What Is Cervical Spondylosis? 

Cervical spondylosis refers to the age-related wear and tear of the cervical vertebrae. It can lead to pain or stiffness in the neck and shoulder. It mostly occurs in people over the age of 50 years.¹ This condition can sometimes be referred to as arthritis or osteoarthritis of the neck. 

The human spine consists of 33 vertebrae, starting in the neck region and moving towards the buttocks region. The different types of spinal vertebrae are:² 

• Cervical: There are seven cervical vertebrae numbered C1 to C7. They are in the neck region and allow the movement of the neck (up, down or sideways) 
• Thoracic: There are twelve thoracic vertebrae numbered T1 to T12. They are in the chest region, and the ribs are attached to them.
• Lumbar: There are five lumbar vertebrae numbered L1 to L5. They are in the lower back region and support the upper spine.
• Sacrum: There are five sacrum vertebrae numbered S1 to S5. These bones fuse with hip bones to form the pelvic girdle while the baby is developing during pregnancy. 
• Coccyx: These are four in number, but they fuse to form one small bone which is attached to pelvic floor muscles and ligaments

Overview 

Cervical spondylosis is mostly seen in old age. But, the changes in the spine start around 30 years of age. It worsens as the person ages. Around 85% of people above the age of 60 are affected by cervical spondylosis. Most of the time, there are no symptoms. Some changes occurring in the spine due to natural ageing are discs losing their volume, ligaments thickening or cartilage wearing over time.¹ Some similar terms to cervical spondylosis are  

• Cervical spondylotic myelopathy (CSM) is a condition where the vertebral discs wear away with time and there is compression in the spinal canal, which results in the worsening of the symptoms. 
• Spondylitis refers to inflammation in one or more vertebrae 
• Ankylosing spondylitis refers to the fusion of vertebrae. 
• Spondylolysis refers to a break or trauma in the lower lumbar area of the spine. It is mostly seen in weightlifters or tennis players.
• Cervical spondylolisthesis refers to the condition where one vertebra slips out to the vertebra below it. 
• Radiculopathy refers to the pinching of nerves at the root.

Causes of cervical spondylitis 

Cervical spondylosis happens due to the changes in the spine due ageing of the body. Changes include: 

• Dehydrated discs: Discs are present between each vertebrae. The discs are flexible and filled with gel-like material that acts as a cushion to absorb any shock. As people age, the discs start thinning. This increases the contact between the vertebrae. 
• Herniated discs: The normal ageing process can cause cracks to appear on the exterior of the discs. This causes the discs to bulge out and pressurises the neighbouring tissues and spinal cord. This can lead to pain, numbness or tingling sensation.
• Osteoarthritis: Osteoarthritis causes the cartilage in the joints to degenerate rapidly over time
• Bone spurs: As the discs start to degenerate, there are abnormal bony growths along the edge of vertebrae. These bony growths can pinch the spinal cord sometimes. 

Signs and symptoms of cervical spondylosis 

Usually, there are no symptoms of cervical spondylosis. But, sometimes, people experience the following symptoms:

• Neck pain 
• Neck stiffness 
• Muscle spasms 
• Dizziness 
• Headaches 
• A popping sound while rotating the neck

Diagnosis of cervical spondylosis

If you feel you have symptoms of cervical spondylosis, it is better to consult your healthcare provider. Some tests that your healthcare provider might conduct to determine if you have cervical spondylosis include:¹

• X-ray: An X-ray can show the changes in the spine and indicate cervical spondylosis. X-rays can also show various other changes, such as bone spurs, cancers, tumours, fractures or infections.
• Magnetic Resonance Imaging (MRI): MRI uses magnetic fields to provide an image of the body. It shows not only bones but also soft tissues such as the spinal cord, discs, or cartilage. It can pinpoint the area of spinal compression or the area where the pain originates from
• Computed Tomography (CT): A CT scan is a radiological procedure which provides a detailed image of the body. A dye can be injected during the procedure, which can give a clear image of the spinal canal or spinal cord.
• Electromyography (EMG): EMG measures the electrical activity in the nerves. It can provide details about the effects of cervical spondylosis on the nerves.

Management and treatment for cervical spondylosis 

There are different options to manage the pain and symptoms of cervical spondylosis depending on its severity. Medications, therapy, surgery, lifestyle changes or home remedies can be beneficial in managing cervical spondylosis. Some of the management techniques are:¹

• Non Steroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications such as ibuprofen or paracetamol can ease neck pain or neck stiffness due to spondylosis.
• Massage: Heat or ice massage can be applied to the neck region where it pains. Heat or ice should be applied for 15-20 minutes at a time.
• Steroid injections: Sometimes, steroid injections can be given to relieve the pain and symptoms caused by cervical spondylosis. Cervical epidural steroid injection, cervical facet joint block and radiofrequency ablation can be helpful in relieving symptoms.
• Therapy: Some exercises might relieve the symptoms of neck pain due to cervical spondylosis. Physical therapy can stretch and strengthen the muscles and improve posture. The exercises might vary depending on the symptoms.
• Brace: In some cases of cervical spondylosis, a therapeutic collar or brace is prescribed. This limits the movement of the neck and helps the muscles to recover. But, make sure to follow the guidelines as excessive use of brace might be harmful 
• Acupuncture: Acupuncture is also helpful in treating neck pain due to spondylosis
• Surgery: Surgery is recommended when the symptoms worsen. In cases of cervical myelopathy (spinal cord is compressed) and cervical radiculopathy (spinal nerve being pinched by disc), surgery can be opted for

Risk factors 

Some of the risk factors for cervical spondylosis are:

• Injuries: Any injuries to the neck area can increase the chances of cervical spondylosis
• Age: Cervical spondylosis mostly occurs in people above the age of 60 years
• Heredity: Some people are more susceptible to cervical spondylosis if someone in their family suffered from it
• Smoking: Smoking is an injurious habit which causes endless health troubles. One of them is cervical spondylosis
• Occupational risk: Some jobs which put excessive stress on the neck can increase the chances of cervical spondylosis

Complications 

Generally, there are no symptoms of cervical spondylosis. But, in severe cases, there might be symptoms and pain in the neck region. If the symptoms are left untreated, there might be permanent damage due to spinal cord compression. This can increase your risk of developing complications like: 

• Cervical myelopathy (A collection of symptoms due to the compression of the spinal cord)
• Cervical radiculopathy (the compression and inflammation of any of the nerve roots of your neck)

FAQs

How can I prevent cervical spondylosis? 

There are no proven methods to prevent cervical spondylosis. However, self-care, like sitting and sleeping in the correct posture, regular exercises, and preventing any stress on the neck, can be beneficial in preventing cervical spondylosis.

How common is cervical spondylosis? 

Cervical spondylosis is common in people over the age of 60 years. Almost 85% of the population above 60 years suffers from this.¹

When should I see a doctor?

If you experience symptoms like neck pain, tingling in the arms, muscle weakness or trouble walking, then you should contact a doctor.

Summary 

Cervical spondylosis refers to general wear and tear of the cervical vertebrae. The human spine is made up of 33 vertebrae, starting from the neck to the buttocks region. The seven cervical vertebrae (C1-C7) in the neck area allow for neck movement. This condition is mostly observed after the age of 60 years, previous neck injury, family history, smoking, or any occupation which puts stress on the neck. Generally, there are no symptoms of cervical spondylosis, but in severe cases, symptoms experienced are neck pain, neck stiffness, muscle spasms, dizziness, headaches, and popping sounds during neck movement. 

Cervical spondylosis can be caused by herniated discs, dehydrated discs, bone spurs, or osteoarthritis. If you experience symptoms, please contact your healthcare provider. Your healthcare provider will diagnose you by using X-rays, MRI, CT scan or electromyogram.

Once diagnosed with cervical spondylosis, you will be started with treatment. The treatment provided will depend on the severity of your symptoms. 

Over-the-counter medications such as ibuprofen or paracetamol can help relieve neck pain. Physical therapy exercises might be recommended depending on the condition of the patient. Hot or cold massages for 15-20 minutes can be applied for some relief. Acupuncture and steroid injections are also given in some cases. Using a therapeutic neck brace can also help in relieving the pain in some cases. In severe cases, surgery is performed. But, care should be taken to follow the guidelines provided by the doctor.