Medicines for Cervical spondylosis

What it is

Cervical spondylosis is a common condition caused by age-related changes ("wear and tear") in the bones, discs, and joints of the neck (the cervical spine). It is very common as people get older — in fact, these changes are so common with age that they can be considered a normal part of ageing, and many people with them have no symptoms at all. When symptoms do occur, they most commonly include neck pain and stiffness, which may come and go, and can be worse with certain movements or after activity or rest. Some people also experience headaches (often starting at the back of the head), and a grinding or clicking sensation in the neck. In most cases, cervical spondylosis is not serious, and the symptoms are manageable. However, in some people, the age-related changes can narrow the spaces where the nerves or spinal cord pass, and this can cause additional symptoms: if a nerve is pinched, there may be pain, numbness, tingling, or weakness spreading into the arm or hand (cervical radiculopathy); and, less commonly, if the spinal cord itself is affected (cervical myelopathy), there can be more significant symptoms, such as problems with hand coordination or dexterity, walking or balance problems, or changes in bladder or bowel control — these are important to recognise, as they need assessment. For most people, though, cervical spondylosis causes neck pain and stiffness that can be managed with simple measures — keeping the neck moving with gentle exercises, pain relief, and good posture — and often improves or fluctuates over time. The key messages are that cervical spondylosis is a common, usually not serious, age-related condition, that neck pain and stiffness are usually manageable with exercises and pain relief, and that symptoms suggesting nerve or spinal cord involvement (spreading arm symptoms, or problems with hands, walking, or bladder/bowel) should be assessed.

How it is treated

Cervical spondylosis is usually managed with simple, conservative measures for the neck pain and stiffness, with assessment for any features suggesting nerve or spinal cord involvement. For the common symptoms of neck pain and stiffness, helpful measures include: keeping the neck moving and staying active, with gentle neck exercises and stretches (rather than resting it completely, as keeping it moving helps), which a physiotherapist or guidance can advise; pain relief and anti-inflammatory measures for the pain (a pharmacist or GP can advise), and using heat or cold for comfort; maintaining good posture, particularly during activities such as computer or phone use, and setting up workstations well; and using a suitable pillow for comfort at night. Most people’s symptoms are manageable with these measures, and often fluctuate or improve over time. Physiotherapy can help, particularly for persistent symptoms, with exercises and advice. It is worth seeing a GP if neck pain is persistent, severe, or not improving, for assessment and guidance. Importantly, certain symptoms need medical assessment because they may indicate that a nerve or the spinal cord is being affected: pain, numbness, tingling, or weakness spreading into the arm or hand (which may suggest a pinched nerve); or, more significantly, problems with hand coordination or dexterity (such as difficulty with buttons or fine tasks), problems with walking or balance, or any changes in bladder or bowel control (which may suggest the spinal cord is affected and need prompt assessment). Where nerve or cord involvement is present, further assessment (including imaging such as MRI) and specialist input guide treatment, which may include specific measures and, in some cases, surgery. The reassuring messages are that cervical spondylosis is a very common, usually not serious, age-related condition, that the neck pain and stiffness are usually manageable with keeping the neck moving, exercises, pain relief, and good posture, and that symptoms suggesting nerve or spinal cord involvement should be assessed so they can be managed appropriately.