Cervical Spondylosis


Cervical spondylosis or degenerative changes in the cervical spine are commonly seen in both young and elder patients. A typical symptom usually starts after prolonged (over months) of chronic bad posture and lack of exercises. Very few cases may have a history of injury or congenital abnormalities and may require different treatment protocol.

Symptoms of cervical radiculopathy start with compression of the nerve roots


In most young patients, the symptoms are typically marked by neck pains associated with numbness, tingling, hot or cold, pricking pain even on rest in any part of arm, elbow, forearm or the wrist and hand. Patients have a long standing history and they do realise that they aren’t paying enough attention to their neck and back. Sometimes there is a sudden increase in numbness, inability to use the upper limb, loss of motor power associated with traumatic or febrile illness are the red flag signs and should be immediately cared for.


Degenerative joints and herniated discs of the cervical spine are most common causes leading to these symptoms. Most patients do well with life-style modification, exercises and medications. While a subset of population might require an invasive intervention or surgical procedure for the same. Young patients benefit most from conservative treatment while a subset of older patients with gross degenerative changes may benefit from surgery.


The diagnosis to cervical radiculopathy is straight forward but the decision making to conserve or treat surgically is difficult. The diagnosis to the disease usually makes use of a detailed history, Clinical examination by a spine surgeon followed by haematological and radiological investigations (Skiagrams, Scanogram, Computed tomography (CT) and Magnetic resonance imaging scan). They delineate exact cause and guide treatment.

Flexion Extension views of the spine have considerable importance and have a major role in decision making of the case

Cervical spondylosis : Importance of flexion extension views


Cervical radiculopathy is most commonly confused with a shoulder pain and vice versa which need a thorough clinical examination to reach the diagnosis. Also there are various connective tissue syndromes which have similar presentations. Fibrofasciitis or Fibromyalgia is the common term used to represent a constellation of neck pain, numbness, upper back pain, headache, vertigo and symptoms similar to radiculopathy. Carpel tunnel syndrome, tennis elbow, adhesive capsulitis and shoulder tendinitis are close differentials of the disease.

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