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Cervical Disk Spondylosis, Part 2

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.                                                                                                             

             Last week, we began to explore Cervical Disk Degeneration (Spondylosis), by first defining and studying the broader topic of Degenerative Disc Disease.

             In this segment, we will get more specific into our subject. First, we will define similar and related terms and then we will examine the causes and symptoms of this specific condition.

 

Clarification of terms

             Many patients are confused by the similarity of the terms spondylitis and spondylosis. When researching spine conditions, it is important to research the correct condition for you. Often, patients diagnosed with spondylitis may have spent all of their time researching spondylosis, which can be frustrating and potentially interfere with your treatment. So let’s take a moment to explain the difference between spondylitis and spondylosis so patients can identify their correct medical condition in order to take proactive steps toward finding a treatment solution.

             Spondylitis is a term used to describe a group of arthritic spine conditions that cause inflammation in the joints and vertebrae. Spondylitis has no known cause, but there is evidence of a genetic component. In severe cases of spondylitis, the arthritis will deteriorate the joints, causing the vertebrae to fuse together and limit mobility in that section of the spine. There is no known cure for spondylitis, but several forms of treatment that can help reduce pain and increase mobility at the site of the condition.

             Spondylosis is a broader term referring to degenerative age-related conditions affecting the spine such as osteoarthritis or degenerative disc disease. It is often caused by general wear and tear of the spine, such as vertebrae compressing over time and deteriorating the discs found between the vertebrae. Spondylosis can lead to compression of nerves in the spinal column, causing severe and chronic pain in the back and extremities.

Symptoms of spondylitis and spondylosis

          Symptoms of spondylitis differ based on the cause and severity of the condition. However, the most common symptoms include:

  • Pain and stiffness in the back

  • Limited mobility

  • Abnormal curvature of the spine

  • Limited range of motion for spine

  • Local and radiating pain in the back, hip, and/or extremities

Symptoms of spondylosis also differ based on the individual and the severity of the spine condition. Most patients experience the following symptoms:

  • Limited flexibility

  • Tingling, numbness and weakness in extremities

  • Difficulty walking

Schedule an appointment with your physician to discuss your symptoms to help your physician determine the nature and severity of your condition. Together, you can create a treatment plan that will fit your needs and your lifestyle. Patients diagnosed with either of these conditions are often able to find relief through a course of conservative treatments, with surgery being seen as a last resort.

 

Cervical Disk Spondylosis

           Cervical Disk Spondylosis develops when one or more of the cushioning discs in the cervical spine starts to break down due to wear and tear. The disk acts as a shock absorber between the bones in the neck. In cervical disk degeneration (which typically occurs in people age 40 years and older), the normal gelatin-like center of the disk degenerates and the space between the vertebrae narrows. As the disk space narrows, added stress is applied to the joints of the spine causing further wear and degenerative disease. The cervical disk may also protrude and put pressure on the spinal cord or nerve roots when the rim of the disk weakens. This is known as a herniated cervical disk.

Risk Factors for Cervical Degenerative Disc Disease

          While nearly everyone eventually gets cervical degenerative disc disease with age, there are some factors that can make it more likely to develop sooner and/or become symptomatic. These risk factors could include:

  • Genetics. Some studies of twins indicate genetics play a bigger role than lifestyle in determining when cervical degenerative disc disease develops and if it becomes painful.
  • Obesity. Weight has been linked to risk for developing degenerative disc disease.
  • Smoking. This habit can hinder nutrients from reaching the discs and cause them to lose hydration more quickly.

In addition, an injury to the spine, such as a herniated disc, can sometimes start or accelerate cervical degenerative disc disease.

Symptoms

          Cervical disc degenerative disorder can be characterized by neck pain. This neck pain can be most prevalent when the patient is upright or moving the head and can be reduced by lying down or reclining. Often the disc will be associated with osteophytes or bone spurs. They can further reduce movement and lead to nerve compression. The cervical nerve roots innervate the back of the head and neck as well as the arms and hands. If they are affected, the patient could have burning, tingling, numbness, and pain in these areas. Sometimes headaches result from cervical degenerative disc problems.

Diagnosis

          Cervical disc disorders if advanced enough are diagnosable on plain x-ray, which shows collapse or reduction in the height of the disc and possible bone spurs and bony end plate changes. An MRI is most useful diagnostic imaging for these conditions. The MRI shows if the disc is degenerated and best identifies the impingement on the nerves by bone or soft tissues surrounding them. Changes in the bony end plates with increased water content in the bone are known as Modic changes.

          In patients with multiple degenerative discs and associated pain, it is often difficult to distinguish which disc or discs are the pain generators. In this circumstance, additional, more invasive types of testing may be required. They could include discography/CT, a technique of injecting the discs with dye and taking a CT scan in which the patient identifies the quality and severity of the pain in each individual disc tested. Another option might be epidural or nerve blocks that are used to determine the level that is causing the nerve symptoms.

 

          Next week, we will delve into the development of cervical disc degeneration, as well as treatment options and even prevention measures patients can take to avoid or lessen this uncomfortable condition.

          If you are experiencing a pain in your neck (no pun intended), 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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