Cervical spondylosis

INTRODUCTION

Cervical spondylosis is a term that encompasses a wide range of progressive degenerative changes that affect all the components of the cervical spine. It is a natural process of aging and presents in the majority of people after the fifth decade of life.

In the cervical spine, this chronic degenerative process affects the intervertebral discs and facet joints and may progress to disk herniation, osteophyte formation, vertebral body degeneration, compression of the spinal cord, or cervical spondylotic myelopathy.

CLINICAL FEATURES

Symptoms of cervical spondylosis manifest as neck pain and neck stiffness and can be accompanied by radicular symptoms when there is compression of neural structures.

RISK FACTORS

• Age, gender, and occupation
• The prevalence of cervical spondylosis is similar for both sexes, although the degree of severity is greater for males.
• Repeated occupational trauma may contribute to the development of cervical spondylosis^.
• Increased incidence in patients who carried heavy loads on their heads or shoulders and in dancers and gymnasts.
• In about 10% of patients, cervical spondylosis is due to congenital bony anomalies, blocked vertebrae, and malformed laminae that place undue stress on adjacent intervertebral discs.

PHYSICAL THERAPY  MANAGEMENT

Manual therapy of the thoracic spine can be used for the reduction of pain, improving function, increasing the range of motion, and addressing thoracic hypomobility^.

Thrust manipulation of the thoracic spine could include techniques in a prone, supine, or sitting position based on therapist’s preference. Also cervical traction can be used as physical therapy to enlarge the neural foramen and reduce the neck stress.

Non-thrust manipulation included posterior-anterior (PA) glides in the prone position. The cervical spine techniques could include retractions, rotations, lateral glides.

Postural education includes the alignment of the spine during sitting and standing activities.

Soft tissue mobilisation was performed on the muscles of the upper quarter with the involved upper extremity positioned in abduction and external rotation to pre-load the neural structures of the upper limb.

Home Exercises include cervical retraction, cervical extension, deep cervical flexor strengthening, scapular strengthening, stretching of the chest muscles via isometric contraction of flexor of extensor muscles to encourage the mobility of the neural structures of the upper extremity.