Prominent presenting signs are:

• Stiff neck (with deterioration over time) 
• Constant or recurring headaches (notably in the back of the head where cervical muscle attach)
• Abnormal sensations or numbness

Depending on which nerves are affected there may be pain or lack of function in dependent areas of the body, notably the arms and hands but occasionally the legs.

More unusually there can be loss of balance or loss of bladder and bowel control when there is spinal cord involvement.

Generally the condition deteriorates over time but it may suddenly start or get dramatically worse. The level of pain varies with individuals – it can be mild or deep and excruciating. Severely affected patients may be unable to move [7].

• Arm Pain

  ACDA is associated with a statistically but not clinically significant improvement in Arm pain VAS and SF-36 physical component summary. [ncbi.nlm.nih.gov]

  Surgery can sometimes be useful for radiating arm pain due to cervical spondylosis, but it does not benefit neck pain. [hse.ie]

  You may experience: Neck pain Constant deep ache that radiates over the shoulder and down to the arms, hands and fingers numbness or weakness of the arms, hands, fingers or legs Muscles spasm, neck stiffness Headache Neck and arm pain can be caused by [singhealth.com.sg]

• Difficulty Walking

  Other signs and symptoms include: Weakness or diminished fine motor skills in all or any extremities Loss or compromised sensory abilities of lower extremities Pain in shoulder or neck Difficulty walking with a proper gait Bladder and bowel dysfunction [newhealthadvisor.com]

  If you have the following symptoms then please see a doctor immediately: pain radiating from the arms pins and needles in the arms or legs loss of feeling in your hands or legs loss of coordination and difficulty walking. [your.md]

  If the spinal cord or nerve roots become pinched, you might experience: Tingling, numbness and weakness in the arms, hands, legs or feet Lack of coordination and difficulty walking Loss of bladder or bowel control When to see a doctor Seek medical attention [mayoclinic.org]

• Dysphagia

  There was a higher incidence of dysphagia in the plate and cage group on the day after surgery and at two months post-operatively. All patients achieved fusion and no graft migration or nonunion was observed. [ncbi.nlm.nih.gov]

• Fecal Incontinence

  This condition may lead to the following: Inability to hold in feces ( fecal incontinence ) or urine ( urinary incontinence ) Loss of muscle function or feeling Permanent disability (occasionally) Poor balance Call your provider if: The condition becomes [nlm.nih.gov]

  Possible Complications This condition may lead to the following: Inability to hold in feces (fecal incontinence) or urine (urinary incontinence) Loss of muscle function or feeling Permanent disability (occasionally) Poor balance When to Contact a Medical [pennstatehershey.adam.com]

  Possible Complications This condition may lead to the following: Inability to hold in feces ( fecal incontinence ) or urine ( urinary incontinence ) Loss of muscle function or feeling Permanent disability (occasionally) Poor balance When to Contact a [ufhealth.org]

  This condition may lead to the following: Inability to hold in feces (fecal incontinence) or urine (urinary incontinence) Loss of muscle function or feeling Permanent disability (occasionally) Poor balance Call your provider if: The condition becomes [medlineplus.gov]

• Neck Pain

  However, evidence for its efficacy in relieving neck pain and recovering neck physiological function has not been established in randomized, placebo-controlled trials. [ncbi.nlm.nih.gov]

  History of neck surgery. Dizziness when moving the neck; drop attacks (suggestive of vascular disease). Differential diagnosis Other nonspecific neck pain lesions - eg, acute neck strain, postural neck ache or whiplash. [patient.info]

  NHS Trust, Stevenage, Hertfordshire SG1 4AB Correspondence to: allan.binder{at}nhs.net Most patients who present with neck pain have “non-specific (simple) neck pain,” where symptoms have a postural or mechanical basis. [doi.org]

• Shoulder Pain

  Clinically, several syndromes, both overlapping and distinct, are seen: neck and shoulder pain, suboccipital pain and headache, radicular symptoms, and cervical spondylotic myelopathy (CSM). [rothmanortho.com]

  It is effective in treating of cervical spondylosis, and pain of neck and shoulders. [gyanunlimited.com]

  RESULTS: The VAS score of preoperative neck and shoulder pain was (6.57±1.34) scores, which decreased to 1.80±0.65 at 1-week postsurgery, and was completely alleviated by the end of 1 month (VAS score 0-2 after 1, 3, and 6 mo after surgery) (Kruskal-Wallis [ncbi.nlm.nih.gov]

  Neck type: The main symptoms are the abnormal feeling of head, neck and shoulder pain, accompanied by corresponding pressure points. It is characterized by neck stiffness, pain, and activity inflexible of neck, it is also the most common type. 2. [ift.edu.mo]

  NECK PAIN (गर्दन दर्द ) SHOULDER PAIN (कंधे का दर्द ) BACK PAIN (पीठ दर्द ) CERVICAL SPONDYLOSIS (गर्दन संबंधी स्पोंडिलोसिस ) JOINTS PAIN (जोड़ों का दर्द ) MIGRAINE (माइग्रेन ) [thegodsblessings.com]

• Cervical Osteoarthritis

  When this condition develops in the cervical spine, it is called cervical osteoarthritis. Cervical osteoarthritis is a degenerative condition that can cause neck pain and stiffness. [spine-health.com]

  Cervical spondylosis, also known as cervical osteoarthritis or neck arthritis, can be a painful and debilitating condition, but with proper care and treatment, many people who suffer from it can lead normal lives. [belmarrahealth.com]

  System(s) affected: musculoskeletal; neurologic Synonym(s): cervical degenerative joint/disk disease; cervical osteoarthritis; cervicalgia Geriatric Considerations Most individuals >65 years of age have evidence of cervical spondylosis on x-ray. [unboundmedicine.com]

• Neck Weakness

  This can cause your legs or hands to feel weak or clumsy. [columbianeurology.org]

  Pain in the neck that may travel to your arms or shoulders Headaches A grinding feeling when you move your neck Weakness in your arms and legs Numbness in your shoulders, arms, or hands Stiffness in the neck Trouble keeping your balance Trouble controlling [thegodsblessings.com]

• Spine Pain

  Overview of Cervical Spondylosis The cervical spine is searated into two groups. The upper and the lower cervical spine. The upper cervical spine is C0-C2 and the lower cerival spine is C3-C7. [morphopedics.wikidot.com]

• Urinary Incontinence

  This condition may lead to the following: Inability to hold in feces ( fecal incontinence ) or urine ( urinary incontinence ) Loss of muscle function or feeling Permanent disability (occasionally) Poor balance Call your provider if: The condition becomes [nlm.nih.gov]

  Possible Complications This condition may lead to the following: Inability to hold in feces (fecal incontinence) or urine (urinary incontinence) Loss of muscle function or feeling Permanent disability (occasionally) Poor balance When to Contact a Medical [pennstatehershey.adam.com]

  Possible Complications This condition may lead to the following: Inability to hold in feces ( fecal incontinence ) or urine ( urinary incontinence ) Loss of muscle function or feeling Permanent disability (occasionally) Poor balance When to Contact a [ufhealth.org]

  This condition may lead to the following: Inability to hold in feces (fecal incontinence) or urine (urinary incontinence) Loss of muscle function or feeling Permanent disability (occasionally) Poor balance Call your provider if: The condition becomes [medlineplus.gov]

• Headache

  Atypical symptoms involved in the questionnaire included dizziness, headache, nausea, vomiting, blurred vision, tinnitus, palpitations, hypomnesia, and abdominal discomfort. [ncbi.nlm.nih.gov]

  The cervical spine and headache. Neurology. 1988;38:1874-1878. To comment on this article, contact [email protected]. [uspharmacist.com]

  They include: Neck pain, which may also be felt (radiate) in arms and shoulder Neck stiffness with restricted head movements Headache, particularly at the back of the head (occipital headache) Tingling, burning sensation or loss of sensation at shoulder [vikaspedia.in]

• Irritability

  This is caused by irritation of a nerve which goes to the arm from the spinal cord in the neck. The pain tends to come and go with flare-ups from time to time. [patient.info]

  Osteophytes may cause narrowing of the intervertebral foramina [A canal through which the nerve root comes out of spine] and irritation of nerve root. Degradation of intervertebral discal proteoglycans also causes irritation of nerve root. [boneandspine.com]

  Irritant cheilitis often comes from lip licking, a constant source of irritation to the skin of the lips, and a very difficult habit to break as many people do it subconsciously. [osmiaorganics.com]

  Poorly fitting dentures can increase the risk of infection in the moist crevices of the lip angles as may other causes of mechanical irritation. [news-medical.net]

  Repetitive, strenuous activities – such as work activities – may also irritate associated muscles, ligaments, and nerves, increasing the risk for cervical spondylosis. [fvortho.com]

• Cervical Radiculopathy

  Cervical radiculopathy. N Engl J Med. Jul 28 2005;353(4):392–399 CrossRef Google Scholar 2. Ellenberg MR, Honet JC, Treanor WJ. Cervical radiculopathy. Arch Phys Med Rehabil. Mar 1994;75(3):342–352. CrossRef Google Scholar 3. [doi.org]

  Treatment of Cervical Spondylosis The pain of cervical spondylosis and Cervical radiculopathy usually resolves without intervention. [boneandspine.com]

  See a doctor if you suspect that you are developing cervical radiculopathy or cervical myelopathy. [patient.info]

  With cervical radiculopathy the pain most often occurs in the cervical region, the upper limb, shoulder, and/or interscapular region [12]. [physio-pedia.com]

• Neck Stiffness

  You may experience: Neck pain Constant deep ache that radiates over the shoulder and down to the arms, hands and fingers numbness or weakness of the arms, hands, fingers or legs Muscles spasm, neck stiffness Headache Neck and arm pain can be caused by [singhealth.com.sg]

  Physical examination reveals neck stiffness and numbness in the affected root. Lab Studies Laboratory values are mostly normal in cervical spondylosis. [boneandspine.com]

  Neck type: The main symptoms are the abnormal feeling of head, neck and shoulder pain, accompanied by corresponding pressure points. It is characterized by neck stiffness, pain, and activity inflexible of neck, it is also the most common type. 2. [ift.edu.mo]

  They include: Neck pain, which may also be felt (radiate) in arms and shoulder Neck stiffness with restricted head movements Headache, particularly at the back of the head (occipital headache) Tingling, burning sensation or loss of sensation at shoulder [vikaspedia.in]

  Share on Pinterest Cervical spondylosis is a kind of arthritis, and causes symptoms such as pain and stiffness. In most cases, there is just a pain in the neck, stiffness, and the occasional headache. [medicalnewstoday.com]

• Paresthesia

  […] arthritis of the cervical spinal joints As space between the vertebrae decreases, there may be compression onto the nerve roots Arthritis can be central- or lateral-foramen based Central: usually bilateral symptoms Lateral: usually unilateral Pain, paresthesia [accessphysiotherapy.mhmedical.com]

  Recurrence is not expected. (12 Dec 1998) cervical disc herniation <radiology> C6-7 (69%), C5-6 (19%), C7-T1 (10%), C4-5 (2%) see: degenerative disc disease (12 Dec 1998) cervical disc syndrome <syndrome> Pain, paresthesias, and sometimes weakness in [m.kmle.co.kr]

  If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs. [en.wikipedia.org]

  […] is painless in more than 50% of patients, when pain is present it may be described as a stabbing, burning sensation or a persistent dull ache radiating throughout the arms to the forearms, at times to the fingers, associated with "pins and needles" paresthesias [cinhs.com]

  Paresthesiae may accompany pain in the cervical region, the upper limb, shoulder or interscapular region. Radiation to the chest may also occur. Physical examination reveals neck stiffness and numbness in the affected root. [boneandspine.com]

A complete physical examination - this should identify limitations to head and neck mobility in all directions as well as locating specific areas of discomfort or weakness.

Radiography- to identify arthritic changes

Magnetic resonance Imaging (MRI) – usually performed when pain does not respond to treatment or when the hands are numb or weak [8].

Electromyography (EMG) and nerve conduction velocity tests can provide information on the activity of nerve roots.

1. Flare-ups can be ameliorated by alternating cold packs and heat therapy
2. Cognitive behavioural therapy helps patients to understand their condition and manage the pain and assists in developing suitable behaviour patterns.
3. Immobilisation of the neck is the cornerstone of conservative treatment since it reduces nerve irritation. Cervical collars vary between soft and more rigid orthosis, including body jackets.
4. Physical traction to relieve some of the nerve pressure in the neck and other forms of therapy by a registered complementary practitioner, e.g. masseur, acupuncturist, chiropractor or osteopath, are indicated.
5. Prescribed medications to reduce the pain include:

• non-steroidal anti-inflammatory drugs (NSAIDs) for long-term control
• narcotics are sometimes used for severe pain that is non-responsive to NSAIDs.

6. Surgery to relieve the pressure on the nerves or spinal cord is performed when there is loss of movement or sensation in a dependent area or severe pain does not respond to any of the above treatments [9].

Cervical spondylosis usually gives some long-term symptoms. In most cases, these are ameliorated by physical or medical therapy and surgery is not required.

Although permanent disability with loss of muscle function or sensation does occasionally occur, complications such as urinary or faecal incontinence and poor balance are very unlikely.

Once the deterioration process has commenced and reached a level of clinical significance, it is likely that it will continue and the patient will always have problems to a certain extent [6].

Although everyday wear-and-tear may initiate changes, there is frequently an underlying history of excessive trauma of the neck due to work or lifestyle activities. There is also a genetic component in the manifestation of this condition [3].

The most important risk factor is ageing and most people show signs of cervical spondylosis by the age of about 60. There appears to be a genetic influence due to its higher incidence in certain families.
Other influences on the development of this condition include -

• Neck injury
• Obesity
• Low exercise levels
• Spinal surgery
• Ruptured cervical disk
• Arthritis
• Osteoporosis

Factors aggravating the disease include:

• Lengthy sitting or standing 
• Moving the head
• Walking
• Sudden movements – e.g. sneezing, laughing, coughing.

A critical part of the development of spondylosis is dehydration of the cervical tissues as part of the ageing process. Intervertebral discs may shrink and this allows increased bone-on-bone contact between adjacent vertebrae and the abnormal abrasion leads to both increased osteoclast activity and subsequent aberrations in bone growth. Similarly connective tissue ligaments may stiffen with dehydration. This makes the neck less flexible and calcification may develop. In the aberrant healing processes bony exostoses grow and can impact directly on nerves or the spinal cord with local inflammation and, in the long run, neural degeneration [5].

Lifestyle choices are important to ensure that ageing is not premature. Dietary, water intake and exercise practices should all be effective to reduce the impact of advancing age. Work condition or leisure activities that lead to neck injuries should be avoided.

Supporting pillows for good sleep posture.

The genetic component of the condition suggests that the offspring of affected parents are more likely to develop the condition, so special attention should be given to these potential sufferers. It might be unwise for couples with a history of severe disease in both families to have children[10].

Cervical spondylosis results from chronic wear and tear of the spine with deterioration of both the vertebrae and intervertebral discs. There is frequently abnormal growth of the vertebrae forming spurs. These changes lead to compression on one or more nerve roots and, in severe cases, the spinal cord can be affected. Presenting signs are related to the particular nerves involved and the severity of the lesions [2].

Definition: A chronic painful condition of the neck in which deterioration changes of the cervical vertebrae impinge on the nerves running close to them and, sometimes, the spinal cord.

Cause: Although there is a genetic component to this condition as it is more prominent in some families, the usual causes are ageing and a history of neck injury from an accident or from work or play related activities.

Symptoms: This condition develops slowly and may first be identified through reduced mobility and stiffness of the neck. Recurring headaches, usually at the back of the head are an early sign. Patients with more severe cases may show abnormal sensation or numbness of the arms and hands, sometimes progressing to muscle weakness. Rarely there is a more severe paralysis or, in the very severe forms, urinary and bowel incontinence or paraplegia.

Diagnosis: The essence of diagnosis is good clinical examination supported by the clinical history. Radiography and MRI scans will provide supporting evidence to confirm a diagnosis. EMG and nerve conduction velocity tests can be used to identify nerve root activity.

Treatment: Collars can be used to prevent movement of the neck, along with physical therapy.

Prevention: Although ageing increases the likelihood of its development, lifestyle choices are important to prevent this condition. Work or leisure activities that lead to neck injuries are liable to increase the incidence of the disease.

The genetic component suggests that the offspring of affected parents are more likely to develop the condition, so this is another area of prevention that should be carefully pondered on with the partner.

Supporting pillows for good sleep posture and careful attention to diet and rehydration activities are likely to slow down the ageing processes.

1. Tsiptsios I, Fotiou F, Sitzoglou K, et al. Neurophysiological investigation of cervical spondylosis.Electromyogr Clin Neurophysiol. Jul-Aug 2001;41(5):305-13.
2. Binder AI. Cervical spondylosis and neck pain. BMJ. Mar 10 2007;334(7592):527-31.
3. Jumah KB, Nyame PK. Relationship between load carrying on the head and cervical spondylosis in Ghanaians. West Afr J Med. Jul-Sep 1994;13(3):181-2.
4. Nurick S. The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain. 1972;95(1):87-100.
5. Ramzi N, Ribeiro-Vaz G, Fomekong E, et al. Long term outcome of anterior cervical discectomy and fusion using coral grafts. Acta Neurochir (Wien). Dec 2008;150(12):1249-56; discussion 1256.
6. Hoff JT, Panadopoulos SM. Cervical disc disease and cervical spondylosis. In: Wilkins RH, Rengachary SS, eds. Neurosurgery. New York, NY: McGraw-Hill; 1996:3756-74.
7. Banaszek A, Bladowska J, Szewczyk P, Podgòeski P, Sasiadek M. Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease. Eur Spine J. Jul 2014;23(7):1523-30.
8. Fouyas IP, Statham PF. Operative treatment of cervical spondylosis. Br J Neurosurg. Dec 1998;12(6):594-5.
9. Sari-Kouzel H, Cooper R. Managing pain from cervical spondylosis. Practitioner. Apr 1999;243(1597):334-8.
10. Ozer AF, Oktenoglu T, Cosar M, et al. Long-term follow-up after open-window corpectomy in patients with advanced cervical spondylosis and/or ossification of the posterior longitudinal ligament. J Spinal Disord Tech. Feb 2009;22(1):14-20.