What Is Cervical Spondylosis?

Arthritis in the neck

Cervical spondylosis is a common age-related neck condition caused by wear-and-tear arthritis of the spinal joints in your neck. The discs naturally dry out over time, which makes them shrink and leads to bone spurs and other osteoarthritis signs and symptoms.

"Cervical" refers to the seven small vertebrae in your neck. "Spondylosis" means degeneration of the discs between the vertebrae.

Typically, cervical spondylosis begins around age 40 and gets worse over time. Men tend to develop it earlier than women.

Cervical spondylosis is also called:

Symptoms of Cervical Spondylosis

A man massages the back of his neck

Shelby Ross / The Image Bank / Getty Images

The main symptoms of cervical spondylosis are neck pain and stiffness. In addition to neck and head symptoms, cervical spondylosis can lead to radiculopathy (a disease of the spinal nerve roots) or myelopathy (in which the spinal cord becomes compressed).

Neck and Head Symptoms

It's possible to have cervical spondylosis without any symptoms. When symptoms do occur, they generally include:

  • Intermittent neck pain (cervicalgia)
  • Neck stiffness
  • Headaches
  • Dizziness
  • Muscle spasms
  • Weakness in the limbs
  • Trouble walking
  • Clicking, grinding, or popping sounds when moving the neck

Headaches from cervical spondylosis tend to be located in the lower skull area. In some people, they're severe enough to be considered the dominant symptom.

Radiculopathy Symptoms

Radiculopathy is a disease process that affects the spinal nerve root, which is the part of the nerve that branches off from the main spinal cord. Symptoms affect the part of the body supplied by that nerve and may include:

  • Pain
  • Weakness
  • Numbness
  • Electrical-shock sensations down an extremity

Most of the time, radiculopathy symptoms result from something putting pressure on the spinal nerve root.

Myelopathy Symptoms

Myelopathy is a condition involving compression of the spinal cord itself. Cervical spondylosis is the most common neck condition that causes myelopathy.

The spinal cord is a long bundle of nerves that runs down the length of the spine. It's housed in the spinal canal, which is a passageway located in the center of your spinal column. It and the brain are the two main components of the central nervous system.

Myelopathy tends to come on slowly over time. It may express itself in a variety of ways including, but not limited to:

  • Radiculopathy symptoms
  • Dizziness
  • "Numb, clumsy hands"

Hand problems are generally caused by cervical myelopathy high in the neck, usually between the vertebrae called C-5 and C-7 (the fifth and seventh cervical vertebrae). They can cause problems with writing and similar activities.

Causes

Xray image of arthritic spine.
Arthritis is one cause of cervical radiculopathy.

CNRI / Science Photo Library / Getty Images

Arthritis in the neck starts with osteophytes (aka bone spurs) that form on vertebral bodies as they break down. Bone spurs are the body’s response to joint wear and tear.

In the spine, bone spurs serve a purpose by helping to increase the degenerating joint's surface area and more evenly distribute the pressure that's placed on it during everyday activity. However, as they grow, they can narrow the spaces that the nerves and spinal cord pass through.

Risk factors for neck arthritis include:

  • Age
  • Genetics
  • Smoking
  • Depression and anxiety
  • Occupation
  • Injury

Age

A major risk factor for cervical spondylosis is age. Once you reach 40, your likelihood of developing neck arthritis increases. By age 60, according to The American Academy of Orthopedic Surgeons, more than 85% of people have cervical spondylosis.

Genetics

If you have relatives with cervical spondylosis, you have a higher risk of developing it yourself. Some researchers think this may be due to inherited factors such as a naturally narrow spinal canal or smaller-than-average passages between vertebrae.

Those narrow passages make it more likely that the highly sensitive spinal cord or nerves will come into contact with other structures, leading to myelopathy and radiculopathy.

Not all research agrees, though. A 2014 study found that the diameter of the spinal canal and vertebral bodies was not associated with an increased risk of cervical spondylosis.

Smoking

Studies show that smoking is a risk factor for neck pain. Researchers suspect smoking could speed up the process of cervical disc degeneration, especially in the lower discs.

This is just one of many reasons you may want to quit smoking.

Depression and Anxiety

Depression and anxiety are psychological risk factors for neck pain in general, and research shows depression may increase your risk of developing cervical spondylosis.

Additionally, these mental health conditions have been linked to poorer outcomes of disc replacement surgery. On a more positive note, though, having less neck pain after the surgery can help alleviate symptoms of depression and anxiety.

Getting Treatment

You don't just have to live with depression and anxiety—effective treatments are available, and they could improve a lot more than just your neck pain.

Occupation

Your occupation can be a significant risk factor for cervical spondylosis if it involves repetitive neck motions, working above your head, heavy lifting, poor ergonomics, or exposure to vibration. Those at risk because of their jobs include:

  • Painters
  • Plumbers
  • Flooring installers
  • Construction workers
  • Truck or bus drivers
  • Anyone who stares at a computer screen that's at the wrong height

Injury

While most people with neck arthritis haven't had previous neck injuries, trauma to your neck—and especially repeated trauma—increases your risk for cervical spondylosis.

Car accidents are a common cause of trauma that may later lead to spondylosis.

Diagnosis

Neck x-ray for diagnosing arthritis or other conditions.
Neck x-ray for diagnosing arthritis or other conditions. plepraisaeng

As with the diagnostic process for most neck and back conditions, your doctor will likely gather information about your cervical spondylosis by taking a history and doing a physical exam. Then, expect one or more types of imaging and possibly a nerve conduction study.

Magnetic Resonance Imaging

When it comes to imaging tests for cervical spondylosis, magnetic resonance imaging (MRI) is the gold standard. This is especially so when your doctor needs to determine the source of your nerve symptoms.

An MRI may help your doctor to see not only your bones, but your soft tissues and nerves, and it may help them to accurately see how much space is left in areas that house the spinal cord and/or nerve roots.

X-Rays

X-rays are also used for diagnosing cervical spondylosis, as they allow visualization of the bony passageways that contain the spinal cord and the spinal nerve roots. If you don’t have nerve symptoms, you may only need an X-ray. 

An X-ray can alert your doctor to things like narrowing in your disc space, the presence of bone spurs, and any decrease in your spinal canal diameter that could lead to myelopathy.

It may also help your doctor classify cervical spondylosis as mild, moderate, or severe.

Computed Tomography Scans

A computed tomography (CT) scan is another diagnostic imaging test commonly given to people with cervical spondylosis. A CT scan is like an X-ray except that it takes multiple images and puts them together to display a cross-section of the area.

The image quality is better than that of an X-ray, so it may allow your doctor to better study your spinal canal and, down the road, any changes in your bones that have occurred since your last CT scan.

Myelography

Myelography is a type of CT scan that involves injecting dye into your body to see certain structures better. Doctors use it to visualize your spinal nerve roots and track down obstructions that could lead to radiculopathy symptoms. 

Nerve Conduction Study

Another test doctors use to diagnose (or confirm a diagnosis of) radiculopathy is a nerve conduction study. It measures how well your nerves are functioning.

Nerve conduction studies sometimes are done in conjunction with an electromyography (EMG) test, which measures nerve-to-muscle functioning both during contraction and relaxation. During the study, electrodes will be placed on your skin that deliver electrical stimulation to your nerves. Some people find this to be uncomfortable.

Treatment

Colorful capsule medications
Pain relievers.

Peter Dazeley / Photographer's Choice / Getty Images

Your primary care doctor may be able to provide treatment for your cervical spondylosis, but they may refer you to a specialist for diagnosis and/or treatment. Neck arthritis specialists include:

Conservative management may help you control pain and slow the progression of the disease. For more severe cases, surgery may become an option.

Conservative Management

While you can't stop age-related joint degeneration from occurring, it is possible to slow down its rate of development. 

If your symptoms are mild or moderate and you don't have progressive nerve problems, conservative care may be all you need. It may involve some combination of:

Surgery

Surgery is not generally necessary for cervical spondylosis. Signs you may need surgery include pain that is difficult or impossible to control, and/or radiculopathy symptoms that worsen over time.

If you do happen to need surgery, a typical procedure is a laminectomy, in which bone spurs and a portion of your vertebrae are removed. A 2018 study published in Bone and Joint Journal found that decompression surgery in the neck, known as anterior cervical decompression, was effective in relieving dizziness symptoms associated with cervical spondylosis.

A Word From Verywell

While the wear and tear that lead to cervical spondylosis may be inevitable, pain and debilitating symptoms are not. Talk to your doctor about any neck pain that's affecting your quality of life, so you can start treatment early and take steps to keep the condition from getting worse.

If you believe you're at risk of developing neck arthritis, talk to your doctor about how you may be able to prevent or delay it.

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