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Cervical spondylosis: a pain in the neck

Cervical spondylosis: a pain in the neck

Though poor posture can lead to cervical spondylosis, pain specialists say that ageing is the primary reason behind the condition. However, early diagnosis can arrest and even reverse it
Photo by Goutham V

It has been almost a year since Suresh Chandra (name changed), a retired bank officer from Bengaluru, started experiencing neck pain. The pain was of moderate intensity but it was nagging and exaggerated at the end of the day, as the 63-year-old prepared to go to bed.

Finally, when he consulted a doctor, Chandra was diagnosed with cervical spondylosis.

Dr Akash Hosthota, an orthopaedic spine surgeon from Bengaluru, who treated Chandra, tells Happiest Health that an increasing number of elderly people are diagnosed with cervical spondylosis. He adds most often, senior citizens experience neck pain for months. “However, they would assume that the pain is due to their sleeping position or some daily chores done wrongly.”

The orthopaedic spine surgeon suggests that the pain should not be neglected as it could indicate the gradual degeneration of the cervical spine. Early diagnosis can delay the progression.

What is cervical spondylosis?

“Cervical spondylosis, to put simply, is the wear and tear of your cervical spine and bones,” explains Dr Bishwaranjan Das, physiotherapist, Kasturba Medical College Hospital, Mangaluru, Karnataka. “It is a chronic spinal degeneration wherein the cervical spine progressively develops a stiffness; this condition, if left untreated, can result in lack of flexibility and mobility of the cervical spine,” he points out.

The pain and tingling sensation in a person living with cervical spondylosis start from the shoulders and pass through the arms and limbs too. Gradually, the locomotor muscles of the person become weak. Thus, typing or writing or holding something steadily becomes difficult for anyone with cervical spondylosis. Typically, the pain increases at night when the body is at rest.

Causes of cervical spondylosis

Citing the reasons for cervical spondylosis, Dr Hosthota says that age-related degeneration of the cervical spine is a major reason for this condition. “Middle-aged and elderly people are largely at risk.”

“The degeneration of the spine occurs due to the dehydration of the cervical disc. The cervical spine encompasses the first seven vertebrae of the spine. Every spine is sandwiched by a disc. This disc is made up of a jelly-like substance that acts as a cushion. Ageing can dehydrate the disc. The dehydration leads to pain,” informs Dr Das.

Additionally, lifestyle and the type of occupation also contribute to spine-related issues.

Poor posture can result in early cervical spine degeneration. “Today, we see young adults in their thirties also complaining of cervical pain. This could be due to long hours of work on their computers,” adds Dr Das.

Research also suggests that extensive use of upper limbs can result in cervical spine degeneration. Women, teachers, manual labourers, construction workers and quarrymen often complain of neck pain in their middle or old ages.

Dr Das, in this regard, reasons that women are more prone to develop cervical spine degeneration than men owing to the relentless domestic chores and the hormonal changes they go through. Additionally, he says, with a larger incidence of obesity among women in their middle age than men, the chance of developing neck pain is higher among women.

Sometimes cervical pain could be due to injury caused by heavy lifting, cycling, riding or racing.

Symptoms of cervical spondylosis

In 2007, Dr Daniel Shedid, MD and Dr Edward C Benzel — neurosurgeons from Cleveland Clinic Foundation, Spine Institute, Ohio — investigated the pathophysiology of cervical spondylosis in the work, ‘Cervical Spondylosis Anatomy.

They enumerate the following warning signs:

  • Neck pain
  • Shoulder pain
  • Reflex issue in the upper extremities (tested through Hoffman’s reflex)
  • Hand numbness
  • Loss of dexterity
  • Lower extremity weakness
  • Paresthesia (a burning sensation in the arms, feet and legs)
  • Hyperalgesia (a heightened pain sensitivity in the body)

A 2022 study published in the Journal of King Saud University – Computer and Information Sciences, describes the symptoms of cervical spondylosis as:

  • Chronic deterioration of the vertebrae and discs of the neck
  • Bony projections along the joints (also known as bone spurs or osteophyte formation)

Dr Hosthota charts the typical trajectory of cervical spondylosis. “It starts with mild neck pain and gradually increases in its intensity. Occasionally, the pain is experienced as a spasm and it requires analgesics/rest.”

However, he recommends that a clinical diagnosis is mandatory when there is:

  1. No relief from neck pain despite resorting to analgesics for more than three days
  2. Limb pain along with neck pain
  3. An alteration in the muscle strength along with neck pain

“In severe cases of cervical spondylosis, there will be a reduction of sensation and body control,” says Dr Das.

Prevalence of this condition

The National Health Interview Survey, US, examined 31,044 men and women in 2006 and found that 13.8 per cent of the respondents reported neck pain. They experienced the pain consistently for three months and it had lasted a whole day or more. This study also indicated that the likelihood of developing cervical spine degeneration increases after the age of 45. 

Treating cervical spondylosis

Dr Hosthota says that Chandra is successfully managing cervical spondylosis with regular medication and exercise. “The condition requires life-long care. Regular neck exercises are the only way to keep spine degeneration at bay,” says Dr Hosthota.

To prevent cervical spondylosis, doctors recommend maintaining proper posture at work, swimming, regular neck exercises, trapezius muscle strengthening exercises and the use of a proper pillow while sleeping. These will keep the spine healthy.

Doctors advise people who spend long hours hunching over their computers to take breaks after every 40 minutes. They should practice at least five minutes of stretching exercises for a healthy spine during their breaks.

Alternative medicine such as yoga and naturopathy can also prevent the degeneration of the spine. The Central Council of Research in Yoga and Naturopathy (CCRYN) largely recommends a balanced diet and regular exercises to reverse and/or delay neck pain.

It is advisable to practise these exercises under the supervision of a trainer.

Balanced diet: A wholesome meal with a healthy intake of calcium, phosphorus and vitamin D can help strengthen the spine muscles. Healthy eating can keep the cervical spine healthy too.

Yoga: Some of the yoga poses that ensure cervical spine health include, tadasana (mountain pose), urdhwa-hasta uttanasana (raised-hands pose), kati-chakrasana (standing spinal twist), ardha-chakrasana (half-wheel pose), konasana (sideward stretching of the spine), pavana muktasana (wind relieving pose), vajrasana (diamond pose), ushtrasana (camel pose), vakrasana (spinal twisting pose), ardha matsyendriyasana (seated-twist pose), marjari asana (cat pose), gomukhasana (cow pose), uttana mandukasana (extended frog pose), matsayasana (fish pose), bhujangasana (cobra pose), shalabhasana (locust pose), dhanurasana (bow pose), makarasana (crocodile pose) and shavasana (corpse pose).

Meditation and breathing: Practising meditation (mindfulness) can help relieve neck pain. Similarly, regulated and controlled breathing techniques (also known as pranayama) can largely help strengthen the spine and abdominal muscles.

Doctors also prescribe good spine rest, analgesics and muscle relaxers as part of the treatment for cervical spondylosis.

(With inputs from Dr Chetana B S)

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