Cervical spondylosis is a term used to describe the gradual wearing down of cartilage, vertebral discs, ligaments, and the bones in the human neck. Common symptoms often manifest as increased neck pain and stiffness.
Sometimes called arthritis or osteoarthritis of the neck, early cervical spondylosis symptoms might be managed with directed physical therapy including icing, heat, and massage. Some mild to moderate cases might require the use of a soft collar and prescription medications. In a more severe case such as herniated disk, bone spurs, or pinched nerves, are treated with injections or surgery.
The Structures of the Cervical Spine
The human spine is made up of 24 vertebrae seven of which are known as the cervical spine of the neck. The cervical spine begins at the base of the skull and continues down protecting the spinal cord. Each of these vertebrae is cushioned by special vertebral discs that essentially act like the body’s shock absorbers. The disks are made of flexible but strong connective tissue filled with a gel-like material.
Each vertebra in the cervical spine has three important joints. The front joint is called the intervertebral disk. Two joints in the back of the spine are called facet joints. Residing in each of these joints is cartilage, which cushions the ends of bones. Ligaments are soft bands of tissue that work with other connective tissues and muscles to help hold the cervical vertebrae together.
Cervical spondylosis is the natural wearing down of these structures. As the natural cartilage wears out over time, the discs start to decrease in volume, which causes them to become dried and cracked, ligaments may thicken, and bone spurs may form where bones rub against each other in areas that are no longer covered with cartilage.
Is Cervical Spondylosis Common?
The natural aging process can easily affect the structures of the surgical spine. Minor signs of cervical spondylosis can start as early as your 30s and by age 60, almost 90% of people have some degree of cervical spondylosis.
Increased Risk Factors For Cervical Spondylosis
While the natural process of aging is the primary cause of cervical spondylosis, there are other genetic and lifestyle factors that can put you at greater risk of developing it or developing it at an earlier age. This includes things like:
- Cigarette smoking
- Family members with cervical spondylosis
- A profession that causes a lot of neck strain
- A previous neck injury, such as a car accident.
- A job with a lot of heavy lifting
- A job where you are exposed to a lot of vibrations
Contributing Factors of Cervical Spondylosis
Cervical spondylosis can affect a number of different structures in the neck and can include other conditions such as:
Disc Degeneration
As the spinal disks in your neck may slowly wear down, discs become thinner. As time goes on the soft tissue progressively loses elasticity. Many people with disc degeneration also notice that they are shorter than they were in the past.
Disc Herniation
The natural process of aging can cause part of your spinal disk to tear or crack. Disc herniation allows the disk to bulge out, pressing on nearby tissue or a spinal nerve. With this type of pressure, you might experience pain, tingling, or numbness.
Osteoarthritis
This is a progressive condition where the cartilage in your joints degenerates (wear down with time). With osteoarthritis, cartilage degenerates faster than with normal aging.
Bone Spurs
As the cartilage in the joints of each vertebra starts to degenerate it can cause bone tissues to rub directly against one another. This promotes abnormal bone growths along the edges of vertebrae, known as osteophytes or bone spurs.
What Are Common Symptoms of Cervical Spondylosis?
Many people start developing cervical spondylosis and do not even know it. Though symptoms tend to increase as the condition progresses. They include:
- Neck pain or stiffness
- Persistent soreness in the neck.
- Muscle spasms in the neck and shoulder muscles
- A clicking, popping, or grinding sound when moving your neck
- Occasional dizziness
- Headaches with no obvious other sources
How Is Cervical Spondylosis Diagnosed?
Diagnosing cervical spondylosis starts with your physician performing a physical exam to find the cause of your neck pain or other symptoms. The severity of your symptoms will help determine how much pressure your cervical spine might be under. During a physical exam, your healthcare provider may check
- The overall flexibility of your neck
- The strength and reflexes in your hands, arms, or legs
- Your peripheral reflexes.
- Your walking gait
If you present with significant signs of cervical spondylosis they will likely perform some X-rays. If more diagnostic imaging is required they will refer you for an MRI or a CT scan. This will reveal the details of soft tissues such as cartilage, nerve roots, muscles, spinal cord, and disks.
How Is Cervical Spondylosis Treated?
The treatment strategy for your cervical spondylosis will be based on your symptoms as well as the presence or absence of other conditions such as bone spurs, osteoarthritis or a history of herniated discs in the neck.
Mild to moderate cases of cervical spondylosis might only require physical therapy, followed by at-home stretching exercises. Your physician or physical therapist might also recommend heat, cold, or massage therapy.
If you don’t start to experience significant improvement in your symptoms more stringent treatment might be necessary. This might include targeted steroidal injections, or prescription pain management medications.
For a more advanced case, your physician might advocate a treatment plan that calls for wearing a soft collar or a brace. It is designed to limit neck movement and help strained muscles rest and recuperate. However, using a brace for too long can lead to muscle atrophy (wasting away). Only use a collar under the guidance of a medical professional.
Treating Moderate to Severe Cervical Spondylosis
If your symptoms are more significant or you haven’t responded well to mild therapeutic methods, then your physician might recommend a strategic nerve block. The location for the block will be based on the diagnostic condition of your cervical spondylosis.
A Cervical Epidural Block is usually called for to address neck or arm pain due to cervical disc herniation can be treated with an injection of a combination of a steroid and anesthetic.
A Cervical Facet Joint Block is a steroid plus anesthetic injection is made into small joints at the affected segments of the cervical spine.
A Media Branch Block & Radiofrequency Ablation is often used to both diagnose and treat chronic neck pain related to cervical spondylosis. It involves damaging the nerves with sound waves that are causing pain in the joint.