MANUAL MINORS
Cervical arthritis, also known as cervical spondylosis, is a degenerative condition affecting the joints, intervertebral discs, and bones of the cervical spine. It is most common in individuals over 50 and is associated with ageing, joint wear, and the formation of bone spurs (osteophytes). Symptoms include neck pain and stiffness, and in severe cases, nerve root or spinal cord compression, leading to radiculopathy or myelopathy.
Diagnosis
Diagnosis is based on a history of chronic neck pain, stiffness, and sometimes pain radiating to the arms or hands, with associated symptoms like tingling or weakness. Physical examination reveals limited cervical range of motion and signs of nerve compression.
X-rays of the neck show degenerative changes such as reduced intervertebral space and osteophyte formation. MRI or CT scans are used to assess nerve compression or cervical myelopathy.
Differential Diagnosis
Pathology | Characteristics |
|---|---|
Cervical disc herniation | Neck pain radiating to the arm, with neurological symptoms |
Cervical sprain | Acute pain following trauma, no signs of joint degeneration in imaging |
Myositis | Muscle pain with inflammation, no visible bone changes on imaging |
Cervical radiculopathy | Pain radiating to the arm, weakness, paraesthesia, no arthritic changes |
Fibromyalgia | Generalised muscle pain with tender points, no degenerative signs |
Emergency Management
Emergency management of cervical arthritis focuses on pain and inflammation control. Analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) are administered, and local heat application can help relieve muscle spasms.
In cases of severe pain or nerve compression, muscle relaxants or oral corticosteroids may be used. If there are signs of spinal cord compression, such as loss of strength, progressive weakness, or changes in bowel/bladder control, urgent referral for detailed imaging is necessary.
Definitive Treatment
Definitive treatment is generally conservative and includes physiotherapy to improve neck mobility, strengthen cervical muscles, and correct posture. Stretching exercises and cervical traction techniques can help alleviate symptoms.
In severe cases, or when there is nerve root or spinal cord compression, surgical intervention may be considered, such as cervical decompression or spinal fusion. Surgery is reserved for patients with intractable pain or progressive neurological symptoms.
Comments