Cervical Arthrosis: Symptoms, Causes, Diagnosis, and Management

What is cervical arthrosis?

Cervical arthrosis, also known as cervical spondylosis or neck arthritis, is a common age-related degenerative condition affecting the bones (vertebrae), discs, and joints in the neck, leading to chronic pain, stiffness, and potentially nerve compression.

Understanding Cervical Arthrosis

Cervical arthrosis refers to the progressive wear and tear of the structures within the cervical spine – the seven vertebrae (C1-C7) that make up your neck. It is essentially osteoarthritis of the neck. As we age, the intervertebral discs, which act as shock absorbers between the vertebrae, can dehydrate and shrink, leading to a narrowing of the disc space. Concurrently, the facet joints, which connect the vertebrae at the back, can also undergo degenerative changes, and the body may try to compensate by growing extra bone, known as bone spurs or osteophytes. These changes can lead to stiffness, pain, and, in more severe cases, compression of the spinal cord or nerve roots.

Anatomy of the Cervical Spine

To understand cervical arthrosis, it's crucial to grasp the basic anatomy of the neck:

• Cervical Vertebrae (C1-C7): These are the individual bones that stack to form the neck portion of the spinal column. They protect the spinal cord and support the head.
• Intervertebral Discs: Located between each vertebra, these are soft, gel-filled cushions that provide shock absorption and allow for spinal flexibility.
• Facet Joints: Paired joints located at the back of each vertebra, they guide and limit the movement between adjacent vertebrae.
• Spinal Cord and Nerve Roots: The spinal cord runs through the vertebral canal, and nerve roots branch off at each level, exiting through small openings called foramina to supply sensation and motor function to the upper body.
• Ligaments and Muscles: A complex network of ligaments provides stability, while numerous muscles facilitate movement and maintain posture.

Causes and Risk Factors

Cervical arthrosis is primarily a degenerative condition, meaning it develops over time due to wear and tear. Key contributing factors include:

• Age: This is the most significant risk factor. The natural aging process leads to disc dehydration and breakdown of cartilage.
• Wear and Tear: Cumulative stress on the neck from daily activities, posture, and repetitive movements.
• Genetics: A family history of arthritis or spondylosis can increase susceptibility.
• Occupational Hazards: Jobs involving repetitive neck movements, heavy lifting, or prolonged awkward postures (e.g., construction workers, dentists, office workers with poor ergonomics).
• Previous Neck Injuries: Trauma, such as whiplash from a car accident, can accelerate degenerative changes.
• Smoking: Has been linked to increased rates of disc degeneration.
• Obesity: While not a direct cause, excess body weight can contribute to overall spinal stress.

Common Symptoms

The symptoms of cervical arthrosis can vary widely in severity and presentation:

• Neck Pain: Often chronic, aching, or stiff, which may worsen with movement or at the end of the day.
• Reduced Range of Motion: Difficulty turning the head, looking up or down, or tilting the head from side to side.
• Headaches: Frequently originating at the base of the skull and radiating to the temples or forehead.
• Crepitus: A grinding, popping, or crackling sensation or sound when moving the neck.
• Radiculopathy (Nerve Root Compression): If bone spurs or disc herniation compress a nerve root, symptoms may include:
  • Pain, numbness, tingling (pins and needles), or weakness radiating into the shoulder, arm, hand, or fingers.
  • Muscle spasms in the neck and shoulders.
• Myelopathy (Spinal Cord Compression): A more serious condition where the spinal cord itself is compressed. Symptoms can include:
  • Difficulty walking, loss of balance, or general clumsiness.
  • Weakness, numbness, or tingling in the legs.
  • Loss of fine motor skills in the hands (e.g., difficulty buttoning a shirt).
  • Bowel or bladder dysfunction (in severe cases). This requires immediate medical attention.

Diagnosis

Diagnosis typically involves a combination of:

• Clinical Examination: A physical assessment by a healthcare professional, including evaluation of neck range of motion, muscle strength, reflexes, and sensation in the arms and legs.
• Imaging Tests:
  • X-rays: Can show bone spurs, disc space narrowing, and alignment issues.
  • MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues like discs, ligaments, and the spinal cord, helping to identify nerve or spinal cord compression.
  • CT Scan (Computed Tomography): Offers detailed bone imaging, useful for assessing bone spurs and spinal canal narrowing.
• Nerve Studies (EMG/NCS): Electromyography (EMG) and Nerve Conduction Studies (NCS) may be performed to assess nerve function and confirm nerve root compression.

Management and Treatment Approaches

The primary goals of managing cervical arthrosis are to alleviate pain, improve function, and prevent further progression. Treatment is often conservative, but surgical options exist for severe cases.

• Conservative Management (Non-Surgical):

  • Physical Therapy: A cornerstone of treatment. A physical therapist can design a program including:
    • Strengthening Exercises: Targeting deep neck flexors, scapular stabilizers, and upper back muscles to improve posture and support the cervical spine.
    • Mobility and Stretching Exercises: To maintain or improve neck range of motion and reduce stiffness.
    • Manual Therapy: Techniques like mobilization or manipulation to restore joint movement.
    • Modalities: Heat, ice, ultrasound, or electrical stimulation to manage pain and inflammation.
  • Pain Management: Over-the-counter pain relievers (NSAIDs), muscle relaxants, or in some cases, prescription medications.
  • Posture Correction and Ergonomics: Education on proper posture during daily activities, at work, and during sleep. Adjusting workstations and utilizing ergonomic supports can significantly reduce strain.
  • Lifestyle Modifications: Maintaining a healthy weight, quitting smoking, and engaging in regular, low-impact aerobic exercise (e.g., walking, swimming) to improve overall fitness and reduce inflammation.
  • Injections: Corticosteroid injections into specific joints or nerve blocks may be used to reduce localized pain and inflammation.

• Surgical Intervention:

  • Surgery is typically considered only when conservative treatments fail to provide relief, or when there is evidence of significant spinal cord compression (myelopathy) or severe, progressive nerve root compression (radiculopathy). Surgical procedures aim to decompress the spinal cord or nerve roots and stabilize the spine.

Prevention and Kinesiological Considerations

While cervical arthrosis is often age-related, proactive measures rooted in kinesiology and biomechanics can help mitigate symptoms and potentially slow progression:

• Maintain Optimal Posture: Be mindful of your head and neck position, especially during prolonged sitting or screen use. Keep your ears aligned over your shoulders.
• Regular Movement and Stretching: Avoid prolonged static positions. Incorporate neck mobility exercises and gentle stretches throughout the day.
• Strengthen Supporting Musculature: Focus on strengthening the deep neck flexors, rhomboids, trapezius, and other upper back muscles to provide better support and stability for the cervical spine.
• Ergonomic Setups: Optimize your workstation, car seat, and sleeping arrangements to minimize neck strain. Ensure your computer monitor is at eye level and your keyboard and mouse are comfortably accessible.
• Avoid Repetitive Strain: Take frequent breaks when performing tasks that involve repetitive neck movements or sustained postures.
• Proper Lifting Techniques: Always lift with your legs, keeping your back straight, to minimize strain on the entire spine.
• Listen to Your Body: Address neck pain or stiffness early. Persistent discomfort should prompt a consultation with a healthcare professional.

Conclusion

Cervical arthrosis is a prevalent condition that can significantly impact quality of life. While it's a degenerative process, a proactive approach incorporating targeted exercise, posture correction, and ergonomic adjustments can effectively manage symptoms, improve function, and support long-term spinal health. For fitness professionals, understanding this condition is crucial for guiding clients safely and effectively, emphasizing the importance of proper movement mechanics and a holistic approach to spinal wellness. Always advise clients to seek medical diagnosis and guidance from a qualified healthcare provider for persistent or worsening symptoms.