Diagnosing that pain in your neck

I've been having neck pain for about a year. I find it difficult to sit for long periods of time. I finally decided to go to a doctor, and he took an x-ray of my neck. After that, he told me I had cervical spondylosis, and that it is fairly common. What is this?

Cervical spondylosis is a degeneration of the joints in the neck (cervical bones = the bones of the neck). There is abnormal wear on the cartilage and bones here. It is a form of arthritis, but it rarely becomes cripping or disabling.

It is indeed a very common cause for long-term neck pain. It is estimated that more than 85 per cent of people over the age 60 are suffering from it.

So what is this 'cervical' region of the backbone?

Your spine is divided into three segments: the cervical spine (neck region), the thoracic spine (the area of your back that corresponds to your chest region) and the lumbar spine (the lower back). The spine then joins to your sacrum and coccyx.

The spine is not a straight piece of bone, but rather, it is divided into smaller bones called vertebra, which join to each other via ligaments. Your cervical spine has seven vertebrae, your thoracic has 12 to correspond with your 12 ribs, and your lumbar has five.

As a result of these vertebrae, you are able to bend, flex and straighten your spine. Your back becomes mobile.

In between these vertebrae, there are intervertebral disks, which consist of jelly-like material encased by a fibrous ring. This helps cushion your spine from external forces.

So what causes cervical spondylosis?

When these disks degenerate and lose water content as a result of age, problems set in. The facets of the vertebrae experience increased pressure and start to degenerate too. The cartilage begins to wear away. Bone begins to rub on bone.

As a result, arthritis develops.

In time, the body may respond to this increased pressure by trying to grow new bones in your facet joints. This results in an overgrowth of bone, called spurs. Unfortunately, they tend to hinder rather than help.

These spurs may press against your spine itself, affecting the collection of nerve fibres that run through your vertebrae to deliver signals back and forth from your brain to your arms, legs and body. Or they may press on the nerves coming out of your spine.

The cervical spine problems may not only affect your arms but your legs as well.

How will I know if I have cervical spondylosis?

Neck pain is the commonest symptom, and no mother-in-law jokes please. The pain can be mild or severe. It may be aggravated by looking up or down for a long time, such as when you are reading a book or knitting or driving.

It can also be made worse after standing or sitting down, or when you sneeze, cough or laugh. It is alleviated by rest or lying down.

The neck pain may be associated with stiffness, which can become worse if you exercise your neck. As a result of nerve compression by spurs, you may have numbness and weakness in your hands, fingers and arms.

You may experience muscle spasms in your neck and shoulders. And when you move your neck, you may hear or feel a grinding or popping sound.

You may also have a headache, which often starts at the back of the head.

Do some people get cervical spondylosis more easily than others?

Yes. You are at risk if:

·Your family has a history of cervical spondylosis or neck pain.

·You smoke.

·Your job involves a lot of neck twisting (like dancing) and overhead work (like repairing ceiling lights, fans and air-conditioning units).

·You have depression or anxiety.

·You have had an injury, eg car accident, etc.

Will I need an x-ray to diagnose this problem?

Yes. A neck x-ray can show bony spurs and loss of disk height.

This can be followed by a MRI (Magnetic Resonance Imaging) to evaluate the state of your soft tissues that would not show up on a simple x-ray, such as your disks, nerves, ligaments and muscles.

If you have numbness or weakness or anything that throws suspicion that your nerves might be compromised, there are EMG (electromyography) and nerve conduction tests that you can do.

Can I get this cured?

If your pain is mild, you can go for physiotherapy or take painkillers. Acupuncture is also good, and so is some form of spinal manipulation, as what chiropractors can do for you.

If the neck pain doesn't go away after all this, you can go for surgery. Surgery can also be performed to relieve the pressure on your nerves and spinal cord.

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