Locations Main Campus: Chesterfield, MO 63017   |   Locations
314-434-1500 314-434-1500   |   Contact Us

Multimedia Encyclopedia


 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Cervical spondylosis

Cervical osteoarthritis; Arthritis - neck; Neck arthritis; Chronic neck pain; Degenerative disk disease

 

Cervical spondylosis is a disorder in which there is wear on the cartilage (disks) and bones of the neck (cervical vertebrae). It is a common cause of chronic neck pain.

Causes

 

Cervical spondylosis is caused by aging and  chronic wear on the cervical spine. This includes the disks or cushions between the neck vertebrae and the joints between the bones of the cervical spine. There may be abnormal growths or spurs on the bones of the spine (vertebrae).

Over time, these changes can press down on (compress) one or more of the nerve roots. In advanced cases, the spinal cord becomes involved. This can affect not just the arms, but the legs as well.

Everyday wear and tear may start these changes. People who are very active at work or in sports may be more likely to have them.

The major risk factor is aging. By age 60, most people show signs of cervical spondylosis on x-ray. Other factors that can make someone more likely to develop spondylosis are:

  • Being overweight and not exercising
  • Having a job that requires heavy lifting or a lot of bending and twisting
  • Past neck injury (often several years before)
  • Past spine surgery
  • Ruptured or slipped disk
  • Severe arthritis
  • Small fractures to the spine from osteoporosis

 

Symptoms

 

Symptoms often develop slowly over time. But they may start or get worse suddenly. The pain may be mild, or it can be deep and so severe that you are unable to move.

You may feel the pain over the shoulder blade. It may spread to the upper arm, forearm, or fingers (in rare cases).

The pain may get worse:

  • After standing or sitting
  • At night
  • When you sneeze, cough, or laugh
  • When you bend the neck backwards or walk more than a few yards or more than a few meters

You may also have weakness in certain muscles. Sometimes, you may not notice it until your doctor examines you. In other cases, you will notice that you have a hard time lifting your arm, squeezing tightly with one of your hands, or other problems.

Other common symptoms are:

  • Neck stiffness that gets worse over time
  • Numbness or abnormal sensations in the shoulders or arms
  • Headaches , especially in the back of the head

Less common symptoms are:

  • Loss of balance
  • Pain or numbness in the legs
  • Loss of control over the bladder or bowels (if there is pressure on the spinal cord)

 

Exams and Tests

 

A physical exam may show that you have trouble moving your head toward your shoulder and rotating your head.

Your health care provider may ask you to bend your head forward and to each side while putting slight downward pressure on the top of your head. Increased pain or numbness during this test is usually a sign that there is pressure on a nerve in your spine.

Weakness or loss of feeling can be signs of damage to certain nerve roots or to the spinal cord.

A spine or neck x-ray may be done to look for arthritis or other changes in your spine.

MRI of the neck is done when you have:

  • Severe neck or arm pain that does not get better with treatment
  • Weakness or numbness in your arms or hands

EMG and nerve conduction velocity test may be done to examine nerve root function.

 

Treatment

 

Your doctor and other health professionals can help you manage your pain so that you can stay active.

  • Your doctor may refer you for physical therapy. The physical therapist will help you reduce your pain using stretches. The therapist will teach you exercises that make your neck muscles stronger.
  • The therapist can also use neck traction to relieve some of the pressure in your neck.
  • You may also see a massage therapist, someone who performs acupuncture, or someone who does spinal manipulation (a chiropractor, osteopathic doctor, or physical therapist). Sometimes, a few visits will help with neck pain.
  • Cold packs and heat therapy may help your pain during flare-ups.

A type of talk therapy called cognitive behavioral therapy may be helpful if the pain is having a serious impact on your life. This technique helps you better understand your pain and teaches you how to manage it.

Medicines can help your neck pain. Your doctor may prescribe nonsteroidal anti-inflammatory medicines (NSAIDs) for long-term pain control. Opioids may be prescribed if the pain is severe and does not respond to NSAIDs.

If the pain does not respond to these treatments, or you have a loss of movement or feeling, surgery is considered. Surgery is done to relieve the pressure on the nerves or spinal cord.

   

 

Outlook (Prognosis)

 

Most people with cervical spondylosis have some long-term symptoms. These symptoms improve with non-surgical treatment and do not need surgery.

Many people with this problem are able to maintain an active life. Some people will have to live with chronic (long-term) pain.

 

Possible Complications

 

This condition may lead to the following: 

  • Inability to hold in feces ( fecal incontinence ) or urine ( urinary incontinence )
  • Loss of muscle function or feeling
  • Permanent disability (occasionally)
  • Poor balance

 

When to Contact a Medical Professional

 

Call your provider if:

  • The condition becomes worse
  • There are signs of complications
  • You develop new symptoms (such as loss of movement or feeling in an area of the body)
  • You lose control of your bladder or bowels (call right away)

 

 

References

Fast A, Dudkiewicz I. Cervical degenerative disease. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 3.

Kshettry VR. Cervical spondylosis. In: Benzel EC, ed. Spine Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 82.

Takagi I, Eliyas K, Stadlan N. Cervical spondylosis: an update on pathophysiology, clinical manifestation, and management strategies. Dis Mon . 2011;57:583-91. PMID: 22036114 www.ncbi.nlm.nih.gov/pubmed/22036114 .

 
  • Skeletal spine - illustration

    The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.

    Skeletal spine

    illustration

  • Cervical spondylosis - illustration

    Cervical spondylosis is a disorder that results from abnormal growth of the bones of the neck and degeneration and mineral deposits in the cushions between the vertebrae. Progressive neck pain is a key indication of cervical spondylosis. It may be the only symptom in many cases. Examination often shows limited ability to bend the head toward the shoulders and limited ability to rotate the head. The goal of treatment is relief of pain and prevention of permanent spinal cord and nerve root injury.

    Cervical spondylosis

    illustration

    • Skeletal spine - illustration

      The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.

      Skeletal spine

      illustration

    • Cervical spondylosis - illustration

      Cervical spondylosis is a disorder that results from abnormal growth of the bones of the neck and degeneration and mineral deposits in the cushions between the vertebrae. Progressive neck pain is a key indication of cervical spondylosis. It may be the only symptom in many cases. Examination often shows limited ability to bend the head toward the shoulders and limited ability to rotate the head. The goal of treatment is relief of pain and prevention of permanent spinal cord and nerve root injury.

      Cervical spondylosis

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Cervical spondylosis

         

         

        Review Date: 4/13/2015

        Reviewed By: Dennis Ogiela, MD, Orthopedic Surgery and Physical Medicine and Rehabilitation, Danbury Hospital, Danbury, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

         
         
         

         

         

        A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.



        Content is best viewed in IE9 or above, Firefox and Google Chrome browser.