Sri Venkateshwara

College of Pharmacy

PRESENTED BY :
1 AKAVARAM SUMAVARSHA
170515881048
B.PHARMACY IV YEAR
SRI VENKATESHWARA COLLEGE OF
PHARMACY..(APPROVED BY A.I.C.T.E &P.C.I,
AFFILIATED TO O.U).
 CERVICAL
SPONDYLOSIS
2
3 CONTENTS:
• INTRODUCTION
• HOW IT STARTS
• CAUSES AND RISK FACTORS
• PATHOPHYSIOLOGY
• SYMPTOMS
• DIAGNOSIS
• TREATMENTS
• CONCLUSION
• REFERENCES
4 INTRODUCTION :
• It is a term referring to degenerative osteoarthritis of the joints
between the centre of the spinal vertebrae.
• According to the studies, the condition is prevalent in more than 90%
of the people, over the age of 65.
• Certain factors like trauma, incorrect posture of the body, pressure
while sleeping and excessive intake of sour food usually increase these
attacks.
• Alternative names for it include cervical osteoarthritis and neck
arthritis.
5 HOW IT STARTS :
• Cervical spondylosis develops as a result of the wear and tear of
cartilage and bones of cervical spine.
• As the spine ages, the discs between the vertebrae desiccate and
become thinner. The ligaments become tight, causing the joints above
or below the affected point to become hypermobile.
• As a result, the bone reacts by generating the osteophytes(bone spurs)
and try to stabilize the spine. This can lead to pressure on the spinal
nerves and sometimes, the spinal cord itself.
6
7 CAUSES & RISK FACTORS :
• AGING:
 It often develops as a result of changes in your
neck joints as you age. Your spinal discs can
become dry and begin shrinking around the
time you turn 40, reducing the cushioning
between bones in the neck and might also
develop cracks.
 This causes them to bulge or become herniated
and might also develop bone spurs.
8 CAUSES & RISK FACTORS :
• OTHER FACTORS:
• Neck Injuries.
• Work related activities that put extra strain on your neck.
• Holding your neck in an uncomfortable position for prolonged
periods of time.
• Being over weight and inactive.
9 PATHOPHYSIOLOGY:
• Intervertebral discs lose hydration and elasticity
with age, and these lead to cracks and fissures.
The surrounding ligaments also lose their elastic
properties and develop bone spurs.
• The disk subsequently collapses, causing the
annulus to bulge outward. As the disk space
narrows, the facets override.
• This change, in turn, increases motion at that spinal
segment and further hastens the damage to the disc.
10 PATHOPHYSIOLOGY:
• The damage includes Annulus
fissures and herniation.
• As the annulus bulges, the cross-
sectional area of the canal is
narrowed. This effect may be
accentuated by hypertrophy of
the facet joints.
11 PATHOPHYSIOLOGY:
• As disc degeneration occurs, the uncinate process overrides and facet
hypertrophy decreases the foramen.
• This change contributes to the radiculopathy that is associated with
cervical spondylosis. Marginal osteophytes begin to develop.
Additional stresses, such as trauma or long-term heavy lifting, may
exacerbate this process.
• These osteophytes stabilize the vertebral bodies adjacent to the level
of the degenerating disk and increase the weight-bearing surface of the
vertebral endplates.
12 PATHOPHYSIOLOGY:
13 SYMPTOMS:
• Pain from the cervical spondylosis can be mild to severe.
• Neck pain and stiffness (may be worse with activity).
• Numbness and weakness in arms, hands, and fingers.
• Trouble walking, loss of balance, or weakness in hands or legs.
• Muscle spasms in neck and shoulders.
• Headaches.
• Grinding and popping sound/ feeling in neck with movement.
14 DIAGNOSIS:
• PHYSICAL EXAM: Physician asks you to bend your head forward
and to each side while putting slight downward pressure on the top of
your head. Increased pain or numbness during this test shows that
there is pressure on a nerve in your spine.
• X-RAY: These pictures are traditionally ordered as the first step in
imaging the spine. X-rays will show aging changes, like loss of disc
height or bone spurs.
15 DIAGNOSIS:
• MAGNETIC RESONANCE IMAGING(MRI): This study can create
better images of soft tissues, such as muscles, discs, nerves, and the
spinal cord.
16
17
PHYSIO-
THERAPY

TREATMENT
OPTIONS

SURGICAL &
MEDICATION NON-
SURGICAL
18 MEDICATIONS:
1. PAIN RELIEF:
 OVER THE COUNTER PAIN KILLERS : Non steroidal anti-
inflammatory drugs are the most effective pain killers for symptoms of
cervical spondylosis. Some commonly used NSAID’s include:
 DICLOFENAC
 IBUPROFEN
 NAPROXEN
19 MEDICATIONS:
2. MUSCLE RELAXANTS:
 If you experience spasms, when your neck muscles suddenly tighten
uncontrollably, your physician may prescribe a short course of muscle
relaxants such as diazepam.
3. INJECTION OF PAIN KILLERS:
 If your arm pain is particularly severe and not settling, there may be an
option of a “transforaminal nerve root injection”, where steroid
medication is injected into the neck .
 This temporarily reduce the inflammation of nerve root and pain.
20 NON SURGICAL TREATMENTS:
1. SOFT COLLARS(NECK
IMMOBILIZATION):
• These collars limit neck motion and
allow muscles of the neck to rest.
• Soft collars should only be worn for
short periods of time because long
term wear can decrease the strength
of the neck muscles.
21 NON-SURGICAL TREATMENT:
2. ENVIRONMENTAL CHANGES:
• Proper lifting techniques.
• Wear soft collar to restrict unwanted
movements.
• Avoiding prolonged sitting or standing, and
selecting the proper chair.
• Using one firm pillow at night to reduce
strain on your neck.
22 NON-SURGICAL TREATMENTS:
 Cervical Traction:
A. Manual cervical traction:
• Manual cervical traction is done by a
physical therapist. While you’re
lying down, they’ll gently pull your
head away from your neck.
• They’ll hold this position for a
period of time before releasing and
repeating.
• Your physical therapist will make
adjustments to your exact positioning
in order to get the best results.
23 NON-SURGICAL TREATMENTS:
B. Mechanical cervical traction:
• Mechanical cervical traction is done by a physical therapist. A harness
is attached to your head and neck as you’re lying flat on your back.
• The harness hooks up to a machine or system of weights that apply
traction force to pull your head away from your neck and spine.
24 NON-SURGICALTREATMENTS:
C. Over-the-door cervical
traction:
• An over-the-door traction
device is for home use. You
attach your head and neck to a
harness.
• This is connected to a rope
that’s part of a weighted
pulley system that goes over a
door.
• This can be done while sitting,
leaning back, or lying down.
25 PHYSIOTHERAPY:
1. HEAT THERAPY:
• Local Heat Application-
• Hot towel is placed directly on
neck muscles
• Hot water bag (heating pad)
directly applied on neck muscles
• Goal of Treatment-
• Improves blood circulation
• Decreases nerve and muscle
inflammation
• Relieves muscle spasm
26 PHYSIOTHERAPY:
2. COLD THERAPY:
• Ice Application-
• Ice is directly applied over skin.
• Ice covered by cloth or filled in a bag is placed
over aching neck muscles.
• Goal of Treatment-
• Decreases inflammation.
• Relieves muscle spasm.
• Reduces nerve irritation by reducing nerve edema.
3. DEEP TISSUE MASSAGE:
• The therapist uses direct pressure and friction and try
to release tension in your soft tissues(ligaments,
tendons, muscles).
27 PHYSIOTHERAPY:
NECK EXERCISES:
28 SURGICAL MANAGEMENT:
1. LAMINECTOMY: It is a
procedure to remove the bony
arches of the spinal canal
decreasing the pressure on the
spinal cord.
2. DISCECTOMY: It is a
procedure to remove a portion
of an intervertebral disc that is
putting pressure on the nerve
root or spinal canal.
29 CONCLUSION:
• Cervical spondylosis is often an age related, condition that cause
stiffness, discomforts and headaches related to neck pain.
• Treatments for cervical spondylosis focus on providing pain relief,
lowering the risk of permanent damage, and helping you lead a normal
life.
• Non-surgical methods are usually very effective.
• your doctor may not be able to reverse the condition, but they can
often recommend conservative treatments to help you overcome the
discomfort and pain.
30 REFERENCES:
• Cervical Epstein N. Posterior approaches in the management of
cervical spondylosis and ossification of the posterior longitudinal
ligament.
• Wang MC, Kreuter W, Wolfla CE, et al. Trends and variations in
cervical spine surgery in the United States: Medicare beneficiaries.
• https://emedicine.medscape.com/article/306036-overview#a5
• Text book of orthopaedic by Maheshwari.
• https://www.mayoclinic.org/diseases-conditions/cervical-
spondylosis/symptoms-causes/syc-20370787.
 THANK YOU
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