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It affects the discs and joints located in the cervical spine, the neck region of the body.
Spondylosis is also known as cervical spondylosis, neck arthritis, or cervical osteoarthritis .
This is a very common age-related health condition.
Generally, the conditions associated with cervical spondylosis arise from the regular wear and tear of the bones and cartilage located in the neck region.
While cervical spondylosis occurs primarily due to age, it can also be caused by additional factors.
In cases of spinal spondylosis, some individuals may experience dizziness, stiffness, and chronic and severe pain in the neck region.
However, in some cases, people with cervical spondylosis have been reported to engage in normal daily activities with minimal or no symptoms.
Causes of spondylosis
The protective cartilage and bones that are present in the neck region are very prone to wear out during the course of daily life.
This could lead to a condition such as spondylitis or cervical spondylosis. Some of the possible causes of spondylosis include:
Bone spurs
Overgrowth of bones in the neck or spine area could be because the body is trying to grow some extra bone to strengthen the spine.
However, the growth of extra bones could begin to put pressure on the delicate areas of the spine, including the surrounding spinal cord, nerves, and muscles, causing pain and discomfort.
Herniated discs
This happens due to the development of cracks in the spinal discs.
These cracks allow the internal material required for damping to leak.
The material could press on the nerves and spinal cord and thus lead to symptoms of spondylosis, including pain radiating to the arms and numbness.
Dehydrated spinal discs
The bones of the spine contain discs between them. The discs are thick, rice cushions that help absorb the impact of twisting, lifting, and other rigorous activities.
The presence of the gel-like material between the discs of the bones in your spine may dry out over time.
This would lead to the bones in the spine called the vertebrae rubbing against each other, which could cause immense pain.
This process usually begins at the age of 40.
Injury
When a neck injury has been sustained during an accident or fall, this could accelerate the aging process of the spinal cord that leads to spondylosis.
Risk factor’s
Several factors can accelerate the process of spinal degeneration. Some are related to movement and include:
- Injuries
- High impact sports.
- Vehicle accidents.
- Falls
- Repetitive movement
- Labor manual.
- Holding the neck in an awkward position for an extended period of time.
- Excessive use.
Other underlying factors that do not involve exercise but increase risk are:
- Genetic predisposition to spinal abnormalities.
- Family history of back pain.
- Previous spinal surgery.
- Overweight or obese
- Smoking.
- Excessive use of alcohol.
- State of malnutrition.
- Sedentary lifestyle.
- Presence of benign or malignant tumors.
The condition of spondylosis is more frequent in people older than 60 years, they are 85 percent more likely to develop the conditions of cervical spondylosis than young individuals.
In addition to age being an important factor, other factors such as accidents or injuries can also contribute to the symptoms associated with cervical spondylosis.
Spondylosis symptoms
In most cases, people who have cervical spondylosis do not report having any major symptoms.
When symptoms of cervical spondylosis do occur, they can range from mild to severe and can also develop gradually or even instantly.
One of the most common symptoms associated with cervical spondylosis is pain around the shoulder blade.
Some people may complain of pain in the entire arm and fingers as well.
Pain in such cases may increase while standing, lifting heavy objects, constantly sitting, sneezing, tilting the neck back, and other specific positions.
Some of the other common symptoms related to cervical spondylosis can include:
- Stiff neck muscles.
- Constant headaches that usually occur towards the back of the head.
- Numbness or tingling that affects the arms and shoulders, could also occur in the legs.
Diagnosis of spondylosis
During the physical and neurological exam, the doctor closely watches the patient’s spine and range of motion while leaning forward, backward, and side to side.
The doctor notices the shape of the spine, including any abnormal curvatures.
The spine is palpated to detect any tender spots, muscle tension or spasms, bumps, or areas of inflammation.
Also, pain is thoroughly evaluated along with other symptoms such as paresthesia, weakness.
When making the diagnosis of cervical spondylosis, it is essential that the doctor rule out the possibility of fibromyalgia.
The diagnostic process to control spondylosis would involve going through specific tests to determine the ease of movement that affects the surrounding muscles, nerves, and bones.
Some of the typical tests used to diagnose cervical spondylosis include imaging tests such as X-rays, CT scans, MRI, electromyogram among others.
X-rays can detect bone spurs or loss of disc height.
Your doctor may order a CT scan or MRI to look at degenerative changes and soft tissue abnormalities in your spine.
Of course, depending on the patient’s symptoms, other types of tests may be recommended.
Complications of spondylosis
- Spinal nerve injury.
- Neck injuries
- Paralysis.
Treatment for spondylosis
Treatment for spondylosis would focus on minimizing pain and reducing the risk of causing permanent damage.
Although spondylosis can be very painful, most patients respond favorably to nonsurgical treatments.
Treatments for spondylosis target back pain and neck pain.
Therefore, the treatment of spondylosis is similar to the treatment of back and neck pain.
The available treatments are divided into several categories: medications, self-care, exercise and physical therapy, complementary therapies (chiropractic and acupuncture), minimally invasive procedures such as injections and finally surgery.
Medicines
Treatment of spondylosis pain commonly includes anti-inflammatory medications, analgesics (pain relievers), and muscle relaxants.
Nonsteroidal anti-inflammatory drugs can be very effective in relieving back and neck pain from spondylosis.
Some of these medications, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), are available without a prescription.
Other non-steroidal anti-inflammatory drugs require a prescription and can be prescribed by a healthcare professional.
Muscle relaxants, such as cyclobenzaprine (Flexeril) and tizanidine (Zanaflex), are examples of prescription medications that can relieve muscle spasm associated with spondylosis.
Pain relievers, such as acetaminophen (Tylenol) and tramadol (Ultram), are used to treat pain.
If the pain is extremely severe, a narcotic medication (Norco, Vicodin among others) is sometimes prescribed for the first few days.
Fish oil is known to be anti-inflammatory and has been shown to improve several conditions, such as heart disease and rheumatoid arthritis.
Certain antidepressants are helpful in treating chronic back pain.
Medications called tricyclic antidepressants, which include amitriptyline (Elavil) and doxepin (Sinequan), have been used for many years, in low doses, to treat chronic back pain, neck pain, and other pain.
Recently, another antidepressant, duloxetine (Cymbalta), has been shown to improve chronic back pain.
Some people find that topical medications, which are massaged directly into the location of the pain, are helpful in relieving the pain of spondylosis.
These drugs work in different ways, and many are available without a prescription.
Some examples of topical medications include Aspercreme, which contains aspirin and is anti-inflammatory.
Capsaicin cream is another topical medication that many find helpful.
Capsaicin is the active ingredient in chili and should not be used in areas where the skin is cut or irritated.
physical therapy
A doctor may prescribe physical therapy for back or neck pain that does not resolve on its own after a few weeks.
Physical therapy is often prescribed for chronic back or neck pain for muscle strengthening and stretching.
Physical therapists can demonstrate specific exercises that, when performed daily, can help strengthen your back and abdominal muscles and prevent recurring pain.
Physical exercise on a regular basis, specifically walking and yoga, has been shown in studies to be beneficial for chronic back pain.
Chiropractic spinal manipulation can be helpful for some people, especially during the first month of pain.
However, certain patients should not undergo spinal manipulation for safety reasons.
Specifically, patients with inflammatory arthritis involving the spine, such as ankylosing spondylitis and, in some cases, rheumatoid arthritis, should not undergo spinal manipulation because of a small but serious risk of spinal cord damage.
Acupuncture for back pain involves inserting very thin needles at various depths into specific areas of the body.
The placement of the needle is designed to balance chi, which is believed to flow in meridians throughout the body.
Acupuncture studies for back and neck pain have had mixed results.
Other alternative therapies, such as homeopathic treatments, have not been shown in studies to improve the symptoms of spondylosis.
Training
Stretching and warm-up exercises (as tolerated) help prepare the patient for active exercise.
Strengthening exercises can help improve spinal flexibility, build strength, and endurance.
To help reduce pain, the patient may be advised to lose weight.
Steroids
Steroids (cortisone) can be injected into the epidural space (the space around the spinal cord).
This is commonly known as an epidural injection. Steroids can also be injected into the facet joints that connect the vertebrae, trigger points in soft tissue, or directly into the intervertebral disc spaces.
These procedures may play a role in managing acute pain, especially radicular pain, radiating to a limb.
Other procedures for back and neck pain include:
- Intradiscal injections (injection of cortisone directly into an intervertebral disc).
- Trigger point injections of steroids, anesthetics, or both.
- Steroid injection into the facet joint.
- Steroid injection into the sacroiliac joints.
- Injection of steroids into the piriformis muscle for piriformis syndrome and radiofrequency denervation (destruction of painful nerves by means of a radiofrequency current), among others.
Surgery
Spondylosis is a chronic condition.
Surgery for patients with chronic low back pain is controversial, as while some studies show improvements in pain and disability, most studies show no improvements compared to non-surgical treatment, such as physical therapy and management of pain. pain.
Also, many patients continue to have chronic back pain after surgery.
However, surgery is sometimes necessary when spondylosis or spinal stenosis causes a nerve problem that is severe or causes progressive nerve damage or difficulty walking.
Surgery is rarely necessary in patients with acute back pain, unless progressive neurological problems develop.
This is because most patients improve dramatically after treatment with medications and physical therapy, and most patients improve within a few days or weeks after the back pain begins.
Spinal decompression surgery involves various surgical procedures that can relieve pressure on the nerves in the back due to spinal stenosis, herniated intervertebral discs, or foraminal stenosis (narrowing of the openings between the facet joints due to bone spurs).
Common techniques for decompression include the following:
- Laminectomy is a procedure to remove the bony arches of the spinal canal (lamina), subsequently increasing the size of the spinal canal and decreasing the pressure on the spinal cord.
- Diskectomy is a procedure to remove a part of an intervertebral disc that is putting pressure on a nerve root or the spinal canal.
- Foraminotomy or foraminectomy is a procedure to expand openings for nerve roots to exit the spinal canal. During a foraminectomy, more tissue is usually removed than during a foraminotomy.
- Osteophyte removal is a procedure to remove bone spurs from an area where they are causing pinching of nerves.
- Corpectomy is a procedure to remove a vertebral body and discs.
- Fusion of the vertebrae is sometimes combined with one or more of these procedures to stabilize the spine.
