Cervical Spondylosis

Cervical spondylosis is age-related wear and tear of the discs and joints of the neck. It is very common after the age of 40, and many people have these changes on an X-ray without any symptoms. When symptoms do occur, they range from simple neck stiffness to pressure on the nerves or the spinal cord.

Symptoms

• Neck only: stiffness, aching that is worse in the morning or after long use, and a grinding feeling on turning the head
• Nerve root pressure: pain, tingling or numbness spreading into the shoulder, arm or fingers
• Spinal cord pressure (myelopathy): clumsy hands, difficulty buttoning clothes or writing, dropping objects, unsteady walking, and electric-shock sensations down the back when bending the neck

Dizziness is often blamed on cervical spondylosis, but it usually has other causes and should be checked properly.

Causes

• Natural ageing: the discs lose water and height, and bony spurs (osteophytes) form
• Thickening of the ligaments inside the spinal canal
• Carrying loads on the head, repeated neck movements or long hours of desk work
• Previous neck injury, smoking and family tendency

Diagnosis

A careful examination of the neck, arms and legs looks for signs of nerve root or spinal cord involvement, including changes in reflexes, hand function and walking. X-rays show disc space narrowing, bony spurs and alignment. An MRI is the key test when there is arm pain, weakness or any sign of myelopathy, because it shows exactly where the nerves or cord are compressed. Since X-ray changes are so common, treatment is guided by symptoms and examination, not by the X-ray alone.

Treatment

The wear itself cannot be reversed, but symptoms can usually be well controlled. For neck pain and stiffness, treatment includes pain-relieving medicines when needed, heat, a regular programme of neck and shoulder exercises taught by a physiotherapist, and attention to posture, pillow height and screen position. Staying active and stopping smoking also help. Arm pain often settles with the same measures, sometimes supported by nerve pain medicines or a targeted injection.

Spinal cord compression (cervical spondylotic myelopathy) needs special attention, because it tends to worsen gradually and lost hand and walking function may not fully return. When myelopathy is significant, surgery is usually advised to relieve the pressure and prevent further damage. Depending on the MRI, this may be done from the front of the neck, by removing discs or bone spurs and stabilising the spine, or from the back, by widening the spinal canal. Surgery is also considered for arm pain or weakness that does not improve with treatment.

When to Seek Urgent Care

• Increasing weakness or clumsiness of the hands
• Worsening balance, frequent falls or difficulty walking
• Loss of control over passing urine or stools
• Sudden worsening after a fall or minor neck injury, which can seriously affect an already narrow canal
• Neck pain with fever or unexplained weight loss

If any of these occur, go to the nearest emergency department immediately.

If you have been told you have cervical spondylosis, or notice changes in your hands or walking, consult Dr. Prashant Sharma at Keshav Super Speciality Hospital, Meerut, for a detailed evaluation.

Related Conditions

• Lumbar Spondylosis
• Slip Disc
• Spinal Nerve Pain (Radiculopathy)
• Spinal Paralysis
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