Cervical Osteoarthritis (Cervical Spondylosis)

Medically Reviewed by Poonam Sachdev on March 12, 2024
11 min read

Cervical spondylosis is also called cervical osteoarthritis. It is a condition involving changes to the bones, disks, and joints of the neck, usually as people age. Cervical spondylosis most often causes neck pain and stiffness. Although cervical spondylosis is rarely progressive, corrective surgery can help in severe cases.

Cervical spondylosis is generally a problem that comes with age, from wear and tear on the neck. The condition can be caused by problems with the cervical spine disks, which act as a cushion between the vertebrae (bones), or because of the spine itself or the ligaments. 

Cervical spondylosis is common. Up to half of people who are middle-aged or older have cervical disks that are worn down, but don’t have any symptoms. These are the causes of cervical spondylosis:

  • Disk dehydration. As your cervical spine disks dry out over time, they shrink, providing less cushioning and causing bone-on-bone contact.
  • Herniated disks. If a disk cracks, its contents can squeeze out and press on your spinal cord or nerve roots. 
  • Bone spurs. Your spine may form abnormal growths called spurs. These spurs narrow the inside of the spinal column or the openings where spinal nerves exit, a related condition called cervical spinal stenosis.
  • Stiff ligaments. Ligaments are bands of tissue that help hold bones and joints in place. They can get stiff over time, making it harder for you to move or bend your neck.

Aging is the major reason for having cervical osteoarthritis (cervical spondylosis). In most people older than age 50, the disks between the vertebrae become less spongy and provide less of a cushion. Bones and ligaments get thicker, encroaching on the space of the spinal canal.

There are other things that might cause cervical spondylosis aside from age. They include:

  • Family history of cervical spondylosis. The condition can be genetic.
  • Injury or trauma to the neck. If you’ve hurt your neck in the past, this could eventually affect your cervical disks and ligaments.
  • Your job, lifestyle, or hobby. Certain occupations, hobbies, or sports make you move your neck in the same way over and over again. Or they could force you to look up repeatedly or for long periods. This can stress the neck disks and ligaments.
  • Smoking. There is a link between smoking and neck pain.
  • Depression. Researchers have found an increased risk of cervical spondylosis in people with depression.
  • Poor posture. How you hold your head as you stand or sit affects the health of your cervical disks and ligaments over time.



The symptoms of cervical spondylosis include:

  • Neck stiffness and pain
  • A headache that may start in the neck
  • Pain in the shoulder or arms
  • Not being able to fully turn the head or bend the neck, sometimes interfering with driving
  • A grinding noise or sensation when the neck is turned

Less common, or "atypical," symptoms include vertigo, headache, palpitation (a fast, pounding, or skipping heartbeat), nausea, discomfort in your belly or digestive system, tinnitus, blurred vision, and hypomnesia (memory problems). Some studies also show that chronic neck pain from causes such as spondylosis have been linked to higher blood pressure.

Symptoms of cervical spondylosis tend to improve with rest. Symptoms are most severe in the morning and again at the end of the day.

Radiculopathy symptoms

A possible complication of cervical spondylosis is cervical radiculopathy, which happens when bone spurs press on nerves as they exit the bones of the spinal column. The most common symptom is sharp, burning pain that shoots down into one or both arms. This pain may ease a bit if you put your hands on top of your head.

You may notice other symptoms in your shoulders, arms, chest, or upper back, and they may worsen when you move your neck. They include:

  • Pins and needles, or tingling, in your fingers or hand
  • Weakness 
  • Numbness 
  • Weakened reflexes

Cervical myelopathy symptoms

If cervical spondylosis causes pressure on the spinal cord (cervical stenosis), it can cause cervical myelopathy. Symptoms of cervical spondylosis with myelopathy include:

  • Tingling, numbness, and/or weakness in the arms, hands, legs, or feet
  • Lack of coordination and a hard time walking
  • Abnormal reflexes
  • Muscle spasms
  • Loss of bladder and bowel control (incontinence)

Cervical spondylosis dizziness

Although not common, some people with cervical spondylosis get dizzy. If you have cervical spondylosis dizziness, you could also have:

  • A feeling like you’re floating
  • Light-headedness
  • Feeling unsteady or like you’re lacking coordination
  • Changes in your posture
  • Vision changes, like your eyes moving quickly
  • Nausea and vomiting
  • Headaches 

Cervical spondylosis headache

People who have cervical spondylosis, especially related to arthritis, may get headaches as well.

Can cervical spondylosis affect the brain?

While cervical spondylosis directly affects your spine, some studies show that the condition can also cause loss in the gray and white matter in your brain. Gray matter helps you with memory and movement, among other tasks. White matter helps you process information and affects your thinking skills. Cervical spondylosis can also make changes in sensorimotor cortex, the part of your brain that controls how you move some parts of your body.

Your doctor will generally begin the examination by asking you about your symptoms and taking a medical history. This includes asking about your family history to see if anyone else has had similar issues. Some common questions your doctor might ask could be:

  • When did the pain start and what is it like?
  • Did anything in particular happen when it started?
  • Does anything you do ease the pain or make it go away? If so, how long does that last?
  • Have the symptoms affected how you do some tasks, like handwriting, typing, or buttoning your shirt?
  • Do you lose your balance or have a hard time with your coordination?
  • Have you ever hurt your neck or had a problem like this before?

This is followed by a physical exam of your body, with a focus on your neck, back, and shoulders. Your doctor will likely test your reflexes and the strength of your hands and arms, check for loss of sensation, and watch how you walk. Your doctor may recommend you see a neurologist, a specialist in nerve disorders. 

To diagnose cervical spondylosis and rule out other possible causes, you might have some of these tests:

Neck X-rays to look for changes in your neck and disks

Magnetic resonance imaging (MRI) to provide more detail when looking for changes in the spine, including pinched nerves

Computed tomography (CT) myelography. This test combines imaging with a dye injected into your spinal canal, so your doctor can see your spinal cord and canal, and nerve roots in more detail.

Electromyography. Small needles (electrodes) are inserted through the skin and into the muscles to check how your muscles contract and relax.

Nerve conduction study. A small shock is sent through electrodes to measure how fast the nerves send signals and how strong the signals are.

Cervical spondylosis X-ray

A cervical spondylosis X-ray can show if there are any bone spurs causing narrowing of the spinal cord. It also might rule out anything else that could be causing your symptoms, like a fracture.

A radiology technologist will have you lie on an X-ray table and will center the X-ray machine over your neck area. You may be asked to move from side to side so the X-rays show different angles.

In most cases, cervical spondylosis treatments are conservative. They include:

  • Rest
  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs) or other non-narcotic products to relieve pain from inflammation
  • Chiropractic manipulation that can help control episodes of more severe pain
  • Wearing a cervical collar to limit movement and provide support
  • Other forms of physical therapy, including heat and cold therapy, traction, or exercise
  • Injecting drugs (corticosteroids and a local anesthetic) into the joints of the spine or the area surrounding the spine, known as epidural steroid injection or cervical facet joint injection

Cervical spondylosis surgery

Cervical spondylosis a chronic (long-term) condition, but surgery is usually only needed if your condition is severe. If you have surgery, the goal is to remove the source of pressure on the spinal cord and nerves. The surgery may also include adding stabilization in the form of implants or through fusion of the vertebrae. Surgery is considered when there is a severe loss of function (for instance, if you had a progressive loss of feeling and function in your arms, legs, feet, or fingers). Any type of spinal cord compression could result in permanent functional disability.

The surgeon can approach the cervical spine from the front (anterior) or the back (posterior). Approaching from the front might be used to remove the disks and spurs that are causing pressure. The disk may be replaced with an implant. A more extensive surgery calls for the removal of both disks and parts of the vertebra. These are replaced with a bone graft or implant.

Approaching from the back would be used to perform either a laminectomy or a laminoplasty. In a laminectomy, the rear parts of the vertebrae in the neck – the lamina and spinous processes – are removed. In a laminoplasty, the vertebra is left in place, but is cut free along one side. Both procedures relieve pressure on the spinal cord or nerves.

As with any surgery, there is risk of infection or complications with anesthesia. Surgery is usually followed by a rehabilitation program.

Physical therapy for cervical spondylosis

It can be hard to move around if your neck is hurting too much. Aside from the pain, you might be worried about causing more damage. Your doctor may recommend you see a physical therapist. A physical therapist would work with you, feeling your neck and manipulating the muscles around it, your shoulders, and your arms. Physical therapists usually provide exercises to do at home to increase your chances of improvement. It’s important to follow your physical therapist’s advice or to explain why you weren’t able to.

Neck pain can make everyday tasks difficult; even sleeping can be hard. But there are some things you can do that might help you keep up with your daily activities and sleep better. 

Cervical spondylosis exercises

Some exercises can help relieve cervical spondylosis pain and improve how you can use your neck. Unless the exercises are given to you by your physical therapist, speak with your doctor before starting any new ones. Also, listen to your body. Do not push yourself “through the pain.” Many people believe “no pain, no gain,” but that’s not the case. Increasing pain could mean more damage to your neck

Here are some examples of exercises you can try unless your doctor has advised you not to do them. 

You can do these exercises sitting or lying down. Start slowly, with only one or two repetitions. If the exercises don’t make the pain worse and you feel comfortable doing so, repeat the exercises throughout the day, gradually increasing repetitions.

  • Head turn

  1. Look straight ahead. Slowly turn your head to one side until you feel it stretch on the opposite side. Don’t force your head any farther.
  2. Hold this position for 2 seconds.
  3. Slowly return to center and then turn in the other direction. Hold the position again and then return to center.
  • Head tilt
  1. Look straight ahead. Slowly tilt your head to one side, towards your shoulder as far as you can go until it’s not comfortable anymore. You should feel a stretch on the other side of your neck.
  2. Hold for 2 seconds.
  3. Slowly return your head to the upright position.
  4. Repeat on the other side. 
  5. Return to center.
  • Forward head tilt 
  1. Look straight ahead.
  2. As if you are nodding, slowly lower your chin to your chest.
  3. Bring your head back up to face forward.
  • Wide shoulder stretch
  1. Look straight ahead.
  2. Allow your arms to hang on each side and then bend your elbows until they are at a right angle.
  3. Turn your hands so the palms of your hands face up towards the ceiling.
  4. Without moving your upper arms (keeping your elbows next to your side), move your lower arms and hands outwards – your right hand to the right, your left hand to the left.
  5. Hold for a few seconds.

Cervical spondylosis pillow

You may see ads for cervical spondylosis pillows. There is little research that shows that one type of pillow is better than another for people with cervical spondylosis. One very small study showed that some people with cervical spondylosis had fewer problems if they used an ergonomic latex pillow, but the researchers did not compare the pillow with other types.

Your best bet is to try different pillows to see what is most comfortable for you. You might also try putting a small pillow under your neck for added support.

Yoga for cervical spondylosis

As with any type of physical exercise, you should check with your doctor before starting a yoga program because some poses may not be good for your neck. Some studies show that some types of yoga might help if you have mild to moderate cervical spondylosis, but it seems that it may only help for the short term, not for a longer period. 

Cervical spondylosis is a condition that results from the wear and tear of your neck, and it affects many people. But since there are certain risk factors, like previous neck injuries, taking care of your neck may help prevent cervical spondylosis or slow it down. Here are some tips:

  • Protect your neck. If you do activities that can hurt your neck, use proper safety equipment. When in a car, be sure the headrest is at the right height for you to protect your neck in case of an accident, no matter how minor.
  • Use good body mechanics both when you are doing high-risk activities and every day. This means don’t stretch your neck or move your head back and forth too quickly. 
  • Avoid repeating motions, such as looking up and reaching above you.
  • Move – stay physically active.

Cervical spondylosis is a progressive condition, but it’s not fatal. It can cause pain and limit your movements. Knowing your risk factors can help you work on preventing cervical spondylosis or help slow down its progress. Early diagnosis means that you and your doctor can manage it and watch if it gets worse. 

  • What is the best treatment for neck spondylosis? There is no one best treatment for cervical or neck spondylosis. A combination of regular exercise, pain relievers if needed, ice packs, or using a cervical collar may all help relieve the pain. 

  • What is the main cause of cervical spondylosis? The main cause of cervical spondylosis is age – wear and tear on your neck causes the cervical disks to deteriorate.

  • What should you not do with cervical spondylosis? Even if your neck is painful, you should still move around as much as possible. Just be gentle with your movements – don’t make sudden sharp movements or do activities that might cause them. 

  • What are the symptoms of a cervical spondylosis flare-up? A flare-up of any condition is the return or worsening of symptoms. So, the symptoms of a cervical spondylosis flare-up would be a return of symptoms after a period of less pain or fewer other symptoms. This means you may have more weakness or numbness in your hands or arms, and more pain.