What is Cervical Spondylosis? What Are Its Symptoms? How Is It Diagnosed and Treated?

Cervical spondylosis is a condition that occurs as a result of age-related degenerative changes in your cervical spine. It can lead to various symptoms ranging from neck pain and numbness to stiffness and restricted movement. In this article, you will find answers to questions such as what cervical spondylosis is, what the symptoms of cervical spondylosis are, how cervical spondylosis is diagnosed, and what cervical spondylosis treatment options are.

What is Cervical Spondylosis?

Cervical spondylosis is a condition that occurs as a result of age-related degenerative changes in your cervical spine. Also known as "neck arthritis," this disorder is associated with wear and tear occurring in the vertebrae and the discs between the vertebrae. It is also referred to as cervical osteoarthritis or degenerative osteoarthritis.

This condition, in which the joints in the neck are affected as a result of recurring minor traumas associated with age, is usually seen in people over the age of 40 and progresses with age. Although it affects both sexes equally, it appears at an earlier age group in men compared to women.

It is particularly observed in the most mobile regions of the cervical vertebrae. The C4-C5, C5-C6, and C6-C7 levels are the most frequently affected areas. Although these findings are detected in the radiological imaging examinations of many people, they sometimes may not cause any complaints.

Changes in the Cervical Spine

As age progresses, degenerative changes occur in the neck bones, discs, and ligaments. As people age, the discs lose moisture and shrink. Consequently, this causes the vertebrae to rub against each other and leads to the formation of bone spurs on the bone margins.

The discs stiffen, and the ligaments connecting the vertebrae thicken. The neck joints undergo degeneration in a process similar to osteoarthritis in other joints such as the knees and fingers. In this process, shortening of the disc space, thickening of the ligaments, and the development of segmental instability are observed.

As disc degeneration progresses, abnormal growths called spurs or osteophytes form on the neck bones. These bone spurs lead to the narrowing of the spinal canal, exposing the spinal cord to compression. As a result, nerve compression called radiculopathy or spinal cord injury called myelopathy may occur.

Relationship with the Aging Process

Most of the age-related degenerative changes in the cervical spine occur after the 5th decade. By the end of their twenties, three-quarters of all people observe tears in some discs. By the mid-thirties, wear and tear in the spinal joints are seen in four out of ten people.

Almost everyone at the age of seventy has wear and tear. However, while a certain rate of disc degeneration is expected with aging, factors such as genetics, smoking, and repetitive neck movement contribute to the progression of cervical spondylosis.

The extent to which normal wear and tear progresses depends on two factors: your genes and your lifestyle. Particularly individuals with a congenitally narrow spinal canal may exhibit clinical findings and symptoms at an early age.

What Are the Symptoms of Cervical Spondylosis?

Symptoms vary from person to person. Although findings of cervical spondylosis are encountered in imaging tests in some people, no complaints arise. However, as the disease progresses, various symptoms manifest themselves.

Neck Pain and Stiffness

The initial symptoms usually begin in the form of mild neck pain. This pain becomes more pronounced especially in the mornings and increases when you stay in the same position for a long time. A tense and painful sensation occurs in your neck region.

Activities requiring neck movement, such as driving, looking up, or turning your head, can worsen the pain. This neck pain, which intensifies in the later period, can radiate towards the shoulder and arm region. Your neck takes on a stiff and difficult-to-move structure.

Headache and Limitation in Neck Movements

Headaches, which are more common in the occipital region, occur. You generally experience tension-type headaches starting from the back of the head and radiating. Pressure on the nerves in the neck region causes this pain.

You experience restriction in neck movements. You have difficulty moving your neck right and left or up and down. Neck stiffness occurs because connective tissues and muscles are strained. This condition, which makes it difficult to turn your head or bend forward, can limit your daily activities.

Numbness in Arms and Shoulders

In the event of nerve root involvement, you feel numbness along with pain in the shoulder, arm, and hands. Numbness and tingling can be seen in the arms, hands, legs, and feet. The narrowing of the nerve channels leads to these symptoms.

It is known that these symptoms increase especially after sneezing. Numbness or tingling in the extremities can also be observed. Consequently, you may have difficulty performing your daily tasks.

Muscle Weakness and Balance Problems

As a result of nerve involvement, weakness develops in the arms, hands, legs, and feet. You experience a loss of strength in your hands or arms, and a decrease occurs in your grip strength. Loss of coordination may appear.

Balance problems begin when pressure is exerted on the spinal cord. Walking difficulty and abnormal deep tendon reflexes can be seen. Symptoms such as stumbling while walking, sudden loss of balance, and a feeling of swaying while standing occur.

Severe complications develop in advanced stages. In severe cases caused by spinal cord compression, you experience coordination impairment. Urinary and fecal incontinence or retention may appear. If the intensity of the pains increases day by day and pain-relieving medications begin to fail, you need to consult a healthcare institution without wasting time.

Causes and Risk Factors of Cervical Spondylosis

The main cause of cervical spondylosis is the natural changes occurring in the spinal structure along with the aging process. However, there are also some factors that can accelerate the emergence of this condition. Understanding these factors is quite valuable in terms of the prevention and management of the disease.

Aging and Disc Degeneration

As age progresses, the discs between the vertebrae lose their water content, thinning and losing their flexibility. The discs lose their fluid content over time and become less flexible. This condition causes the discs to be damaged more easily.

Especially after the age of 40, many people experience a certain amount of disc degeneration. The decreased water amount causes the discs to harden and they become unable to provide as much shock absorption as before. Discs that have lost their flexibility cannot keep the load distribution between the vertebrae in balance.

Bone Spurs and Osteophytes

Bone protrusions can form as a result of wear and tear in the spine. These protrusions are known as osteophytes or commonly as bone spurs. It is a repair attempt made by the body with the purpose of self-protection when the joint cartilage wears out.

Bone protrusions are most frequently seen in people aged 60 and over, but they can also occur in younger people. These newly formed bone protrusions can put pressure on neighboring nerves over time, restrict spine movements, and lead to neck pain.

Genetic Factors and Family History

The risk is higher in individuals with a family history of cervical spondylosis. Genetic factors can create a predisposition to early disc degeneration in some individuals. Changes in genes regulating cartilage and collagen production can affect the structural integrity of spinal discs.

Disc degeneration can appear at an earlier age or in a more severe manner in people with a family history of spine problems. Genetic predisposition can increase the likelihood of developing herniated discs in the cervical spine.

Postural Disorders and Occupational Diseases

Long-term poor posture can lead to extra pressure on the neck vertebrae. Activities such as working at a computer for a long time, looking down at a phone, or carrying heavy loads place excessive load on the neck region. Those with the habit of sitting leaning forward or hunched over cause the progression of arthritis by constantly placing a load on the neck region.

Occupations requiring repetitive neck movement or continuous vibration increase the predisposition to early-onset spondylosis. The exposure of the neck region to constantly recurring movements due to occupational or sporting activities leads to overuse or strain.

Trauma and Past Injuries

Injuries experienced in the neck region in the past can accelerate the development of spondylosis. Previous severe neck injuries dependent on trauma can accelerate joint deterioration. Neck injuries can negatively affect spine health and increase the risk of spondylosis.

Traumas such as falls from heights and traffic accidents can increase spinal cord injury in cases of cervical spondylosis that have not given sudden symptoms. Sports injuries also lay the groundwork for the aforementioned disorder by creating damage in tissues.

How Is Cervical Spondylosis Diagnosed?

When diagnosing cervical spondylosis, your doctor first listens to your complaints and performs a comprehensive evaluation. The diagnostic process consists of several stages, and each stage helps determine the exact problem in your cervical spine.

Physical Examination and Initial Evaluation

In the initial evaluation, your doctor learns the onset time, severity, and when your neck pain worsens. They ask questions about your past injuries, occupation, and daily activities. Tracking your symptoms facilitates the diagnostic process.

During the physical examination, your neck movements are tested. Your doctor evaluates how comfortably you can move your neck, your amount of right-and-left rotation, and your forward-bending ability. A neck range of motion examination is performed, and it is checked whether there is pain during movement.

Reflexes are checked to understand whether the spinal cord and nerve roots are under pressure. The muscle strength of your arms and legs is measured. Sensory examinations are performed to determine numbness or loss of sensation areas. The sensory strength of the arms and legs can be measured together with reflex tests.

Imaging Methods

Imaging tests allow detailed examination of your neck vertebrae. Cervical direct radiography shows structural changes in the spine and the presence of osteophytes. X-rays reveal abnormalities in the bone structure.

Magnetic resonance imaging detects nerve compression, disc problems, and soft tissue damage. Cervical MRI provides detailed imaging of the spinal cord, nerves, muscles, and other soft tissues. This imaging method is used to visualize degenerative changes occurring in cervical spondylosis and to determine the severity of the disease.

Computed tomography clarifies the size of neck arthritis by providing detailed images of bones. Cervical CT can show the presence of a hard disc. Myelography is also among the diagnostic methods.

Nerve and Muscle Function Tests

Electromyography is performed to understand whether nerves are affected due to neck arthritis. EMG measures how well muscles and nerve cells respond to electrical signals. This test measures the conduction velocity of nerves to determine whether there is compression.

Nerve conduction velocity studies can also be performed. EMG and nerve conduction velocity studies provide objective information about nerve root compression in patients with relatively minor symptoms. Needle EMG can show findings of chronic nerve involvement. In cases of cervical spondylosis, EMG can provide information about nerve involvements prior to clinical and some laboratory findings.

Cervical Spondylosis Treatment and Management

Cervical spondylosis treatment is shaped according to the severity of your clinical condition. The aim of treatment is to reduce pain, increase spine mobility, and prevent nerve compression. Most patients achieve relief with non-surgical methods.

Medication Treatment Options

Medication treatment is the first preferred method in pain and inflammation management. Nonsteroidal anti-inflammatory drugs are used to reduce neck pain and inflammation. Pain relievers provide benefits especially during acute periods.

Muscle relaxant medications alleviate spasms in the neck muscles. In severe cases, corticosteroid injections can be administered. Corticosteroid and local anesthetic injections are made into the joints between the vertebrae. Epidural steroid injections suppress nerve inflammation in radiating arm pains.

Physical Therapy and Exercises

Physical therapy plays an indispensable role in the treatment of cervical spondylosis. The primary goal is to strengthen your neck muscles and increase flexibility. It helps correct your posture and reduce stress on the spine.

Manual therapy techniques relieve stiffness in the joint. Mobilization, soft tissue techniques, and traction are applied. Traction alleviates nerve compression by increasing the intervertebral space. Neuromobilization improves the relationship of nerves with surrounding tissues.

Exercises increase neuro-muscular coordination and postural awareness. Activation of deep neck flexors, ensuring scapular stability, and preservation of range of motion are targeted. The chin tuck exercise is effective for postural balance. Isometric resistance exercises safely strengthen the neck muscles.

Lifestyle Changes

Changing your daily habits increases the success of treatment. Your computer screen should be at eye level. Prefer using a headset when talking on the phone. Use an ergonomic chair.

Check your pillow height and softness. Protect your neck region in cold weather. Avoid staying in the same position for a long time. Maintain mobility with light neck exercises. Quitting smoking improves your spinal disc health.

Wearing a cervical collar in the acute period restricts neck movements and reduces nerve irritation. Cervical traction, hot-cold therapy alleviate symptoms. Massage therapy and acupuncture can also be utilized.

When Is Surgical Intervention Necessary?

Surgical treatment is considered as a last resort. If conservative treatments fail or neurological findings worsen, a surgical intervention is performed. Progressive cervical myelopathy is the most important surgical reason. Cervical radiculopathy causing unbearable pain also requires surgery.

With the anterior approach, the herniated disc or bone protrusions are removed from the front part of the neck. With the posterior approach, narrowings of the spinal canal are relieved by removing posterior elements. If necessary, posterior stabilization is performed with titanium screws.

Prevention Methods

Targeted neck exercises increase muscle strength. Stretching and massage preserve mobility. Correct posture while working or driving reduces stress on the neck. Avoid heavy loads and use proper lifting technique.

Exercise regularly, but stay away from activities that will strain the neck. Manage stress and rest regularly. Add omega-3 fatty acids and vitamin E to your diet. Consume dark green leafy vegetables.

Frequently Asked Questions

Does cervical spondylosis heal?

Cervical spondylosis cannot be completely prevented, but it can be brought under control. It is a condition that can regress when detected early and handled with correct methods. Relief is achieved when muscles are worked correctly, postural awareness is developed, and neuro-muscular coordination is supported.

The form of treatment depends on the severity of your symptoms. Your doctor may suggest medication treatment, physical therapy, or surgical intervention if necessary. Lifestyle changes help slow down its progression. Targeted neck exercises increase muscle strength and support your vertebrae better.

Is cervical spondylosis dangerous?

If left untreated, the spinal cord or nerve roots can be severely compressed. Nerve compression can cause permanent damage to your spinal cord. Treatment before neurological damage occurs helps preserve nerve function and your quality of life.

In severe cases, the compressed spinal cord can cause numbness, lack of coordination, and loss of movement. In advanced conditions, weakness in the arms, loss of balance, and loss of fine motor skills are observed as a result of nerve root compression or spinal cord involvement. Therefore, early intervention and monitoring of symptoms are quite important.

In which age group is it more common?

Age is the most important risk factor, and more than 85% of individuals over 60 are affected. It is usually seen in people over the age of 40 and progresses with age. It is commonly encountered especially after the age of 40.

Spondylosis disorder is generally encountered at advanced ages. However, various external factors trigger this disease, raising the incidence rate especially after the age of 30. It can also appear at young ages due to reasons such as genetic factors, postural disorders, and working at a computer for a long time.

How effective are exercises?

Exercise is indispensable in the restructuring of the cervical region. Walking is good for spondylosis. Start with a 5-10 minute walk and gradually increase it to 30 minutes. It is beneficial to start walking when pain is brought under control with medications.

The goal is not only to strengthen muscles but also to increase neuro-muscular coordination and postural awareness. Exercises must definitely be planned under the guidance of a physiotherapist. Regular medical exercise sessions strengthen the muscles around the neck, increase flexibility, and help the body regain its movement capability.

Summary

Cervical spondylosis is a natural part of aging, but you can bring its symptoms under control. Early diagnosis and the correct treatment approach significantly improve your quality of life. Most patients achieve relief with medication treatment, physical therapy, and lifestyle changes.

Therefore, if your neck pain is increasing or making your daily activities difficult, you need to consult a specialist. Regular exercise, correct posture, and an ergonomic working environment slow down the progression of the disease. When you take your symptoms seriously and comply with recommended treatments, you can protect your neck health.