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Cervical spondylosis

What is cervical spondylosis?

Cervical spondylosis is a degenerative, or wear-and-tear, condition affecting tissue and bones in the neck.

A person with cervical spondylosis is likely to experience neck pain, stiffness and headaches.

The discs of the cervical spine in the neck gradually break down, lose fluid and become stiffer.

Around 90% of adults will experience some degree of cervical spondylosis by the time they reach their 60s.

What are the risk factors for cervical spondylosis?

Ageing is the major factor for developing cervical spondylosis. In most people 50 years old, the discs between the vertebrae become less spongy and provide less of a cushion. Bones and ligaments get thicker, encroaching on the space of the spinal canal.

Another factor might be a previous injury to the neck. People in certain occupations or who perform specific activities such as gymnasts or other athletes may put more stress on their necks.

Poor posture might also play a role in the development of spinal changes that result in cervical spondylosis.

What are the symptoms of cervical spondylosis?

The symptoms of cervical spondylosis include:

  • Neck stiffness and pain
  • Headache that may originate in the neck
  • Pain in the shoulder, arms or chest
  • Grinding noise or sensation when the neck is turned

Symptoms of cervical spondylosis tend to improve with rest. Symptoms are most severe in the morning and again at the end of the day.

If cervical spondylosis results in pressure on the spinal cord (cervical stenosis), it can damage nerves, a condition called cervical myelopathy. Symptoms of cervical spondylosis with myelopathy include:

  • Tingling, numbness and/or weakness in the arms, hands, legs or feet
  • Lack of coordination and difficulty walking
  • Abnormal reflexes
  • Muscle spasms

Another possible complication of cervical spondylosis is cervical radiculopathy, when changes in bone structure, for example formation of bone spurs, causes pressure on nerves as they exit the bones of the spinal column. Pain shooting down into one or both arms is the most common symptom.

How is cervical spondylosis diagnosed?

Your doctor will generally begin by asking you about your symptoms and looking at your medical history. This will be followed by a physical examination of the body, with a focus on the neck, back and shoulders to find sore spots. The doctor is also likely to test reflexes and watch you walk. An abnormal gait caused by difficulty walking is one of the symptoms.

Other tests that might be done include imaging such as X-rays, computerised tomography (CT) and magnetic resonance imaging (MRI) of the spine. You might also be referred to a neurologist.

What are the treatments for cervical spondylosis?

In most cases cervical spondylosis treatments are conservative. They include:

  • Rest
  • Use of nonsteroidal anti-inflammatory medicines ( NSAIDs) or other non-narcotic products to relieve pain from inflammation
  • Chiropractic manipulation that can help to control episodes of more severe pain
  • Wearing a cervical collar to limit movement and provide support – this should only be for short-term use (no longer than a week unless medically advised to wear it for longer) as long-term use can worsen symptoms.
  • Other forms of physiotherapy, including the application of heat and cold therapy, or exercise
  • Injecting medicine (corticosteroids and a local anaesthetic) into the joints of the spine
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