Cervical Spondylosis

Cervical spondylosis describes any kind of “wear and tear” changes to the spine in your neck. “Cervical” refers to your neck. “Spondylosis” is when any part of your spine begins to wear out. Healthcare providers sometimes call it arthritis of the neck.

It’s a very common and natural part of growing older. Spine changes usually start in your 30s. By age 60, about 9 in 10 people have cervical spondylosis.

If you have cervical spondylosis, your neck may ache, hurt or feel stiff. There’s no cure. But treatments can keep it from getting worse.

Symptoms of cervical spondylosis

You can have cervical spondylosis without symptoms. If you do have symptoms, they may include:

• Neck pain
• A stiff neck
• A bump or knot in your neck
• Headaches

Talk to a healthcare provider if your neck hurts or feels stiff for more than a few days.

If spine changes lead to pressure on your spinal cord, you may have other symptoms. For example, you could develop numbness, muscle spasms and/or movement issues.

Cervical spondylosis causes

Aging is the main cause of spondylosis of the neck. As you age, the rubbery cushions between your spinal bones — your spinal disks — dry out. This is known as degenerative disk disease. It can lead to several other changes in your spine structure, like:

• Bones in your spinal joints rubbing against each other (osteoarthritis)
• Bone spurs on your vertebrae
• Changes in your spinal alignment
• Herniated or bulging disks
• Reduced disk height
• Narrowing of the space around your spinal cord (spinal stenosis)

Risk factors

Cervical spondylosis is a natural and expected process. But certain factors may speed up the process or make it worse, like:

• Doing work that requires you to spend hours every day looking up or down
• Having a family history of cervical spondylosis
• Having a history of neck injury
• Obesity
• Straining your neck to lift heavy objects
• Smoking

Complications of this condition

Complications can arise if spondylosis of the neck leads to spinal cord damage. There are two main types:

• Cervical myelopathy: This is when something compresses (squeezes) the spinal cord in your neck. It can make your hands feel numb or cause muscle weakness.
• Cervical radiculopathy: This is a pinched nerve in your neck. It can cause pain that spreads down your arm, muscle weakness and a “pins and needles” feeling.

Cervical spondylosis can also cause long-term (chronic) neck pain. Each of these complications can greatly affect your quality of life. That’s why it’s key to get medical care when you first notice symptoms.

How doctors diagnose cervical spondylosis

A healthcare provider will do a physical exam, including looking for bumps or knots in your neck. They may check your:

• Neck flexibility
• Muscle strength and reflexes in your hands, arms or legs
• Gait (how you walk)

Your provider may recommend other tests to get detailed images of your spine. Some tests check how your skeletal muscles and nerves work. Tests may include:

• X-ray
• CT or MRI scan
• Myelogram
• Electromyography (EMG)
• Nerve conduction study

How is it treated?

Treatment for cervical spondylosis mainly helps ease symptoms and prevent severe spinal cord damage.

In general, healthcare providers start with nonsurgical treatments. For example, they may recommend:

• Physical therapy to strengthen your neck and upper back muscles
• Over-the-counter pain relievers
• NSAIDs or a corticosteroid to help with inflammation
• Muscle relaxants
• Short-term use of a soft neck collar

If you have significant neck pain, your provider may recommend treatments like a cervical epidural steroid injection or radiofrequency ablation.

If your spinal cord is squeezed, you may need surgery. The type of surgery depends on what’s causing the damage. For example, a laminectomy removes the bony arch of vertebrae. Another type of surgery is a spinal fusion.

Together, you and your provider will discuss which treatments make the most sense for you.

When should I see my healthcare provider?

Reach out to your provider if your symptoms aren’t getting better with treatment.

Sometimes, severe neck pain along with the following symptoms may be signs of a serious medical issue. Get help right away if you have:

• Neck pain that’s getting worse
• Numbness or tingling in your arms
• Trouble with coordination or walking
• Muscle weakness or heaviness in your arms or legs
• Loss of bladder or bowel control

What can I expect if I have this condition?

Cervical spondylosis is a chronic condition. The wear and tear generally gets worse with time. But that doesn’t guarantee that your symptoms will get worse, too.

If neck pain is your main symptom, it may get better with nonsurgical therapies. It’s more difficult for healthcare providers to predict your outlook when you have spinal cord damage. Some people get symptom relief with surgery. Others have long-term nerve problems and pain despite surgery.