Cervical Spondylosis

February 8, 2017

Cervical Spondylosis or Cervical Osteoarthritis is a physical condition caused by the wear and tear of bones and cartilage in the neck (cervical vertebra) region.  It is a common cause of chronic neck pain.

Cervical Spondylosis is a degenerative disorder at the level of the cervical spine. It can be described as the result of degeneration of the intervertebral discs or the corpus vertebrae in the cervical region. Possible characteristics are Degenerative Disc Disease, the formation of osteophytes, facet and uncovertebral joint arthritis, ossification of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum, spinal stenosis. In some cases this degeneration also leads to a posterior protrusion of the annulus fibers of the intervertebral disc. This protrusion can cause compression of nerve roots, which in turn can lead to pain, motor disturbances such as muscle weakness, and sensory disturbances. As the spondylosis progresses there may be even interference with the blood supply to the spinal cord where the vertebral canal is narrowest. However, in some people, the nearby muscles, ligaments, or nerves may become irritated or ‘pressed on’ by the degenerative changes. So, cervical spondylosis often causes no problems but can be a cause of neck pain, particularly in older people.

The cervical spine is made up of small circular bones (vertebrae) stacked on top of each other. Between each vertebrae is an intervertebral disc which acts like a shock absorber and allows flexibility of the spine. Muscles and ligaments run between, and are attached to, the vertebrae. Nerves from the spinal cord pass between the vertebrae going to the shoulder, neck, arm, and upper chest.


Cervical spondylosis arises from degenerative changes that occur in the spine as a person ages. These changes are normal and they occur in everyone. In fact, nearly half of all people middle-aged and older have worn disks that do not cause painful symptoms. The following are causes –

  • Cervical Stenosis is a condition when the disc degenerates, the normal relationships of the bones are lost and there is a condition of instability- one vertebra moving in an abnormal manner in relation to the next vertebra. In an attempt to stabilize, new bone grows outward – osteophytes. Osteophytes can be found near the disc spaces and around the facet joints. If they grow in areas where nerves or the spinal cord are nearby, they can impinge or compress these structures. This can cause pain, numbness, tingling, or weakness to varying degrees. If significant enough to cause nerve dysfunction, it is known as cervical stenosis.
  • Cervical Disc Herniation is more or so like the disc prolapse/herniation in the lower back. In the process of sustaining increased mechanical loads, the outer aspect of the disc, known as the annulus becomes stressed and with time, small tears can form in it. The gel center, known as the nucleus, can be ejected from the disc through an annular tear. This is called a disc herniation. If the disc herniates in the direction of the spinal cord or nerve root, it can cause neurologic compromise. Disc herniations in the cervical spine can be serious. If significant enough, they can cause paralysis of both the upper and lower extremities, though this is extremely rare.
  • In most cases, a patient complains of neck pain associated with radiating pain to one arm. This is caused by compression of a nerve root. With time some herniated discs resolves or shrinks. Sometimes, disc herniations can persist, causing prolonged symptoms and neurologic problems, which may lead to surgical considerations.

What are the Risk Factors?

Age is the most common risk factor for cervical spondylosis. The condition is extremely common in patients who are middle-aged and older.

Other factors that may increase your risk for developing cervical spondylosis and neck pain include –

  • Genetics—a family history of neck pain and spondylosis
  • Smoking—clearly linked to increased neck pain
  • Occupation—jobs with lots of repetitive neck motion and overhead work
  • Depression or anxiety
  • Previous injury or trauma to the neck


For most people, cervical spondylosis causes no symptoms. When symptoms do occur, they typically include pain and stiffness in the neck. This pain can range from mild to severe. It is sometimes worsened by looking up or looking down for a long time, or by activities in which the neck is held in the same position for a prolonged period of time—such as driving or reading a book. The pain usually improves with rest or lying down.

Other symptoms may include –

  • Headaches
  • Grinding or popping noise or sensation when you turn your neck
  • In some cases, cervical spondylosis results in a narrowing of the space needed for the spinal cord or nerve roots. If this occurs, your symptoms may include numbness and weakness in the arms, hands, and fingers
  • Trouble walking, loss of balance, or weakness in the hands or legs
  • Muscle spasms in the neck and shoulders

The pain may get worse –

  • After standing or sitting
  • At night
  • When a person sneezes, coughs, or laughs
  • When a person bends the neck backwards or walk more than a few yards

Less common symptoms are –

  • Loss of balance
  • Loss of control over the bladder or bowels (if there is pressure on the spinal cord)


Medications – During the first phase of treatment, your doctor may prescribe several medications to be used together to address both pain and inflammation

  • Acetaminophen – Mild pain is often relieved with acetaminophen.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) – Often prescribed with acetaminophen, NSAIDs such as ibuprofen and naproxen are considered first-line medications for neck pain. They relieve both pain and swelling and may be prescribed for a number of weeks, depending on your specific symptoms. Other types of pain medication can be considered if you have serious contraindications to NSAIDs or if your pain is not well controlled.
  • Muscle relaxants – Medications such as cyclobenzaprine or carisoprodol can be used to treat painful muscle spasms.

Blockers –

  • Cervical epidural block – In this procedure, steroid and anesthetic medicine is injected into the space next to the covering of the spinal cord (“epidural” space). This procedure is typically used for neck and/or arm pain that may be due to a cervical disk herniation, also known as radiculopathy or a “pinched nerve.”
  • Cervical facet joint block – In this procedure, steroid and anesthetic medicine is injected into the capsule of the facet joint. The facet joints are located in the back of the neck and provide stability and movement. These joints can develop arthritic changes that may contribute to neck pain.
  • Medial branch block and radiofrequency ablation – This procedure is used in some cases of chronic neck pain. It can be used to both diagnose and treat a painful joint. During the diagnosis portion of the procedure, the nerve that supplies the facet joint is blocked with a local anesthetic.

Surgery – Surgery is not commonly recommended for cervical spondylosis and neck pain unless the doctor determines that –

  • A spinal nerve is being pinched by a herniated disk or bone (cervical radiculopathy), or
  • The spinal cord is being compressed (cervical spondylotic myelopathy)

Soft cervical collar – This is a padded ring that wraps around the neck and is held in place with Velcro.

Ice, heat, and other modalities – The doctor may recommend careful use of ice, heat, massage, and other local therapies to help relieve symptoms.

Physical therapy – Physical therapy is usually the first nonsurgical treatment that the doctor will recommend. Specific exercises can help relieve pain, as well as strengthen and stretch weakened or strained muscles. In some cases, physical therapy may include posture therapy or the use of traction to gently stretch the joints and muscles of the neck.

Alternative Treatment

5-HTP (5-hydroxytryptophan) is the precursor of the neurotransmitter serotonin. It is obtained commercially from the seeds of the plant Griffonia simplicifolia. There is a small amount of research evaluating the use of 5-HTP for fibromyalgia, and early evidence suggests that 5-HTP may reduce the number of tender points, anxiety, and intensity of pain and may improve sleep, fatigue, and morning stiffness.

DHEA (dehydroepiandrosterone), the majority of clinical trials investigating the effect of DHEA for systemic lupus erythematosus (SLE) support its use as an adjunct treatment.

Omega-3 fatty acids, fish oil, alpha-linolenic acid – Multiple randomized controlled trials report improvements in rheumatoid arthritis, including morning stiffness and joint tenderness, with the regular intake of fish oil supplements for up to three months. Benefits have been reported as additive with anti-inflammatory medications such as NSAIDs (like ibuprofen or aspirin).

S-adenosyl-L-methionine (SAMe) is a naturally occurring molecule that is found in humans. SAMe is present in almost every tissue and fluid in the body, and has been studied extensively in the treatment of osteoarthritis. SAMe reduces the pain associated with osteoarthritis and is well tolerated in this patient population.

Proteins,Calcium and vitamin D – Proteins and Vitamin C are necessary for the development of a healthy bone metrix. Vitamin D, calcium, phosphorous and the essential trace minerals are essential for healthy bones.

Glucosamine– Several human studies and animal experiments report benefits of glucosamine in treating osteoarthritis of various joints of the body, although the evidence is less plentiful than that for knee osteoarthritis. Some of these benefits include pain relief, possibly due to an anti-inflammatory effect of glucosamine, and improved joint function.

Alpinia, also known as Chinese ginger, has been studied in combination with another ginger species for the treatment of cervical sondylosis.

Beta-carotene is a member of the carotenoids, which are highly pigmented (red, orange, yellow), fat-soluble compounds naturally present in many fruits, grains, oils, and vegetables (green plants, carrots, sweet potatoes, squash, spinach, apricots, and green peppers). Beta-carotene supplementation does not appear to prevent cervical spondylosis, but it may slow progression of the disease.

Boron is a trace element, which is found throughout the global environment. Based on human population research, individuals who eat foods rich in boron (including green vegetables, fruits, and nuts) appear to have fewer joint disorders.

Boswellia has been noted in animal and laboratory studies to possess anti-inflammatory properties. Based on these observations, boswellia has been suggested as a potential treatment for rheumatoid arthritis and cervical spondylosis.

Chiropractic is a healthcare discipline that focuses on the relationship between musculoskeletal structure (primarily the spine) and body function (as coordinated by the nervous system), and how this relationship affects the preservation and restoration of health.

Chlorophyll – Diets high in chlorophyll have been hypothesized to modify intestinal flora resulting in improved management of immune disorders including rheumatoid arthritis and other related disorders.

DMSO (dimethyl sulfoxide) – Applying DMSO to the skin may help treat CS.

Niacin – Vitamin B3 is made up of niacin (nicotinic acid) and its amide, niacinamide, may be useful in the treatment of cervical spondylosis.

Probiotics – In limited study, Lactobacillus GG was associated with improved subjective well-being, as well as reduced symptoms of rheumatoid arthritis and other related disorders.

Selenium supplementation has been studied in spondylosis patients with mixed results. Additional research is necessary before a clear conclusion can be drawn.

Chondroitin sulfate, a component of shark cartilage, has been shown to benefit patients with spondylosis.

Methylsulfonylmethane, or MSM, is a form of organic sulfur that occurs naturally in a variety of fruits, vegetables, grains, and animals. MSM is a normal oxidation product of dimethyl sulfoxide (DMSO).

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive technique in which a low-voltage electrical current is delivered through wires from a small power unit to electrodes located on the skin. Electrodes are temporarily attached with paste in various patterns, depending on the specific condition and treatment goals.

Rose hips have traditionally been used by herbalists as an anti-inflammatory and antiarthritic agent.

Devil’s claw (Harpagophytum procumbens) originates from the Kalahari and Savannah desert regions of South and Southeast Africa. There is increasing scientific evidence suggesting that devil’s claw is safe and beneficial for the short-term treatment of pain related to degenerative joint disease.

Chondroitin – Multiple clinical trials have examined the use of oral chondroitin in patients with osteoarthritis of the knee and other joints (spine, hips, and finger joints).

Acupuncture is commonly used throughout the world. According to Chinese medicine theory, the human body contains a network of energy pathways through which vital energy, called chi, circulates. These pathways contain specific “points” that function like gates, allowing chi to flow through the body. Needles are inserted into these points to regulate the flow of chi.

Yoga is a natural and side-effect free remedy for Cervical Spondylosis. A regular practice of this ancient science leads to a flexible body, calm mind and a positive attitude towards life.


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