Pain in the
neck is common and may be a natural consequence
of aging in people over 35. Like the rest of the body, bones in the neck
(cervical spine) progressively degenerate as we grow older. Over time, arthritis
of the neck (cervical spondylosis) may result from bony spurs and problems
with ligaments and discs. The spinal canal may narrow (stenosis) and compress
the spinal cord and nerves to the arms. Injuries can also cause spinal cord
compression. The pain that results may range from mild discomfort to severe,
crippling dysfunction.
Symptoms
Cervical spondylosis can lead to chronic pain and stiffness in the neck
that may also radiate to the upper extremities (radiculopathy).
Neck pain and stiffness may be worse with upright activity.
You may have numbness and weakness in the arms, hands and fingers, and
trouble walking due to weakness in the legs.
You may feel or hear grinding or popping in the neck when you move.
Muscle spasms or headaches may originate in the neck.
The condition can make you feel irritable and fatigued, disturb your
sleep and impair your ability to work. See your doctor soon for diagnosis
and treatment.
Doctor’s exam
Give the doctor your complete medical history. This can help him or her
rule out other conditions that cause symptoms similar to cervical spondylosis.
The doctor will examine you physically and may take X-rays or use other
diagnostic imaging tests to see inside the body.
Medical history: Tell the doctor if you have any illnesses or chronic
conditions. Describe the exact location of neck pain and when the problem
began. What does the pain feel like? Have you ever injured your neck or
been previously treated for neck pain?
Physical exam: The doctor may identify tender spots along the back
of your neck and evaluate your ability to move the neck in various directions.
He or she may test your reflexes and the function of nerves and muscles
in the arms and legs. The doctor may want to watch you walk.
Imaging: X-rays and/or MRI (magnetic resonance imaging) studies may show
bone spurs and other abnormalities and reveal the extent of damage to the
cervical spine.
In certain cases, you may need additional tests before the doctor can
make a diagnosis. Sometimes the doctor may want you to see a neurologist
for evaluation.
Treatment
If you have cervical spondylosis, symptoms may last for several months
or become chronic. Most of the time if symptoms are mild, the doctor may
recommend a variety of non-surgical treatments. Rest, medication and physical
therapy may take away most of your symptoms, but do not treat the underlying
cause. The doctor may want to see you again to check if symptoms have
gotten better, worse or stayed the same.
Rest. You may need to wear a soft cervical collar or neck brace to limit
neck motion and relieve nerve irritation.
Medication. The doctor may prescribe non-steroidal anti-inflammatory
medications (NSAIDs) or other non-narcotic pain relievers to relieve pain
and reduce swelling.
Physical therapy. A cervical traction device, hot and cold therapy or
active exercise program may help relieve symptoms. Exercises may include
neck strengthening, neck and shoulder stretching and aerobic exercises.
Gentle massage and improving your posture may also help.
Surgery. Surgery may be necessary if you have severe pain that does not
improve with other treatments or progressive neurological symptoms. Surgery
may remove bone spurs or disk material (decompression) and provide lasting
relief.
