From the Guidelines
Cervical spondylosis is a common age-related condition characterized by the degeneration of the cervical spine, involving wear and tear of the discs and joints in the neck over time, leading to changes in the bones, discs, and ligaments, as noted in the context of cervical radiculopathy 1.
Definition and Prevalence
Cervical spondylosis is defined by the degeneration of the cervical spine, which can lead to symptoms such as neck pain, stiffness, and headaches, and sometimes numbness or weakness in the arms, hands, or fingers if nerves become compressed. It is a common condition that affects many individuals as they age, with most people over 60 showing some signs of cervical spondylosis on X-rays, though many remain symptom-free 1.
Clinical Presentation
The clinical presentation of cervical spondylosis can vary, but it often includes a combination of neck pain with pain in one arm, accompanied by varying degrees of sensory or motor function loss in the affected nerve-root distribution, as seen in cervical radiculopathy 1. Cervical radiculopathy is less prevalent than cervical or neck pain, with an average annual age-adjusted incidence of 83.2 per 100,000 people 1.
Diagnosis and Treatment
In the absence of red flag symptoms, imaging may not be required at the time of initial presentation, as spondylotic changes are commonly identified on radiographs and MRI in patients over 30 years of age and correlate poorly with the presence of neck pain 1. Treatment usually begins with conservative approaches, and surgery is rarely needed unless there is significant nerve compression causing persistent pain or neurological problems.
Management
Conservative management includes over-the-counter pain relievers, physical therapy focusing on neck strengthening and stretching exercises, and occasionally muscle relaxants for muscle spasms. Heat or cold therapy, proper ergonomics, and maintaining good posture can also help manage symptoms. The goal of treatment is to alleviate symptoms, improve function, and enhance quality of life, considering the natural history of the condition and the individual patient's needs and preferences.
From the Research
Definition and Overview
- Cervical spondylosis is a common degenerative change in the cervical spine, characterized by bulge or herniation at C3-C4, C4-C5, and C5-C6 2.
- It is a condition that affects the joints and discs in the neck, leading to pain and stiffness in the neck and surrounding areas.
Relationship with Age
- The incidence of cervical spondylosis increases with age before 50 years and decreases with aging after 50 years, especially in the elderly after 60 years 2.
- The occurrence rate of bulge or herniation at C3-C4, C4-C5, C5-C6, and C6-C7 also increases with aging before age 50 years and decreases with aging after age 50 years 2.
Symptoms and Treatment
- Cervical spondylosis can cause severe stiffness and non-radicular axial neck pain, which can be refractory to conservative therapy 3.
- Epidural steroid injections may be effective in improving axial neck pain and stiffness in patients with cervical spondylosis 3, 4.
- The use of epidural steroid injections in the management of cervical spondylosis is still being studied, and more research is needed to determine its effectiveness 4.