Introduction
Cervical spondylosis is a medical condition that results in the progressive degeneration of the cervical spine, intervertebral discs, ligaments, and cartilaginous material as a natural part of the aging process. The vertebrae are a group of interconnected, uniquely shaped bone segments that make up the spinal column.
The neck contains seven of these, known as the cervical vertebrae (C1 to C7). As a part of aging, these discs thin out, and the edges of these vertebrae might get rough. The wear and tear of the vertebrae and discs of the neck are known as cervical spondylosis.
Etiology
- The primary factor is age-related degeneration.
- C5-6 is the most prevalent site of degeneration, followed by C6-7 and C4-5.
- It affects both men and women, albeit the severity is higher in men.
- Repeated damage and mechanical activities like twisting, and bending may lead to the development of cervical spondylosis.
- Increased incidence is seen in patients who carried heavy weights on their heads or shoulders, as well as dancers and gymnasts.
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Causes and Risk Factors
- Aging
- Trauma
- Repetitive mechanical activities like twisting, and bending without breaks.
- Living a sedentary lifestyle
- Poor posture
- Obesity
- Tobacco abuse /Smoking
Indications and Clinical Features
Cervical spondylosis is usually characterized by discomfort, pain, and stiffness localized around the neck along with headache. The pain can extend to the shoulders, arms, hands, and the base of the head over time.
It can get worse by staying in the same posture or by activities that need the neck to be maintained in the same posture for an extended length of time, such as driving or reading a book.
Some of the most prevalent indications depending on the two main types of cervical spondylosis are as follows
Cervical Radiculopathy– There can be tingling, numbing, and a weak sensation in the arms, hands, legs, or feet.
Cervical Myelopathy– tere is degeneration and damage to the spinal cord itself. This can lead to coordination and gait issues, bladder or bowel control problems, abnormal reflexes, and muscle spasms.
The severity of symptoms varies according to the stage of the condition and degree of degeneration. Spondylosis may be seen on diagnostic imaging, although the patient may be asymptomatic and vice versa.
Diagnosis
It includes a physical examination by the doctor followed by imaging tests.
Physical examination includes analyzing the neck’s range of motion, determining if there is pressure on the spinal nerves or spinal cord, testing the reflexes and muscular strength, and observing the gait to see if spinal compression is influencing it.
Imagining tests include X-rays, MRIs, CT scans, and myelography.
Physical Management Therapy
Physical management for cervical spondylosis is very subjective. Individualized treatment is recommended, however rehabilitative exercises, proprioceptive re-education, manual therapy, and posture education are the common line of treatment.
Exercise, mobilization, and/or interventions by themselves have limited proof. In subacute or chronic mechanical neck pain with or without headache, mobilization and/or manipulations in conjunction with exercises are useful for pain relief and improvement in daily functioning.
Manual Therapy– Depending on the therapist’s choice, thrust manipulation of the thoracic spine may involve procedures performed in a prone, supine, or seated posture. Cervical traction can also be utilized as a kind of physical therapy to widen the neural foramen and relieve neck tension.
Education– The alignment of the spine during sitting and standing activities is part of postural education. The client should be educated on how to prevent cervical spondylosis from developing early by maintaining good neck strength and flexibility, leading an active and healthy lifestyle, and avoiding neck injuries.
Rehabilitation Exercises- Cervical retraction, cervical extension, deep cervical flexor strengthening, scapular strengthening, and stretching of the chest muscles can be performed to encourage the mobility of the neural structures.
Author – Asmita Shah (INFS Faculty)
References-
Norkin, Cynthia C, and D J. White. Measurement of Joint Motion: A Guide to Goniometry. Philadelphia: F.A. Davis, 1995.
Clinical Orthopaedic rehabilitationBroadsman
Brukner, Peter, Karim Khan, and Peter Brukner. Brukner & Khan’s Clinical Sports Medicine. Sydney: McGraw-Hill, 2012.
Therapeutic Exercise: Foundations and Techniques – Kolby & Carolyn Kisner
