Most people experience minor aches and pains in their back or neck from time to time, but if the pain persists, it may be a sign of a concerning spinal problem.

Cervical spondylosis is a common condition that results from wear and tear on the disks, joints and bones of the neck. “Cervical” refers to seven stacked bones in the neck, and “spondylosis” describes age-related wear and tear.

“This is a problem caused by a degenerative arthritis in the cervical spine,” says orthopaedic spine surgeon Scott Vincent, MD. “Cervical spondylosis likely makes up about 40% of the patients we see, and among them, patients with cervical spondylosis may also have arthritis in other places along the spine.”

Common symptoms

It is possible to have cervical spondylosis without symptoms, but the initial warning sign is often persistent neck pain or stiffness. Also common is a clicking, popping or grinding sound when you move your neck. This may indicate bone spurs, which can develop as your body tries to strengthen the spine.

Neck pain may progress to other worsening symptoms if the condition leads to nerve compression, including:

• Dizziness or headaches at the back of the head.
• Radiating arm or shoulder pain.
• Numbness, tingling or weakness in the arm and hands.
• Balance issues. 

In more advanced cases, the spinal cord can be affected. This is known as cervical myelopathy, which occurs as a result of cervical spondylosis. “Compression of the spinal cord, in addition to the nerve compression, can cause balance difficulties or potentially dexterity issues as well,” adds Dr. Vincent. 

Diagnosis and risk factors

Your doctor will conduct a physical exam and likely order an X-ray to assess for arthritis and any changes to your spine. If nerve issues are suspected, an MRI is used to diagnose spondylosis and determine the extent of spinal cord or nerve involvement.

Although cervical spondylosis can occur in younger individuals, it is more common in older adults and is primarily associated with the effects of arthritis and aging.

“Cervical spondylosis has a strong genetic component, and factors like smoking can accelerate the degeneration,” says Dr. Vincent. “Traumatic injuries can also aggravate existing spondylosis and make the symptoms more severe.”

How is cervical spondylosis treated?

As a chronic condition, the changes that occur in the spine cannot be reversed. While the underlying arthritic changes tend to be progressive, early intervention can help manage the condition and prevent more serious complications.

A specific treatment plan is tailored to an individual’s needs and can often be effectively well-managed through a combination of conservative treatments. Care typically begins with: 

• Home exercises and stretching.
• Cold or heat therapy.
• Nonsteroidal anti-inflammatory medications (NSAIDs).
• Physical therapy.
• Pain management. 

If symptoms persist or worsen, an MRI will help inform if more advanced treatments are necessary, including epidural injections or surgery to relieve the pressure on the nerves or spinal cord. 

Surgical treatment highly depends on a person’s health history, symptoms, the nature of the condition and the severity of nerve compression. The most common surgical approach is an anterior cervical discectomy and fusion (ACDF).

Read about how spine surgery transformed a physical therapist’s back pain and perspective.

At what point should I see a doctor?

Let pain be your guide in determining the balance between activity and rest. Symptoms can come and go, but if they persist or worsen, consult your primary care physician or a spine specialist for an assessment.

“If you’re unsure, make an appointment to see what may be going on,” says Dr. Vincent. “Get an evaluation if you have neck pain that continues for more than 4 to 6 weeks despite the use of anti-inflammatory medications, pain that is getting worse or waking you at night, or certainly if you are experiencing nerve compression symptoms.”