Cervical spondylosis is that condition of the neck when the vertebrae in the neck and the adjoining discs degenerate over time. Most of the times it is an age related disease but it may not be said that this will not occur in younger people. Actually the condition starts developing from the age of around 30.
The symptoms like neck pain, stiffness of the neck, occasional headaches and similar problems may show up in course of time. And there are some treatments available to relieve the symptoms, prevent any damage of permanent nature to the nerve or retard the process of degeneration.
The treatment of cervical spondylosis is done with the help of combination of various methods including that of medicine and physical therapy.
Ways to Treat Cervical Spondylosis
Medicine for Pain Relief
This is the commonest of all treatments for the pain associated with cervical spondylosis. And can be done through various ways.
Over the Counter Drugs
The commonest way to treat any pain is an over the counter drug. This is also true for cervical spondylosis. Non-steroidal anti-inflammatory drugs or NSAIDS as they are commonly called have been found to be quite effective in getting over the pain. Most of the times, it is Ibuprofen which is prescribed rather than aspirin because it is known to have lesser side effects.
But such over the counter drugs may not be recommended for patients who are also suffering from conditions like hypertension, diseases of the liver or heart, asthma or even gastric and stomach ailments. In such cases the drug that is often used is paracetamol. But the advice of the physician is recommended in such patients.
This is the second level of treatment of pain in cervical spondylosis. If the NSAIDs fail to provide relief to the patient then the physician recommends this drug, which is a mild opiate to be taken along with the regular pain killer. I would like to remind that this is a drug that should not be abused. One of the common side effects of this drug is constipation.
To make sure that the patient does not suffer from it, the physician often recommends food with high fiber content and lots of water to drink. So the patient is asked to eat wholegrain breads, pasta, oats, beans, fruits and vegetables, etc. Codeine is a drug that is recommended for short term use in cases where NSAIDS alone cannot contain the pain. It is not suitable for patients who are suffering from breathing problems.
This is the third in line of treatment of cervical spondylosis and prescribed in conditions when the patient experiences muscle spasms. Muscle relaxants like diazepam are prescribed to ease the stiffened muscle. But these medicines are also sedatives and they can make the person feel dizzy as well as drowsy.
During the course of this drug the patients are advised not to drive or take alcohol. The effect of alcohol can take effect sooner than expected when under influence of this drug. Since this is a sedative, it should not be used more than 7 to 10 days at a stretch.
Amitriptyline is used only when the normal drugs fail to provide relief even after a month or longer. This drug was originally developed as an anti-depressant, but it was found that when used in very little amount they are also good pain killers.
However, it has its own set of side effects like dry mouth, drowsiness, vision blurring, constipation and difficulty in passing urine. Those having a history of heart diseases are not recommended this drug.
Sometimes the patient may complain of a prickly feeling as if pins and needles are being pricked on the neck and shoulder. Along with it the patient also may complain of radiating pain in the arm. This is caused by squeezing of nerve roots between the vertebrae and discs and the irritation caused by it.
Gabapentin is the drug used for such condition and may take over two weeks to show its result. It is actually a drug used for treatment of epilepsy, but in these conditions it has also been found useful. The side effects of this drug include skin rashes and unsteady feeling. But these go away as soon as the medication stops.
This is the treatment of extreme condition. When the pain does not subside even after all the possible oral medications, then there is no option but to go for steroidal injections at the nerve roots.
But this is an aspect that should be best left to the physician who can diagnose the condition of the patient before referring him or her to the pain clinic.
Normally physical therapy goes on simultaneously with medication for providing relief both on immediate and long term fronts. Postural exercises are recommended in the initial stages where some exercises tend to relax the compression. Aerobic exercise like walking and swimming are also good in these conditions. Use of a hard pillow while sleeping can reduce the strain in the neck.
In the more advanced stages cervical traction is recommended. It is a mechanical process where the chin and head are provided support for relieving the pressed nerves. One method used for relieving pain is shortwave diathermy where a heating pad is placed on the neck to relax the muscles.
Falling within the scope of physical therapy is the use of collars. The patient may be recommended the soft collar which is worn during sleep to prevent any awkward bend of the neck; and the hard collar which is generally used during the day time to keep the neck stretched. Such collars are generally removed with the relief of pain and are not generally recommended for more than a week at a stretch.
This may be called the extreme treatment of cervical spondylosis. Generally surgery is used to stop further degeneration in cases of progressive myelopathy and in stopping the radiating arm pain which is generated due to compression of the nerve roots.
But in such cases surgery is recommended when all the other methods of treatment fail to reduce the severity of such conditions and the compression of nerves is established by MRI.