Cervical spondylosis is damage to the cervical vertebrae and their bearings, thereby compressing the spinal cord and causes pain in the neck, shoulders, and head. Cervical spondylosis is also known as cervical osteoarthritis or arthritis of the neck.
One of the most common causes of cervical spondylosis is osteoarthritis. Osteoarthritis can occur with age. Osteoarthritis of the neck will cause the cervical spine and its bearings to experience tissue damage. This condition further causes pressure on the spinal cord.
It is estimated that about 90% of people aged 60 years and over are susceptible to cervical spondylosis. Although it is more common in the elderly, cervical spondylosis can also occur in young people. Usually this is triggered by previous injuries to the head and neck area.
Causes of Cervical Spondylosis
Cervical spondylosis is generally caused by structural changes and tissue damage to the spine and cervical spine. Some conditions and diseases that can cause cervical spondylosis are:
- Bone bearing thinningThe cervical spine is shaped like a pillar that has segments. Between the segments are filled with bony pads. With age, these bearings will thin out due to reduced fluid in the bearings.
- Bone bearing herniaAs a result of aging, the neck bones can also experience fragility and cracks. This can lead to protrusion (herniation) of the bony pads that eventually press on the spinal cord.
- Stiff ligamentsAging can also cause the ligaments or connective tissue between the cervical vertebrae to become stiff and inflexible.
- Cervical calcificationIn response to the thinning of the bony cushion, the cervical vertebrae will form additional tissue in an effort to maintain the integrity of the cervical vertebrae. This extra bone tissue can put pressure on the spinal cord.
In addition to some of the causes above, there are a number of factors that can increase a person's risk of suffering from cervical spondylosis, including:
- Age increase
- Smoking habit
- Have a family history of cervical spondylosis
- Doing work that often involves the neck, for example, often carrying objects or weights
- Have you ever had a neck injury?
Symptoms of Cervical Spondylosis
Spondylosis can result in narrowing of the spinal canal and eventually compressing the spinal nerves. This condition triggers a number of symptoms, such as:
- The gait that looks jerky
- Stiff neck
- Neck pain that can get worse when you cough, sneeze, sit or stand
- Pain in the head, shoulders, arms, to the fingers
- Arm or hand feeling weak, stiff, or tingling
- Difficulty walking and coordinating movements
- Spasm or involuntary (unconscious) movements of the legs appear
- Sometimes it can be accompanied by balance disorders and loss of ability to hold urination and defecation
However, cervical spondylosis can also occur without symptoms. This can result in damage to the cervical spine and the cushion does not press against the spinal cord.
When to go to the doctor
Check with your doctor if you experience the complaints and symptoms as mentioned above, especially if you have had a neck injury. Prompt treatment is necessary to prevent complications.
Immediately do an examination to the doctor if you start to have difficulty walking and can not hold urination and defecation.
If you have been diagnosed with cervical spondylosis, check with your doctor regularly. In addition to monitoring the results of therapy, this routine examination also aims to reduce the risk of complications.
Diagnosis of Cervical Spondylosis
To diagnose cervical spondylosis, the doctor will first ask questions about the patient's complaints and medical history, especially if the patient often experiences stiffness and pain in the neck.
After that, the doctor will perform an examination to see the movement of the neck or arm and leg reflexes. It aims to determine the presence of nerve damage due to spinal narrowing. To confirm the diagnosis, the doctor will perform supporting examinations in the form of:
- X-ray of the spine, to see calcification at once to rule out other conditions, such as tumors, infections, or fractures
- CT scan, to see a more detailed picture of the bones, in some circumstances a CT scan using contrast fluid can also be done
- MRI, to find out more specifically the stressed nerve tissue
- Electromyography (EMG) and nerve conductivity tests, to determine the electrical activity between nerves and muscles, as well as the speed at which these electrical impulses are delivered
Cervical Spondylosis Treatment
Treatment for cervical spondylosis depends on the severity of the symptoms. The goals of this treatment are to relieve pain, prevent permanent damage to the spine, cushions, and nerves, and help the sufferer to continue to function normally.
Some of the treatment options that will be given by the doctor to treat cervical spondylosis are:
Drugs
Patients with cervical spondylosis who have mild symptoms will usually be advised to take over-the-counter pain relievers, such as paracetamol.
However, if the patient's pain and other complaints are getting worse, the doctor may prescribe medication to relieve the symptoms of cervical spondylosis. Some types of drugs that may be prescribed by a doctor are:
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce pain and inflammation
- Corticosteroid drugs, such as prednisone injection, to reduce inflammation, so that it can relieve complaints and symptoms
- Muscle relaxants, such as eperisone or chlorzoxazone, to reduce muscle tension caused by cervical spondylosis
- Antiseizure drugs, such as pregabalin and gabapentin, to reduce pain from irritation of the nerves
- Tricyclic antidepressant drugs, such as amitriptyline, to reduce chronic pain from cervical spondylosis
- Opioid pain relievers, such as oxycodone, to reduce pain that is severe and doesn't go away after other drugs are given
Physiotherapy
Physiotherapy is done to strengthen the muscles in the neck and shoulders. This treatment method will restore the function of movement.
Operation
Although it can't restore the patient's condition to 100%, surgery can be done to prevent the condition and damage to the spine and bearings from getting worse. The types of spinal surgery that can be done to treat cervical spondylosis are laminectomy and discectomy procedures.
The surgical procedure is usually performed in cases of pain that cannot be relieved by any treatment or there is pressure on the spinal cord causing symptoms to continue to worsen.
Self-medication
In addition to undergoing treatment from a doctor, cervical spondylosis sufferers are also advised to do treatment at home by:
- Compress the neck with warm water or ice water
- Using a neck brace (braces or collar neck)
- Doing light exercise that doesn't involve movement of the neck on a regular basis
- Avoid neck down, twisting, or looking up
- Avoid sitting or standing for too long
- Choose a comfortable chair to sit
Complications of Cervical Spondylosis
Untreated cervical spondylosis has the potential to cause a number of complications, including:
- Paraplegia, which is the loss of the ability to move both lower limbs
- Quadriplegia, which is the loss of the ability to move all limbs, including the arms, hands, legs, and feet
- Recurrent infections of the chest wall
- Permanent damage to the spinal cord
Prevention of Cervical Spondylosis
There are several steps you can take to prevent cervical spondylosis, including:
- Always be active, move diligently, and exercise regularly
- Maintain good posture when sitting or standing and keep your shoulders perpendicular to your hips
- Use personal protective equipment, such as a helmet or headgear, while working or playing sports
- Do an examination to the doctor if there is a history of cervical spondylosis in the family