From the Research
Cervical spondylosis treatment should initially focus on conservative approaches, including physiotherapy, analgesia, and selective nerve root injections, reserving surgery for moderate to severe myelopathy patients who have failed conservative treatment 1. The primary goal of treatment is to reduce inflammation, relieve pressure on nerves, strengthen supporting muscles, and improve spinal alignment to manage pain and prevent further degeneration.
Conservative Treatment Approaches
- Pain management with over-the-counter medications like acetaminophen or NSAIDs such as ibuprofen or naproxen
- Prescription muscle relaxants like cyclobenzaprine or short-term opioids for more severe pain
- Physical therapy, typically 2-3 sessions weekly for 4-6 weeks, focusing on neck strengthening, posture improvement, and range-of-motion exercises 2
- Home remedies including applying ice for 15-20 minutes every 2-3 hours during acute pain, followed by heat therapy after 48-72 hours
- Lifestyle modifications, including ergonomic adjustments at work, proper sleeping positions with a cervical pillow, and regular breaks from prolonged neck positions
Surgical Intervention
Surgery, such as anterior cervical discectomy and fusion or cervical artificial disc replacement, is reserved for cases with severe neurological symptoms or when conservative treatments fail after 6-12 months 3.
Key Considerations
- A detailed neurological examination is crucial for diagnosis, taking into account cervical levels and integrating imaging findings with clinical findings 4
- Differential diagnoses for cervical spondylosis include various neurological diseases, and misdiagnosis can be prevented by careful examination and integration of findings
- The course of the disease and ultimate prognosis for patients with cervical spondylosis are highly variable, with many patients experiencing a relatively benign form of the disease 4