Mr James Langdon

BSc (Hons) MB BS MRCS (Eng) FRCS (Orth) Consultant Orthopaedic Spinal Surgeon

Neck Pain

Cervical spondylosis is the medical term used to refer to general ‘wear and tear’ that occurs between the bones in the neck. The condition is also known as degenerative osteoarthritis. Cervical spondylosis can lead to episodes of stiffness and neck pain. Cervical spondylosis is common. In severe cases of cervical spondylosis the spinal cord or the nerves in the neck can become compressed.

Who is at risk from cervical spondylosis?

As cervical spondylosis is primarily an age-related condition, the older you get the more likely it is that you will develop the condition. It tends to develop earlier in men than women. It is estimated that by the age of 70, nearly 100% of all people will have some degree of cervical spondylosis. However, not everyone develops symptoms.

Symptoms

The majority of people who get symptoms from cervical spondylosis will experience episodes of neck stiffness and pain. Neck pain arises when these worn joints and discs become inflamed. This inflammation cannot be seen on a scan. The initial injury is often minor and rarely causes pain. It is this gradual inflammation that causes pain.

There are 2 common patterns of neck pain:

Constant neck pain or ache. This type of pain generally aggravated after exercise, and made worse by any prolonged activity such as reading or driving. This type of pain can be worse first thing in the morning, and in the evening after a long day.

Repetitive episodes of acute neck pain. This type of pain generally waxes and wanes. A seemingly trivial activity can lead to an acute episode of severe and incapacitating neck pain developing over the course of a few hours. These episodes can last a few days or a few weeks. Over time the pain may fail to fully resolve between episodes leaving the patient with a constant neck pain or ache, that continues to flare up on a regular basis.

With cervical spondylosis it is possible for the nerves or the spinal cord to become compressed. This is called cervical radiculopathy and cervical myelopathy.

Cervical radiculopathy – If the nerves are being compressed then this can cause arm pain, numbness, pins and needles and weakness.

Cervical myelopathy – If the spinal cord is being compressed then this can also lead to numbness, pins and needles, and weakness in the hands. It can also result in a loss of fine hand function making you clumsy with a tendency to drop things, a change in the way that you walk, and a loss of bladder and bowel control.

Treating cervical spondylosis

In most cases the symptoms of cervical spondylosis can be managed using a combination of over-the-counter medication (ibuprofen or paracetamol), and exercise. In cases where there is evidence of damage to the nerves, surgery may be required.

You may benefit from seeing a physiotherapist/osteopath/chiropractor who will be able to teach you some exercise techniques designed to strengthen your neck muscles and reduce the strain on your spine.

At night you should use one firm pillow, rather than two soft pillows, as this will reduce the strain on your neck. The use of a neck brace or collar is not recommended as it can make your muscles weaker and your symptoms worse.