Cervical spondylosis

Cervical spondylosis is age-related wear and tear of the bones, discs, and joints in the neck (cervical spine). It's very common with age — the spine naturally degenerates, and by age 60 most people have some degree of it on imaging, often without symptoms. In India, cervical spondylosis is increasingly seen in younger people too, driven by prolonged hours at computers and on mobile phones.

What happens

• Intervertebral discs lose water and shrink
• Bone spurs (osteophytes) can form
• Ligaments can thicken
• Joints wear down
• Over time these can narrow the spinal canal (cervical stenosis) or press on nerves

Symptoms

Many people have no symptoms. When symptoms occur, they can include:

• Neck pain and stiffness — often worse after long sitting or awkward posture
• Pain spreading to the shoulders or upper back
• Headaches, especially at the back of the head
• Numbness, tingling, or weakness in the arm or hand (if a nerve is pinched — cervical radiculopathy)
• Clumsiness, balance problems, or difficulty walking (if the spinal cord is affected — cervical myelopathy; less common but more serious)
• Bladder or bowel problems in severe spinal cord compression (emergency — go to hospital)

Diagnosis

Usually diagnosed from history and examination. Imaging (X-ray, MRI, or CT) is used when there are nerve or cord symptoms, or symptoms aren't improving with conservative treatment.

Treatment

Most cases manage well without surgery:

• Posture and ergonomics — keep screens at eye level, change position often, don't hunch over phones for long periods
• Physiotherapy — neck strengthening and stretching, postural retraining
• Heat, ice, massage — short-term symptom relief
• Pain relief — paracetamol, NSAIDs, muscle relaxants for short periods
• Activity — keep moving; prolonged rest worsens stiffness
• Yoga and gentle stretching — well-suited, but avoid extreme neck movements
• Cervical collar — only for short periods, if at all. Long-term use weakens neck muscles.
• Steroid injections — for severe nerve-root pain not responding to other measures
• Surgery — considered for progressive weakness, myelopathy with cord compression, or persistent severe pain despite conservative treatment

Prevention and long-term care

• Keep neck and upper back muscles strong — regular exercise, including activities that target these muscles (yoga, Pilates, swimming)
• Break up screen time — every 30-60 minutes, stretch and change position
• Use supportive pillows — medium firmness, keeping the neck in a neutral position during sleep
• Don't smoke — smoking accelerates disc degeneration
• Maintain a healthy weight