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Cervical Spine Disorder


Symptoms:

  • Pain
  • Weakness
  • Numbness

Symptom: Pain

Neck pain and symptoms caused by a cervical (neck) spine disorder are a very common problem for many adult Americans. The cervical spine is composed of many different anatomic structures, including muscles, bones, ligaments, and joints. Each of these structures has nerve endings that can detect painful problems when they occur. The different parts of the cervical spine are normally well balanced and able to handle all of the movements, stresses, and strains of the body gracefully. However, when the different parts of the cervical spine are injured or start to wear out, your neck can be a significant source of pain and discomfort.

Studies show that approximately fifty percent of the population has evidence of degenerative changes in their cervical spine by the age of fifty. These changes happen because the discs that act as shock absorbers between the vertebral bodies of the cervical spine wear out as we grow older. As the intervertebral discs wear out, they begin to collapse, or herniate, and become less flexible. The common causes of neck pain and cervical disorders include arthritis, injuries, and trauma. In some situations neck pain can also be a warning sign of something more serious such as spinal cord compression, a tumor or spinal infection.

Any patient suffering from neck, shoulder, head or arm pain should be examined by a doctor in order to determine where the pain originates and what is causing the pain. The tissues involved in producing the pain must also be identified, and how they are being irritated must also be understood. The history of the pain and any activities that may have triggered it are also important factors in diagnosis and treatment. Impairment of movement in any part of the cervical spine can be responsible for pain, discomfort, and disability.

Accurate evaluation of pain in the neck, shoulder, arm, or head requires knowledge of functional anatomy. If you are suffering from neck pain or pain you believe may be caused by a cervical spine disorder you should seek the medical advice of a physician.

Symptom: Numbness
Numbness is a very common and significant symptom of a cervical disorder. However, it is a poorly understood and difficult to describe symptom. Numbness is usually caused by what is commonly called a "pinched nerve." A nerve can get "pinched" or blocked by a number of cervical disorders. This blocking of the nerve causes the flow of nutrients to the nerve's membrane to slow down. This slow down can eventually cause the membrane to lose its ability to transmit tiny electrical charges and the nerve fiber may eventually die. When enough nerves stop working, the skin may feel numbness or a muscle supplied by the nerve may not be able to function normally.

A common cause for numbness in the arms or legs, associated with back or neck pain, is a herniated disc that "pinches" a nerve where it exits the spinal column. When the outer lining (annulus) of a disc "tears," its center (the nucleus) may rupture and press a spinal nerve(s) against the bony surface of a vertebra. Another cause of numbness is degenerative disc disease. DDD can cause bone spurs to form around the nerve roots. This usually occurs inside the foramen - the opening in the cervical spine where the nerve root leaves the spine to travel into the arm. If these bone spurs get large enough, they may begin to rub on the nerve root causing irritation. This causes the same symptoms as a herniated disc. The irritation causes: pain to run down the arm, numbness to occur in the areas to which the nerve provides sensation, and weakness in the muscles that the nerve supplies.

Spinal stenosis, or the narrowing of the spinal canal is another disorder that can cause the symptom of numbness. In the late stages of spinal degeneration, bone spurs and arthritic changes can make the space available for the spinal cord, within the spinal canal, much smaller. The bone spurs may begin to press on the spinal cord or the nerve roots, and that pressure on the nerves in the spinal cord can cause numbness.

Symptom: Weakness
Weakness is not one of the more common symptoms of a cervical spine disorder, but when it is present it indicates a relatively more severe case of nerve compression and it does require in-depth investigation. Patients may suffer from an inability to balance their head, weakness in their arm(s), inability to work with arms over the head, grip weakness, dropping things from one or both hands, breaking dishes, or difficulty eating or writing. If several or all of the nerves for one muscle are involved, muscle atrophy can be extreme. The symptom of weakness can be caused by either pain in the muscles that are trying to move or by damage to the nerve, that supplies the muscle, to the point where it is no longer able to contract.

"Weakness can be assessed in six grades:


0

_

no evidence of any contractility

1

trace only

evidence of slight contractility but with no joint motion

2

poor

complete range of motion with gravity eliminated

3

fair

complete range of motion against gravity only

4

good

complete range of motion against gravity with some resistance

5

normal

complete range of motion against gravity with full resistance"3

A common cause for weakness in the arms associated with neck pain is a herniated disc that "pinches" a nerve where it exits the spinal column. When the outer lining (annulus) of a disc "tears," its center (the nucleus) may rupture and press a spinal nerve(s) against the bony surface of a vertebra. Another cause of weakness is degenerative disc disease (DDD). DDD can cause bone spurs to form around the nerve roots. This usually occurs inside the foramen - the opening in the cervical spine where the nerve root leaves the spine to travel into the arm. If these bone spurs get large enough, they may begin to rub on the nerve root causing irritation. This causes the same symptoms as a herniated disc. The irritation causes: pain to run down the arm, weakness to occur in the areas to which the nerve provides sensation, and weakness in the muscles that the nerve supplies.

Spinal stenosis, or the narrowing of the spinal canal is another disorder that can cause the symptom of weakness. In the late stages of spinal degeneration, bone spurs and arthritic changes make the space available for the spinal cord, within the spinal canal, much smaller. The bone spurs may begin to press on the spinal cord or the nerve roots, and that pressure on the nerves in the spinal cord can cause weakness.

Difficulty Walking

Difficulty walking due to generalized weakness or problems with balance and coordination can be caused by several different cervical spine problems. One of the more worrisome reasons that someone has trouble walking or problems with gait and balance is that the spinal cord is being squeezed by bone spurs and other degenerative changes in the cervical spine. This condition, called myelopathy, affects the entire spinal cord and is very different from isolated points of pressure on the individual nerve roots. Myelopathy can be difficult to detect, because it usually develops gradually and also occurs at a time in life when people are beginning to slow down a bit anyway. Many people who have myelopathy will begin to have difficulty with things that require a fair amount of coordination, like walking up and down stairs or fastening the buttons on clothing.
Changes in coordination, recent weakness, and difficulty doing tasks that used to be easier because your body seemed more responsive in the past, are definite warnings signs that you should see a doctor. Diagnosis of walking difficulties can sometimes pose a problem for the physician. There are many reasons why elderly people have difficulty walking, and not everyone has a problem with their cervical spine. However, this is a symptom that is taken very seriously by doctors, and every attempt will be made to find the cause of the weakness and disability. Often this requires further tests, like MRI's or CT scans, and often consultation with other doctors who are specialists in areas of medicine such as neurology.


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