Cervical Spondylosis

Cervical spondylitisis a common degenerative condition of the cervical (neck) spine that most likely is caused by age-related changes (wear and tear) in the intervertebraldisks and vertebrae of the neck. Research has shown that CSM (cervical spondyloticmyelopathy) is the most common cause of non-traumatic weakness in limbs and a persistent stiffness and nagging pain in the neck.

Most often in people above the age of 40, the intervertebraldiscs get progressively dehydrated and they become more compressible and less elastic. Mineral deposition starts occurring in the intervertebraldisc resulting in secondary changes.

Although majority of individuals over 40 years of age demonstrate significant radiological evidence of the above changes, only a small percentage develop symptoms of the same. Another noteworthy point is that sometimes the degenerative changes in the cervical spine can be visible on the X-ray as early as in 30’s but it does not call for any treatment if the patient is not symptomatic.

Positioning the body to the same side during sleep, with the shoulder muscles and the neck compressed, also develops faulty alignment in the cervical spine. In due course the spine is bent, the front surface of the bones and disc are excessively pressurized damage occurs.

 

Causes, incidence, and risk factors

 

This is basically a mechanical disorder.
Very stiff muscles in the cervical region can, over the years, cause a kinking of the cervical spine to the front.
Bad posture and lack of exercise to the cervical region are the key factors which are responsible in a majority of the patients.
Lying in bed with several pillows propping up the neck into an unnatural position can affect the alignment of the cervical column, causing a forward inclination.
Reclining on sofas with the spine hunched and the neck pushed forward is bad for cervical alignment.
Hunching over the computer for many hours, occupational hazards such as those of a writer, an illustrator or a painter, all cause the spine to be bent forward all the time.

The so-called executive chairs are ill-designed and push the neck out of alignment. No chair should reach over the head. The level should be up to the shoulder blades so that the chest can stretch over the edge keeping the body upright.
In India, railway porters carry heavy loads on their heads but they do not suffer from cervical pain (as one would expect) from the heavy load they carry every day. Only in the group of people who never exercise their bodies does this occur most frequently.

Symptoms

Neck pain and stiffness is one of the earliest presentations of cervical spondylitis. Some of the characteristic features of this condition are:
Chronic or episodic pain and stiffness in the neck and shoulder region
The pain tends to get worse over a period of time
There may be periods initially when the pain disappears completely; later as the disease advances the pain may remain persistent.
Pain may radiate (travel) from neck to shoulders, arms, forearms, hands, lower part of the head, upper back
Coughing, sneezing, other movements of the neck may worsen symptoms
Along with pain, there may be abnormal sensations (tingling numbness), loss of sensation, weakness in any of the above regions.
There may be non-specific headaches in the lower part of the back of head
Sensation of loss of balance
Loss of control over the bladder or bowels (if the spinal cord is compressed)
Occasionally there may be atypical pain presenting as chest pain or breast pain (false angina)

Signs and tests

The doctor may find certain clear pointers to this disease on examination of the patient:
Spasm of the neck muscles
Limited range of movements of the neck –bending forward, backward, sideways, rotating the head are all limited
Weakness of muscles of the arms, forearms
Altered sensation in the shoulder region, arms, forearms, neck, etc.
Reflexes are often reduced
poorly localisedtenderness,
limited range of motion,
minor neurological changes.
Do’s and Dont’sIf 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 posturesDo use firm collars while travelingDo not lift heavy weights on head or back Do not turn from your body but turn your body moving your feet firstDo turn to one side while getting up from lying downDo the exercises prescribed regularly Do use firm mattress, thin pillow or butterfly shaped pillowDo not lie flat on your stomach.

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