CERVICAL SPONDYLOSIS

General Information

DEFINITION--Degenerative changes of bones in the neck that place pressure on nerves and muscles to the arms, legs and bladder.

BODY PARTS INVOLVED

• 7 bones of the neck.
• Disks between the bones.
• Blood vessels to the head.
• Bladder and lower legs (advanced stages).

SEX OR AGE MOST AFFECTED--Adults of both sexes. More common in males after 40, increasing after age 60.

SIGNS & SYMPTOMS--

Any of the following:

• Pain in the neck, radiating to the shoulder blades, top of the shoulders, upper arms, hands or back of the head.
• Crunching sounds with movement of the neck or shoulder muscles.
• Numbness and tingling in the arms, hands and fingers; some loss of feeling in the hands; and impairment of reflexes.
• Muscle weakness and deterioration; diminished reflexes.
• Neck stiffness.
• Headache.
• Dizziness; unsteady gait.
• With advanced disease, loss of bladder control and leg weakness.

CAUSES

Arthritis (inflammation of a joint). > Injuries such as: automobile accidents with "whiplash" injury; athletic injuries; sudden jerks on the arms; falls.

• Osteoarthritis (wear and tear on joints that accompanies aging).
• Outgrowths of bone that sometimes occur with aging.

RISK INCREASES WITH

• Adults over 60.
• Fatigue or overwork.
• Neck injury.

HOW TO PREVENT

• Avoid sitting in cramped positions.
• Sleep without pillows. Use a soft fabric collar or towel to support the neck.
• Avoid injury. Wear protective headgear for contact sports. Use seat belts in vehicles and keep headrests at proper height.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• X-rays or MRI scan (See Glossary) or other diagnostic tests may be obtained to confirm the diagnosis.

APPROPRIATE HEALTH CARE

• Self-care for mild symptoms.
• Doctor's treatment for signs of nerve-root pressure (symptoms in the head, arms or bladder) or pain.
• Ultrasonic treatments may be recommended.
• Surgery (sometimes) to fuse neck bones, remove a damaged disk or enlarge the spinal-cord space.

POSSIBLE COMPLICATIONS

• Reduced neck flexibility after surgery or treatment.
• If untreated, a spastic gait may result as the disease progresses.

PROBABLE OUTCOME--Minor symptoms usually respond well to treatment and subside slowly. Severe symptoms may persist indefinitely.

How To Treat

GENERAL MEASURES--

• Wear a soft fabric collar (Thomas collar) to prevent unexpected neck-muscle strain.
• Apply moist heat. Take hot showers and let the water beat on neck and shoulders for 10 to 20 minutes twice a day. Between showers, apply hot soaks to neck. Soak towel or cloth in hot water, wring out and apply.
• Improve your posture. Pull in the chin and abdomen when sitting or standing. Use a firm chair and sit with buttocks against the back.
• Sleep without a pillow. Instead, use a cervical pillow, wear a soft fabric collar, or put a small rolled towel under the neck.
• If numbness or pain affects the hands or arms, buy or rent a cervical-traction apparatus. To set it up, follow directions that accompany the apparatus.

MEDICATION--

• For minor discomfort or disability, you may use aspirin or acetaminophen.
• For serious discomfort, your doctor may prescribe stronger pain medicine, muscle relaxants or tranquilizers.

ACTIVITY--Any activity that does not cause symptoms is recommended.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of cervical spondylosis.
• Symptoms persist or worsen despite treatment.