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Cervical Spondylosis Neck Pain in the Elderly


What is cervical spondylosis?

Cervical spondylosis is a condition where there is chronic neck pain due to age-related damage of the bones and cartilage present in-between the bones of the neck. With progressive aging the discs present between the bones loose water and shrinks resulting in the formation of abnormal bony spurs.

Cervical spondylosis is a very common problem with advancing age and the problem may run in the families. This condition affects more than 90% of people over 65 years of age but in many of these patients there may not be any symptoms. Treatment options are pain relieving and muscle relaxing drugs and exercise but surgery is required in very severe cases.

Cervical Spondylosis Symptoms

In many cases there may not be any symptoms but when symptoms occur they include pain and neck stiffness. In severe cases there may be narrowing of the canal or abnormal growth of bones (bony spur) which compresses the nerves passing through the canal. This can result in abnormal sensations like tingling, numbness (loss of sensation) and weakness of the arms, hands, legs or feet.

The patient’s gait may become unsteady with loss of balance, poor control of bowel or bladder function which results in leaking of urine or stool. In severe cases the compression of the nerves may lead to permanent damage of the function of the nerves and the symptoms become irreversible.

Causes of Cervical Spondylosis

With progression of age, the cushion-like structure between the vertebrae (spinal bones) known as the intervertebral disc gradually becomes damaged. These discs prevents friction between two adjacent vertebrae. It can affect any vertebrae but in cervical spondylosis it is the neck (cervical) vertebrae that are damaged. These pathological changes of wear-and-tear include :

  • Loss of water (dehydration) of the disc.
  • Shrinking of the discs resulting in frictional injury between the contact areas of the two adjacent cervical vertebra.
  • Protrusion of the jelly-like substance present in the discs.
  • Compression of the nerves passing through the spinal canal.

In response to degeneration of the intervertebral discs, the body tries to compensate by producing excess new bone which is deposited in the space between the affected cervical vertebral bone, This causes the cervical vertebrae to fuse and leads to stiffness, loss of flexibility and severe degree of pain. The ligaments that provide support to the vertebral column also becomes stiff with age due to deposition of calcium (calcification) resulting in a loss of flexibility of the neck.

Risk factors

Common risk factors include :

  • Advancing age.
  • Overuse of the joint as in people with certain jobs or hobbies that involves lifting heavy weights, repetitive neck movements or maintaining an awkward position of the neck for prolonged duration of time.
  • Trauma to the neck muscles.
  • Certain genetic factors as this condition is more common in members of same family.

Cervical Spondylosis Treatment

Treatment options depend upon the severity of the symptoms. The different modes of treatment are :

  • Intake of drugs like pain killers, muscle relaxants, anti-convulsant agents and steroid injections in the affected joint.
  • Exercise to strengthen the muscles of the back especially in the neck and shoulder region.
  • Use of traction may help to increase the space in the compressed canal thereby relieving compression on the nerves.

In severe cases, surgery is attempted in patients with major of narrowing of the spinal canal in order to relieve the pressure on the nerves. However, symptoms like neck pain may persist thereafter.

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