What is spondylosis?
Spondylosis is a disorder that is caused by the degeneration of the discs which are soft cushions, present between the vertebrae. This results in the vertebrae rubbing together and exerting pressure on the nerves. As the condition progresses, the bones may move out of their natural positions, causing pain and disability.
How is it caused?
# Wear and tear of the joints that accompanies aging, a condition called osteoarthritis.
# Inflammation of the joint.
# Injuries such as automobile accidents, athletic injuries, sudden jerks on the arms, falls.

What are the signs and symptoms?
1. Neck pain.
2. Loss of sensation of the shoulder or arms.
3. Weakness of the arms.
4. Difficulty in moving the head, and neck stiffness that may deteriorate gradually.
5. Headaches.
6. Loss of control of the bladder or the bowel.
7. Loss of balance.
8. Ear noise or buzzing.
9. Muscle weakness in the shoulders, arms or hands.

How is the condition diagnosed?
X-rays of the neck or MRI scans may be obtained to show abnormalities that indicate cervical spondylosis. A CT scan or spine MRI confirms the diagnosis. A myelogram (X-ray or CT scan after injection of a dye into the spinal column) may be recommended to clearly identify the compression of the nerves.

What is the treatment?
The goal of treatment is to relieve pain and prevent permanent spinal cord injury. Specific head movements may cause some pain and discomfort, for which painkillers may be given. Exercises to strengthen the neck muscles may be suggested. A cervical collar may be used to restrict neck movements and reduce pain. In some cases, neck traction may also be suggested in addition to the cervical collar.

Surgical decompression of the spinal cord in the neck may be required in severe cases if there is loss of movement, sensation or function.

Exercise your neck and keep active :

Aim to keep your neck moving as normally as possible. As far as possible, continue with normal activities. In the past, some people have worn a neck collar for long periods when a flare-up of neck pain developed. It is now known that if you wear a collar for long periods it may cause the neck to 'stiffen up'. Therefore, try to keep your neck as active as possible.

Medicines
Painkillers are often helpful. You need only take them when symptoms flare-up.

1. Paracetamol at full strength is often sufficient. For an adult this is two 500 mg tablets, four times a day.
2. Anti-inflammatory painkillers. Some people find that these work better than paracetamol. They include ibuprofen which you can buy at pharmacies or get on prescription. Other types such as diclofenac, naproxen, or tolfenamic need a prescription. Some people with asthma, high blood pressure, kidney failure, or heart failure may not be able to take anti-inflammatory painkillers.
3. A stronger painkiller such as codeine is an option if anti-inflammatories do not suit or do not work well. Codeine is often taken in addition to paracetamol. Constipation is a common side-effect from codeine. To prevent constipation, have lots to drink and eat foods with plenty of fibre.
4. A muscle relaxant such as diazepam is sometimes prescribed for a few days during a flare-up of pain if your neck muscles become tense and make the pain worse.

Other advice

1. A good posture may help. Brace your shoulders slightly backwards, and walk 'like a model'. Try not to stoop when you sit at a desk. Sit upright.
2. A firm supporting pillow seems to help some people when sleeping.
3. Physiotherapy. Therapies such as traction, heat, cold, manipulation, etc, may be tried when you have a flare-up of pain. However, the evidence that these help is not strong. What may be most helpful is the advice a physiotherapist can give on neck exercises to do at home.

Treatment may vary and you should go back to see a doctor if:

The pain becomes worse.
Humbness, weakness, or pins and needles develop in an arm or hand.

Other pain relieving techniques may be tried if the pain becomes chronic (persistent). Chronic neck pain is also sometimes associated with anxiety and depression which may also need to be treated.

In some cases, a nerve may become irritated, pressed on or 'trapped' which can cause persistent severe pain or other symptoms in an arm such as muscle weakness. In some cases special x-rays and scans may be advised to look for the exact site of the problem. In some cases, surgery may be an option to relieve the symptoms.
 

  Examples of Disc Problems

 Pain referral zones of the posterior neck muscles

Traction for Spondylosis

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