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Bone and Spine

Orthopedic health, conditions and treatment

Cervical Spondylosis- Causes, Presentation and Treatment

By Dr Arun Pal Singh

In this article
    • Anatomy and Pathophysiology
    • Pathoanatomy
    • Presentation of Cervical Spondylosis
    • Differential Diagnosis
    • Lab Studies
    • Imaging in Cervical Spondylosis
      • MRI
      • CT and CT Myelography
    • Treatment of Cervical Spondylosis
      • Nonoperative treatment
      • Drugs
      • Lifestyle Modification
      • Surgical Treatment
    • References

Cervical spondylosis is a term for degenerative changes (wear and tear) of the vertebral discs and facets 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.

Cervical Spondylosis often progresses with age and frequently involves multiple levels.

Though it is a natural degenerative process of the cervical motion segment it may lead to clinical conditions like cervical radiculopathy [radiating pain in the regions supplied by cervical spine nerves],  cervical myelopathy [due to progressive stenosis], and cervical disc disease.

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 the congenitally fused spine, cerebral palsy, Down syndrome etc may be risk factors for cervical spondylosis.

Anatomy and Pathophysiology

Read Detailed Anatomy of Cervical Spine

The cervical spine is formed by the seven vertebrae which are named C1 to C7.

Atlas or C1 vertebra along with the Axis (C2) forms the joint connecting the skull and spine and are specialized to allow a greater range of motion.

axis-vertebra-1

 

axis-vertebra2

 

C3 to C7 vertebrae have a relatively uniform anatomic configuration but are quite different than C1 and C2 vertebrae.

  • The vertebral body is larger in coronal than its sagittal diameter and separated by intervertebral discs
  • The upper surface of the vertebral body is concave transversely
    • The lower surface is concave from front to back
  • The transverse processes are each pierced by the foramen transversarium [not consistent in C7]
  • From vertebral bodies, pedicles project from anteromedial to the posterolateral direction.
  • Facet joints
    • Superior articular facets face backward, upward, and slightly medially
    • The Inferior facets are forward, downward, and slightly laterally.
  • The laminae arise from the posteromedial border of the lateral masses project posterior and toward the midline to form bifid spinous processes.
  • The spinous process is short and bifid.
    • C7 has an enlarged spinous process called vertebra prominens.

Ligaments and muscles provide stability and motion.

From the spinal cord, at each vertebral level spinal nerves exit through neural foramina to supply their respective regions.

Boundaries of neural foramen are

  • Anteromedially – uncovertebral joints
  • Posterolaterally – facet joints
  • Superiorly –  pedicle of the superior vertebra
  • Inferiorly- pedicle of the lower vertebra
  • Medially-  Edge of the endplates and the intervertebral discs.

The foramina are largest at C2-C3. they progressively decrease in size down to C6-C7.  Spinal nerve occupies 25-33% of the foraminal space.

The spinal nerves exit above their correspondingly numbered vertebral body from C2-C7.

The first nerve C1 is between the occiput and the atlas (C1) and the eighth nerve exits between C7 and T1.

Pathoanatomy

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.

There is a loss of hydration and elasticity with age leading to fissures.

Ligaments also lose the water content and develop bony spurs due to traction.

The cracks lead to biomechanical incompetence of the disc causing the annulus to bulge outward. This reduces disc space and overriding of facet joints.

This leads to increased motion at that spinal segment, leading to further damage.

The changes may lead to a decrease in the area of the canal due to hypertrophy of facet joints and ligamentum flavum. Facet joint hypertrophy and hypertrophy of the uncinate process of the vertebral body cause a decrease in intervertebral foraminal space posterolaterally and anterolaterally respectively.

Intervertebral foramina is the canal through which the nerve root comes out of the spine.

Marginal osteophytes then begin to develop due to stress. The process could be hastened by trauma or long term heavy use of the neck.

The osteophytes tend to stabilize the vertebral bodies and increase the weight-bearing surface of the vertebral endplates.

Mostly asymptomatic, these osteophytes may cause compression on nearby muscles, ligaments, or nerves to cause pain in the neck and surrounding area. The involvement of a nerve leading to pain and other symptoms in the upper limb is called cervical radiculopathy.

 

Cervical Spondylosis with severe anterior osteophytes cervical spine
Cervical Spondylosis with severe anterior osteophytes cervical spine

Degradation of intervertebral discal proteoglycans also causes irritation of nerve root leading 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.

The 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

Cervical spondylosis presentation depends on the severity and duration though all cases do not progress. The spectrum of the presentation can be

  • Cervical pain
  • Cervical radiculopathy
  • Cervical spondylotic myelopathy

Intermittent neck and shoulder pain [Cervical pain] is the most common complaint in cervical spondylosis.

The pain is often accompanied by stiffness, with radiation into the shoulders or skull.

When the degeneration causes compression of nerves it could lead to sensory and motor dysfunction [pain, numbness and weakness].

The patients with cervical pain usually have symptoms due to degenerative disc disease, pain in facet joints or ligamentous lesions leading to ligamentous instability.

  • Neck pain and/or suboccipital headaches
  • The pain may radiate to shoulder, scapula or arm
  • The pain may interfere with sleep

Paresthesiae may accompany pain in the cervical region, the upper limb, shoulder or interscapular region. Radiation to the chest may also occur.

Cervical radiculopathy occurs due to the compression of cervical nerve roots.

The symptoms are

  • Radiating pain to the upper limb when sensory fibers are affected
  • Muscle weakness when there is the involvement of motor nerve fibers

Cervical myelopathy is often seen in severe spondylosis of long-standing origin. It has a different combination of symptoms consisting of a motor and sensory loss depending on the part of the cord involved.

Physical examination reveals neck stiffness and numbness in the affected root. Neural findings aer often seen in myelopathy.

Differential Diagnosis

  • Cervical Myofascial Pain
  • Whiplash Injury
  • Brachial Plexopathy
  • Normal aging associated weakness
  • Vitamin B12 deficiency

Lab Studies

Lab studies are mostly not needed and are often normal.

Imaging in Cervical Spondylosis

Routine anteroposterior and lateral x-rays of the cervical spine demonstrate

[See what is normal in cervical spine x-ray]

  • Loss of cervical lordosis
  • Disc space narrowing
  • Osteophytes
  • Facet joint arthritis
  • Degenerative changes of uncovertebral joints
  • Endplate sclerosi

Other findings that should be looked into for there presence or absence

  • Sagittal diameter
    • Normal is about 17mm
    • <13mm causes cord compression

Oblique view of the cervical spine is done to look for

  • foraminal stenosis [Often due to uncovertebral joint arthrosis]

Flexion-extension views may be needed to detect cervical spine instability and look for compensatory subluxation above or below the spondylotic stiff segment.

MRI

MRI is not 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.

MRI is the best modality to evaluate the health of neural structures like nerve roots and spinal cord. Therefore it has greater role in cervical radiculopathy and myelopathy than cervical pain.

It can reveal disc protrusion and provides direct imaging in multiple planes.

The findings of MRI need to be correlated clinically to avoid false-negative and false-positive results.

CT and CT Myelography

CT is useful to provide a better bony definition, osteophytes and also reveals ossification of the posterior longitudinal ligament.

CT myelography can provide a good amount of information on degrees of spinal cord compression and can be done in patients where MRI cannot be done [as in patients with metal implants or pacemakers]

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.

In general, the treatment of cervical spondylosis can be nonoperative or operative.

Nonoperative treatment

Neck Immobilization

Immobilization of the neck can be done by

  • Soft cervical collar
  • Philadelphia collar
  • Rigid orthoses
  • Minerva jacket [rare]

The orthoses are worn as long as long as possible during the daytime. With the improvement of symptoms, the wearing of orthoses should be during strenuous activity.

Prolonged use of orthoses may reduce muscle tone and cause neck stiffness from disuse.

Drugs

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 the above drugs or do not tolerate nonsteroidal anti-inflammatory drugs or have moderate-to-severe pain due to significant structural spondylosis.

Gabapentin and pregabalin are also effective on nerve pains.

Lifestyle Modification

Lifestyle modifications include

  • Posture improvements
  • Ergonomic changes in the workplace
  • Neck relaxation methods to avoid strain on cervical spine techniques to avoid strain on the cervical spine.

Other Measures

  • Physical therapy
  • Neck strengthening
  • Balance and gait training
  • Cervical traction

Surgical Treatment

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 choice of surgical method depends on the site and extent of the compression. These are

  • Foraminotomy
  • Anterior cervical discectomy with fusion
  • Cervical disc replacement

Laminoplasty is a procedure used for cervical myelopathy.

References

  1. Kuo DT, Tadi P. Cervical Spondylosis. StatPearls. 2020 May
  2. Kuijper B, Tans JT, van der Kallen BF, Nollet F, Lycklama A Nijeholt GJ, de Visser M. Root compression on MRI compared with clinical findings in patients with recent-onset cervical radiculopathy. J Neurol Neurosurg Psychiatry. 2011 May. 82(5):561-3.

 

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Filed Under: Spine

About Dr Arun Pal Singh

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab.

This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.

You can follow him on Facebook, Linkedin and Twitter

Reader Interactions

Comments

  1. Piyush Updhyay says

    November 28, 2008 at 12:19 pm

    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.

  2. Dr Arun Pal Singh says

    November 28, 2008 at 5:15 pm

    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.

  3. Trisha says

    January 21, 2009 at 4:24 am

    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.

  4. Dr Arun Pal Singh says

    January 21, 2009 at 7:53 am

    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?

  5. Sandrine says

    June 14, 2009 at 12:51 am

    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.

  6. Dr Arun Pal Singh says

    June 16, 2009 at 9:48 pm

    @Sandrine,
    I think you should visit a physician. you might have beginning of cervical spondylosis.

    take care

  7. Stephanie Wells says

    November 21, 2009 at 4:29 am

    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.

  8. Dr Arun Pal Singh says

    November 21, 2009 at 8:49 pm

    @Stephanie Wells,

    Your symptoms are on right and foraminal narrowing on left.

    How are they related?

  9. Jyoti says

    December 20, 2009 at 4:20 am

    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.

  10. Dr Arun Pal Singh says

    December 22, 2009 at 5:35 am

    @Jyoti,
    You should see a spine surgeon.

  11. alaikya says

    January 11, 2010 at 8:14 pm

    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

  12. Dr Arun Pal Singh says

    January 12, 2010 at 3:30 pm

    @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.

  13. Kola says

    February 11, 2010 at 10:34 pm

    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?

  14. Dr Arun Pal Singh says

    February 18, 2010 at 8:14 pm

    @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.

  15. david says

    March 11, 2010 at 3:06 pm

    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

  16. Dr Arun Pal Singh says

    March 18, 2010 at 6:33 am

    @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.

  17. Manikyam says

    April 7, 2010 at 7:29 pm

    Hi,

    Is Hands(palm,fingers) SWELLING happens with Cervical spondylosis?

    Thanks

    Manikyam

  18. Dr Arun Pal Singh says

    April 8, 2010 at 12:02 am

    Usually it does not happen.

  19. june shirley says

    April 30, 2010 at 8:07 pm

    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.

  20. Dr Arun Pal Singh says

    May 10, 2010 at 8:22 am

    @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.

  21. june shirley says

    May 10, 2010 at 3:00 pm

    Dear Dr. Thank u so much. what is the treatment for it. My age is 43.

  22. Dr Arun Pal Singh says

    May 10, 2010 at 8:54 pm

    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.

  23. leela says

    June 11, 2010 at 11:15 am

    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.

  24. Dr Arun Pal Singh says

    June 16, 2010 at 5:47 pm

    @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.

  25. rahul khatri says

    July 30, 2010 at 11:53 am

    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

  26. Dr Arun Pal Singh says

    August 2, 2010 at 8:30 pm

    @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.

  27. ginette says

    September 10, 2010 at 12:12 am

    Hello,I have cervical spondylosis and wondered if lifting light weights as part of my exercise regime would cause further damage? Many Thanks.

  28. Dr Arun Pal Singh says

    September 28, 2010 at 3:39 am

    @ginette,

    They should not.

  29. amy says

    October 24, 2010 at 12:59 am

    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

  30. vlatko says

    November 8, 2010 at 11:20 am

    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

  31. vlatko says

    November 8, 2010 at 11:22 am

    P.S. I am 22 years old :)

  32. Dr Arun Pal Singh says

    November 11, 2010 at 5:48 pm

    @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.

  33. Dr Arun Pal Singh says

    November 14, 2010 at 1:19 pm

    @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.

  34. Dr Arun Pal Singh says

    November 14, 2010 at 1:19 pm

    @vlatko,
    OK

  35. DK says

    November 22, 2010 at 8:03 pm

    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

  36. Dr Arun Pal Singh says

    November 27, 2010 at 6:29 pm

    @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.

  37. Bodhisattwa Mukherje says

    September 14, 2011 at 4:09 am

    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

  38. Dr Arun Pal Singh says

    September 14, 2011 at 5:52 pm

    @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.

  39. Varun Pratap Singh says

    October 29, 2011 at 6:58 am

    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.

  40. Dr Arun Pal Singh says

    November 19, 2011 at 5:41 pm

    @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.

  41. Juv says

    February 21, 2012 at 2:07 am

    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!!!

  42. victoria says

    February 28, 2012 at 2:05 pm

    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?

  43. Dr Arun Pal Singh says

    March 29, 2012 at 6:38 am

    @Juv,

    You seem to have cervical spondylosis. Have you consulted a physician?

  44. juv says

    April 14, 2012 at 2:32 am

    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:(:(

  45. Dr Arun Pal Singh says

    April 18, 2012 at 2:06 pm

    @victoria,

    If your medications are not helping, yes. surgery can be considered.

    Have you discussed it with your doctor.

  46. SWATI AGGARWAL says

    April 25, 2012 at 7:58 pm

    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.

  47. dewdrop says

    May 8, 2012 at 4:49 am

    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?

  48. Omer says

    May 30, 2012 at 11:50 pm

    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

  49. Dr Arun Pal Singh says

    June 7, 2012 at 2:32 pm

    @SWATI AGGARWAL,

    I think you should either see an orthopedician or neurosurgeon.

  50. Manikyam T says

    June 7, 2012 at 7:22 pm

    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

  51. maliha says

    June 21, 2012 at 6:50 pm

    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??

  52. Dr Arun Pal Singh says

    June 23, 2012 at 5:35 am

    @Manikyam T,

    No its not but that does not rule out absence of CS either.

  53. Omer says

    June 25, 2012 at 8:07 pm

    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

  54. Dr Arun Pal Singh says

    July 1, 2012 at 8:37 am

    @dewdrop,

    May be but the diagnosis would be made by the doctor you see in person.

  55. Dr Arun Pal Singh says

    July 6, 2012 at 1:27 pm

    @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.

  56. Dr Arun Pal Singh says

    July 6, 2012 at 1:51 pm

    @Omer,

    I think I have responded. If your query is not resolved, please feel free to ask again.

  57. muriel thornton says

    August 6, 2012 at 6:38 pm

    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?

  58. victoria says

    September 7, 2012 at 8:40 am

    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

  59. Dr Arun Pal Singh says

    September 13, 2012 at 1:10 am

    @muriel thornton,

    What is exactly meant by lifting the head up? What is the limitation.

  60. Dr Arun Pal Singh says

    September 13, 2012 at 10:11 pm

    @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.

  61. Anna says

    November 1, 2017 at 10:36 am

    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.

  62. Dr Arun Pal Singh says

    November 21, 2017 at 6:11 am

    Would this help?

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