Pain in the NECK ?( Cervical SPONDYLOSIS)
In todays world who doesn’t have a Neck pain? This has become a common complaint we see in everyday orthopaedic practice. The term cervical spondylosis is an age related wear and tear of the cervical spinal discs.
Lets know a little more about the Anatomy of the neck joints:-
There are seven cervical vertebrae between each vertebrae there are discs which act as shock absorber and also facetal joint lined with articular cartilage giving us the full range of movements of the neck like bending the neck forward (Looking down) backwards (Looking up), sideways ( right and left).Did you ever realize , the neck movements are more compared to rest of the body resulting in degeneration of disc and the joints resulting in cervical Spondylosis. Usually pain in the neck can present with stiffness and pain radiating to the shoulder, upper limb right up to the fingers, front of chest wall and head also. Degeneration the disc and joint are common after the age of 60years. But degeneration can be precipitated by repeated injuries to the neck, comuting by bus everyday for work for a long distance, hobbies involving severe neck movements in the younger age group could be few reasons .
Myofacial symptoms – mainly pain in the neck radiating to the scapular region (shoulder blade)and shoulder common in the youngster working in IT Companies.
Radicular symptoms – here the disc prolapses causing pressure on the nerve root with severe electric shock like pain radiating down along the upper arm, forearm and fingers. It is common in the younger age group.
Vascular symptoms– patients have pain in the neck with reeling sensation and vertigo.
Symptoms like difficulty in walking and dressing may be due to pressure on the spinal cord. If the pain in the neck is constantly preventing and disturbing routine activities , he or she must consult the orthopaedic surgeon. After examination the surgeon will take x-ray and other investigation like blood sugar etc,. It is important to take x-ray and at times MRI also may be warranted to rule out any fractures, infection or malignancy.
Mainly pain killer tablets, non steroidal anti-inflammatory tablets, local application of pain balm and physiotherapy. Patient must abstain from doing heavy work. Physiotherapy in the form of short wave diatheramy, cervical traction and shoulder shrugging and bracing exercise to ease muscles spasm and to relieve pressure on the nerve root.If there is radiculorpathy and vascular symptoms causing giddiness, cervical collar should be worn for 1 week day and night.
If the pain does not subside with the above treatment or if there is any neurological deficit MRI of cervical spine is a must. According to the serverity cervical discectomy and anterior cervical fusion may be necessary.
It is important to know once the degeneration of disc has occurred it is permanent. Avoid strenuous work that cause pain and do regular shoulder shrugging, bracing and neck exercise to refrain from recurrence.