Cervical spondylosis

Definition

Cervical spondylosis is a disorder in which there is wear on the cartilage (disks) and bones of the neck (cervical vertebrae). It is a common cause of chronic neck pain.

Alternative Names

Cervical osteoarthritis; Arthritis - neck; Neck arthritis; Chronic neck pain; Degenerative disk disease

Causes

Cervical spondylosis is caused by aging and chronic wear on the cervical spine. This includes the disks or cushions between the neck vertebrae and the joints between the bones of the cervical spine. There may be abnormal growths or spurs on the bones of the spine (vertebrae).

Over time, these changes can press down on (compress) one or more of the nerve roots. In advanced cases, the spinal cord becomes involved. This can affect not just the arms, but the legs as well.

Everyday wear and tear may start these changes. People who are very active at work or in sports may be more likely to have them.

The major risk factor is aging. By age 60, most people show signs of cervical spondylosis on x-ray. Other factors that can make someone more likely to develop spondylosis are:

Symptoms

Symptoms often develop slowly over time. But they may start or get worse suddenly. The pain may be mild, or it can be deep and so severe that you are unable to move.

You may feel the pain over the shoulder blade. It may spread to the upper arm, forearm, or fingers (in rare cases).

The pain may get worse:

You may also have weakness in certain muscles. Sometimes, you may not notice it until your doctor examines you. In other cases, you will notice that you have a hard time lifting your arm, squeezing tightly with one of your hands, or other problems.

Other common symptoms are:

Less common symptoms are:

Exams and Tests

A physical exam may show that you have trouble moving your head toward your shoulder and rotating your head.

Your health care provider may ask you to bend your head forward and to each side while putting slight downward pressure on the top of your head. Increased pain or numbness during this test is usually a sign that there is pressure on a nerve in your spine.

Weakness of your shoulders and arms or loss of feeling can be signs of damage to certain nerve roots or to the spinal cord.

A spine or neck x-ray may be done to look for arthritis or other changes in your spine.

MRI or CT scans of the neck are done when you have:

EMG and nerve conduction velocity test may be done to examine nerve root function.

Treatment

Your doctor and other health professionals can help you manage your pain so that you can stay active.

A type of talk therapy called cognitive behavioral therapy may be helpful if the pain is having a serious impact on your life. This technique helps you better understand your pain and teaches you how to manage it.

Medicines can help your neck pain. Your doctor may prescribe nonsteroidal anti-inflammatory medicines (NSAIDs) for long-term pain control. Opioids may be prescribed if the pain is severe and does not respond to NSAIDs.

If the pain does not respond to these treatments, or you have a loss of movement or feeling, surgery is considered. Surgery is done to relieve the pressure on the nerves or spinal cord.

Outlook (Prognosis)

Most people with cervical spondylosis have some long-term symptoms. These symptoms improve with non-surgical treatment and do not need surgery.

Many people with this problem are able to maintain an active life. Some people will have to live with chronic (long-term) pain.

Possible Complications

This condition may lead to the following:

When to Contact a Medical Professional

Call your provider if:

References

Fast A, Dudkiewicz I. Cervical degenerative disease. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 3.

Kshettry VR. Cervical spondylosis. In: Steinmetz, MP, Benzel EC, eds. Benzel's Spine Surgery. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 96.