Cervical spondylosis, also known as cervical osteoarthritis or neck arthritis, is a common age-related condition that affects the joints and discs in the neck. In most cases it can be managed with conservative treatments and a rehabilitative approach. Injection treatments can be used to facilitate a rehabilitative approach and help break the pain cycle in patients who fail to make progress with conservative management.
Cervical spondylosis is usually diagnosed on clinical grounds alone. Although pain is predominantly in the cervical region, it can be referred to a wide area, and is characteristically exacerbated by neck movements. Neurological change should always be sought in the upper and lower limbs, but objective changes occur only when spondylosis is complicated by myelopathy or radiculopathy, or when unrelated causes like disc prolapse, thoracic outlet obstruction, brachial plexus disease, malignancy, or primary neurological disease are present.
Most patients do not need further investigation, and the diagnosis is made on clinical grounds alone. Plain radiographs of the cervical spine may show a loss of normal cervical lordosis, suggesting muscle spasm, but most other features of degenerative disease are found in asymptomatic people and correlate poorly with clinical symptoms. Magnetic resonance imaging of the cervical spine is the investigation of choice if more serious pathology is suspected, as it gives detailed information about the spinal cord, bones, discs, and soft tissue structures. However, normal people can show important pathological abnormalities on imaging, so scans need to be interpreted with care.