Neck pain and stiffness that gets progressively worse may be an indication of cervical spondylosis. The pain may range from mild to severe and debilitating. The condition may last for several months before improving, or it may become chronic. Other signs and symptoms may include:

• Neck pain that radiates to the shoulders and arms
• Numbness or weakness in the arms, hands and fingers
• Headaches that radiate to the back of the head
• Loss of balance
• Numbness or weakness in the legs, if the spinal cord is compressed
• Loss of bladder or bowel control, if the spinal cord is compressed

Causes

As you age, the disks of your spine become drier and less elastic. Degeneration can cause some of the disks to bulge and, in some cases, cause the central cartilage of the disks to protrude through a crack in the ring that surrounds the disk (herniate). The surrounding ligaments become less flexible, and the vertebrae may develop bone spurs.

These degenerative changes may be a result of wear and tear throughout your life. An earlier injury to your neck may predispose you to this degeneration. By age 60, most people will show signs of cervical spondylosis on X-ray, although they may not have signs or symptoms.

Risk factors

Aging and wear and tear on your spine are the major risk factors for cervical spondylosis.

When to seek medical advice

Call your doctor if:

• You have neck pain that doesn't respond to over-the-counter pain medications
• The pain worsens
• You develop numbness in your arms or legs

Screening and diagnosis

Your doctor will take a history of your condition and conduct a physical exam. He or she may test the flexibility of your neck by having you bend your head to your shoulder and turn your head from side to side. Diagnostic tests may include the following:

• Nerve functions test. Your doctor may check for neurological changes due to compression of the spine by testing your reflexes and seeing how the nerves and muscles in your arms and legs function. He or she may watch you walk to determine whether spinal compression is affecting your gait.
• Neck or spinal X-ray. An X-ray may show abnormalities, such as bone spurs, that indicate cervical spondylosis.
• Computerized tomography (CT) scan or magnetic resonance imaging (MRI). A CT scan of your spine uses X-ray technology, but produces a more detailed image than X-ray can. MRI uses a magnetic field and radio waves and can produce detailed, cross-sectional images of your spine. These tests may help your doctor determine the extent of damage to your cervical spine.
• Myelogram. This test involves generating images using X-rays or CT scansafter dye is injected into the spinal canal. The dye makes areas of your spine more visible

Complications

Cervical spondylosis is the most common cause of spinal cord dysfunction in older adults. If the condition progresses and isn't treated, or if treatment isn't successful, the disabilities may become permanent. Complications may include:

• Pressure on the spinal cord. Degenerative changes in the spine can lead to narrowing of the spinal canal that houses the cord (spinal stenosis), resulting in pressure on the cord anywhere along the spine. Cervical spondylosis can cause narrowing of the canal of the cervical spine, which can lead to numbness and weakness in your arms as well as your legs, even affecting your ability to walk. Pressure on the spinal cord also may cause loss of bowel or bladder control (cervical myelopathy).
• Pressure on the spinal nerves (cervical radiculopathy). Spinal stenosis, bone spurs or herniated disks can put pressure on the roots of one or more nerves that branch off the spinal cord at the neck. The pressure irritates the nerve, which may cause pain, tingling, burning, weakness or numbness down your arms or in your hands.