Neck Arthritis - Chronic Neck Pain – Cervical Spondylosis

By Dr Guy Ashburner | April 19, 2018

Neck Arthritis - Chronic Neck Pain – Cervical Spondylosis

“For people with acute and subacute neck pain, Spinal Manipulation was more effective than medication in both the short and long term” Annals of Internal Medicine, Jan 2012

Cervical spondylosis is an age-related degeneration (‘wear and tear’) of the bones (vertebrae) and discs in the neck. As we get older the discs become thinner and the vertebrae move closer together.

Further degeneration due to poor posture, trauma and inappropriate exercise will cause mechanical loading (compression) of one vertebra (neck bone) on another vertebrae which will increase the rate of joint damage.

This loading may create ‘spurs’ of bone, known as osteophytes which can form at the edges of the vertebrae and the facet joints. Over time, these changes can press down on (compress) one or more of the nerve roots. In advanced cases the spinal cord becomes involved which then involves shooting pain down the arms and legs, muscle weakness in fingers and arms as well as bowels/bladder dysfunction.

Symptoms like neck stiffness often develop slowly over time. But they may start or get worse suddenly. After a trauma, like a car accident or misuse, decorating a ceiling, the neck can be irritated and start causing pain. The pain may be mild, or it can be deep and so severe that you are unable to move. The most common symptom is neck pain. Headaches are also common. This aching, burning, tingling pain sometimes spreads towards one or both shoulders, down the upper part of the back between the shoulder blades, or down an arm to a hand or fingers. This is caused by irritation of a nerve as it passes between the vertebrae on route to the arm from the spinal cord in the neck. Varying degrees of nerve irritation and compression can also cause loss of sensation or abnormal sensation in the shoulder, arm and hand, e.g. Pins and needles or numbness in the fingers. The pain may come and go, or may be continuous. The neck may feel stiff, and sudden movements may cause or worsen pain especially after a long period of inactivity, for example, after sleeping. Movement of the neck may make the pain worse.

A healthy spine should move from the top of your neck down to T4 or T5 thoracic vertebra which is located directly between your shoulder blades. When we become tense around the shoulder girdle from mental tension or poor posture, the upper thoracic spine (T1-T3) loses its mobility and tightens, forcing the lower part of the neck (typically C5-7) to have to over work in order to make up for the lack of mobility in the upper thoracic spine. Over time this causes the lower cervical spine to become irritated, mechanically overloaded and inflammation to build in the joints in this region of the spine. Years of factors such as poor posture, muscle imbalance, mental tension, and inappropriate exercise leads to both alignment and mobility changes that result in mechanical overloading of these vulnerable regions within our lower neck. Left unchecked this can lead to the development of spinal arthritis or spinal degenerative change. A good reason to keep your spine functioning at its best…after all it’s the only one you’ve got. Cervical spondylosis is a serious condition that needs time and care to avoid worsening.

Thoracic Spine Manipulation results in superior clinical benefits that persist beyond the 1-month follow-up period for patients with acute neck pain – Journal of Orthopaedic and Sports Physical Therapy, Jan. 2009

Osteopaths use a variety of manipulative techniques, postural and exercise advice for the management of neck pain. Osteopathic care is safe, gentle and effective. It is a condition which, if caught early, may be helped by an Osteopath. The early effects of Cervical Spondylosis are mild, so when appropriate an osteopath will refer for x-rays or have an MRI done. These diagnostic tests enable an osteopath to identify spinal disc and joint damage early. Depending on the severity of the imaging results the osteopath may refer to a neurologist. Most people over the age of 50 have some degree of degeneration (spondylosis) without experiencing any painful or neurological symptoms.

A 2007 published research in the BMJ (British Medical Journal) by Dr. Allan Binder (Rheumatologist) summarized that the best treatment for cervical spondylosis includes exercise, manipulation, and mobility.

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