Cervical spondylosis (Neck pain) is one of the most common spine dysfunction, which is also referred to as cervical degenerative disease. Due to age as the prime trigger factor, it is mostly seen in the elderly people. According to the Journal of Disease-a-Month, approx. 20%-50% of adults suffer from neck pain every year, and a majority of them are caused by cervical spondylosis. Apart from the lumber spondylosis, it is one of the commonest medical issues, treated by the health care providers.
The spine is made up of 33 bones, called vertebrae, which are stacked one above the other. These bones connect to create a space (canal), which protects the spinal cord. The first seven vertebrae which begin at the base of the skull and neck comprise to form the cervical spine. Cervical spondylosis occurs in the cervical spine, the seven small vertebrae forming the neck.Other parts of the spine are:
Spinal cord and spinal nerves:
These "electrical" cables travel through the spinal canal carrying signals (messages) between the brain and muscles. The nerve roots branch off from the spinal cord through openings in the vertebrae.
These are intervertebral discs flexible that are found between your vertebrae. They act as shock absorbers when you walk or run.The inter-vertebral discs are flat, round and about half an inch thick.
The inter-vertebral discs consist of two components:
Causes of Cervical Spondylosis
Cervical spondylosis occurs mainly due to the degenerative changes that occur in the spine with increased age. These changes are normal, which happen with everybody. In fact, almost half of all middle-aged and older have worn discs that do not cause painful symptoms.
Disc degeneration and bone spur
As spinal discs age, they lose height and begin to swell (bulge). They also lose water content, begin to dry and, in turn, become weak. This problem makes the settling or collapse of the disc space and loss of disc space height.
As the facet joints progress, pressure also begins to degenerate and develop arthritis, similar to the one that happen in the articulation of the hip or knee. Articular cartilage smooth, slick that covers and protects the joints wears away.
If the cartilage is completely worn, it can result in bone rubbing on bone. To compensate for the lost cartilage, your body may respond by growing new bone in the facet joints to help keep the vertebrae. Over time, this bone overgrowth - called bone spurs - can reduce the space for the nerves and the spinal cord to pass through (stenosis).
Age is the most common risk factor for neck pain or cervical spondylosis. The condition is very common in patients who are middle-aged and older.
Other factors that may increase the risk of developing cervical spondylosis or neck pain are:
Symptoms of Cervical Spondylosis
In most of the cases, cervical spondylosis causes no symptoms. When symptoms occur, they usually include:
Pain and stiffness in the neck, which can range from mild to severe. Sometimes it exacerbated by looking up or looking down for a long time, or activities in which the neck is held in one position for an extended period of time such as driving or reading a book. The pain is usually relieved by rest or lying down.Other symptoms may include:
Diagnosis of Cervical Spondylosis:
Your doctor might suggest some tests to help confirm the diagnosis of cervical spondylosis.
It provides images of dense structures, such as bone and joint space. An X-ray shows the alignment of the bones along its neck. It can also reveal degenerative changes in the cervical spine, such as loss of disc height and the presence of bone spurs.
Magnetic resonance imaging (MRI) scans:
These studies create better images of soft tissues in the body, such as muscles, discs, nerves and spinal cord. An MRI can help determine if your symptoms are caused by damage to the soft tissues, such as a bulging or herniated disc.
Computed tomography (CT):
More detailed than a simple x-ray, a CT scan can help your doctor better see your spinal canal and any bone spurs.
This is a special type of CT scan. In this procedure, a dye is injected into the spinal canal to make the spinal cord and nerve roots more clearly visible.
Treatment of Cervical Spondylosis:
The aim of the cervical spondylosis treatment is to provide pain relief, prevent the risk of permanent damage, and help the patients lead a quality life. Usually, the non-operative treatments work excellent in this condition.
Non-steroidal anti-inflammatory drugs:
Often prescribed with acetaminophen, a drug like Ibuprofen, which is considered as the first-line of medicine for neck pain. This drug addresses both pain and swelling, and may be prescribed for a number of weeks.
Mild pain is often relieved with acetaminophen. The goal of pharmacotherapy is to reduce pain and inflammation.
None of the above medicines should be taken without consultation from an orthopedic specialist.
Surgery is not commonly recommended for cervical spondylosis and neck pain unless your doctor confirms that:
Patients with progressive neurological symptoms such as numbness, arm weakness, or falling, are more likely to be helped by surgery.
Physiotherapy management in Cervical Spondylosis:
Physiotherapy is usually the first non-surgical treatment that your doctor might recommend. Specific exercises can help relieve pain, strengthen and stretch the muscles weakened or strained. In some cases, physiotherapy may include posture therapy or the use of traction to stretch the joints and muscles of your neck gently. Physiotherapy programs vary in length but usually last for 6-8 weeks. Typically, sessions are scheduled 2 to 3 times a week.
TENS unit may be issued to a patient for home use. E-stimulator is used to stimulate your muscles through variable intensities of electrical current.
It helps to decrease muscle spasms and also act as a natural painkiller. TENS also drive out inflammation, herald healing properties, relax and re- educate the muscles which involved.
Physiotherapist uses different heating modalities to improve blood circulation to the target area because an increased blood flow brings more O2 and nutrients to that area. Blood is also needed to remove waste created by muscle spasms, and it also assist in decrease pain.
Soft tissue manipulation:
This technique targets spasms and chronic muscle tension and pain that perhaps build up through daily life stress. You could also have spasms or muscle tension because of strains or sprains.
During physiotherapy the physiotherapist uses direct pressure and friction to try to release the tension in your soft tissues (ligaments, tendons, muscles).
There is no specific way to prevent this condition. However, some lifestyle changes can delay the process of degeneration.
Prevention of Cervical Spondylosis:
The lifestyle changes include: