Cervical spondylosis is the term used for general wear and tear of the spinal vertebrae in your neck. As you age, the vertebrae actually dehydrate and therefore shrink, and bone spurs and other symptoms of osteoarthritis begin to develop.
This form of spondylosis is quite common and does get worse as you get older. Additionally, there seems to be a genetic link because in some families, it will happen more often than it does in other families.
Over ninety percent of individuals over the age of 65 have x-ray evidence of cervical spondylosis and osteoarthritis that appears on x-rays of the neck. Typically, these people do not experience any symptoms of cervical spondylosis. However, when there are symptoms that occur, nonsurgical treatments are usually the best option- and are very effective.
Symptoms of Cervical Spondylosis
Most of the time, cervical spondylosis actually has no apparent symptoms. When the symptoms do occur, however, they usually only affect the neck, leading to stiffness and pain.
Cervical spondylosis sometimes narrows the space that is needed by the spinal cord and nerves that originate at the spinal cord, passing through the spine and through the rest of your body. If your spinal cord or nerve roots are pinched, you could experience symptoms such as
- Tingling, weakness, and numbness in your legs/feet or arms/hands.
- Overall lack of coordination and difficulty with walking.
- Loss of bowel/bladder control.
Please note that if you experience a sudden onset of weakness or numbness or loss of bowel/bladder control, you should seek medical attention immediately.
Causes of Cervical Spondylosis
As you get older, your bones and cartilage that make up your spine- from your back to your neck- develop wear and tear. There’s nothing you can do to stop this- it’s a natural part of life. Some of the changes you are likely to experience are:
Dehydrated Discs- discs are cushions between the vertebrae that make up your spine. By the time you reach the age of 40, your spinal disks have begun to dry out and even shrink- which allows the vertebrae to have more bone on bone contact.
Herniated discs- age is also a factor in affecting the exterior of the spinal discs. Quite often, cracks will appear, which cause herniated or bulging discs- which typically press on the nerve roots and spinal cord.
Bone Spurs- often, disc degeneration will cause the spine to produce extra bone, referred to as bone spurs, in an effort to strengthen the spine. These spurs actually can end up pinching the nerve roots and spinal cord.
Stiff Ligaments- your bones are connected by cords of tissue known as ligaments. As you get older, these begin to calcify and stiffen, which makes your neck much less flexible.
Risk Factors for Cervical Spondylosis
There are several risk factors for developing cervical spondylosis. These include:
Age- cervical spondylosis is actually a normal part of the aging process. Over the years, your spinal discs dehydrate and shrink.
Occupation- there are certain careers/jobs that actually cause extra stress/pressure to be put on your neck. This can include lots of overhead work, repetitive motions of your neck, and putting your neck in awkward positions.
Neck Injuries- the risk of developing cervical spondylosis is increased if you have had previous neck injuries.
Genetic Factors- though not fully understood as of yet, there seems to be a genetic link in families who have multiple members that develop cervical spondylosis.
Complications of Cervical Spondylosis
If your nerve roots or spinal cord becomes extremely compressed due to cervical spondylosis, the damage can actually be permanent.
Diagnosing Cervical Spondylosis
Your physician will check the range of motion for your neck during a physical examination. In order to see if there is pressure on your spinal cord or nerves, he/she will test your reflexes and also check muscle strength. Additionally, your physician may want to watch you walk to see if spinal compression has affected your gait.
Using Imaging to Test for Cervical Spondylosis
There are several different imaging tests that can be used to offer details and guidance in diagnosing and treating your cervical spondylosis.
X-Ray of the Neck- an x-ray will reveal any abnormalities, for example- bone spurs, that are indicative of cervical spondylosis. Primarily, this is ordered to check for rare, but serious causes for neck stiffness and pain, such as infections, fractures, or even tumors.
CT Scan- a CT scan takes multiple x-rays from many different directions, and then puts them together to create a cross-sectional view of the structures that are in your neck. A CT gives much greater detail than a typical x-ray- especially when it comes to your bones.
MRI- an MRI uses radio waves and a magnetic field to produce a detailed cross sectional view of both your bones and soft tissues. This helps to point out the areas where nerves could be getting pinched.
Myelogram- this particular test involves injecting a special dye into the spinal canal and then generating images using x-rays or CT scans. The dye makes the areas of your spine much more visible.
Tests for Nerve Function
Sometimes, imaging tests simply aren’t enough- it is helpful to find out if the nerve signals are properly traveling to your muscles. These tests include:
Electromyogram, or EMG- this test reveals the electrical activity in your nerves as they transmit messages to your muscles when they’re contracting and when they’re at rest. The whole reason to do an EMG is to figure out the health of your muscles and the nerves that are controlling them.
Nerve Conduction Study- electrodes will be attached to your skin just above the nerve that is being looked at for this test. A small shock will then be passed through that nerve in order to measure the speed and strength of nerve signals.
Treatment for Cervical Spondylosis
The treatment path for your cervical spondylosis will depend on how severe your signs and symptoms are. The whole goal of treatment is to relieve pain, prevent permanent injury to your nerves and spinal cord, and to help you to maintain your usual activities as much as possible.
Medications
You should first try over the counter analgesics or anti-inflammatory medications. However, if those do not work, your physician could suggest the following:
- Muscle Relaxers
- Anti-seizure Drugs
- Narcotics
- Steroid Injections
Therapy for Cervical Spondylosis
Your physician may suggest that you visit a physical therapist to learn some exercises to strengthen and stretch your neck and shoulder muscles. In some cases, individuals with cervical spondylosis could benefit from traction, which helps to give more space in the spine if your nerve roots are being pinched.
Surgery for Cervical Spondylosis
If the above more conservative treatments don’t work or if your signs and symptoms are getting worse instead of better, you may need to consider surgery as an option. This will create more room for your nerve roots and spinal cord. This could involve removing bone spurs or a herniated disk, or even the removal of a portion of a vertebrae.
