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Cervical Spondylosis
Cervical Osteoarthritis
Definition:
A disorder that results from abnormal growth of the bones of the neck
(cervical vertebrae) and degeneration and mineral deposits in the cushions
between the vertebrae (cervical disks).
Causes, incidence, and risk factors:
Cervical spondylosis results from chronic degeneration of the cushions
between the neck vertebrae (cervical disks) and mineral deposits (calcification)
in the disks. There may be abnormal growths or "spurs" on the vertebrae (the
bones of the spine).
This causes gradual compression of one or more of the nerve roots, resulting in
progressive pain and movement or sensation abnormalities that resemble herniated
cervical disk but are usually less severe. The spinal cord may be compressed
(spinal cord trauma) with resultant movement or sensation or function losses of
the areas controlled at and below the level of compression.
Risks include old neck injury (which may have occurred several years
previously). However, the disorder also occurs commonly in older people who have
no history of neck injury . It is thought to result from normal changes of
aging.
Prevention:
Many cases are not preventable. Prevention of neck injury (such as proper
equipment and techniques when playing sports) may reduce the risk.
Symptoms:
neck pain (may radiate to the arms or shoulder)
loss of sensation or abnormal sensations of the shoulder, arms, or (rarely) legs
weakness of the arms or (rarely) legs
difficulty moving the head, neck stiffness that progressively worsens
headaches, particularly in the back of the head
loss of control of the bladder or bowels (if spinal cord is compressed)
loss of balance
ear noise/buzzing
muscle weakness (decreased muscle strength, independent of exercise) in the
shoulders, arms, or hands
Signs and tests:
Progressive neck pain is a key indication of cervical spondylosis. It may be
the only symptom in many cases. Examination often shows limited ability to flex
the head toward the side (bend the head toward the shoulders) and limited
ability to rotate the head. Weakness or sensation losses indicate damage to
specific nerve roots or to the spinal cord. Reflexes are often reduced.
A spine or neck X-ray shows abnormalities that indicate cervical spondylosis.
A CT scan or spine MRI confirms the diagnosis.
A myelogram (X-ray or CT scan after injection of dye into the spinal column) may
be recommended to clearly identify the extent of injury.
An EMG may also be recommended.
Treatment:
The goal of treatment is relief of pain and prevention of permanent spinal
cord trauma and nerve root injury.
In mild cases, no treatment is required. Discomfort is minimal and often occurs
only when triggered by specific head movements. Exercises to strengthen the neck
may be recommended. Restriction of neck movement reduces pain. This is often
accomplished with a cervical collar (neck brace). Intermittent neck traction may
be recommended instead of, or in addition to, a cervical collar. This usually
consists of a halter-like device placed on the head and neck and attached to
pulleys and weights.
For severe cases, hospitalization with complete bedrest and traction for 1 or 2
weeks may be needed. Analgesics or muscle relaxants may help to reduce pain.
Surgical decompression of the spinal cord in the neck may be recommended if
there is significant loss of movement, sensation, or function. It may also be
needed if pain is severe or if pain is unresponsive to other treatment. Surgical
procedures may also include removal of abnormal bone growths, and stabilization
of the neck with hardware or by fusion of the cervical vertebrae.
Expectations (prognosis):
The outcome varies Some cases are mild and never require treatment. Other
cases are progressive and chronic. Some cases are severe. In a few cases,
permanent disability results from compression of the spinal cord.
Complications:
chronic neck pain
progressive loss of muscle function or feeling
permanent disability (occasional)
inability to retain feces (fecal incontinence)
unable to keep from leaking urine (urinary incontinence)
Calling your health care provider:
Call for an appointment with your health care provider if cervical spondylosis
has been diagnosed and symptoms worsen, or if new symptoms develop such as loss
of movement or sensation of an area of the body.
Unnatural straightening of the neck is maintained by muscle tightness and
fixations of the joints in the neck. Traction helps loosen these tight joints
and muscles. You should also be seeing a health care
professional.
THIS PRODUCT IS NOT FOR RECENT SPRAIN / STRAIN INJURIES, OR ACUTE CONDITIONS.
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