Cervical spondylosis, also known as cervical osteoarthritis or neck arthritis, can be a painful and debilitating condition, but with proper care and treatment, many people who suffer from it can lead normal lives.
Cervical spondylosis is common as people age. You don’t hear the term a lot because most people refer to it as either cervical osteoarthritis or neck arthritis. The condition impacts more than 85 percent of people over the age of 60. Some people have a mild case and experience few or no symptoms at all, while others have chronic, severe pain and stiffness. The condition is essentially one that affects the joints and discs in the neck.
Anatomy of cervical spine
The cervical region of the spine is located at the neck and made up of seven vertebrae. They are annotated by the letter “C” and numbered from one to seven. The first two cervical vertebrae, C1 and C2, are highly specialized and are given unique names: atlas and axis, respectively. The reason for these two vertebrae being of greater interest is they provide a unique set of articulations that provide a great degree of mobility for the skull. Approximately 50 percent of flexion-extension of the neck happens between the occiput of the skull and C1. Rotation of the neck happens between C1 and C2. Unlike other parts of the spine, the cervical region has a great range of mobility.
Prevalence of cervical spondylosis
Cervical spondylosis is the most common cause of non-traumatic spastic paraparesis and quadriparesis. One report found that 23.6 percent of patients presenting with non-traumatic myelopathic symptoms had cervical spondylotic myelopathy.
While no significant data has been produced, it appears that cervical spondylosis affects males earlier than females. One study using radiologic evidence found that the prevalence of cervical spondylosis in males was 13 percent in the third decade. This percentage reached nearly 100 percent by the age of 70 years. The prevalence in women was found to range from five percent in their fourth decade of life and 96 percent when they reached the age of 70.
Cervical spondylosis: Causes and risk factors
We all have bones and protective cartilage around our necks, which are prone to wear and tear. This wear and tear are what leads to cervical spondylosis. Just how the deterioration occurs varies from person to person. There can be many different causes of cervical spondylosis.
Bone spurs: Sometimes, an overgrowth of bone can occur as the body is trying to grow extra bone to help make the spine stronger. The extra bone can push against the spinal cord and nerves.
Dehydrated discs: Gel-like material inside the discs between bones can dry out over time. This causes bones to rub together. This drying out typically begins around age 40.
Herniated discs: Spinal discs can develop cracks, which allow cushion material to leak and press on the spinal cord and nerves.
Injury: A fall, a car accident, or any injury to the neck can speed up aging.
Ligament stiffness: Cords connecting the spinal bones can become stiff over time and make it difficult to move the neck.
Overuse: Early wear and tear can occur if someone’s occupation or hobbies involve repetitive movements or heavy lifting.
There are risk factors for cervical spondylosis to consider. While herniated discs, dehydration, and bone spurs are due to aging, there are other factors that can increase your risk of neck arthritis. For example, neck injuries can happen at any stage of life, work-related activities such as lifting can happen at various ages, as well as holding your neck in an uncomfortable position for long periods of time can lead to stress on the joint and ligaments. Studies show that genetics play a role, too. Those who smoke and those who are overweight are also at a higher risk of getting cervical spondylosis.
What are the symptoms of cervical osteoarthritis
As outlined above, cervical spondylosis symptoms are different for each individual. However, here’s a look at some common signs and symptoms.
- Neck stiffness
- Neck pain
- Headache (originating from the neck)
- Pain in the arms or shoulders
- Difficulty turning head or bending neck
- A grinding sensation or noise when turning neck
Unfortunately, there are some situations where cervical spondylosis results in pressure on the spinal cord. This is a condition called myelopathy. People with myelopathy may also experience some of the following symptoms.
- Tingling or numbness in arms, hands, legs, or feet
- Lack of coordination
- Abnormal reflexes
- Muscle spasms
Something called cervical radiculopathy is also possible. This occurs when bone spurs press on nerves as they exit the bones of the spinal column. This can lead to pain shooting down one or both arms.
If you or someone you know experiences sudden onset of numbness or tingling in the shoulder, arms, or legs, or has bladder control issues, medical attention should be sought as soon as possible.
Cervical spondylosis complications
Cervical Radiculopathy (Type I Syndrome)
Characterized by neck pain with radiation to the upper extremity causing pain, weakness, and/or numbness. This condition can be the result of a combined compression and inflammation of the spinal nerve.
Cervical Myelopathy (Type II Syndrome)
Characterized by weakness in all four extremities with a reduced or absent appreciation of pain, touch, vibration, or position sense. Reflexes may be normal or may exhibit a self-sustaining ankle clonus (rhythmic movement). Muscles appear to be rigid due to increased muscular tone. This may also extend to the muscular lining of the bladder, causing increased urinary frequency, especially at night.
Type III Syndrome
This condition encompasses a collection of different etiologies, but have in common a painful joint dysfunction in the spine. Type III syndrome is characterized by neck pain together with radiation to one or more of the following: the medial scapula, chest wall, shoulder area, and head.
How to diagnose neck arthritis?
A cervical spondylosis diagnosis usually comes after a doctor has ruled out other conditions. For example, some people may think they are suffering from cervical osteoarthritis, but they just might have fibromyalgia.
A physician will start by testing movement and determining if bones, muscles, or nerves are affected. An orthopedic specialist might be involved in the diagnosis. Once a physical exam is conducted, tests will likely be ordered. These tests are designed to examine a person’s reflexes, detect range of motion, check muscle weakness, and look for any sensory deficits. If cervical spondylosis is suspected, the following tests may be conducted.
- X-ray – checks for bone spurs or other abnormalities
- CT scan – provides detailed images of the neck
- MRI – helps locate pinched nerves and highlights certain areas of the spine.
- EMG (electromyography) – checks nerve functioning
- Nerve conduction study – checks speed and length of signals sent by nerves.
Treating cervical spondylosis
No one wants to live in constant pain or be restricted in daily activities. Treating cervical spondylosis is all about relieving pain and helping people maintain their normal activities. It is also about helping people prevent further injury or permanent spinal cord problems. Let’s look at some of the possible treatments, keeping in mind that the approach depends on the severity of each individual’s condition.
- Medications – Doctors may prescribe anti-inflammatories to relieve pain and inflammation, corticosteroids such as prednisone to ease pain, muscle relaxants to relieve muscle spasms in the neck, anti-seizure medications to dull pain in damaged nerves, prescription pain relievers like Percocet, or antidepressants that have been known to ease neck pain.
- Therapy – Physical therapists can guide a person through exercises to stretch and strengthen the neck. Some people benefit from the use of traction.
- Acupuncture – Stimulating certain points in the neck with needles to encourage pain relief.
- Surgery – This can involve removing a herniated disc or bone spur, removing part of a vertebra, or fusing a segment of the neck. Surgery is usually a last resort.
Change in lifestyle for cervical spondylosis
Of course, people want to avoid surgery, but some people also would rather turn to cervical spondylosis home remedies rather than traditional medications. Many people with mild neck arthritis have found that home remedies are very helpful. For example, people who are able to maintain some sort of exercise on a daily basis can do well. This could be something as simple as walking each day. Others find that heat or ice can bring great relief. Sometimes, a soft neck brace is just what the neck muscles need to rest. A neck brace should only be worn for short periods of time though, otherwise it will weaken neck muscles over time.
While we can’t stop the aging process, we can take steps to protect our skeletal structure. Many rheumatologists and orthopedic specialists suggest that we avoid constantly engaging in activities that put pressure on the neck, avoid lifting heavy weight when possible, take short breaks in-between work and other activities to give the neck a rest, meet our daily calcium intake, stay hydrated, and consume lots of fruits and green leafy vegetables.
Exercises for cervical spondylosis
The worst sleeping position is on your stomach as it causes your neck to turn away, leading to neck strain and misalignment of your joints all throughout the night. It is recommended to sleep on your back without a pillow to help promote the natural curve of the spine.
Start by sitting cross-legged on the floor with both feet on your thigh (padmasana). Raise your right hand sidewise until it’s shoulder level. Place your left hand on your left knee, making a ring with your thumb and index finger (gyan mudra). Now turn your head to the left side and hold this position. Repeat on the opposite side.
Start by sitting on the floor crossed legged (sukhasana) and resting both hands the knee while making a ring with your thumb and index fingers (gyan mudra). Close your eyes and slowing breathe in and out while you concentrate on your breathing. Do this 10 times and then rest.
Start by sitting on the floor crossed legged (sukhasana) and keeping your index finger on both hands inside their respective ears. Now close your eyes and utter the word “AUM” while exhaling. Do this 10 times.
Start by sitting cross-legged on the flow with both feet on your thigh (padmasana) and resting both hands the knee while making a ring with your thumb and index fingers (gyan mudra). Close your eyes and concentrate on a singular object. You can also focus on your breathing while you meditate for two minutes.
Neck stretches to the side
Begin by relaxing your shoulders and sit up straight and comfortably in a chair. Start to tilt your head slowly off to one side as if you wanted your ear to touch your shoulder. Go as far as you can without straining yourself and hold for 10 to 15 seconds. Slowly return back to center and complete this stretch on the other side.
Lay on the floor with a rolled towel behind your neck for support. Slowly bring your chin towards your neck while keeping your head on the floor. Hold this for six seconds then release for 10 seconds. Complete a few times.
Active cervical rotation
Sitting upright in a chair, slowly turn your head to look over your right shoulder. Keep your chin level and hold for 10 to 15 seconds before turning your head back center, looking ahead of you. Then complete this to your left side. Repeat a few times.
Shoulder blade squeeze
While standing, squeeze your shoulders as to bring them together. Avoid raising your shoulders and hold for six seconds then release. Repeat eight to 12 times.
Sitting or standing comfortably, roll your shoulders backward in a circular motion. Repeat two to four times.
- Sit with good posture when sitting for long hours in a chair or when standing
- Reduce tension on your neck and spine by practicing Pranayam and meditation
- drink milk and milk products as they are rich in calcium
- Avoid forward bending exercise. These may include jogging and running.
- Avoid caring heavy bags and avoid lifting weights
- Avoid sitting overly soft chairs or beds
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