CERVICAL spondylosis affects the disc and joints of the cervical spine. As we age, the cervical disc dehydrates and shrinks, resulting in osteoarthritis of the joints of the cervical spine.
In short, cervical spondylosis means osteoarthritis of the cervical spine. As it progresses, signs of osteoarthritis develop, which include a bony spur and disc space narrowing.
As we age, the bones and cartilage that make up our cervical joint gradually develop wear and tear. These changes can include dehydrated disks.
Disks act like cushions between the vertebrae of your spine. By the age of 40, most people's spinal disks begin drying out and shrinking, which allows more bone-on-bone contact between the vertebrae.
Age also affects the exterior of your spinal disks. Cracks often appear, leading to bulging (herniated) disks — which sometimes press on the spinal cord and nerve roots.
Disk degeneration often results in the spine producing extra amounts of bone in a misguided effort to strengthen the spine. These bone spurs can sometimes pinch the spinal cord and nerve roots.
Ligaments are cords of tissue that connect bone to bone. Spinal ligaments can also stiffen with age, making your neck less flexible.
WHO'S AT RISK?
Risk factors for cervical spondylosis include:
• Age — cervical spondylosis is a normal part of ageing.
• Occupation — jobs that involve repetitive neck motions, awkward positioning or a lot of overhead work put extra stress on your 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, while others will not.
• Smoking — smoking has been linked to increased neck pain.
• Being inactive and overweight.
Pain relief oils, creams and heating pads do help in relieving cervical pain. They help ease sore neck muscles.
But if the patient's spinal cord or nerve roots become severely compressed as a result of cervical spondylosis, the damage can be permanent. This can lead to cervical myelopathy. The symptoms are numbness and weakness in the arms, hands and fingers.
In severe cases, patients develop trouble walking, loss of balance or weakness in the hands or legs, and bowel and bladder incontinence.
TREATMENT
There is no one best treatment or approach for cervical spondylosis. Treatment for this condition should be a combination of methods.
The main treatment for cervical spondylosis is almost always non-surgical. A combination of analgesic and physical treatments are the mainstay.
Physical treatments include specific exercises which can help relieve pain, as well as strengthen and stretch weakened or strained muscles.
Posture therapy or the use of traction to gently stretch the joints and muscles of your neck is also highly recommended.
Medications which are usually prescribed are paracetamol, non-steroidal anti-inflammatory drugs (NSAIDS), muscle relaxants, oral steroids and topical NSAIDS.
There are many exercises that can relieve cervical pain. These include cervical retraction, cervical extension, deep cervical flexor strengthening, scapular strengthening and stretching of the chest muscles.
Furthermore, manual therapy, thrust manipulation, non-thrust manipulation, postural education, soft tissue mobilisation and cervical traction also play an important part in one's cervical exercise regime.
These exercises and physical therapies should be tailored to the individual patient and include supervised isometric exercises, pro-prioceptive re-education, manual therapy and posture education.
*The writer is a specialist in orthopaedic surgery at Pantai Hospital Cheras.
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