Cervical Spondylitis: Symptoms, Treatment and Exercises

Cervical spondylosis, also known Cervical Spondylitis, is a common degenerative disease that affects the bones in the neck (vertebral bodies) and the intervertebral discs. It is usually a consequence of advancing age or undue mechanical stresses.

Symptoms of Cervical Spondylitis

Many people with cervical spondylosis have no symptoms whatsoever. 

In those who are symptomatic, pain and stiffness of the neck are common. The pain may vary from mild to severe. It may worsen with neck movements and or with activities such as reading and driving where the neck is held in the same position for a long time. 

Other symptoms include:

  • Headache

  • Muscle spasm

  • Creaking when turning your neck

  • Loss of balance

  • The weakness of the upper and lower limbs

  • Numbness of arms, hands, or fingers

  • In severe cases where the spinal cord is compressed, bladder and bowel function are impaired. 

  • If nerve roots arising from the spinal cord are compressed, the pain radiates to other areas of the body such as arms, shoulders, and head. 

Diagnosis of Cervical Spondylitis

After obtaining a brief medical history and physical examination, your doctor would recommend some tests. During the physical examination, your doctor will check your neck, shoulders, arms, and legs.  The examination will include testing of:

  • Strength of your arms, hands, and fingers

  • The flexibility of your neck and arms

  • Reflexes

  • Gait (how you walk)

  • Different types of sensations

 

Diagnosis of Cervical Spondylitis

Your healthcare provider will order some tests to confirm the diagnosis, including:

  • X-rays and Computed tomography (CT):  Give information about dense structures such as bones. It will provide information about the extent of  degenerative changes in the cervical spine  

  • Magnetic resonance imaging (MRI): Allows to show a better view of the nerves, discs, muscles, and spinal cord. 

  • Myelogram: A type of CT scan where a contrast dye is injected into the spinal canal for getting a better image of the spinal cord and nerve roots.

  • NCS (Nerve conductions Study) and Electromyography (EMG): Measures the electrical impulses in the nerves and evidence of involvement of muscles that they innervate. 

  • Blood tests

Treatment of Cervical Spondylitis

Most cases of cervical spondylosis are resolved by non-surgical treatment. However, some patients may require surgical intervention. 

Non-surgical treatment: 

  • Physical therapy: Performing specific exercises to ease the pain and to strengthen the muscles. In a few cases, the use of traction may be needed. Physical therapy is usually done 2-3 times per week and lasts for 6-8 weeks. 

  • Medications: Drugs are used to relieve pain and inflammation. Some common medications used include

  • Nonsteroidal anti-inflammatory drugs

  • Muscle relaxants 

  • Steroid-based injections 

    • Cervical epidural block: Steroid and anaesthetic drugs are injected into the epidural space. This technique is used for neck and/or arm pain.  

    • Cervical facet joint block: Steroid and anaesthetic drugs are injected into the capsule of the facet joint.

  • Ice, heat: Applying ice or heat may alleviate symptoms temporarily

  • Soft cervical collar: A padded ring that stays around your neck and held in place with Velcro. This is done to limit any neck movement. It should be worn for a short period only. 

Surgical treatment:

Surgical treatment is usually not recommended unless your healthcare provider finds:

  • Cervical radiculopathy - the spinal nerve is compressed by a bone or a herniated disc

  • Cervical spondylotic myelopathy - spinal cord is compressed

Surgery may also be recommended if there is severe pain that is not responsive to conservative treatment. 

Surgery usually involves removing bone spurs, a part of the vertebra or fusing a segment of the spine using bone grafts or other techniques.

FAQs

1. What are the causes of cervical spondylosis?

As you age, your spine goes through changes. Degeneration is one of the causes of cervical spondylitis where your discs become thinner.  A herniation is another cause wherewith age, your spinal disc tears or cracks. Other causes include osteoarthritis and bony spurs. 

2. What are the risk factors of cervical spondylosis?

Old age is a common risk factor. Other risk factors include genetics, smoking, previous neck injury, and heavy lifting. Straining your neck for many hours or keeping your head in an uncomfortable position for many hours are risk factors as well. 

3. How common is cervical spondylosis?

With age, your spine changes. By the time you are in your 30s, your spine begins a wearing-down process. 9 out of 10 people will have cervical spondylosis by the age of 60. 

4. How do I prevent myself from getting cervical spondylosis?

Maintaining a good posture, doing appropriate exercises to strengthen the muscles around the spine, and avoiding injuries to the neck may help in delaying the onset of spondylosis. When playing any sport, make sure you use the right equipment to prevent stress to the spine. 

5. What is the outlook of cervical spondylosis?

Most early symptoms such as pain can be treated at home with medications and simple lifestyle changes. However, some people may develop complications such as bone spurs, disc herniation, and nerve compression. In these types of situations, more medical attention is required such as stronger medications, steroid injections, and surgery. This would vary from person to person. 

Dr (Lt gen) C S Narayanan VSM

HOD And Consultant - Department Of Neurology

Manipal Hospitals, Dwarka, Delhi

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