What is cervical spondylosis?

Neck pain is a common complaint, especially as people get older. In fact, it’s one of the most common musculoskeletal problems we experience, with studies suggesting around two-thirds of us suffer neck pain at some point in our lives (i). Many of these cases of neck pain are caused by a condition called cervical spondylosis.
 
Also referred to as cervical spondylitis, cervical arthritis or simply neck arthritis, cervical spondylosis gets its name from the seven vertebrae (bones) in the neck (cervical) and the term used when parts of the spine begin to show signs of wear and tear (spondylosis). In fact, it’s a normal sign of ageing since the discs and joints in the neck start to degenerate naturally over time. But while there’s no actual cure for cervical spondylosis, there are several ways to get symptom relief and also possibly stop the condition getting worse.
 

How your neck works

 
Your spine is made of 24 vertebrae, all stacked on top of each other. When connected, the vertebrae form a central canal that houses and protects your spinal cord, through which nerves travel, transmitting messages from your muscles to your brain (and vice versa). In the neck, the first two vertebrae are slightly different from the rest as they attach the spine to the skull, while the other five are like the other vertebrae in the rest of the spine.
 
Between each vertebra is a disc that lets your spine be flexible and acts as a shock absorber whenever you walk or run. Each disc is about half an inch thick, flat and round, and consists of a tough, flexible outer part and a soft centre. Meanwhile there are ligaments attached to the vertebrae that support the vertebrae and make them stronger, with muscles also attached that allow the spine to bend and move.
 
According to Patient UK, degeneration of the vertebrae and discs happens to everyone and tends to start some time after the age of about 30 (ii). This degeneration consists of the discs becoming thinner, while small, rough areas of bone called osteophytes can develop along the discs’ edges. Bulges, tears, or leaks in a disc – a condition a called herniated, prolapsed or ‘slipped’ disc – can also develop, as can dehydration of the discs and stiffness in the ligaments of the spine.
 
All of these things can affect the spine, making the muscles, ligament and nerves compressed and irritated, the result of which includes a very sore neck. However, some people with cervical spondylosis don’t experience any symptoms, even when X-rays of their necks show the presence of factors such as osteophytes and disc thinning.
 

Who’s affected by neck pain?

 
Some of the things we know about who gets neck pain include the following (iii):
 

• People aged 50 - 59 are the most likely to be affected

• Slightly more women experience neck discomfort than men

• Neck pain starts earlier in men than in women

• Around 10 per cent of people with neck pain are thought to have chronic neck pain (neck pain that lasts longer than three months)

• The majority of men older than 50 years and women older than 60 years have evidence of degenerative changes in their cervical spines

 

Are you at risk of cervical spondylosis?

 
Besides age – which is the most common risk factor for cervical spondylosis – it’s thought that several other things can make you susceptible for developing it too, including:
 

• A family history of neck pain and cervical spondylosis

• Smoking

• Being overweight

• Poor posture

• Physical inactivity

• Jobs or activities that involve lots of repetitive neck motions, overhead work, or heavy lifting

• Depression and anxiety

• Injuries and trauma to the neck

 
Knowing about these factors can help you identify whether or not you’re at risk, and if so to take steps where possible towards preventing cervical spondylosis – you could try to improve your posture, for instance, give up smoking, lose weight or stay more physically active. It’s also worth being aware of the fact that cervical spondylosis – while it can be painful and uncomfortable – isn’t life threatening, and there are things you can do to help yourself feel better (read on for more about self-help measures for cervical spondylosis).
 

What are the symptoms of cervical spondylosis?

 
Symptoms of cervical spondylosis can vary from one person to the next, with some experiencing mild neck pain and others more intense neck pain. The pain often comes and goes, causing flare-ups every now and then (for instance, the pain can return if you strain a neck muscle or twist your neck awkwardly – though there’s not always a reason for a flare-up). Sometimes the pain spreads, causing neck and shoulder pain or even pain that travels down your arm to your hand or fingers (this is usually a result of spinal nerve irritation – see Cervical radiculopathy, below).
 
Cervical spondylosis can cause other symptoms too, including:
 

• A stiff neck (or combined neck pain and stiffness) – this often happens first thing in the morning.

• Neck pain and headache, with a headache often starting above the neck at the back of the head.

• Tingling (pins and needles) in your arm or hand, caused by irritation of a spinal nerve.

• A grinding noise or sensation when you turn your neck.

• Problems with your balance (though this is less common).

 
Other rare symptoms of cervical spondylosis include nausea, dizziness and light-headedness, tinnitus, blurred vision, stomach discomfort and memory problems.
 

If it’s not cervical spondylosis, what else could it be?

 
Not all cases of neck pain are caused by cervical spondylosis, some are a result of other conditions such as:
 

• Acute neck strain

• Whiplash

• Infections such as osteomyelitis or tuberculosis

• Fibromyalgia 

• Rheumatoid arthritis and other inflammatory conditions 

• Osteoporosis 

• Paget’s disease of bone

 

Should you see your GP?

 
If you’re experiencing neck pain, it’s always a good idea to consult a health professional who can diagnose cervical spondylosis and recommend treatments. However, according to the NHS, you should see your GP straight away – or call NHS 111 – if any of the following apply to you (iv):
 

• You have neck pain that’s getting much worse

• Your arms or legs feel heavy or weak

• You have pins and needles in an arm on top of pain in your neck or arm

• Your neck pain is worse when you move

• You have pain between your shoulder blades

• You have a stiff neck

• You’re having problems with your balance

 
Meanwhile, call 999 for an ambulance immediately if any of these things are affecting you as they could be a sign of a medical emergency:
 

• Problems with walking that are new

• Loss of bladder or bowel control

• Sudden lack of co-ordination (if you struggle to do simple things like doing or undoing buttons)

• Your face has dropped on one side

• You can’t lift up both arms and keep them there

• You’re slurring your speech, or your speech is garbled
   

What are the complications of cervical spondylosis?

 
Sometimes cervical spondylosis can progress and cause one of two other conditions – cervical radiculopathy and cervical myelopathy (though it’s worth mentioning that most cases of cervical spondylosis don’t progress in this way). If you think you’re affected by either of these conditions, tell your doctor about it without delay.
 
Cervical radiculopathy   This is the name for a compressed or ‘pinched’ nerve in your neck. Several things can lead to cervical radiculopathy, with one of the most common being the spinal degeneration of cervical spondylosis. For instance, osteophytes can make the areas that nerves travel through in the spine narrower, resulting in the nerves becoming compressed. A disc in the neck that has become herniated can also press on a nerve where the nerve passes between the vertebrae.
 
Cervical radiculopathy causes neck pain and other symptoms including numbness, tingling and pain and weakness in an arm or hand, plus shooting pains down an arm (usually just one arm is affected but sometimes both) or pain at the back and side of the head, depending on which nerves are involved. Sometimes you can also experience extreme neck pain with cervical radiculopathy that’s bad enough to stop you getting a good night’s sleep.
 
According to the National Institute of Health and Care Excellence (Nice), cervical radiculopathy is mostly found in people aged 50 - 54, with 107 per 100,000 men affected each year compared with 64 per 100,000 women (v).
 
Cervical myelopathy   Cervical spondylosis is also a common cause of cervical myelopathy, a condition caused by pressure or damage to the spinal cord. Where cervical spondylosis is the cause, the canal through which the spinal cord travels becomes narrower as a result of degenerative changes in the vertebrae. A herniated disc can also cause cervical myelopathy when the disc bulges into the spinal canal, irritating and putting pressure on the spinal canal.
 
Symptoms of cervical myelopathy can reduce your quality of life, including walking difficulties, numbness or clumsiness in the hands and bladder problems including not being able to empty your bladder properly and bladder weakness. You may also experience pain that feels like an electric shock radiating down your spine when you flex your neck (Lhermitte’s sign).
 
Also often called degenerative cervical myelopathy, or DCM for short, cervical myelopathy is the most common cause of spinal cord impairment in adults worldwide. Studies suggest cervical myelopathy affects five per cent of people aged 40 and older (vi).
 

How is cervical spondylosis treated?

 
Cervical spondylosis can be diagnosed via a physical examination, though you may need tests including X-rays, scans, electromyography (EMG) and nerve conduction study tests to confirm the extent of the damage to your neck.
 
If your diagnosis is positive, your doctor or specialist may advise you to try the following treatments:
 

• Painkillers are often recommended for neck pain relief, such as paracetamol – though some people may also need anti-inflammatory pain relief instead or combined with paracetamol (these include ibuprofen and prescription anti-inflammatories such as naproxen and diclofenac). If you need stronger pain relief your GP may prescribe codeine or a low-dose tricyclic antidepressant if your neck pain is persistent.

• Physiotherapy is another neck pain treatment you may be advised to try – your physiotherapist might, for instance, use techniques such as traction, manipulation and heat and cold therapies. Your physiotherapist can also show you neck exercises you can do yourself at home that can be helpful (read on to find out more about gentle neck exercises you can try yourself).

• Steroid injections in the neck are another type of cervical spondylosis treatment, however their effects are usually only temporary.

• Surgery may be an option for some people with severe cervical spondylosis – typically those also with cervical radiculopathy or cervical myelopathy – and can stop the symptoms from getting worse. However, it doesn’t work for everyone.

 

Neck exercises and self-care

 
Depending on the severity of your symptoms and the degeneration of your vertebrae, the only treatments you may need when you’re first diagnosed with cervical spondylosis could be pain relief and gentle neck exercises. The following four neck exercises from Arthritis Research UK (vii) are typical examples:
 
1. Neck tilt   Tilt your head down to rest your chin on your chest. Tense your neck muscles gently and hold for five seconds. Return to the starting position, then repeat five times.
 
2. Neck tilt (side to side) Tilt your head down towards your shoulder, leading with your ear. Tense your neck muscles gently and hold for five seconds. Return your head to centre and repeat on the opposite side. Repeat five times on each side.
 
3. Neck turn   Turn your head towards one side, keeping your chin at the same height and moving within comfortable limits. Tense your neck muscles gently and hold for five seconds. Return your head to centre and repeat on the opposite side. Repeat five times on each side.
 
4. Neck stretch   Keeping the rest of your body straight, push your chin forward so your throat is stretched. Tense your neck muscles gently and hold for five seconds. Return your head to centre and push it backwards, keeping your chin up. Hold for five seconds. Repeat five times.
 
Add these exercises to your daily routine gradually. Some level of pain is acceptable, but you should stop if the pain becomes excessive (if that happens, reduce the number of repetitions you do, do the movements more slowly and take longer breaks between exercises). If you need help with doing these exercises – and to make sure you’re doing them correctly – it’s always a good idea to ask your GP if they could refer you to a physiotherapist.
 
Meanwhile, try to reduce or avoid activities that strain your neck, such as looking down or up for long periods of time or holding your neck in an awkward or uncomfortable position. Using heat or cold packs that you can buy from pharmacies may also help when you’re having a flare-up of neck pain.
 

Natural support for a painful neck

 
Here are a few nutritional supplements that may be useful for managing the symptoms of neck pain:
 
PEA   Short for palmitoylethanolamide, PEA is a fatty acid produced naturally by the body and is found in all cells, tissues and fluids. You can also get it in foods such as soya beans, peanuts, eggs, flaxseed and milk.
 
An endocannbinoid-like chemical that belongs to a family of fatty acid compounds called amides, PEA is often described as an alternative to CBD, as both substances are thought to have similar properties. Researchers, however, suggest PEA is safer than CBD, since it has been studied more extensively and has a more robust safety profile (viii) with no known side effects (ix). A review of 16 clinical trials and meta-analysis also confirms PEA has painkilling actions (x).

Turmeric   The active antioxidant substance in turmeric called curcumin is often recommended for managing discomfort. While there aren’t any notable studies that have looked specifically at turmeric and its use in cervical spondylosis, experts have found it may be useful in managing the symptoms of arthritis (xi).
 
B vitamins   B vitamins play an important role in nervous system function. Some of the B vitamins may even help with neuropathic (nerve) pain. For instance, some experts claim taking B vitamins – particularly vitamins B1, B6 and B12 – may help repair damaged or irritated nerves, and that being deficient in these vitamins may lead to permanent nerve degeneration and pain (xii). These nutrients are found in a range of foods, but a handy way to top-up your Bs is to take a B complex supplement (though you can take many of the B vitamins individually if you wish).

Magnesium   Found naturally in the body, magnesium is needed for more than 300 biochemical reactions including muscle and nerve function. It has been studied in a variety of pain conditions, with researchers finding it may help with several types of pain including nerve pain (xiii) – though they added that more large-scale studies are needed to better understand how magnesium may help manage chronic pain. 
 

Need to find out more?

 
There’s lots more information on a wide variety of health problems that cause pain in the pain section of our health library. 

 

References:

1. Vos C et al. (2007) "Management of acute neck pain in general practice: a prospective study." British J of Gen Pract 57(534):23-28. Available online: https://bjgp.org/content/57/534/23.

2. Available online: https://patient.info/bones-joints-muscles/neck-pain/cervical-spondylosis.

3. Available online: https://patient.info/doctor/cervical-spondylosis-pro.

4. Available online: https://www.nhs.uk/conditions/cervical-spondylosis/.

5. Available online: https://cks.nice.org.uk/topics/neck-pain-cervical-radiculopathy/.

6. Brannigan JFM et al. (2022) "Degenerative cervical myelopathy education in UK medical schools: a national cross-sectional survey of medical students." Br J Neurosurg 36(6):728-736. Available online: https://www.tandfonline.com/doi/full/10.1080/02688697.2022.2106355.

7. Available online: https://www.csp.org.uk/system/files/4_neck_pain.pdf.

8. Clayton P et al. (2021) "Palmitoylethanolamide: A Potential Alternative to Cannabidiol." J Diet Suppl. 28;1-26. Available online: https://www.tandfonline.com/doi/full/10.1080/19390211.2021.2005733.

9. Clayton P et al. (2021) "Palmitoylethanolamide: A Natural Compound for Health Management." Int J Mol Sci. 22(10): 5305. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8157570/.

10. Gabrielsson L, Mattsson S, Fowler CJ. (2016) "Palmitoylethanolamide for the treatment of pain: pharmacokinetics, safety and efficacy." Br J Clin Pharmacol. 82(4): 932–942. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094513/.

11. Shep D et al. (2019) "Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study." Trials 20(1):214. Available online: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3327-2.

12. Geller M et al. (2017) "B Vitamins for Neuropathy and Neuropathic Pain." Vitam Miner. 6:2. Available online: https://www.hilarispublisher.com/open-access/b-vitamins-for-neuropathy-and-neuropathic-pain-2376-1318-1000161.pdf.

13. Baltrusch S. (2021) "The Role of Neurotropic B Vitamins in Nerve Regeneration." Biomed Res Int. 9968228. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8294980/.

14. Park R et al. (2020) "Efficacy and Safety of Magnesium for the Management of Chronic Pain in Adults: A Systematic Review." Anesth Analg. 131(3): 764-775. Available online: https://journals.lww.com/anesthesia-analgesia/fulltext/2020/09000/efficacy_and_safety_of_magnesium_for_the.20.aspx.

 

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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.

 

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