“Oh, my aching neck!” If you are one of the thousands of people who suffer neck pain along with a variety of other symptoms, you may have cervical spondylosis with radiculopathy.
Many people initially assume that they have slept in an awkward fashion or otherwise injured their neck, yet the pain never goes away.
However, there are a variety of safe and effective ways to treat this common neck disorder. Understanding this disorder is key to reducing the pain and getting the medical care you need.
What Is Cervical Spondylosis With Radiculopathy?
Our cervical spine is the segment of our spinal column in our neck. This small length of vertebrae and discs supports the heavy weight of our head. Over time, our spines undergo an increasing amount of wear and tear, whether from age or from the activity.
According to Spine-Health Website, spondylosis is the general name for the pain and stiffness resulting from this wear-and-tear. However, because this term is general, there are often much more specific causes of your pain and other symptoms.
Cervical spondylosis has many causes. Arthritis can damage the neck joints and cause pain and stiffness. Bone spurs, also known as osteophytes, also can cause these symptoms as they impede movement and press uncomfortably on surrounding tissues and nerves.
Breakdown and compression of the discs that separate and cushion the vertebrae also is a major cause.
Regardless of the underlying cause, people with this disorder can suffer from a wide variety of unpleasant symptoms.
The wide range of symptoms can make this disorder difficult to identify. While there are no definitive treatments, there are many ways to reduce the pain or to eliminate it entirely.
Radiculopathy is a common effect of cervical spondylosis. Your spinal cord runs through your vertebrae where it can be protected from injury.
Nerve roots exit your spinal column to send and receive messages from the rest of your body. When your nerve roots are compressed or impinged upon, according to MedicineNet experts call this radiculopathy.
Radiculopathy can cause pain in your extremities, headaches, and a variety of symptoms. It often recedes on its own in weeks or months, but it sometimes persists for a much longer time. Like spondylosis, the treatments are aimed at reducing or getting rid of symptoms entirely.
A Pain in the Neck and More: Signs and Symptoms
There are many signs and symptoms associated with cervical spondylosis with radiculopathy. First, people will notice an increase in pain and stiffness in the neck. Second, the radiculopathy can cause pain, numbness, and tingling in the hands, arms, shoulders, neck, or head.
People also may notice a headache, vertigo, and other concerning symptoms if the radiculopathy affects the nerve roots that supply the face and head.
It is important to have these symptoms evaluated by a doctor, as they can also be caused by serious diseases such as stroke.
These symptoms may be constant, but they more commonly come and go with different movements and positioning of the neck.
What Causes Cervical Spondylosis With Radiculopathy?
The Merck Manual lists several causes of cervical spondylosis. The exact cause will determine the prognosis and treatment plan.
First, arthritis can cause this disorder. Arthritis can come either from very physical work causing damage to joints, or from genetics, or from age.
Regardless of why arthritis happens, it can cause stiffness and pain. When joints are damaged enough to reduce the spaces where nerves exit the spinal column, radiculopathy is the result.
Second, osteophytes, or bone spurs, can cause this disorder and its symptoms. Bone spurs are growths of bone material that occurs when bone is damaged.
These growths can press on nerves, causing radiculopathy. They also can catch on joints during normal movements, reducing the range of motion.
Last, disc disease is a major cause of cervical spondylosis with radiculopathy. Our discs provide a cushion between joints and absorb shock. As we age, they become more brittle and thin, leaving less protection for the spinal cord and also less space for nerves to exact the spinal column.
In most cases, this disorder is caused by a combination of factors rather than just one thing. The most important thing to remember is that if you have this disorder, it is not your fault. Although there is no cure, there are many treatments that can alleviate symptoms.
Imaging and Other Diagnostic Tools
Medical experts at Medscape recommend several tests to make a cervical spondylosis diagnosis. First, they will likely do bloodwork to rule out infections, metabolic disorders, and other life-threatening diseases that can cause similar symptoms.
In addition, you will likely have imaging to look at the condition of the bones and discs in your spinal column. Some providers will use x-ray or CT scan as these are less expensive options that can show the condition of bones.
However, MRI is the preferred imaging modality as it also can show the condition of soft tissues such as discs.
This imaging is important because it will likely show damage related to changes in your bones. In addition, it will show if there is a rare disorder causing your symptoms such as a tumor.
Diagnosing radiculopathy, or impingement of nerves can be more complicated. In some cases, an MRI can show narrowed spinal canals and other structural issues that could cause nerve pain, numbness, and tingling.
Electromyography, or EMG, is the gold standard for diagnosing radiculopathy. This test electrically stimulates nerves and examines whether muscles react to this stimulation.
It can determine if symptoms such as numbness, tingling, and shooting pain are due to problems in the spinal cord or issues in the peripheral nerves themselves. Dr. Robert Whitten, a Physical Medicine and Rehabilitation specialist, explains how these tests work in this video.
In many cases, doctors can diagnose radiculopathy using physical examination skills. They can test reflexes and physical sensation to determine the extent and cause of nerve damage. This prevents patients from having to undergo more complicated and expensive tests such as EMG.
None of these tests can definitely make a diagnosis, but they can provide evidence. From these tests, a health care provider should be able to make a definitive diagnosis and treatment plan so patients can begin to get relief.
Treatment Options
Every treatment plan for this disorder is unique and tailored to the patient’s physical limitations and symptoms.
The Mayo Clinic recommends beginning with conservative treatments. These include anti-inflammatory medications, steroids, and muscle relaxants. Doctors also may try anti-depressant medications and anti-seizure medications that have been found to reduce nerve pain.
Pain medications such as opiates used to be commonly prescribed for cervical spondylosis with radiculopathy.
However, studies find that they only help for a very short amount of time and can have serious risks and side effects. For these reasons, most doctors no longer prescribe opioids for chronic musculoskeletal problems.
Physical therapy and gentle exercise are also highly effective for this kind of neck pain. Physical therapists can show patients how to stretch and strengthen their cervical spine so to relieve pain and stiffness.
Some patients have success with alternative remedies such as acupuncture. It is important to talk to your physician before trying these, as some may actually cause more damage to your spine.
Is Surgery a Good Option?
Surgery is not usually a first-line option for cervical spondylosis with radiculopathy. However, there are a few times when it is appropriate. If the condition is caused by bone spurs, removing them can immediately alleviate symptoms.
If damaged vertebrae or degenerated vertebral discs are a contributing factor, there are surgeries that can help. However, these surgeries are not uniformly effective and have extended recoveries, so most doctors will try other treatments first.
Some surgeries are used as a last effort when symptoms are debilitating but no other treatments have helped. These include spinal fusions, in which the cervical spine is strengthened with metal hardware and bone grafting.
Concerning Signs and Symptoms to Watch For
There are a few rare disorders that can mimic cervical spondylosis with radiculopathy. These include certain types of cancer and rare metabolic disorders. Much of the testing and imaging for this disorder is intended to rule out serious medical problems.
However, there are certain symptoms that people should watch for and report immediately. These include sudden loss of function, such as a sudden inability to walk or incontinence of the bowel or bladder. This disorder is chronic, so it should not cause sudden and severe changes such as this.
Sudden onset headache, facial droop, difficulty talking or swallowing, seizures, and other neurological symptoms require immediate medical care. These can indicate a tumor or stroke, both of which are emergency medical problems.
Cervical spondylosis with radiculopathy is usually not dangerous, but it can be painful and inconvenient. Once the cause of the disorder is identified, it can usually be treated successfully.
If you or a loved one have symptoms of this disorder, it is important to seek medical care and to follow the prescribed treatment plan exactly.
