Cervical spondylosis is a term for degenerative changes (wear and tear) of the vertebral discs of the cervical spine. It is considered to be a normal part of aging. It is not symptomatic in many people but may cause recurring neck pain.
Read Anatomy of Cervical Spine
In cervical spondylosis, the edges of the vertebrae often develop small, rough protrusions of the bone (osteophytes) which are in response to thinning of discs.
Mostly asymptomatic, these osteophytes may cause compression on nearby muscles, ligaments, or nerves to cause pain in the neck and surrounding area. Involvement of a nerve leading to pain and other symptoms in the upper limb is called cervical radiculopathy.
Cervical spondylotic myelopathy refers to changes in the cord due to cervical spondylosis that causes weakness of the hands and other parts of the body.
Cervical spondylotic myelopathy is discussed separately as its presentation is quite different.
Causes of Cervical Spondylosis
Age-related wear and tear is the biggest factor for the development of cervical spondylosis. However repeated occupational trauma like carrying loads, professional dancing, gymnastics etc. which put repeated strains on the neck may contribute.
Familial cases have also been reported suggesting possible genetic factors also. Smoking is another suggested risk factor.
Conditions that cause increased mobility or instability to a segment of the cervical spine like congenitally fused spine, cerebral palsy, Down syndrome etc may be risk factors for cervical spondylosis.
Pathophysiology of Cervical Spondylosis
Cervical spondylosis is the result of disc degeneration. With age, intervertebral discs lose water, fragment, and collapse. This causes increased mechanical stress at the cartilaginous endplates. This further causes bone formation under the periosteum. This is an attempt by the body to stabilize adjacent vertebrae.
Osteophytes may cause narrowing of the intervertebral foramina [A canal through which the nerve root comes out of spine] and irritation of nerve root. Degradation of intervertebral discal proteoglycans also causes irritation of nerve root. This would lead to cervical radiculopathy.
Cervical spondylotic myelopathy occurs when the changes in cord occur because of degenerative changes causing mechanical compression, spinal cord ischemia and stretch injury to the spinal cord. Patients with narrow spinal canal are predisposed to developing cervical spondylotic myelopathy. Space may be further worsened by hypertrophy of the ligamentum flavum, thickening of bone, degenerative kyphosis, and subluxation.
[Cervical spondylotic myelopathy]
Presentation of Cervical Spondylosis
Intermittent neck and shoulder pain is the most common complaint in cervical spondylosis. The pain usually comes and goes but may persist in some persons with occasional exacerbation.
The pain is often accompanied by stiffness, with radiation into the shoulders or skull. A headache, unilateral or bilateral upper limb may be involved. The pain may stop at the shoulder or occur till the fingers.
Paresthesiae may accompany pain in the cervical region, the upper limb, shoulder or interscapular region. Radiation to the chest may also occur.
Physical examination reveals neck stiffness and numbness in the affected root.
Lab Studies
Laboratory values are mostly normal in cervical spondylosis.
Imaging Studies
Routine anteroposterior x-rays of the cervical spine demonstrate loss of cervical lordosis, disc space narrowing, osteophytes, facet joint osteoarthritis etc.
CT and MRI are no routinely done for cervical spondylosis. MRI may be indicated in cases where radiculopathy is not amenable to treatment or in cases of spondylotic myelopathy to assess cord damage.
Treatment of Cervical Spondylosis
The pain of cervical spondylosis and Cervical radiculopathy usually resolves without intervention. The treatment includes neck immobilization, drug treatments, lifestyle modifications and physical modalities like traction, manipulation, and exercises.
Neck Immobilization
Soft collar, Philadelphia collar, rigid orthoses, and Minerva jacket are commonly used for immobilization of the neck. The collar is worn as long as possible during the daytime. With the improvement of symptoms, the wearing of collar should be during strenuous activity. Prolonged use of collar may reduce muscle tone and cause neck stiffness from disuse.
Drug Therapy
Nonsteroidal anti-inflammatory drugs are the mainstay of drug treatment for reducing inflammation and pain. Patients with chronic symptoms should receive tricyclic antidepressants like amitriptyline.
Muscle relaxants such as thiocolchicoside, tizanidine, carisoprodol, and cyclobenzaprine may help patients with neck spasms.
Use of opioid drugs is restricted to patients who are not relieved with above drugs or do not tolerate nonsteroidal anti-inflammatory drugs or have moderate-to-severe pain due to significant structural spondylosis.
Lifestyle Modification
Lifestyle modifications include posture improvements, ergonomic changes in the workplace, relaxation techniques to avoid strain on the cervical spine.
Surgery
Surgery is indicated in patients with
- Intractable pain [Pain that is not responding to treatment]
- Progressive neurologic deficits
- Documented compression of nerve roots or of the spinal cord
The aim of surgical treatment is decompression of the neural structures/spinal cord and fusion of the unstable spine.
The surgeries done are foraminotomy, anterior cervical discectomy with fusion, cervical disc replacement etc.
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I have problem with Cervical Spine sciene last 2 year, for that i am faceing problem of solder & nack pain, give me the proper solution.
Piyush,
When you ask for a medical advice, you should provide maximum possible information to the person from whom you seek the advice. Shoulder and neck pain can originate from many causes. Cervical spondylosis is one of them.
If you have not done yet, you must consult an orthopedician for check up and diagnosis.
We at boneandspine would like to help you but we do not have the information to work upon.
Moreover, we do not do the diagnosis making. That involves examination of the patient which cannot be done without meeting the person.
Get in tough with an orthopedican and follow his advice.
If you have any query you are always welcome to write to us.
I hope that helps.
I have been experiencing neck, shoulder and arm pain since a car accident in July of last year. I have had two MRI's and have tendonitis in my Supraspinatus and two partially degenerated discs in my neck… between c5 and c6 as well as between c7 and t1. They think the tendonitis is caused from loss of nutrition from nerves in the neck. I am only 29 years old, but am very active in skiing and grew up as a gymnast. My neck was pain free for the most part before the car accident, but it was weak from what I've learned. I have been in Physical Therapy, massage and chiro (have stopped the chiro) since July. In PT, we do light weights and manual therapy on my neck and shoulder. My neck has gotten so much stronger, which is great. So, I have seen some results, but still continue to get a lot of pain in my teres major area where my armpit meets my back, as well as in my tricep and down my arm into my pinkie finger. I also get numbing as the day goes on and lose heat in my arm and hand. I also have pain on the top of my shoulder between my neck and my arm, but most of that is the tendonitis I think. I just got the results of the neck recently and they put me in Prednisone for 12 days. I'm afraid of taking this because of the side effects and weight gain. Next step is injections. I will continue with PT 6 hours a week. Do you have any suggessions I should bring to my doctor or opinions about Prednisone orally? Thank you.
Trisha,
Do you have any pain on movements of shoulder especially when you lift it upwards as in saying Hail or goodbyeing?
When were you diagnosed to have tendonitis and what were your complaints at that time?
What were the reasons for putting you on steroids?
Were you ever put on traction?
How much better have you got after PT?
Hi there,
I have been having a lot of headaches, stiff neck, dizziness, backpain. When i finally got an x-ray done, it shows that my cervical spine is very straight instead of curved.
I would like to know if this is irreversible or if i can do anything?
thank u
Sandrine.
@Sandrine,
I think you should visit a physician. you might have beginning of cervical spondylosis.
take care
Dr. Singh,
I was recently in an MVI, on 11/11/09, where I was hit when a car trying to turn Right in a storm, hydroplaned and hit the L Front of my car. I unfortunately saw him coming and braced for impact. I have now been under Dr's care since then and have R. neck and shoulder pain, burning and tingling all the way down my R. Arm, mostly though in my neck and R. shoulder. I have had CT's and now an MRI today and just got the results of Foraminal narrowing due to Spondylosis, leftward @ c4-c5??
I know this is OA, but 1) I am only 41 yoa 2) I have never had any back or neck issues, ever 3) I do not have any Calcium deficiencies, and actually was told I had high levels of calcium from having calcium in our water where I grew up 4) I am not peri or menopausal and have my hormone levels checked every year and actually just did about 1 month ago!
I guess my question is, can this be exacerbated this bad from a minor MVA? I am in pain and want to get better and now I just want to cry! Thank you for your insight into this.
@Stephanie Wells,
Your symptoms are on right and foraminal narrowing on left.
How are they related?
Hi,
My mother was having pain in neck and spine about 6 yrs ago. She got operated ine spine as doctors says it was lumbar spondlysis.But no reduction in pain.
Now for the last 2 yrs she is having pain in legs . And now pain in arm and underarms.
Please help whom should we consult.
@Jyoti,
You should see a spine surgeon.
sir,
i am having cervical spondylytis. doctors r telling that i have to go for surgery because there is a problem in c5 and c6. but i am taking naturopathy for reducing the pain. i am afraid if i go for surgery i will gain more weight.. so can u plz give me a good suggestion.. i am unable to sleep at nights due to severe pain. and even severe pain at left shoulder and left side of the neck and the whole left hand. i am unable to bend my neck even back side or turn left side
@alaikya,
Discuss the things with you treating doctor and if you need another opinion, you may see a second doctor.
I will not be able to address your concerns as I cannot examine you.
Can cervical spondylosis give symptoms such as 'heat' in the lower back, buttock area and under the feet? other symptoms i feel include 'sensations in my fingers, feet, face and most parts of my body actually?
an xray i took also reports that there is a straightening of the cervical spine. what does this mean?
@Kola,
Usually cervical spondylosis does not give rise ot symptoms in lower back.
But other symptoms in upper back and hands can be due to cervical spondylosis.
Normally the cervical spine is curved with convexity on front side. When this convexity is lost, it is called straightening of cervical spine.
i was told when i was 25yrs old by a doctorthat i had spondylosis in my lower back.Ihave been working construction since ive been 17.Im now 47 yrs old and still working,but my back starting hurting really bad,an mri showed severe slippage and the disc are touching.I also have it in my neck,which causes terrible pain up the back of my head.The doctor is going to give me my first injection for my back in a couple of days.At first my main concern was getting back to work,i am very proud of never missing work,but now im wondering about disability,im only 47,how bad will this be in 5 yrs from now,ive been off work for 7 weeks resting and doing theropy with no results.Is it wrong of me to think of disability,i dont want to do more damage to my body,im already struggling now,i dont know how bad my neck is yet,he wants to deal with one thing at a time.please send me comments thank you
@david,
Per se spondylosis does not cause disability but if your work involves manual labour, you might find that difficult.
We cannnot predict the future also. Take precautions and you should recover.
Hi,
Is Hands(palm,fingers) SWELLING happens with Cervical spondylosis?
Thanks
Manikyam
Usually it does not happen.
Dear Dr,
I had a severe right hand pain, adding on to the neck and continuously i use to get head ache. I thought it could be gas and met a cardiologist who suggested me to go to a neurologist. i met the neurosurgen and a orhopaedic dr.
I had taken an xray for cervical spine lateral/flexion which says osteophytes at multiple levels.
Alignment is normal, cv juncition is normal, c1&c2 junction is normal intervebral disc space normal, prevertebral soft tissues are normal.
Medicine were pantocid, skelact and the other one neurbga. Just wanted to know if im going to bed ridden or disabled.
I'm little worried, I'm not married, I'm single, with no support. Will I be able to work on computers, Will I be able to work,walk and live a little loner.
@june shirley,
You seem to have cervical spondylosis and that is quite a common condition. You did not mention your age.
Cervical spondylosis is discomforting but does not cause neurological deficit that you are worried about inn most of the cases and in those too after long standing problem.
Dear Dr. Thank u so much. what is the treatment for it. My age is 43.
I cannot advise the treatment because I have not examined you personally. You would need to see a doctor who can examine you and then prescribe.
Generally speaking analgesics, posture improvement and physiotherapy are modalities of treatment.
hello sir,i'm suffering from the following problems since 2weeks. the problem started with fall in b.p and dizziness,the next day when i visited the doctor he gave me some medicines but after taking the medicine condition became more worse may be because it was too strong medicines. though my b.p was normal,but i had severe headache with fainting feeling and also had fever. again i visited the same doctor and he gave me some more medicines. this time condition was improved but not completely,i'm still suffering from dizziness,fainting feeling and generalised body weakness. i changed the doctor,he checked my b'p and temperature,and both were normal. he adviced me for an xray of cervical spine, which suggested marginal osteophyte formation with normal iv space,nd was diagnosed cervical spondylosis. but i'm not satisfied,please suggest me what should i do.
@leela,
While giddiness is a known occurrence with cervical spondylosis, I am unable to place dizziness in the given context.
I think you should see a specialist in medicine.
my mother is suffring cervical problem that mean she doesn't sleep well becuse during sleeping her neack pain start so please tell me how can we remove this problem and what is the good posture of sleeping
@rahul khatri,
The best advise I can give you is to see a doctor for the problem. This website does not diagnose or prescribe the treatment.
Hello,I have cervical spondylosis and wondered if lifting light weights as part of my exercise regime would cause further damage? Many Thanks.
@ginette,
They should not.
Hello…I was told by a neurologist that I have "bone slippage in my cervical spine" he concluded this after hearing my symptoms and reading the MRI. I am going to see a physical therapist for a consultation, and to see a neurosurgeon. My symptoms are a numb/tingling feeling on the left side of my head by my ear, and neck soreness. I am only 39 years old. He prescribed 1000mg of Naproxen daily, as well as Flexorill at night. Are these symptoms that can usually be reversed with physical therapy, and if so, how long does it typically take? My occupation is fairly physical, climbing ladders, lifting, etc. Will I be able to return to this occupation?
Thank you for any questions you can answer,
Amy
Hi!
I have cervical spondylosis at c3 and c4 and i feel stiff neck all the time, headache, back pain, pain in the left arm, chest pain. I did x-rays and it is confirmed that i have cervical spondylosis. I feel slight dizziness, for example when i am in one position for while than turn my head left or right i feel slight dizziness, and it happens very often. Also it happened twice that i felt dizziness while i was sleeping, and it woke me up, and my room was spinning a lot! So my question is: Is that kind of dizziness common for cervical spondylosis and can it happened if you are laying in some position that can cause the dizziness?
Thank you very much,
Best regards
P.S. I am 22 years old :)
@amy,
Most of your questioned would be answered themselves with time.
Quite a lot of them can be answered by your treating doc.
Physical therapy does help a lot of people and is mainstay of conservative treatment.
@vlatko,
Giddiness can occur in cervical spondylosis and usually manifests when position changes.
to determine if it is from cervical spine or from other surce, you need to get examined.
@vlatko,
OK
Dear Arun,
I have a pain in my right neck and Shoulder area . I consulted it with a Doctor, based on xray results he concluded that there is new formation of bone in my c.spine (Cervical Spine Lateral View) which disturbs my Neural networks in that area. I am 25 and a Software Engineer by Profession (Frequently using Bike for Transports).
My question is , Is it i need to under go a surgery or its curable with Medicines and exercises. I want a Permanent cure from this Pain.Kindly give your Suggestions.
Thank you very much
@DK,
You have what we term as cervical spondylosis.
You are quite young for this ailment. I presume it would be due to prolonged PC usage.
I am 29 yrs old. I undergo regular weight training. recently I have been diagnosed with cervical spondilysis. The inter vertebrae distance are nornmal but there are osteophytes in C-4 and C-5. I have been told that this is due to sitting in computers for long time I am under rest now. Will I be able to weight train in future. Please advise
@Bodhisattwa Mukherjee,
You would be put on physiotherapy soon in a normal course of treatment.
After that you can ask your physician if it is okay to move to harder exercises.
Hi Arun,
I am 25 years old and work in an IT company since last year, Novemeber 2010 I was experiencing back pain in my lower back near Lumbar curve and sometimes near sacral curve.
The pain is usually on the left hand side, that to the left of spine, near a bone. I was asked for a Sacrolaic joint (left) MRI which showed no inflamation. I also got X-Ray of my back. The diagonostic centre told me that my spine curve is straight.
I did phyiso excercises for 4 months continously, now the pain is less but, its always there. Now since I am young I am not able to struggle properly for my career. What should I do to get properly fit, I have physio sessions for 3 months with IFT, US and diathermic. What has happende to me. Is my curve problem so severe that i can't get normal. I see only straight curve in x-ray for which I was told to excercise. Will that curve be restored through excercise? I have been told yes, but it will take 1 year. Is that true. I have pain mainly near left sacroloaic joint.
Please guide as you have guided others too.
@Varun Pratap Singh,
This could be a long discussion. Would you please post your query at Bone And Spine Forum
Tell me about your occupation and number of hours you spend sitting in front of PC/laptop
You would be able to upload images as well. A registration {free} is required before you could post.
Hey,i am an 18 year old gal,i have bad pain in d nape of d neck which radiates to the left shoulder n hand,,,which is disturbing my sleep..xray says dr is straightening of cervical spine probably due to muscle spasm!is this something to do with cervical spondylitis?please help!!!
this is what my MRI showed
C4 — 5: Mild to moderate disc narrowing. Posterior disc protrusion. Mild central canal narrowing. Minimal mixed spondylitic foraminal narrowing on the right. Mild to moderate spondylitic foraminal narrowing on the left.
C5 — 6: Moderate disc narrowing. Broad posterior disc protrusion with moderate central canal narrowing. Mild cord deformity at this level. No abnormal cord signal. Mild to moderate left and moderate to severe right mixed spondylitic foraminal narrowing.
C6 — 7: Moderate disc narrowing. Broad posterior disc protrusion, mild central canal narrowing. Moderate foraminal narrowing bilaterally, left greater than right.
plus my neck is -10 degrees in the wrong direction and i am only 40yrs old
i have severe weakness on my right side along with bilateral numbness in both hands at night when i sleep enough that it wakes me at least 3x's a night. i am also experiencing needle pricks in my neck regularly and radiating pain in both arms. i seem to be dropping things more often and i have constant muscle strain. i am a home health worker who pulls and rolls a 240lb woman in bed. the more i do the greater the pain and with that an increase in muscle spasms. i have LORAZEPAM for the muscle spasms, PREDNISONE for inflammation, and now DILAUDID for pain. is surgery my only hope?
@Juv,
You seem to have cervical spondylosis. Have you consulted a physician?
Ya i did consult a doctor and he just prescribed pain kiler and a hard pillow..m a medicl stdnt n my other prob is m nt able to stand for a long time i have bad muscular dull aching pain nd joint pain feel lethargic and sleepy al d time:(:(
@victoria,
If your medications are not helping, yes. surgery can be considered.
Have you discussed it with your doctor.
Hello doctor,
My mom (51 years) is having severe pain and shivering in her left arm. We get MRI done. Its showing that her cervical spine is very straight instead of curved. We consulted with a neurologist and he suggested for some medicine and physio-therapy. Its been a month now but there is no improvement. Please suggest which type of doctor should i consult with? Should i consult with nuerologist, orthopadecian, or some other specialist. Please suggest.
one day morning i woke up and had neck and shoulder blade pain which persisted for a month and i went to seek advice from an ortho , he took an xray but nothing serious came in xray, he gave me the medicines saying that i should go for 5 days phsyotherepay and i should go for an MRI as it could be be the start of cervical spondylosis
i took teh medicines but there effect was temporary.
pain s shifing from shoulder to collar bone and sometimes burning sensation in my upper arm ans sometimes pain in my lower neck.
are these the symptoms of spondylitus?
Hi, I have been suffering from straightening of cervical spine for 6 months now. My main problem is not the neck tension/stifness but the daily headaches I get and it's been 6 months of these headaches/ neck spasm. I got MRI of spine and brain done and also MRV done. all results came out normal except for cervical spine MRI saying "straightening of cervical spine". I am 30 years old (male) and was a regular at the gym. I am not sure what caused by muscle spasm but it could be due to the following reasons:
a) workout at the gym combined with boot camp classes
b) sleeping position – i used to sleep on my chest with head sidewards and used to watch tv in the same position
c) I had been on Accutane (isotretinoin) for 4 months – I am not sure if this caused by neck spasm/straightening but I read online that isotretinoin has side effects but I couldn't really find if it causes muscle spasm.
I am on Lyrica 75 mg one tablet at night and it helps with my headache at night but i get a headache again in the afternoon the next day which usually last till the evening. I have been to every possible doctor – GP, Neurologist, Physiotherapist but my neck spasm is not going away.
Is straightening of cervical spine curable? it's been 6 months and constantly thinking of why this isn't resolving.
Please advise what I should do.
Thanks,
Omer
@SWATI AGGARWAL,
I think you should either see an orthopedician or neurosurgeon.
Hi Sir,
My sister suffer from CS and She is under medication.
She has her left palm swollen always. Is it a symptom of CS.
Thanks for your time.
Manikyam T
my father has been diagonised with cervical spondylosis…he is suffering from severe pain in neck and shoulder…I just wanted to know how long does this pain reside and whether this pain will reduce or not..??and what precautions shall he take for keeping the pain away??
@Manikyam T,
No its not but that does not rule out absence of CS either.
Omer says:
May 30, 2012 at 6:20 pm
Your comment is awaiting moderation.
Dear Dr Arun, would appreciate if you could please respond.
Thanks,
Omer
@dewdrop,
May be but the diagnosis would be made by the doctor you see in person.
@maliha,
The condition is treatable with medicine and exercises. And it is important not to strain the neck much.
Follow what your doctor has advised you.
@Omer,
I think I have responded. If your query is not resolved, please feel free to ask again.
I am 88, and about a year ago I had a bad attack of sciatica which hospitalised me for about a week. The sciatica is a lot better, but it has left me with a problem in lifting my head up, which I find very frustrating. Is there anything I can do to remedy this problem?
Dr Arun Pal Singh Reply:
April 18th, 2012 at 8:36 am
@victoria,
If your medications are not helping, yes. surgery can be considered.
Have you discussed it with your doctor.
my answer:
i did see a surgeon about my condition but he said i need to wait 5 to 10 more years before i do anything. my neck has begun causing nausea and vomiting
@muriel thornton,
What is exactly meant by lifting the head up? What is the limitation.
@victoria,
OK! You need to make a decision. And you need to consult someone in person who can help you to reach at a decision.
If you think that your present physician is not able to meet your expectation, seeking another opinion is an option.
Hi Dr. Arun, Helpful article. My age is 27 and i had a cervical strain. Could you please suggest me some tips related to my seating positions on chair while working on computer, posture or other exercise, healing tablets and all that are related to this.
Thanks in advance.
Would this help?