Cervical Spondylosis

Mayfield, where this clinic is based, has reasonably large number of elderly residents; consequently I regularly see patients affected by Cervical Spondylosis. This is an age-related degeneration of the discs (between the vertebra) in the neck, leading to a loss of height/length of the spine. The vertebral joints can then push together, rub down and wear out. We all develop some degeneration in the vertebrae and discs from our third decade onward, but in most cases the major degenerative changes occur primarily in the 6^th and 7^th decade of life.

One feature of the degeneration is that the edges of the vertebral joints can develop small, rough protrusions of bone looking like ‘spurs’ called osteophytes. These can compress the nerves as they exit from between the vertebra. The nerves that supply the arms with sensation and power originate from the mid and lower neck; ironically this is where most wear and tear also occurs. As a result, neurological symptoms in the arms are reasonably common in this condition and can produce tingling, pins and needles, pain and numbness sometimes as far as the fingers. Another common cause of these radicular symptoms to the arms is the ‘inflammation’ that all this rubbing and wearing out produces in the vertebral bones, ligaments, joints and neck musculature.

Symptoms can range from mild to severe, or nothing at all, but they may include:

• Pain in the neck which may spread to the shoulders and base of the skull. Movement of the neck may make the pain worse. The pain can spread down an arm to a hand or fingers. The pain tends to come and go with flare-ups from time to time. You may have a flare-up of pain after unaccustomed use of your neck.
• Headaches may occur. The headaches often start at the back of the head just above the neck and travel over the top to the forehead.
• You may develop ‘pins and needles’ in part of an arm or hand. This symptom is caused by irritation of a spinal nerve. These symptoms suggest more pressure on a nerve.
• If you develop dizziness or blackouts when turning the head or bending the neck. This can suggest that the vertebral artery which supplies the brain is being nipped by the degenerative changes in the spine.

Help yourself – Exercise your neck and keep active –

• Aim to keep your neck moving as normally as possible and not let it ‘stiffen up’. Every few hours gently move the neck around even if you are sitting on the sofa and especially if you are working at a desk or on a PC or laptop.
• Good posture may help –  Yoga and Pilates also improve neck posture and are worth trying.
• A good supportive pillow – can help some people when sleeping. Use enough but not too many pillows as this can set off your neck.
• Medicines – Painkillers are often helpful along with anti-inflammatory. Always speak to your GP and pharmacist about starting to take a course of these especially if you are on other types of medication.
• Osteopathy – Various treatments can be provided by an osteopath. These include soft-tissue techniques, articulation, cold treatment, ultrasound etc. What is often most helpful is the advice the osteopath can give on neck exercises and other self-treatment methods for home.