Tingling and numbness in hands - symptoms of cervical spondylosis

Dear Readers,

L.J. is a 63-year-old gentleman from St. James. Over the last five years he has been developing arthritis. L.J. says he experiences stiffness and pain in his left shoulder and knees, especially in the mornings when he wakes.

Last year he started feeling "numbness" and tingling in his right hand. He saw a doctor this year who x-rayed his neck and told him that he has cervical spondylosis in his neck which has affected the nerves to his hand. L.J. asks "what is cervical spondylosis?"

Cervical spondylosis is a very common disorder affecting the CERVICAL spine which is the "neck" region of the spine. Arthritic degeneration there can cause some degree of joint instability and inflammation. This inflammation of the neck region is often associated with bony outgrowths from the vertebrae called OSTEOPHYTES which are a part of the entire degenerative process. Both the inflammation and osteophyte formation can cause damage to the nerves as they leave the cervical vertebrae as well as cause spinal cord compression.

The disorder affects males more than females. In the young adult with this condition, trauma to the neck region from sports or strenuous labour can cause this condition, but in older people with more sedentary lives it is the recurring smaller injuries which result from prolonged flexing of the head and neck which eventually results in the symptoms the person experiences.

Recurring pain in the neck with stiffness of the neck muscles and, sometimes, headaches, are among the first symptoms experienced in this condition. When the disease "pressures" (compresses) the nerves in the neck region, pain, tingling and, even weakness, can be experienced in the upper limbs. In its worst presentation this disease process occurring in the "neck" region of the spine can lead to spinal cord compression and result not only in numbness and weakness in the hands but also cause symptoms in the lower body with reduced bladder control, loss of sexual potency in men and spasticity in all the limbs.

When CERVICAL SPONDYLOSIS is suspected, x-rays are usually performed on the neck which will confirm the diagnosis. Computerised tomographic (CT) scanning or MRI (magnetic resonance imaging) are also very useful procedures to define in detail the area of the spinal cord which is affected. MRI and CT scanning are,however, quite expensive procedures.

In mild cases where there is a little neck pain and some minor "tingling" in the fingers and hands, conservative treatment is usually enough. Often the doctor will prescribe a supporting neck collar and give the person a prescription for non steroidal anti-inflammation mediation (NSAID) such as Baufer, Voltaren, Ansaid, Mobic, Cataflam, Surgam, Indomethacin, and many others which are available with a doctor's prescription. A course of physiotherapy with cervical traction, short-wave diathermy treatment and heat treatment might also be necessary to reduce the pain, the tingling and the numbness experienced in the hands. The affected person should sleep only on a low pillow, improve their posture and avoid carrying all heavy loads.

When the disease process in the neck has already progressed significantly, the person might need to see an orthopaedic surgeon as surgery to the neck might be necessary to remove pressure from the nerves in the neck and to stabilise the neck by fusing the bones in the neck.

Exercise, while always perceived as a health conscious act, will need to be modified or curtailed in the person with cervical spondylosis.

By DR AJ MORGAN

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