Cervical Spondylosis

What is cervical spondylosis?

Cervical spondylosis is a type of degenerative disease that affects your neck. Normally, soft disks between the bones in your spine (vertebrae) give cushioning. With cervical spondylosis, these disks become squeezed (compressed). Also the facet joints and ligaments of your spine become larger and thicker. As a result, your neck becomes more stiff over time.

When this happens, the connective tissue (cartilage) that lines the vertebrae on each side of the disk where they touch can wear away. Once this protective cartilage is gone, bony growths called bone spurs may form on your vertebrae where they rub together. Nerves attached to your spinal cord may have less room to pass between the vertebrae on their way out of the spine. The spinal canal is also narrowed, which can compress or reduce blood flow to the spinal cord. This can cause weakness in the arms and legs and problems with bowel and bladder function.

What causes cervical spondylosis?

This condition becomes more common with age. But many people don't have symptoms. You may not even know that these changes are going on in your neck.

Cervical spondylosis usually doesn't lead to disability. But sometimes these changes in the spine can cause the spinal cord or nerve roots attached to it to become compressed. This can cause your legs or hands to feel weak or clumsy.

Who is at risk for cervical spondylosis?

You may be at higher risk for cervical spondylosis if you:

• Are older in age

• Had an injury to the neck

• Have a family history of cervical spondylosis

• Smoke

• Have a job that needs repetitive neck movements

What are the symptoms of cervical spondylosis?

Symptoms of cervical spondylosis can include:

• Pain in the neck that may travel to your arms or shoulders

• Headaches

• Discomfort when you move your neck

• Weakness in your arms and legs

• Numbness in your shoulders, arms, or hands

• Stiff neck

• Trouble keeping your balance, especially when walking

• Trouble controlling your bladder or bowels

How is cervical spondylosis diagnosed?

Your healthcare provider will give you a physical exam to see if you have this condition. You will likely discuss any neck injuries you've had and describe your symptoms. The healthcare provider will likely check your neck, shoulders, arms, and legs to see how well they're working. Other tests that may help make a diagnosis include:

• Imaging tests. X-rays, MRIs, and CT scans all provide images of the structures in your spine for the healthcare provider to see. These can show the bones, disks, muscles, and nerves in and around your neck, as well as your spinal cord.

• Myelography. During this test, the healthcare provider injects a dye into the fluid around your spinal cord. Then a CT scan is done to see how the bone spurs and disks are interacting with the nerves.

• Electromyography. This test shows how well your nerves are passing along signals from your spinal cord to your muscles.

• DEXA scan. This is done to find out your bone density.

• Blood work. May be done to eliminate other causes of your symptoms.

How is cervical spondylosis treated?

Your healthcare provider can recommend a variety of treatments for pain relief from this condition, depending on your needs. These may include:

• Medicines. Nonsteroidal anti-inflammatory drugs, such as ibuprofen or aspirin may help, as well as opioid pain relievers and muscle relaxants.

• Physical therapy. A physical therapist can teach you stretching and strengthening exercises that may ease symptoms.

• Ice or heat. Cool your neck with an ice pack or heat it with a warming pad as directed by your healthcare provider or physical therapist.

• Collar. Wearing a soft collar around your neck for short periods may help your symptoms. But it can cause your neck to get weak if you wear it too long.

• Shots. A healthcare provider can inject steroid medicine and pain-relieving medicines into the painful joint in your neck. Or the medicines can be injected into the space next to your spinal cord.

• Surgery. In most cases, surgery is not needed. But surgeons can do different procedures to ease pressure on the spinal cord or the nerves leaving your spine, if needed. A surgeon can remove bone from around the opening that allows the nerve to exit the spine. Or the surgeon can remove bone from other parts of the vertebrae. The surgeon may also fuse bones in the spine after one of these procedures. If you have surgery, an anesthesia provider will put you to sleep beforehand so you don't feel it.

What can I do to prevent cervical spondylosis?

You may not be able to prevent cervical spondylosis. But these steps may lower your risk:

• Stay physically active.

• Use good posture.

• Prevent neck injuries by always using the right equipment and the right form when exercising or playing sports.

• Try not to injure your neck.

• Don't smoke.

How do I manage cervical spondylosis?

Talk with your healthcare provider about the best nonsurgical ways to help ease your symptoms. The best choice may be a combination of medicine and physical therapy.

Key points about cervical spondylosis

• Cervical spondylosis is a type of degenerative disease that affects your neck. The soft disks between the bones in your spine become squeezed.

• This condition becomes more common with age. But many people don't have symptoms.

• Symptoms can include neck pain, a stiff neck, arm and shoulder pain, or incontinence.

• Many treatments are available, including medicine, physical therapy, ice or heat, shots, and surgery. Sometimes a combination of treatments works best.

• To reduce your risk, stay active, use good posture, and prevent neck injuries.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.