Cervical spondylosis

Cervical spondylosis is a condition involving degenerative changes in the vertebrae (neck- bones), intervertebral disk and their joints. Cervical spondylosis also known as cervical osteoarthritis is the most common cause of neck pain and stiffness. It usually affects middle-aged and older people. The wear and tear associated with cervical spondylosis tends to start after the age of 30. The typical feature of degeneration associated with neck arthritis is thinning of disk and the vertebral degeneration which leads to formation of abnormal outgrowths in vertebrae known as spurs or osteophytes. These osteophytes may lead to narrowing of spinal column which may cause spinal cord compression and may result in dysfunction.

Aging can be a major factor for development of cervical spondylosis and it may remain symptomless in many people. Symptoms may vary from mild to severe. In severe cases the spinal cord compression may cause arm and leg symptoms. Most commonly observed neck arthritis symptoms are:

1. Neck pain which may radiate to head, shoulder or arms and occurs because of irritation/compression of nerves going to head, shoulder or arms from spinal cord. Pain is usually recurrent in nature and may have flare ups also.

2. Neck stiffness or difficulty in movement such as side to side movement of head or bending of neck which may aggravate pain.

3. Sensations below the neck may also decrease.

4. It is observed that symptoms become most severe in the morning and at the end of the day.

5. Cervical Radiculopathy: Because of vertebral outgrowths or osteophytes the spinal nerves, exiting from spinal column may get compressed which may result in pain, weakness, numbness or dysfunction in part of hand or arm. Radiating pain in one or both arms is most commonly observed.

6. Cervical Myelopathy: Sometimes pressure from worn vertebrae or disc may damage the spinal cord which may result in:

  • Tingling sensation, numbness or weakness in arms, hands, legs or feet.
  • Difficulty in walking
  • Leg movements may become spastic(jerky)
  • In severe cases loss of control over bladder and bowel can also be seen.

Cervical Spondylosis treatment: Mostly the treatment in cervical spondylosis are conservative which focuses on minimizing the neck pain and keeping the neck movement as normal as possible to avoid stiffness. Treatment includes:

Medication: It involves use of NSAIDS such as Paracetamol, Ibuprofen, Diclofenac and Naproxen to relieve pain and inflammation. In severe pain, opioid derivatives e.g. codeine can also be given. In chronic neck pain tricyclic antidepressants such as Amitriptyline can also be given. In severe cases, epidural steroid injections in joints of the spine are recommended.

Physiotherapy: It may include traction, heat and cold application or manipulation. In mild cases gentle neck exercises are recommended.

Maintaining a good posture with the help of cervical collar while working. Improving the bad posture habits with the help of yoga, pilates and chiropractic manipulation will also help.

Surgery: Surgery is considered only in severe cases when there is persistent numbness or loss of function in arms, legs, feet or fingers due to compression of spinal cord. The aim is removal of the bony osteophytes or disc causing pressure on the spinal cord. Surgery cannot reverse the damage already caused but is helpful in preventing additional damage.

Presently India is gaining immense popularity in field of health tourism. More and more people are opting India for their treatment. Many are visiting India for cervical spondylosis surgery as well. Spine surgeons in India are preferred because of their use of recent and improved technology, cost effective treatment, hospitality and ease of communication.