Treatment for cervical spondylosis aims to relieve symptoms of pain and prevent permanent damage to your nerves .
Non-steroidal anti-inflammatory drugs (NSAIDs) are thought to be the most effective painkillers for symptoms of cervical spondylosis. Some commonly used NSAIDs include:
If one NSAID fails to help with pain, you should try an alternative.
However, NSAIDs may not be suitable if you have asthma , high blood pressure , liver disease, heart disease or a history of stomach ulcers . In these circumstances, paracetamol is usually more suitable. Your pharmacist or GP can advise you.
If your pain is more severe, your GP may prescribe a mild opiate painkiller called codeine. This is often taken in combination with NSAIDs or paracetamol.
A common side effect of taking codeine is constipation . To prevent constipation, drink plenty of water and eat foods high in fibre, such as wholegrain bread, brown rice, pasta, oats, beans, peas, lentils, grains, seeds, fruit and vegetables.
Codeine may be unsuitable for a number of people, especially if taken for long periods of time. Your GP can advise on whether it is safe for you to take codeine.
It is generally not recommended for people who have breathing problems (such as asthma) or head injuries, particularly those that increase pressure in the skull.
If you experience spasms, when your neck muscles suddenly tighten uncontrollably, your GP may prescribe a short course of a muscle relaxant such as diazepam.
Muscle relaxants are sedatives that can make you feel dizzy and drowsy. If you have been prescribed diazepam, make sure you do not drive. You should also not drink alcohol, as the medication can exaggerate its effects.
Muscle relaxants should not be taken continuously for longer than a week to 10 days at a time.
If pain persists for more than a month and has not responded to the above painkillers, your GP may prescribe a medicine called amitriptyline.
Amitriptyline was originally designed to treat depression, but doctors have found that a small dose is also useful in treating nerve pain. You may experience some side effects when taking amitriptyline, including:
Do not drive if amitriptyline makes you drowsy. Amitriptyline should not be taken by people with a history of heart disease.
Gabapentin (or a similar medication called pregabalin) may also be prescribed by your GP for helping radiating arm pain or pins and needles caused by nerve root irritation.
Some people may experience side effects that disappear when they stop the medication, such as a skin rash or unsteadiness. Gabapentin needs to be taken regularly for at least two weeks before any benefit is judged.
If your radiating arm pain is particularly severe and not settling, there may be an option of a "transforaminal nerve root injection", where steroid medication is injected into the neck where the nerves exit the spine. This may temporarily decrease inflammation of the nerve root and reduce pain.
Side effects include headache, temporary numbness in the area and, in rare cases, spinal cord injury (limb paralysis).
Your GP would have to refer you to a pain clinic if you wished to explore thisoption.
You could consider:
The long-term use of a neck brace or collar is not recommended, as it can make your symptoms worse. Do not wear a brace for more than a week, unless your GP specifically advises you to.
Surgery is usually only recommended in the treatment of cervical spondylosis if:
Surgery may also be recommended if you have persistent pain that fails to respond to other treatments.
It's important to stress that surgery often doesn't lead to a complete cure of symptoms. It may only be able to prevent symptoms from getting worse.
The type of surgery used will depend on the underlying cause of your pain or nerve damage. Surgical techniques that may be used include:
Most people can leave hospital within three to four days, but it can take up to eight weeks before you can resume normal activities. This may have an impact on your employment, depending on the type of work you do.
Many people are recommended to return to work on a part-time basis at first, although you should discuss this with your employer before surgery.
Like all surgical procedures, surgery on the cervical spine carries some risk of complications, including:
If it's decided that you could benefit from surgery, your consultant will discuss the risks and benefits with you.
Cervical spondylosis is the medical term for neck pain caused by age-related wear and tear to bones and tissues.
Symptoms of cervical spondylosis include neck pain and shoulder pain. The pain can be severe if you develop cervical radiculopathy or cervical myelopathy.
To better understand the causes of cervical spondylosis, it is useful to know more about the structure of your spine.
Cervical spondylosis is usually suspected if there are typical symptoms of neck pain and stiffness. It will also be considered as a cause of radiating arm pain, problems with use of the hands or difficulty walking.
Treatment for symptoms due to cervical spondylosis aims to relieve pain and prevent permanent damage to your nerves.