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Cervical Spondylosis Treatment
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is Cervical Spondylosis?
Cervical spondylosis is a term used to describe the age-related changes that occur in the spinal discs of the neck. This condition is part of the natural ageing process and is characterised by the degeneration of the discs and joints in the cervical spine, which is the part of the spine located in the neck. As individuals age, these spinal discs undergo dehydration and shrinkage, leading to the development of osteoarthritis and the formation of bone spurs along the edges of the bones.
This condition encompasses a range of degenerative changes affecting all components of the cervical spine, including the intervertebral discs, facet joints, joints of Luschka, ligamenta flava, and laminae.
Causes of Cervical Spondylosis
Cervical spondylosis can be caused by various factors, most commonly due to age-related wear and tear.
- Age-Related Degeneration
The development of cervical spondylosis is primarily attributed to the natural ageing process. The discs between the vertebrae in the neck, which act as cushions, begin to dry out and shrink over time, leading to more bone-on-bone contact and the development of osteoarthritis. Many individuals over 60 may experience some degree of spinal disc and joint degeneration. - Occupational Stress
Jobs that involve repetitive neck motions or awkward positioning of the neck can place extra stress on the cervical spine. These occupational demands can accelerate the degenerative process. - Previous Neck Injuries
Individuals with a history of neck injuries may experience accelerated degeneration in the cervical spine, increasing the risk of developing cervical spondylosis. - Genetic Factors
Studies suggest that genetic predisposition may play a role in the development of cervical spondylosis. Some individuals in certain families may be more prone to these degenerative changes. - Certain Medical Conditions
Certain medical conditions can contribute to the development of cervical spondylosis. Conditions such as rheumatoid arthritis or osteoporosis can affect the health of the spine, leading to an increased risk of spondylosis. Additionally, metabolic disorders that affect bone and tissue health may also play a role.
Symptoms and Signs
Cervical spondylosis may not always present with symptoms, particularly in its early stages. When they do occur, they typically manifest as follows:
- Neck Pain and Stiffness: The most common symptom is pain and stiffness in the neck. This pain can range from mild to severe and may be exacerbated by certain actions, such as looking up or down for prolonged periods. Rest or lying down generally helps in alleviating this discomfort.
- Radiating Pain to the Shoulders and Arms: In some cases, the discomfort can extend beyond the neck, radiating to the shoulders and arms. This may cause additional discomfort and limit the range of motion.
- Headaches: Cervical spondylosis can also lead to headaches, often resulting from muscle spasms in the neck and shoulder region.
- Neck Popping or Sensation: Some individuals may experience a popping noise or sensation when turning the neck.
- Numbness or Weakness: Numbness, weakness, or a tingling sensation in the arms, hands, and fingers can occur if there is compression of the spinal nerves or spinal cord.
- Coordination and Balance Issues: In more severe cases, individuals might experience a lack of coordination and difficulty in walking, attributed to compression of the spinal cord.
- Loss of Bladder or Bowel Control: In rare cases, severe compression of the spinal cord can lead to loss of bladder or bowel control, indicating a need for immediate medical attention.
Diagnosis
The process of diagnosing cervical spondylosis involves a combination of clinical evaluation and imaging tests.
- Physical Examination: This includes assessing the range of motion in the neck and evaluating upper limb reflexes, sensation, and muscle strength to check for pressure on spinal nerves or the spinal cord. The neck specialist will also observe the patient’s gait to check for spinal compression signs.
- Imaging Tests: X-rays can show changes like bone spurs and disc space narrowing indicative of cervical spondylosis and rule out other causes of neck pain and stiffness. Sometimes an MRI can be used to produce more detailed images, to help identify areas where nerves might be pinched. A CT myelography may also be used to visualise the spinal cord, spinal canal, and nerve roots more clearly.
- Nerve Function Tests: These tests may be conducted to determine if nerve signals are travelling properly to the muscles. Common tests include an electromyography or a nerve conduction study.
Non-Surgical Treatment Options
Non-surgical treatments, designed for cases of mild to moderate cervical spondylosis, aim to relieve pain, improve function, and prevent further progression of the condition.
Medications
A spine specialist may recommend various medications for treatment, subject to individual diagnosis.
- Pain Relievers: Over-the-counter pain medications like ibuprofen or naproxen can alleviate pain and inflammation. In some cases, prescription-strength medications may be necessary.
- Corticosteroids: Short courses of oral steroids, or steroid injections, may be used for severe pain.
- Muscle Relaxants: Medications such as cyclobenzaprine can relieve muscle spasms in the neck.
- Anti-Seizure Medications: Some medications used for epilepsy can help dull the pain from damaged nerves.
- Antidepressants: Certain antidepressants, due to their pain-modulating properties, can be effective in managing neck pain associated with cervical spondylosis.
Physical Therapy
The neck specialist may recommend exercises to stretch and strengthen the muscles in the neck and shoulders. Some patients benefit from traction, which can help create more space within the spine, thereby alleviating nerve root compression.
Surgical Treatment Options
Surgical intervention may be considered when non-surgical treatments fail to provide relief or in cases where neurological symptoms, such as severe pain, weakness, or loss of coordination, are worsening.
Decompression Surgery |
The goal of decompression surgery is to relieve pressure on the spinal cord and nerves. This may involve removing bone spurs, removing portions of the vertebrae or extracting a herniated disk. |
Spinal Fusion |
In some cases, the stability of the cervical spine needs to be restored. Spinal fusion involves joining two or more vertebrae permanently, using bone grafts, metal rods, or screws to maintain spinal stability. |
Laminectomy |
This procedure involves removing part of the vertebral bone (lamina) to relieve pressure on the spinal cord or nerves. |
Discectomy |
This involves the removal of the part of a herniated disc that is pressing on a nerve or the spinal cord. |
Prevention Strategies
While cervical spondylosis is largely an age-related condition and not entirely preventable, some strategies can help reduce the risk or slow its progression.
- Maintain a Good Posture - Proper posture, especially while sitting or using electronic devices, can reduce stress on the cervical spine. Keeping the neck aligned with the spine helps prevent undue strain.
- Regular Exercise - Engaging in regular physical activity, including exercises that focus on neck strength and flexibility, can support spinal health. Activities like swimming, walking, and yoga can be beneficial.
- Setting up an Ergonomic Environment to Reduce Neck Strain - Setting up an ergonomic work environment can help in minimising strain on the neck. This includes adjusting the computer screen to eye level and using chairs that support the spine's natural curve.
- Avoid Repetitive Stress - Avoiding activities that put repetitive stress on the neck, such as certain occupational tasks or sports, can help prevent the onset of cervical spondylosis symptoms.
- Maintaining a Healthy Weight - Maintaining a healthy weight can reduce stress on the spine and neck, which may decrease the risk of cervical spondylosis.
- Quit Smoking - Smoking cessation is beneficial as smoking has been linked to increased neck pain and spinal issues.
Dr Poh Seng Yew (傅圣耀)
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 20 years of experience, Dr Poh Seng Yew (傅圣耀) is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
What Is the Difference Between Cervical Spondylosis and a Slipped Disc?
Cervical spondylosis and a slipped disc, also known as a herniated or bulging disc, are distinct conditions affecting the spine. Cervical spondylosis refers to the general age-related wear and tear of the spinal discs and joints in the neck. This condition involves gradual degeneration over time. In contrast, a slipped disc occurs when there is displacement or movement of one of the spinal discs, often due to injury, trauma, or excessive strain, leading to symptoms such as acute nerve compression and sharp pain.
What Exercises Can Help Treat Cervical Spondylosis?
Certain exercises, aimed at neck strength and flexibility, may be recommended for managing cervical spondylosis. These include gentle stretching exercises, neck tilts, and rotations that help maintain mobility and reduce stiffness. Strengthening exercises for the neck and shoulder muscles can also support the cervical spine. Engage in these exercises under the guidance of a neck specialist to ensure they are performed correctly and safely.
What Happens If Cervical Spondylosis Is Left Untreated?
Leaving cervical spondylosis untreated may lead to a progression in symptoms and increased discomfort. In some cases, it could result in further degeneration of the spine, leading to more serious issues such as nerve compression, increased pain, and reduced mobility. Early and proactive management of cervical spondylosis can help in maintaining a better quality of life and preventing complications. Consult with a neck specialist for a personalised treatment plan that can effectively address your condition.