree as they grow older.

Symptoms and Causes of Spondylosis (Cervical)

What are the symptoms of cervical spondylosis?

Cervical spondylosis often develops without any noticeable symptoms, especially in its early stages. However, when symptoms do occur, they typically affect the neck and nearby areas. Common symptoms include:

• Neck pain: This can range from mild discomfort to more severe, persistent pain.
• Stiffness in the neck: Reduced flexibility in the neck, making it harder to turn or tilt your head.
• A lump or tight spot in the neck area: Some people may feel tightness or a noticeable bump in the neck muscles.
• Muscle spasms: Sudden, involuntary tightening of neck muscles, which can be painful.
• A clicking, grinding, or popping sound with neck movement: Movements of the neck may produce these sounds, especially during certain motions.
• Dizziness: Some individuals may feel lightheaded or unsteady.
• Headaches: Neck-related headaches, often starting at the base of the skull and radiating towards the forehead.

What causes cervical spondylosis?

The most common cause of cervical spondylosis is the natural aging process. As we get older, the components of the spine, including the discs and joints, begin to deteriorate. This wear and tear can lead to various medical conditions that contribute to the development of cervical spondylosis, including:

• Degenerative disc disease: The spinal discs lose hydration and flexibility, leading to a breakdown of the cushioning between vertebrae.
• Herniated discs: When a disc’s outer layer tears, the soft inner material can bulge out and press on nearby nerves.
• Osteoarthritis: The breakdown of cartilage in the joints of the spine can cause pain and stiffness.
• Bone spurs (osteophytes): Bony growths may form along the edges of the vertebrae, leading to nerve compression.
• Spinal stenosis: This occurs when the spinal canal narrows, putting pressure on the spinal cord and nerves.

What triggers cervical spondylosis?

Although cervical spondylosis develops gradually with age, certain factors can increase the likelihood or speed up its progression. These risk factors and triggers include:

• Being age 60 or older: The condition is most common in people aged 60 and older.
• Smoking: Smoking accelerates spinal degeneration and can increase the risk of neck problems.
• Jobs that require constant neck strain (looking up or down): Jobs or activities that require repetitive neck movements, such as constantly looking up or down, can strain the cervical spine.
• Lifting heavy objects that stress the neck: Straining the neck while lifting or carrying heavy items can contribute to spinal wear and tear.
• A family history of the condition: Having close relatives with cervical spondylosis increases your chances of developing the condition.
• Previous neck injuries: A history of neck trauma or injury can increase the risk of early or more severe spondylosis.

What are the complications of this condition?

While cervical spondylosis itself is common and often manageable, in some cases, it can lead to more serious complications, including:

• Cervical myelopathy: This condition occurs when the spinal cord in the neck becomes compressed, potentially leading to problems with balance, coordination, and even bladder or bowel control in severe cases.
• Cervical radiculopathy: Also known as a pinched nerve, this occurs when nerves exiting the spinal cord become compressed, causing pain, numbness, or weakness in the arms, shoulders, or hands.

Can cervical spondylosis affect the brain?

No, cervical spondylosis does not directly impact the brain. The condition is limited to the cervical spine, which affects the discs, vertebrae, and surrounding tissues in the neck. Although it can cause discomfort and pain in the neck and related areas, it does not interfere with brain function. However, symptoms like dizziness or headaches can sometimes be experienced due to the involvement of nearby nerves and structures in the upper spine.

Diagnosis and Tests

How is cervical spondylosis diagnosed?

To diagnose cervical spondylosis, a healthcare provider will begin with a thorough physical examination. They will look for any visible signs of issues in the neck, such as bumps or muscle tightness, and assess your overall neck function. Key aspects of the physical exam may include:

• Neck range of motion: The provider will check your ability to move your neck in different directions, such as bending, turning, or tilting, to assess the range of motion and any pain or stiffness during movement.
• Muscle strength and reflexes: They will examine the strength and reflexes in your hands, arms, and legs to identify any weakness or delayed responses that may suggest nerve compression or spinal cord involvement.
• Reflexes: Testing reflexes helps to detect any abnormal nerve activity, which can be a sign of nerve damage or irritation.
• Your walking pattern (gait): Observing how you walk helps evaluate your balance and coordination, which can sometimes be affected by cervical spondylosis if there is spinal cord compression.

What tests help diagnose cervical spondylosis?

In addition to the physical exam, diagnostic imaging and nerve function tests are often used to get a more detailed view of the spine and surrounding tissues. These tests help the healthcare provider confirm the diagnosis and assess the severity of the condition. Some common tests used include:

• X-ray: An X-ray provides a basic image of the spine, showing changes such as bone spurs, loss of disc height, or narrowing of the spaces between vertebrae.
• CT (computed tomography) scan: A CT scan offers a more detailed cross-sectional view of the spine, providing greater clarity on bone structure and possible issues like herniated discs.
• MRI (magnetic resonance imaging) scan: An MRI uses magnetic fields to create detailed images of soft tissues, including the spinal cord, discs, and nerves. This test is crucial for identifying nerve compression or damage.
• Myelogram: A myelogram involves injecting contrast dye into the spinal canal to better highlight the spinal cord and nerves on X-ray or CT images, helping to identify compression or narrowing.
• Electromyography (EMG): This test evaluates the electrical activity of your muscles to determine if there is nerve damage affecting muscle function.
• Nerve conduction study: This test measures how well electrical signals travel along a nerve, helping to identify any blockages or delays in nerve function due to compression or other issues.

These tests, along with the physical examination, allow healthcare providers to accurately diagnose cervical spondylosis and plan appropriate treatment options based on the severity of the condition.

Management and Treatment

What is the best treatment for cervical spondylosis?
The best treatment focuses on relieving your symptoms. In most cases, healthcare providers begin with noninvasive, conservative options. These may include:

• Physical therapy to improve neck mobility and strength.
• Over-the-counter pain medications to manage discomfort.
• Ice or heat application on the neck for 15 minutes, several times a day, to reduce pain and inflammation.
• A soft collar or brace to provide neck support.

For more severe cases of neck pain, treatments such as cervical epidural steroid injections or radiofrequency ablation may be recommended to reduce inflammation and pain.

If these treatments do not provide relief or if there are complications such as cervical myelopathy or cervical radiculopathy, spinal fusion surgery may be suggested as a more invasive option.

What are the treatment side effects?

Noninvasive treatments typically have minimal side effects. However, more advanced treatments like steroid injections, radiofrequency ablation, or spinal fusion surgery can come with their own risks. Your healthcare provider will discuss the potential side effects and complications of these treatments with you in detail.

A note from One Spine Clinic

As we age, our bodies undergo various changes, and cervical spondylosis is one of them. It can lead to neck pain, stiffness, or discomfort. While anyone can develop this condition, those who frequently look up or down for extended periods are at a higher risk. Although cervical spondylosis can’t be cured, treatments are available to reduce stiffness and ease pain. If you experience neck pain or stiffness lasting more than a few days, it’s important to consult with a healthcare provider.

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