Join Date: Oct 2009
Re: hurts in back right to middle of head..sensitive to touch
Cervical spondylosis, also known as degenerative osteoarthritis, is a condition that causes neck pain and stiffness. It tends to occur in the second half of life and is usually a natural consequence of ageing, although it is also possible for it to develop at a young age.
About half the population develop cervical spondylosis by the age of 50, with this figure rising to 70% by the age of 60. Cervical spondylosis affects both sexes, but men usually develop it at an earlier age than women.
Over the years, the vertebrae (bones in the neck) undergo wear and tear which can lead to cervical spondylosis. However, neck injury may trigger the degeneration, especially when it occurs in younger men.
The symptoms of cervical spondylosis include:
neck pain and stiffness that may spread to the base of your skull, shoulders and sometimes down your arms, to the hands and fingers,
a loss of movement in your neck,
an increased risk of other injuries to your neck,
a loss of sensation (numbness) in your shoulders, arms, hands, fingers and sometimes in your legs (you should tell your GP if you have these symptoms as they might indicate that you have a trapped nerve),
intermittent shooting pains in your neck, arms, shoulders or upper back due to pressure on the nerve roots,
a loss of balance,
dizziness and blackouts ( if there is pressure on the vertebral artery ) fatigue and irritability,
loss of control of the bladder (if spinal cord is compressed),
headaches, which often start at the back of the head, just above the neck, before moving over the top to the forehead,
fear of falling, and
Cervical spondylosis is usually an age-related condition that is caused by the degeneration of the discs and vertebrae in your neck. However, it can occasionally occur in younger people. This degeneration causes a narrowing of the space between the vertebrae and for benign bony growths (osteophytes) to form on the vertebrae.
A previous neck injury, such as whiplash (which may have occurred several years ago) can increase the risk of developing cervical spondylosis. Carrying heavy items on your shoulders or straining your neck during exercise may also trigger this condition.
How cervical spondylosis develops
The spinal cord is protected by vertebrae stacked one upon the other. The spaces between each vertebra are filled with structures called intra-vertebral discs. These discs act as cushions and protect the vertebrae and the nerves and blood vessels in between them. They also make your spinal cord flexible, allowing your head to turn and your neck to bend. The discs are made up of a tough, fibrous outer tissue with an inner core of elastic or gel-like tissue.
With age, your discs gradually shrink and become tougher and more unyielding. As the amount of padding between the vertebrae gets smaller, your spine loses its stability. To counteract this, small spurs (osteophytes) develop in the vertebrae to help to stabilise your backbone and protect the spinal cord.
However, these spurs can put pressure on your spine which can cause problems with the nerves and blood vessels. As a result, the spinal cord may narrow and compress and you may experience weakness, numbness and pain in various parts of the body, which may affect walking and other activities.
Cervical spondylosis can usually be recognised by the symptoms. However, to rule out other possibilities and confirm the diagnosis, various tests can be carried out. These include:
physical examination - this involves identifying tender spots along the back of your neck, evaluating your ability to move the neck and rotate your head, testing your reflexes and the function of your nerves and muscles in the arms and legs, and watching you walk.
X-ray - a spine or neck X-ray will highlight bone spurs (osteophytes) and any other abnormalities. It will also reveal the extent of the damage or misalignment of your cervical spine.
CT scan (computerised tomography) - this produces a 3-dimensional image that is much more detailed than an x-ray, so that the bones involved can be seen more clearly.
myelogram this process involves injecting a special dye into your spinal column. An X-ray or CT scan is then carried out and will clearly identify the extent of the injury.
MRI - magnetic resonance imaging can detect disc and spinal cord problems because it is able to create images of areas from various angles. However, these images may not show enough detail of the vertebrae themselves.
EMG (electromyogram) - this is used to detect disorders in the skeletal muscles and can take up to an hour to perform.
neurological examination - this can help to find out which nerve roots are involved, based on the location of the pain, numbness, the pattern of weakness and changes in reflex responses.
The main forms of treatment for cervical spondylosis involve pain relief and prevention of permanent spinal cord and nerve root injury. Most symptoms respond to basic treatment such as:
pain relieving medicines - pain can be treated with paracetamol or with non-steroidal anti-inflammatory medications (NSAIDs), such as aspirin or ibuprofen. These can help to reduce pain and swelling. People with certain conditions such as asthma, high blood pressure, heart problems or kidney failure may not be able to take anti-inflammatory drugs. A stronger painkiller, such as codeine, can be taken if anti-inflammatory drugs are unsuitable or do not work. If your pain is particularly bad, a muscle-relaxing medicine, such as diazepam, may help as a very short-term measure.
neck collar or brace - this limits neck movement so that the shoulders are taking the weight of the head. However, a neck collar should only be used as a short-term measure and for no longer than a week. Rigid collars are better for limiting movement of the cervical spine but may reduce muscle tone and cause neck stiffness. A firm supporting pillow may also help you when sleeping.
exercise - can help relieve symptoms and strengthen neck and shoulder muscles. Low-impact aerobic exercise, such as walking or swimming, may also be beneficial.
traction - in some cases intermittent neck traction may be recommended for one to two weeks. This treatment may be available in hospital or at home.
pain-relieving injections if your pain is severe, and is not responding to other forms of treatment, a short course of corticosteroids may be recommended. The corticosteroid is injected, with anaesthetic, into the spaces between the vertebrae. However, this form of treatment is not recommended on a long term basis.
physiotherapy- is often helpful to relieve the pain during an acute attack and to help strengthen the surrounding muscles and to improve neck mobility.
complementary therapy - this may help relieve tension, manage pain, and strengthen neck and back muscles. The options include; massage, yoga, chiropractic, acupuncture and work on improving posture.
In cases of severe or chronic pain or loss of movement, surgery may be recommended. It is an option if other forms of treatment don't help, or if there is the possibility of serious problems involving the nerves.
Surgery can be used to relieve pressure on the nerve root, spinal cord and blood vessels and to stabilise the spine. It involves removing bone and disc tissue in your neck (called decompression of the spine) and can significantly reduce pain. However, these effects sometimes only last for a period of one year or less, so surgery is a last resort and must be carefully considered before being undertaken.
A procedure known as prosthetic intevertebral disc replacement is sometimes used in severe cases of cervical spondylosis. The process involves replacing damaged discs in the neck with artificial ones. If left untreated, or if treatment is unsuccessful, cervical spondylosis can lead to permanent disability.
As cervical spondylosis is part of the ageing process, there is not much that can be done to prevent it. However, taking regular exercise and limiting activities that place pressure on the head, neck, and shoulders can help to prevent some of the symptoms. The best exercises for the health of the cervical spine are low-impact activities, such as swimming, walking, or yoga.
Lowering the risk of neck injury by using the correct equipment and techniques when playing sports, may reduce the risk of developing cervical spondylosis.
Good posture whilst standing, sitting, working at the computer, driving and sleeping will also help to prevent damage to the spine.
NO MATTER HOW SICK I AM,THERE IS ALWAY'S SOMEONE SICKER.