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Cervical Disk Spondylosis, Part 1

A common cause of neck pain and radiating arm pain, Cervical Disk Spondylosis develops when one or more of the cushioning discs in the cervical spine (neck) starts to break down due to wear and tear.                                                                                                             

          This week, we will begin to explore Cervical Disk Degeneration (Spondylosis), a degeneration of the cervical disks - the neck region of the spine.

          In this segment, we will study the broader subject of Degenerative Disc Disease in general to better understand our specific subject. We will define terms and discuss causes and symptoms of this common condition.  

 

What is Degenerative Disc Disease?

           Degeneration of the discs particularly in the moving sections of the spine like the cervical and lumbar levels is a natural process of "aging." When this "aging" process occurs more rapidly or prematurely it is considered "degeneration". The dehydration or desiccation of the disc material reduces the flexibility and typically the height of the disc. In some cases, the degeneration causes pain from loss of disc height and abnormal motion or compression between the vertebra and causing pain.

Diagnosing Degenerative Disc Disease

The following process is typically used to diagnose degenerative disc disease:

  • A medical history is collected that details current and past symptoms of neck or back pain, including when the pain started, how often pain occurs, where pain is felt, and the severity of pain and its impact on mobility. A medical history may also include information on sleep and dietary habits, exercise and activity level, and how symptoms are eased or worsened by activity or posture.
  • A physical exam is conducted, which may include feeling along the spine for abnormalities (palpation), a reflex test, and/or a range of motion test that includes bending the spine forward, backward, or to the side.
  • An imaging test may be ordered in some cases to find or confirm disc degeneration in the spinal column. An MRI scan is usually used for suspected disc degeneration, which can show disc dehydration, tears or fissures in the disc, or a herniated disc. A dehydrated disc may be referred to as a dark disc or black disc, because it looks darker on an MRI scan.

It is important to note that the amount of pain does not correlate to the amount of disc degeneration. Severely degenerated discs may not produce much pain at all, and discs with little degeneration can produce severe pain—a handful of studies have found prevalent disc degeneration in people not experiencing any disc pain.

For this reason, a diagnosis of degenerative disc disease should always rely on a combination of a medical history, a physical exam, and any imaging tests ordered.

As a final note, it is helpful for patients to know that the amount of pain does not correlate to the amount of damage in the spine. Severely degenerated discs may not produce much pain at all, and discs with little degeneration can produce severe pain. What this means for patients is that even if they are experiencing severe pain, it does not necessarily mean that there is something seriously wrong with their spine and does not necessarily mean that they need surgery to repair any damage.

Common Symptoms of Degenerative Disc Disease

          Degenerative disc disease most commonly occurs in the cervical spine (neck) or the lumbar spine (lower back), as these areas of the spine undergo the most motion and are most susceptible to wear and tear.

          The most indicative symptom of degenerative disc disease is a low-grade, continuous pain around the degenerating disc that occasionally flares up into more severe, potentially disabling pain. Pain flare-ups can be related to recent activity and abnormal stress on the spine, or they may arise suddenly with no obvious cause. Episodes can last between a few days to several weeks before returning to low levels of pain or temporarily going away entirely.

Other common symptoms of degenerative disc disease include:

  • Increased pain with activities that involve bending or twisting the spine, as well as lifting something heavy

  • A “giving out” sensation, caused by spinal instability, in which the neck or back feels as if it is unable to provide basic support, and may lock up and make movement feel difficult.

  • Muscle tension or muscle spasms, which are common effects of spinal instability. In some cases, a degenerated disc may cause no pain but muscle spasms are severely painful and temporarily debilitating.

  • Possible radiating pain that feels sharp, stabbing, or hot. In cases of cervical disc degeneration, this pain is felt in the shoulder, arm, or hand (called a cervical radiculopathy); in cases of lumbar disc degeneration, pain is felt in the hips, buttocks, or down the back of the leg (called a lumbar radiculopathy).

  • Increased pain when holding certain positions, such as sitting or standing for extended periods (exacerbating low back pain), or looking down too long at a cell phone or book (worsening neck pain).

  • Reduced pain when changing positions frequently, rather than remaining seated or standing for prolonged periods. Likewise, regularly stretching the neck can decrease cervical disc pain, and taking short, frequent walks during the day can decrease lumbar disc pain.

  • Decreased pain with certain positions, such as sitting in a reclining position or lying down with a pillow under the knees, or using a pillow that maintains the neck’s natural curvature during sleep.

The amount of chronic pain—referred to as the baseline pain—is quite variable between individuals and can range from almost no pain or just a nagging level of irritation, to severe and disabling pain.

Chronic pain from degenerative disc disease that is severe and completely disabling does happen in some cases, but is relatively rare.

 

          Next week, we will focus our investigation on Cervical Disk Spondylosis, a specific form of degenerative disk disease. We will define and clarify similar and related terms, and discuss causes and symptoms of this specific condition.

            If you believe you are experiencing Cervical Disk Spondylosis, don’t wait for your family physician; visit Excel Rehabilitation Services on Burnside Ave. in Gonzales, Louisiana. You will receive one-on-one care from an experienced physical therapist!

 

Sources:

http://spinecenter.ucla.edu/cervical-degenerative-disc-disease

https://emedicine.medscape.com/article/1144952-overview

https://www.laserspineinstitute.com/back_problems/spondylitis/cervical/

https://www.spine-health.com/conditions/degenerative-disc-disease/cervical-degenerative-disc-disease

https://www.spine-health.com/conditions/lower-back-pain/spondylosis-what-it-actually-means

https://www.webmd.com/pain-management/features/neck-pain#1

 

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