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Cervical Spondylosis: Understanding Neck Degeneration
Neck pain is the modern-day “badge of honor” for anyone who spends hours staring at screens, hunching over desks, or simply growing older. But when that nagging discomfort turns into chronic stiffness, radiating pain, or even tingling in the arms, it might be more than just bad posture—it could be Cervical Spondylosis.
Cervical Spondylosis is a degenerative condition affecting the neck’s vertebrae, discs, and joints. It’s like your spine’s way of telling you, “Hey, I’ve been holding your head up for decades; a little maintenance would be nice!”
So, what exactly happens in Cervical Spondylosis, and more importantly, how can you manage it? Let’s break it down.
Pathophysiology of Cervical Spondylosis: What’s Happening in Your Neck?
Your cervical spine (aka your neck) consists of seven vertebrae stacked on top of each other, cushioned by discs that act like shock absorbers. Over time, due to aging, wear and tear, and repetitive strain, these discs start to degenerate, leading to:
- Disc Dehydration & Shrinkage – Less cushioning between vertebrae means more friction and pain.
- Bone Spurs (Osteophytes) – Your body’s attempt at self-repair, but these bony outgrowths can compress nerves.
- Ligament Thickening – The ligaments stiffen, reducing flexibility and making head movements feel like a workout.
- Spinal Cord Compression (Myelopathy) – Severe cases can press on the spinal cord, leading to weakness, balance issues, and even loss of bladder control (yes, it gets that bad).
Etiology of Cervical Spondylosis: What Causes It?
While aging is the most common culprit, other factors accelerate neck degeneration:
- Poor Posture – Looking down at your phone for hours? Say hello to “tech neck.”
- Repetitive Movements – Athletes, office workers, and even hairstylists constantly move their necks, wearing down the discs faster.
- Injury & Trauma – A past neck injury can speed up degeneration.
- Genetics – If neck problems run in your family, you might be at a higher risk.
- Sedentary Lifestyle – Less movement = weaker neck muscles = more strain on the spine.
Early Signs & Symptoms of Cervical Spondylosis
Cervical Spondylosis isn’t just about a stiff neck. It can present with:
Motor Symptoms:
- Neck Pain & Stiffness – Worse in the morning and after prolonged inactivity.
- Reduced Range of Motion – Turning your head becomes a challenge.
- Muscle Weakness – Grip strength may weaken, making simple tasks harder.
Sensory Symptoms:
- Tingling & Numbness – Radiating pain in the arms and hands due to nerve compression.
- Headaches – Often originating from the neck and spreading to the back of the head.
Severe Symptoms (Myelopathy):
- Loss of Coordination – Difficulty walking or performing fine motor tasks.
- Bladder & Bowel Dysfunction – A rare but serious complication due to spinal cord compression.
Investigations for Cervical Spondylosis: How Is It Diagnosed?
1. Imaging Studies:
- X-ray – Shows bone spurs and narrowing of disc spaces.
- MRI (Magnetic Resonance Imaging) – Provides a detailed view of nerve compression and soft tissue damage.
- CT Scan – Helps assess bony structures more clearly.
2. Nerve Conduction Studies & EMG:
- Electromyography (EMG) – Measures nerve function and helps differentiate nerve compression from other conditions.
3. Physical Examination & Clinical Tests:
- Assessing range of motion, strength, and reflexes to determine the severity of nerve involvement.
What We’ll See in Investigations
- X-ray Findings: Bone spurs, narrowed disc spaces, and misalignment.
- MRI Findings: Nerve root compression, disc herniation, and spinal cord narrowing.
- Nerve Tests: Slower nerve conduction indicating compression.
Assessment of Cervical Spondylosis
On Observation:
- Forward head posture.
- Restricted neck movement.
- Muscle atrophy in advanced cases.
On Palpation:
- Tenderness along the cervical spine.
- Tightness in neck muscles, particularly the levator scapulae and trapezius.
On Examination:
- Spurling’s Test – Pain radiating down the arm when pressure is applied to the head.
- Lhermitte’s Sign – An electric shock sensation down the spine when the neck is flexed.
Other Physical Therapy Tests:
- Neck Distraction Test – Relieves symptoms when the neck is pulled upward.
- Cervical Rotation Test – Restricted movement indicates joint involvement.
Management of Cervical Spondylosis
1. Non-Surgical Management
Lifestyle Modifications:
- Posture Correction – Keep screens at eye level.
- Exercise & Stretching – Focus on neck mobility and strengthening exercises.
- Ergonomic Adjustments – Proper chair, keyboard, and workstation setup.
Physical Therapy:
- Manual Therapy – Mobilization to restore movement.
- Strengthening Exercises – Targeting deep neck flexors.
- Postural Retraining – Encouraging proper alignment.
Medications & Pain Management:
- NSAIDs (Ibuprofen, Naproxen) – Reduce pain and inflammation.
- Muscle Relaxants – Help ease muscle spasms.
- Corticosteroid Injections – For severe nerve pain.
2. Surgical Intervention (For Severe Cases)
- Discectomy & Fusion – Removing damaged discs and fusing vertebrae.
- Laminectomy – Removing part of the vertebra to relieve spinal cord pressure.
Conclusion: Take Charge of Your Neck Health
Cervical Spondylosis is a pain in the neck—literally! But with early intervention, proper management, and a little self-care, you can keep your neck happy, healthy, and mobile for years to come.
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