Cervical Spondylosis is the technical term for wear and tear on the neck. There are many terms, which usually fit under it. Some include neck arthritis, pinched nerve, herniated disc, ruptured disc, blown out disc, and slipped disc. To understand what it is and how it can be treated, you have to understand what the neck does and how it is designed.
The neck’s job is to hold up the head and protect the spinal cord. The disc is the natural shock absorber in your spine. It sits between the bones of your spine and provides cushioning, as well as connecting one bone to the other. The disc is constructed like a tire, with a hard, rubbery layer around the outside called the annulus. The inside is filled with a gelatin-like material called the nucleus.
When a disc herniates, the outer covering of the disc, the annulus, breaks. The material inside then squirts out. Your body responds to this as neck and arm pain. Sometimes, if the pressure on the nerve is great enough, there can be loss of nerve function causing numbness, weakness, and loss of reflexes. In the worst cases, your ability to walk, or bowel and bladder function can be affected.
With wear and tear, the joints in the neck also wear out. The body builds bone spurs to try to stop this rough motion. Sometimes, however, these bone spurs can cause a tightening or pinching around the nerves as they leave the spinal cord, which can sometimes cause tightness around the whole spinal cord.
What Treatments Exist?
Exercise: Exercise which strengthens your neck muscles, done along with instruction on posture and movement, has been shown to be very effective. A physical therapist can be helpful in assisting you in this exercise. With good strength and proper body mechanics, you can decrease the amount of pressure on the nerve.
Non-steroidal, Anti-inflammatory Medications: These medications (ie: Ibuprofen, Relafen, Lodine, Voltaren, Naprosyn, DayPro, etc.) can decrease pain and inflammation. Taken along with an exercise program, they can significantly relieve your pain. Patients may react differently to each of these medications. Often patients need to try several before the best one is found. Some new medications only need to be taken once or twice a day and are easier on your stomach. These medications do not cure the problem; rather they allow you to function in spite of it.
Steroids: You may be given an oral steroid, or an injection of a steroid around the nerves that are being squeezed. A steroid is the most powerful anti-inflammatory medication. Through this injection, a small amount of the most powerful medication is inserted exactly where your problem occurs. An x-ray machine is utilized to easily place the medication on the exact location. While this does not “cure” the problem, it can quickly calm it down, occasionally for many months. Often, when combined with a therapy program, this improvement can be nearly permanent. If needed, these injections can be repeated periodically.
Surgery: Surgery is recommended if the nerves are showing evidence of increasing damage, or if pain is intolerable despite other treatments. The primary goal of the operation is to prevent further damage to the nerves and the spinal cord. Often weakness and numbness improves, but this is not always the case.
In the most common case of neck surgery, a cut is made in the front of the neck. The other structures in the neck are moved aside until the spine is seen. The disc is then removed along with any bone spurs that may be compressing the nerves or the spinal cord. A piece of bone, either from your hip area or from a bone bank, is then placed in the space where the disc used to be. Occasionally, a plate is used to hold it in place. Sometimes a collar is used to protect the neck until the bone has healed (approximately three months). Hospitalization after surgery can last one to five days. Following surgery additional exercises are given to strengthen the neck muscle as well as instruction on how to protect your neck. Usually a full range of work and recreational activities is possible following surgery.