Cervical spondylosis is a type of degenerative disease that affects your neck.
In the cervical spine this chronic degenerative process affects the intervertebral discs and facet joints, and may progress to disk herniation, osteophyte formation, vertebral body degeneration, compression of the spinal cord, or cervical spondylotic myelopathy.
Neck pain is a widespread condition, and the second most common complaint after low back pain. This condition is associated with a significant burden of disease with substantial disability and economic cost.
Although ageing is the primary cause, the location and rate of degeneration as well as degree of symptoms and functional disturbance varies and is unique to the individual.
Clinical Presentation:
Cervical spondylosis presents in three symptomatic forms as:
Non-specific neck pain - pain localised to the spinal column.
Cervical radiculopathy - complaints in a dermatomal or myotomal distribution often occurring in the arms. May be numbness, pain or loss of function.
Cervical myelopathy - a cluster of complaints and findings due to intrinsic damage to the spinal cord itself. Numbness, coordination and gait issues, grip weakness and bowel and bladder complaints with associated physical findings may be reported.
Symptoms in Cervical spondylosis:
Symptoms of cervical spondylosis can include:
Pain in the neck that may travel to your arms or shoulders
Headaches
Dizziness or vertigo
Numbness in your shoulders, arms, or hands
Stiffness in the neck
Poor balance
Rarely, syncope, triggers migraine
Risk Factors: Risk factors for cervical spondylosis include:
Age. Cervical spondylosis occurs commonly as part of aging.
Occupation. Jobs that involve repetitive neck motions, awkward positioning or a lot of overhead work put extra stress on the neck.
Neck injuries. Previous neck injuries appear to increase the risk of cervical spondylosis.
Genetic factors. Some individuals in certain families will experience more of these changes over time.
Smoking. Smoking has been linked to increased neck pain.
Complications in Cervical spondylosis :
If cervical spondylosis severely compresses your spinal cord or nerve roots, the damage can be permanent.
DIAGNOSIS :
Neck X-ray
Magnetic resonance imaging (MRI)
Computed Tomography (CT)
Electromyography
Nerve conduction study
Tretatment for Cervical spondylosis is a type of degenerative disease :
Treatment for cervical spondylosis depends on its severity. The goal of treatment is to relieve pain, help you maintain your usual activities as much as possible, and prevent permanent injury to the spinal cord and nerves.
Medical management
Pharmacologic agents, including nonsteroidal anti-inflammatory drugs (NSAIDs), oral steroids, muscle relaxants, anticonvulsants, and antidepressants can be prescribed for pain relief.
PHYSIOTHERAPY
A physical therapist can teach you exercises to help stretch and strengthen the muscles in your neck and shoulders. This can be one of the best treatments for the pain and stiffness. Some people with cervical spondylosis benefit from the use of traction, which can help provide more space within the spine if nerve roots are being pinched.
Treatment should individualised, but generally includes rehabilitation exercises, proprioceptive re-education, manual therapy and postural education
Mobilisation and/or manipulations in combination with exercises are effective for pain reduction and improvement in daily functioning in sub-acute or chronic mechanical neck pain with or without headache.
In patients experiencing radicular pain, cervical traction may be incorporated to alleviate the nerve root compression
Postural education includes the alignment of the spine during sitting and standing activities.
Thermal therapy provides symptomatic relief TENS/IFT and ultrasound therapy appears to be ineffective
Soft tissue mobilisation was performed on the muscles of the upper quarter with the involved upper extremity positioned in abduction and external rotation to pre-load the neural structures of the upper limb
Home Exercises include cervical retraction, cervical extension, deep cervical flexor strengthening, scapular strengthening, stretching of the chest muscles via isometric contraction of flexor of extensor muscles to encourage the mobility of the neural structures of the upper extremity
Surgery for Cervical spondylosis
If conservative treatment fails or if neurological symptoms — such as weakness in your arms or legs — worsen, you might need surgery to create more room for your spinal cord and nerve roots.
Dr. Veeram Chandrakala | Physiotherapist | Prolife Hospital | Bangalore
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