Cervical spondylosis & Neck pain

CERVICAL SPONDYLOSIS

What is cervical spondylosis?

Cervical spondylosis is a degenerative process and incidence of cervical spondylosis increases with aging.  With aging, there is wear and tear on the vertebrae (bones of the spine) and the disks between these vertebrae. Bony growths called osteophytes  (or spurs) and prolapsed  disc  cause compression over the nerves , blood vessels and the spinal cord.

What causes cervical spondylosis?

It is due to increased stress over the cervical  vertebrae which causes protrusion of the intervetebral disc , calcification of the ligaments and  osteoplytes formation . Osteophytes are the abnormal bony projection.

Stress over the vertebrae is mostly increased by prolong  work in sitting posture , lifting weight  over the head , wrong posture or due to old age.

What are the common symptoms of cervical spondylosis?

Cervical spondylosis  causes neck pain and stiffness that  may extend to the shoulder upper arms, hands  and  back of head.. Other common symptoms are : Numbness ( loss of feeling) , tingling or weakness  in the arms, hands, and fingers. Neck pain may worsen and there may be associated  headache and dizziness. Pressure over the spinal cord causes muscle weakness or muscle spasms and stiffness and weakness of the lowe limbs.

How to recognize Cervical  Spondylosis?

Any person who feels neck pain or stiffness of the neck muscles or sensory deficit or weakenss of the limbs should consult a doctor.

X-ray of the cervical spine  and MRI of the cervical spine are required to diagnose cervical spondylosis. Sometimes other investigations like Nerve conduction studies are required.

What are the treatment options?

Simple analgesics, anti spasticity drugs , physiotherapy, restriction of neck movements with cervical collar, can provide relief in early stages of cervical spondylosis..

Neurotrophic vitamins, help in the neural compression.

Sometimes surgery is required if patient does not improve with  conservative   management .

 Neurosurgical operations are required to treat disc prolapse, canal stenosis,  osteophytes  &     myelopathy and other  manifestation of cervical spondylosis.

Operative intervention prevents the  further neurological deterioration in a  patient of cervical spondylosis

Can  cervical spondylosis be prevented?

·           Improve your posture.

·           Use a firm chair and sit with  straight back.

·           Sleep without a pillow. Instead, use a cervical pillow, wear a soft fabric collar, or put a small rolled towel under the neck

·           You can prevent some neck injuries, which might help prevent the risk. Wear protective headgear for contact sports. Use seat belts in vehicles and keep headrests at proper height.

·           Excessive movements and neck  injuries to be avoided.

·           One should avoid lifting a very heavy object over his/her head.

·           The jerky massage  or chiropractic practice may  damage the cervical spine.

·           Regular exercise of the neck prevents the occurrence of cervical spondylosis.

·           Contact sports, like wrestling, football etc, increase the risk of neck injury so people with spondylosis should avoid contact sport.

·           Regular intake of neurotrophic vitamins ( vitamin B6, B12,Vitamin E) and wearing a cervical collar can prevent further deterioration of a patient.

·           Neurosurgical intervention cervical spine discoidectomy and fixation decreases the risk of developing myelopathy(card dmamage) is severe cases of cervical spondylosis.

What are the Rehabilitation options for patients with lumbar spondylosis?  

The physiotherapy measures include isometric exercise, tanscutanaeous  nerve stimulation, ultrasonic diathermy help in rehabilitation.

External immobilization like cervical collar is must for early mobilization of the cervical spondylotic patient.

Prosthesis Like spinal instrumentation, artificial disc prosthesis help in early rehabilitation of patient.

Ergonomic modification and  training in use of assistive and adaptive techniques to increase independence in ADL  prevent recurrence of  symptoms.

Training in simulated work and progressive repetitive tasks help to decrease spinal stress and build strength for specific activities.

Functional capacity evaluation is done to determine the strength ares and limitations.

Home modification is advised for safe performance of ADL activities.

Sources: IHBAS Delhi Team, Online Resources