Home / Conditions / Cervical spondylosis
Age-related wear in the neck. Nearly everyone develops it eventually and most people never feel it — so the question worth answering is not whether you have it, but whether it is pressing on anything.
Cervical spondylosis is the gradual wear that affects the discs, joints and bones of the neck with age. You may also see it called cervical osteoarthritis, degenerative cervical spine disease, or simply neck arthritis.
Three things happen, slowly and together. The discs lose water and flatten, so the vertebrae sit closer. The small joints at the back of the spine wear like any other joint. And the body responds to both by laying down extra bone at the margins — osteophytes, or bone spurs.
None of that is a disease in the ordinary sense. It is what necks do over decades, in the same way skin wrinkles and hair greys.
The upper panel is a normal neck. Discs evenly spaced, clear openings, nerve roots leaving without obstruction.
The lower panel is the same region with spondylosis. Compare the disc spaces first — they have narrowed, so the vertebrae sit closer together. Then look at the margins of the bones, where spurs have grown into the space that used to be clear. One disc has bulged backward.
Nothing here is painful in itself. What the lower panel shows is a neck with less room in it than it used to have — and whether that matters depends entirely on whether anything has run out of space.
This is the most important idea on the page, and the one most likely to save you unnecessary worry.
Most people with cervical spondylosis have no symptoms whatsoever. Scan a room full of people over sixty and the great majority will show these changes, regardless of whether their necks hurt. The changes are so common that finding them on your scan tells us comparatively little on its own.
So a report saying "degenerative changes" or "cervical spondylosis" is not a diagnosis of the cause of your pain. It is a description of your anatomy. Whether it explains your symptoms depends on whether the level involved matches what an examination finds — and often it does not.
Where it does cause trouble, it usually shows up as:
These come from the worn joints and discs themselves. The more consequential symptoms happen when the wear starts to press on something.
Discs that have flattened and bone that has grown take up space that used to belong to nerves. Where that becomes significant, one of two things follows — and they are quite different.
A nerve root is compressed where it leaves the spine.
Pain, numbness or tingling running down one arm, often ending in specific fingers, sometimes with weakness in one particular movement.
Usually painful, usually one side, and the majority improve without surgery.
The spinal cord itself is compressed.
Clumsy hands, difficulty with buttons, deteriorating handwriting, unsteady walking — frequently with no neck pain at all.
Often painless, often both sides, tends to progress, and the damage can be permanent.
Both can also be caused by spinal stenosis, which is the narrowing itself, and by a disc herniation on top of the existing wear.
Ordinary neck stiffness from spondylosis can be assessed in the usual course of things. These cannot, because they suggest the cord or a nerve is involved:
Call us on +65 8849 0677. We will see you the same day and arrange imaging where it is needed.
If we are closed, go to an emergency department — we are shut on Sundays and after 1pm on Saturdays.
Call +65 8849 0677Given how common the changes are, the examination carries more weight than the imaging here.
It cannot be reversed, and it would be dishonest to suggest otherwise. What can be done is manage symptoms well and watch for the situations that need more.
Regular movement, screen at eye level, and breaking up long periods in one position. Unglamorous, and it does more for day-to-day symptoms than anything else on this list. Sustained neck flexion — looking down at a phone or a low monitor — is the load most people can actually change.
Stretching for range of movement, strengthening so the muscles carry more of the load, and sometimes traction. Worth doing properly rather than as a few exercises on a sheet.
Anti-inflammatories, and briefly a muscle relaxant where spasm is a large part of it. Heat helps muscular soreness; ice helps an acute flare.
A collar can settle an acute flare over a few days. Extended use weakens the very muscles that support the neck, which makes things worse in the medium term. If you have been wearing one for weeks, that is worth reviewing.
Image-guided injections to the facet joints or around an affected nerve root, both to relieve pain and to establish which level is responsible. Cervical epidural injections and facet joint injections are among Dr Tung's procedures.
Surgery does not treat spondylosis. It treats what spondylosis has caused — a compressed root or cord — so it is considered where there is myelopathy, significant or progressing weakness, or radiculopathy that has not settled with proper conservative treatment.
All are performed here, from the front or the back depending on where the compression sits.
Most people with cervical spondylosis do not need a spine surgeon. The value of an assessment is in answering a question that imaging alone cannot.
No. It is degenerative change rather than a disease to be eliminated, and it cannot be reversed. It is, however, very treatable: symptoms can be managed well, and the situations that need more can be identified and dealt with.
Possibly, but it does not follow automatically. These changes appear on the scans of most older adults, including those with no pain at all. What matters is whether the level involved matches what an examination finds.
The changes progress slowly with age. Symptoms do not track them reliably — many people's necks feel better over time even as the imaging looks worse. What is worth watching for is the development of arm or hand symptoms, or any unsteadiness.
For a few days during a bad flare, possibly. Not for weeks. Extended use weakens the muscles supporting the neck, which makes the underlying problem harder to manage.
Phone use does not cause the degenerative changes, which are largely age-related. Sustained neck flexion does load the neck and can make symptoms considerably worse, which is why it is one of the more useful things to change.
No. Bring any imaging, and note whether you have any arm symptoms, hand clumsiness or change in your walking — those matter more than the neck pain itself.
Cervical radiculopathy · Cervical myelopathy · Neck pain · Spinal stenosis · Slipped disc · Cervicogenic headache · Decompression surgery
If a scan has shown spondylosis, the useful question is whether it explains your symptoms — and whether anything is being compressed.
