Cervical arthrosis: symptoms, causes and treatment

By Cristiano Antonino On Jan 26, 2023

Cervical arthrosis is a degenerative disease involving changes to the bones, intervertebral discs, joints and cartilage (the protective film that covers the ends of the bones) of the cervical spine, the upper part of the spinal column

It is related to normal wear and tear due to ageing: with age, in fact, just like the rest of the body, these structures slowly degenerate.

In particular, with age the discs of the cervical spine become damaged, lose fluid and become stiffer.

As a result of this process, abnormal spurs or growths called osteophytes can form on the bones of the neck.

These outgrowths can also cause narrowing of the spinal canal, the channel through which the spinal cord and its nerve endings flow, a related condition called cervical spinal stenosis, which can cause neck pain and stiffness.

There are, however, other factors besides ageing that contribute to the onset of the disease.

In all cases, certain precautions and treatments can be taken to improve the situation.

Cervical arthrosis, outline of anatomy

The spinal column is composed of 24 bones, called vertebrae, which are stacked on top of each other.

These bones connect to create a channel that protects the spinal cord, the structure that sits in the spine (it also passes through the neck) and is responsible for transmitting nerve stimuli throughout the body.

It does this through nerves: ‘electrical’ cables that travel through the spinal canal, carrying messages from the brain to the muscles and vice versa.

The nerve roots branch out from the spinal cord through openings in the vertebrae (foramen).

The seven small vertebrae that begin at the base of the skull and form the neck make up the cervical spine.

Between each vertebra there are pads: the intervertebral discs, circular structures consisting of a central gelatinous nucleus, the nucleus pulposus, and an outer shell of intertwined elastic fibres, the annulus.

What is cervical arthrosis

Cervical arthrosis occurs when the intervertebral discs of the cervical spine become progressively thinner and the cartilage wears away.

As a result of this process, the two neighbouring vertebrae rub against each other, wearing each other out, causing bony beaks to form and hindering movement.

The part affected by arthrosis thus loses its functionality, becomes stiff, creaks and may appear swollen.

Causes of cervical arthrosis

Cervical arthrosis is a normal sign of age: it is difficult for an older person not to suffer from it.

In most people over the age of 50, the discs between the vertebrae become less spongy and provide less support.

In addition, bones and ligaments become thicker, encroaching on the space of the spinal canal.

However, the degree of degeneration varies from person to person: while in some cases it is accentuated, in others it is mild.

The reason is that various factors can intervene in this degenerative process and aggravate it.

Here are the main ones:

the female sex: women are more vulnerable to the disorder;
sedentariness: the less one moves, the more one becomes immobile. Sedentariness worsens muscle contraction and joint stiffness;
obesity: it leads to overloading at the joint level, as a result, bones and cartilage are forced to bear much more weight than they should;
the genetic component: people with other cases in the family are more prone to cervical arthrosis than average;
cigarette smoking: it tends to accentuate the wear and tear process and symptoms;
previous traumas and/or injuries to the area and bone diseases: they change the balance of the skeletal structure, favouring the development of the disease;
certain occupations or activities, which stress the neck area and require many repetitive movements of the neck;
posture alterations and scoliosis: they force the discs to bear weights in an unnatural attitude, facilitating the appearance of degenerative processes.

Cervical arthrosis, how it manifests itself

Cervical arthrosis is often a silent disease, especially in its early stages.

When it manifests itself, it does so mainly with the following symptoms

more or less intense neck pain due to wear and tear of the discs and rubbing of the vertebrae. Sometimes the pains worsen when looking up or down or doing activities in which the neck is held in the same position for a prolonged period of time, such as driving or reading a book;
stiffness of the part;
pain in the shoulders or arms;
inability to turn the head fully or bend the neck, which sometimes interferes with driving;
noise or jarring sensation when turning the neck.

Less common or ‘atypical’ symptoms include dizziness, headaches, palpitations, nausea, discomfort in the abdomen or gastrointestinal system, blurred vision and memory problems (hypomnesia).

According to some studies, chronic neck pain due to causes such as spondylosis is linked to increased blood pressure.

Possible complications of arthrosis

If cervical arthrosis causes pressure on the spinal cord (cervical stenosis), a condition called cervical myelopathy may occur.

Symptoms of this condition include tingling; numbness and/or weakness in the arms, hands, legs or feet; lack of co-ordination and difficulty walking; abnormal reflexes; muscle spasms; and loss of bladder and bowel control (incontinence).

Another possible complication of cervical atrosis is cervical radiculopathy, which appears when bone spurs press on the nerves that emerge from the bones of the spine.

Pain affecting one or both arms is the most common symptom.

Sometimes, cervical arthrosis can be associated with a hernia, i.e. the protrusion of the soft nucleus of the intervertebral disc.

This protrusion can compress and inflame the nerve roots in the area and the spinal cord, causing pain and weakness in the neck, which radiates to the arm.

Cervical arthrosis – the diagnosis

In the presence of suspicious symptoms, it is a good idea to contact your doctor, who may refer you to an orthopaedic specialist.

To diagnose cervical arthrosis, the doctor first carries out a thorough anamnesis, asking the patient to describe the symptoms experienced and his or her state of health, and to recount his or her personal and family medical history.

This is followed by a physical test of the body, with a particular focus on the neck, back and shoulders.

The doctor is also likely to examine the reflexes and strength of the hands and arms, check for loss of sensation and observe the person while walking.

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The doctor may also press gently on the neck and shoulders, looking for trigger points (sensitive) or swollen glands.

Cervical arthrosis, what tests to do

To better investigate the situation, the doctor may also request specific tests, such as:

-radiography, which provides images of dense structures such as bone. It will show the alignment of the bones along the neck. It can also reveal degenerative changes in the cervical spine, such as loss of disc height or the presence of bone spurs;

-Magnetic resonance imaging, which provides images of the body’s soft tissues, such as muscles, discs, nerves and spinal cord. An MRI can help determine whether symptoms are caused by soft tissue damage, such as a bulging or herniated disc;

-tac, which can help the doctor better visualise the spinal canal and any bone spurs;

-myelogram, an imaging procedure in which contrast medium is injected into the spinal canal to make the spinal cord and nerve roots appear more clearly;

-electromyography (EMG), which measures the electrical impulses of muscles at rest and during contractions. It can be performed in conjunction with nerve conduction studies, which are carried out to determine whether a spinal nerve is functioning properly;

-blood tests, which are useful to check for inflammation.

If necessary, a neurological examination may also be required.

Cervical arthrosis, treatments

Cervical arthrosis does not necessarily need to be treated: only when it manifests itself painfully is action taken to try to alleviate the discomfort.

In most cases, treatments for cervical arthrosis are conservative.

They may include:

rest in the acute phases of the disease, when symptoms are very intense;
physiotherapy: this is usually the first non-surgical treatment recommended by the doctor. Specific exercises can help relieve pain, as well as strengthen and stretch weakened or strained muscles;
the use of non-steroidal anti-inflammatory drugs (NSAIDs) or other medicines, such as muscle relaxants and painkillers, to relieve pain from inflammation;
massage, which can help control episodes of more intense pain;
the use of a cervical collar to restrict movement and provide support;
other forms of physical therapy, including iontophoresis, ultrasound, tens, heat and cold therapy, traction, chiropractic or osteopathic manipulation;
the injection of drugs (corticosteroids and local anaesthetic) into the joints of the spinal column or the area surrounding the spinal column itself;
gymnastics during non-acute periods. In particular, so-called ‘gentle gymnastics’ are recommended, such as stretching, yoga, swimming, which involve movements that are harmonious and not too violent for the body.

Arthrosis, when surgery is needed

Cervical arthrosis tends to be a chronic condition, but surgery is only necessary in rare cases, when there is compression of the spinal cord and/or loss of function, e.g. in the case of progressive loss of feeling and function in the arms, legs, feet or fingers.

The goal of surgery is to remove the source of pressure on the spinal cord and nerves.

Surgery may also include the addition of stabilisation in the form of implants or by fusion of the vertebrae.

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