Cervical spondylosis is a common age-related condition affecting the neck. This article explores how it can influence brain function and related symptoms.
Understanding Cervical Spondylosis
Cervical spondylosis, also known as neck arthritis, is age-related wear and tear impacting the neck’s vertebrae. It develops from degenerating cartilage and bones, causing stiffness, neck pain, and headaches. As spinal discs dehydrate and shrink, bone spurs can develop along the vertebrae.
This degeneration affects intervertebral discs, facet joints, and ligaments. Many people over 60 are affected, though many experience no symptoms. When symptoms occur, they include neck pain, stiffness, a grinding sensation, or pain radiating into the arms or shoulders, often with numbness, tingling, or weakness.
Pathways to Brain Impact
Cervical spondylosis can influence brain function through several interconnected pathways.
Reduced Blood Flow
Vertebrobasilar insufficiency, where compression of vertebral arteries reduces blood flow to the brainstem and cerebellum, can lead to dizziness, visual disturbances, and hearing changes.
Spinal Cord Compression
Cervical myelopathy occurs when the spinal cord is compressed within the cervical spine. This compression can disrupt signals traveling to and from the brain, affecting motor control, sensory perception, and cognitive functions. Studies have shown that patients with cervical myelopathy may exhibit altered brain activity patterns, such as increased activity in the motor cortex.
Chronic Pain and Inflammation
Chronic pain and inflammation stemming from cervical spondylosis can also affect brain chemistry and function. Persistent pain can lead to structural changes in the brain, including reductions in gray matter volume and alterations in white matter integrity in areas like the prefrontal cortex. These changes may contribute to cognitive and emotional symptoms, impacting pain processing centers and potentially leading to mood alterations.
Proprioception and Nerve Irritation
Issues with neck proprioception (the body’s sense of its position and movement) can result in cervicogenic dizziness. While not a direct structural impact on the brain, this can lead to balance problems that are perceived as brain-related. The irritation of cervical sympathetic nerves can also disrupt the autonomic nervous system’s regulation of inner ear function, contributing to symptoms like dizziness and tinnitus.
Recognizing Brain Related Symptoms
When cervical spondylosis affects the brain, symptoms beyond typical neck pain may emerge.
Dizziness and Balance Issues
Dizziness and balance issues are common, manifesting as vertigo, a sensation of spinning, or general unsteadiness. These balance problems can arise from altered brain activity patterns in areas responsible for coordination, such as the vestibular system and cerebellum.
Cognitive Changes
Cognitive changes, often described as “brain fog,” can include memory issues, forgetfulness, and difficulty concentrating. Research indicates that cervical spondylosis can lead to a decrease in both gray matter volume and white matter integrity in the brain, affecting memory and information processing.
Visual and Hearing Disturbances
Patients may also experience visual disturbances, such as blurred vision, double vision, or difficulty focusing. These visual problems can be linked to nerve compression or reduced blood flow to the eyes and visual cortex. Hearing changes, including tinnitus (ringing or buzzing in the ears), are also reported. This can occur due to changes in blood flow in the vertebral arteries or irritation of nerves in the cervical spine affecting auditory pathways.
Other Symptoms
Swallowing difficulties, known as dysphagia, can sometimes be a rare but significant symptom when bone spurs in the cervical spine mechanically obstruct or interfere with the esophagus. Cervicogenic headaches, which originate in the neck but are felt in the head, are another frequent symptom. These headaches often start at the back of the head and can radiate to the front or behind the eyes, sometimes worsening with neck movement. Fatigue and mood changes, such as anxiety and depression, can also be present, potentially linked to the chronic pain and brain alterations associated with the condition.
Addressing Brain Related Concerns
If cervical spondylosis is suspected of affecting brain function, seeking a healthcare professional’s evaluation is important. A proper diagnosis helps to differentiate these symptoms from other conditions.
Diagnosis
The diagnostic process typically involves a physical examination to assess neck flexibility, muscle strength, reflexes, and gait. Imaging tests provide detailed views of the spine and surrounding structures. An X-ray can reveal bone spurs, while a Magnetic Resonance Imaging (MRI) scan offers detailed images to pinpoint nerve compression or spinal cord involvement. Computed Tomography (CT) scans, sometimes with myelography using a dye, can also provide clarity on spinal canal narrowing and nerve root issues. Nerve function tests, such as electromyography, may be used to assess nerve signal transmission.
Treatment
Management principles often begin with non-surgical approaches. Physical therapy, including stretching and strengthening exercises, can help alleviate symptoms and improve neck function. Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or nerve pain medications, may be prescribed for pain relief. In severe cases, or when neurological symptoms worsen despite conservative treatment, surgical intervention might be considered to relieve pressure on the spinal cord or nerve roots.