Nerve compression caused by degenerative cervical spondylosis is a condition caused by herniated cervical discs, which may press on the spinal nerve roots and cord. Typically, the disease increases with age. It is most common between the ages of 40 and 50, and males outnumber females by a ratio of 1.7 to 1.
Symptoms
- Sharp shooting pain and discomfort that spreads from the neck to the arm.
- Numbness and weakness in the arms, hands, legs, or feet
- Loss of balance, abnormal gait with frequent fall
- Inability to hold urine or feces due to loss of excretory control
When should you see a doctor?
Urgent care is required for patients if they experience numbness, weakness, loss of balance, and unable to control the excretory system.
Causes
The cervical vertebrae and discs will degenerate due to incorrect or repetitive motions over time. This degeneration will have the following consequences:
- Disk degeneration - Cervical discs begin to degrade around age 35, causing the spinal joints to work harder and narrowing the spinal nerve foramen.
- Herniated disks - With increased age, degenerated discs are prone to herniate and may impinge on the spinal cord and nerve roots.
- Bone spurs - Intervertebral disc degeneration can result in the formation of bone in the vertebrae to support the joints, but this can likewise impose pressure on the spinal cord and nerve roots.
Risk Factors for cervical spondylosis
- Age - Cervical spondylosis is more common as we age.
- Occupation - Jobs requiring repetitive neck motions in an awkward posture or work requiring a neck extension place additional strain on the neck.
- Neck injury - Prior neck injuries increase the risk of developing cervical spondylosis.
- Smoking- Smoking makes cervical spondylosis more likely.
Diagnosis
The physician will take a medical history and perform a physical examination, check the cervical vertebra's mobility, and assess the function, strength, and reflexes of the nerve innervating a muscle for the pressing consequence of a herniated disc. Walking gait will be tested to ascertain the extent of the spinal cord compression effect.
Additional Investigations
Medical imaging can give extensive information that helps guide diagnosis and therapy. Here are several examples:
- Neck X-ray - Changes in the spine, such as bone spurs, can be seen on an X-ray, indicating cervical spondylosis. A neck X-ray can also rule out more severe and unusual causes of neck pain and stiffness, such as tumors, cancer, infections, or fractures.
- MRI - MRI provides comprehensive pictures and data of where the nerves may be pinched and help with the treatment plan.
Nerve function examinations
You may require testing to establish whether nerve impulses are reaching your muscles adequately. Nerve function testing includes the following:
- Electromyography - This test analyzes the electrical activity of the muscle in response to nerve impulse stimulation during contraction and rest.
- Nerve conduction study - Electrodes are placed on the skin just above the examined nerve to measure the amplitude and speed of nerve impulses.
Treatment
The severity of symptoms determines the treatment plan. The objective of treatment is to alleviate pain, assist you in maintaining as many of your usual activities as possible, and avoid irreparable damage to the spinal cord and nerves.
Medications
If over-the-counter pain medicines are insufficient, your doctor may prescribe:
- Nonsteroidal anti-inflammatory drugs. They provide relief to nerve-root-compression neck pain.
- Corticosteroids. A brief course of oral prednisolone may help with pain relief. If your pain is severe, you may benefit from steroid injections.
- Muscle relaxants. Certain medications, such as cyclobenzaprine, can alleviate neck muscle spasms.
- Anti-seizure medicines. Certain epilepsy medications such as gabapentin can minimize the pain of nerve injury.
- Antidepressants. Certain antidepressants can help alleviate neck discomfort caused by cervical spondylosis.
Physical Therapy
A physical medicine and rehabilitation doctor can design an exercise program that augments the flexibility and strength of the neck and shoulder muscles. Some individuals with cervical spondylosis may benefit from cervical traction by increasing the space between the cervical vertebrae.
Surgery
You may require surgery to provide more space for your spinal cord and nerve roots. If conservative treatment fails and neurological symptoms, such as an arm or leg numbness, and weakness, worsen to the point you cannot pick up objects, or your gait becomes abnormal.
During surgery, removal of a herniated disk, bone spurs, or portion of a vertebra may happen. Cervical spine fusion using bone grafts and metal rods may be necessary.
