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 What is Cervical Spondylosis/Cervical Osteoarthritis / Degenerative neck disease ? |
| General Informations about Vertebral Structure |
| General Informations about Cervical Spondylosis/Cervical Osteoarthritis / Degenerative neck disease |
| What are the symptoms of Cervical Spondylosis/Cervical Osteoarthritis / Degenerative neck disease ? |
| How is Cervical Spondylosis/Cervical Osteoarthritis / Degenerative neck disease Diagnosed ? |
| How is Cervical Spondylosis / Cervical Osteoarthritis / Degenerative neck disease Treated ? |
| Frequently Asked Questions |
| Glossary |
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| What is Cervical Spondylosis/Cervical Osteoarthritis / Degenerative neck disease ? |
Cervical Spondylosis is a degenerative disease affecting the joints of the cervical vertebrae (Bones of the back of neck) with deposition of minerals in the discs (cushions) , which is present in between the vertebral bones.
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| General Informations about Vertebral Structure |
The spinal cord is protected by a column of bones called vertebrae which are stacked vertically on one another. There are seven cervical vertebrae and eight nerves arising from the vertebrae.
Each vertebral bone is attached to the next vertebral bone by means of Inter-vertebral joints. There are spaces between each bone that are occupied by a structure called Inter vertebral disc (cushion).
The Vertebral discs are made up of tough outer tissue with inner elastic tissue. Each disc acts as cushion to the vertebral bones and protects the nerves and blood vessel that pass between the two vertebrae. The discs also gives flexibility to the spinal cord for free movement.
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| General Informations about Cervical Spondylosis/Cervical Osteoarthritis / Degenerative neck disease |
The area, which are commonly affected by Cervical Spondylosis are from the fourth to seventh vertebral bones. The discs present in between the two vertebrae loses height due to ageing or degeneration or sometimes due to injury.
In cervical spondylosis the ligament of the joints become thick and shortened. The disc space becomes narrow and gradually compresses the nerve. In advanced cases of Cervical Spondylosis, spinal cord is affected and may also lead to paralysis of the arm.
Galen as far back as in 160 AD recognized this protective effect of the discs and said:
'Probably then, provident nature made the nerves grow out from the spinal medulla right at the point where the lateral parts of the vertebrae come to an end, so that the nerves may not suffer in any way'.
Who are commonly prone to cervical spondylosis?
 It is common in middle-aged people.
Women are affected more than men.
Degeneration occurs at different people at different rates. Pain is not common in all who undergo the ageing process, it occurs in the presence of any one of the precipitating factor as enlistd in the causes below..
What are the causes of cervical spondylosis?
Injury
Bad posture
Occupational strain
Body type
Life style
Injury
cervical spondylosis can be caused by previous injury, repeated fractures or dislocations of the joints of neck. These cause abnormal tear of joints, ligaments and the structures surrounding the joints.
Bad posture
Incorrect posture adapted by habit or due to poor skeletal set up in the neck predisposes abnormal tear of the neck joints.
What is bad posture that can cause cervical spondylosis ?
The head is held forwards from normal position.
The shoulders are held up and forward.
The chest is bent and rounded.
The pelvic area is tilted backwards.
The hips, knees and ankles are bent.
Occupational strain
The physical discomfort, which arises through an occupation is occupational stress. The physical strain, intensity of work and duration of working hours all constitutes the occupational strain.
Life style
The various styles of activity adapted in daily life can cause strain or tear of the structures of the neck and lead to cervical spondylosis. An example is awkward positions adapted while sleeping.
Body type
Body type also predisposes cervical spondylosis
- Thick necks with hump at the back
- Long backs
These body types are more prone to cause strain or tear of the neck tisues.
"All limbs but not the face are deprived of motion and sensation, when a condition has arisen at the level of the spinal cord where the first nerves leave, since this prevents a flow of the faculties from the brain to the limbs. Likewise, when only half [of the spinal cord] where these nerves originate is affected, the paralysis does not involve all the parts further down but only those, of course, at the right or left side."
Galen, [130-200] |
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| What are the symptoms of Cervical Spondylosis/Cervical Osteoarthritis / Degenerative neck disease ? |
Pain
Neck pain
Shoulder pain
Headache
Muscle tightness
The muscles covering the regions like back of neck shoulder , side of neck will be stiff and painful.
Referred pain
There may be no pain felt over the neck but referred pain maybe present in arm, elbow, thumb and fingers.
Limitation of movement
The neck movements are limited. Extending the neck up is difficult and restricted due to pain and stiffness, but flexing the neck down is possible.
Loss of bladder and bowel control
In extremely severe cases, if the spinal cord is affected, there will be loss of balance and also loss of bladder and bowel control.
Muscle weakness
The muscles responsible for maintaining the neck in erect position can become weak.
Sensory loss
The bones of the neck applies pressure over the nerves passing through them and can causes loss of sensation in the arm or fingers.
General tiredness and anxiety - can be present.
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| How is Cervical Spondylosis/Cervical Osteoarthritis / Degenerative neck disease Diagnosed ? |
The doctor will first ask a few pertinent questions and then examine the normal aligned position of the neck and will then perform certain special tests and X-rays if he suspects this condition.
Special Test
Neck Compression Test (Spurling's Test) - This test is done by the doctor to confirm the presence of cervical spondylosis. The test is done while you are sitting on a chair, and the doctor extends your neck, turns and rotates the neck to the side where pain is present and he will carefully compresses your head by pressing gently. This may cause pain and sometimes giddiness if you have cervical spondylosis.
X-ray (Side of neck view)
If cervical spondylosis is present, the x-ray features are as follows:
There will be bony outgrowths at the margin of the joints.
There will be reduced space between the vertebrae of neck.
The opening between the bones will be narrowed.
MRI Scan
The MRI features of a cervical spondylosis are as follows:
Loss of normal curvature of neck
Vertebral bone canal diameter is decreased
Spinal canal is narrowed
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| How is Cervical Spondylosis / Cervical Osteoarthritis / Degenerative neck disease Treated ? |
Medical
Physiotherapy
Relaxation
Lifestyle Modifications
Ergonomics
Surgical
Medical Treatment
Usually Analgesics and muscle relaxants are advised . In more severe cases the orthopaedic doctor may suggest cortisone injections near the joints of the vertebral bodies to ease the swelling of the nerves and relieve pain.
Surgical Treatment
If the medical treatment and physiotherapy fails, and the condition is severe, where the nerves are affected, surgery may be required.. Decompression of the nerve is done to relieve the nerve which is compressed by the bones and the disc.
Physiotherapy
The goal of physiotherapy treatment is to relieve pain, and enhance movements of the neck.
Shortwave diathermy - A disc or heating pad is placed over the back of the neck. The warmth obtained from the shortwave diathermy current relaxes the muscle and the pain is relieved.
Cervical Traction - Traction is a mechanical device, which supports the head and chin. It is used to relieve the nerve compression by a bone.
Posture correction - Simple postural exercises can be taught to correct the faulty position of the neck.
Motivation is given to maintain the erect posture:
Collars - Two types of collars can be prescribed:
1. Soft Collar - Soft collar is used during night times to prevent awkward position of the neck during sleep.
2. Firm Collar - Firm collar steadies the neck and relieve pain, especially during traveling or work. It is removed when the pain subsides.
Relaxation
Relaxation is essential part of treatment. Tension in neck and shoulder muscle, pain, anxiety are all relieved by relaxation.
Relaxation can be done in two ways:
Physical Relaxation.
Mental Relaxation.
Physical Relaxation:
The whole body is relaxed by free suitable and comfortable positions, so that the muscles are freed from tension and the pain is relieved. For eg., position of relaxation - when you are lying flat on your back.
One pillow under the head
One cushion for the shoulder and
One under knees.
The pillow should be firm and thin
This position will allow relaxation for your body while lying down.
Relaxation while sitting.
The head, neck and shoulder are supported by high backed chair, with a small pillow at lower back.
Feet supported on stool or low bench
Arm, resting on arm of chair or pillow
Mental Relaxation
Positive thinking and using imagination is the way of relaxing mentally. This type makes one feel better and breaks the pain cycle. Muscle tension, anxiety, loss of sleep and pain are all relieved by mental relaxation exercises like yoga.
Lifestyle Modifications
Some modifications in life style will help in over coming problems of cervical spondylosis. For example:-
Avoid any strain of neck and shoulder like reading and writing for long hours.
Avoid the use of very soft cushion bed and avoid using a very high pillow.
Ergonomics
Ergonomics concentrates on the architectural design of furnitures like desk, chairs, tables etc. The design of the furniture should be such that it should support the body structure without causing any undue strain to the muscles of the back and neck .
Do's and Dont's
If you are prone to cervical spondylosis, Avoid bad roads, if travelling by two or four wheelers
Do not sit for prolonged period of time in stressful postures
Do use firm collars while traveling
Do not lift heavy weights on head or back
Do not turn from your body but turn your body moving your feet first
Do turn to one side while getting up from lying down
Do the exercises prescribed regularly
Do use firm mattress, thin pillow or butterfly shaped pillow
Do not lie flat on your stomach.
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| Frequently Asked Questions |
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| Glossary |
Cervical vertebrae - The first and eight bones of the vertebrae that supports the neck and its structure.
Spinal cord - It is a long ,neural, conical structure extending as a continuation of the brain. Spinal cord consists of many nerves, which is supported by the vertebral column of bones.
Inter vertebral disc - It is a cushion like structure found in between two vertebral bones.
Posture - The normal alignment of all the segments of the body. The position or bearing of the body.
Occupational stress - The discomfort caused by the physical and mental state of body due to an occupation.
MRI - Magnetic Resonance Imaging. It is a diagnostic method, which uses magnetic resonance to give out the image of the scanned structure.
Ergonomics - An applied science concerned with studying the structure of a person and designing and arranging items like furniture so that these are most effectively and safe for the proper functioning of the body. (Human Engineering)
De-compression - Surgical way of removing narrowing bone and disc, that compresses the nerves of the spinal cord.
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