Cervical Spondylosis: Neck Pain, Arm Numbness & When to See a Neurologist in Hyderabad

Cervical spondylosis — often called 'cervical disc disease' or 'neck arthritis' — is the single most common cause of neck pain combined with arm symptoms in adults over 40. It is increasingly being seen in younger adults in their 30s, driven by prolonged desk work, smartphone use, and sedentary lifestyles.

What Is Cervical Spondylosis?

Cervical spondylosis refers to age-related degenerative changes in the cervical (neck) spine:

• Disc degeneration: Loss of disc height and water content
• Osteophytes (bone spurs): Bony outgrowths at disc edges
• Facet joint arthritis: Wear of the small joints between vertebrae
• Ligament thickening: Particularly the ligamentum flavum

By age 60, over 90% of people have some degree of cervical spondylosis on MRI — but only a minority develop symptoms. The problem occurs when these changes compress nerve roots (radiculopathy) or the spinal cord (myelopathy).

Cervical Radiculopathy — Symptoms

When a nerve root is compressed, symptoms appear in the arm, not just the neck:

• Neck pain radiating into the shoulder, arm, or hand — along a specific pattern depending on which level
• Tingling or numbness in specific fingers (C6: thumb and index finger; C7: middle finger; C8: ring and little finger)
• Weakness of specific arm or hand muscles
• Symptoms worsen with neck extension (tilting head back)

Cervical Myelopathy — The More Serious Form

When the spinal cord itself is compressed (myelopathy), symptoms are more diffuse:

• Clumsy hands — difficulty with fine movements (writing, buttoning clothes)
• Unsteady gait — feeling of imbalance when walking
• Weakness in both arms or legs
• Urgency or difficulty controlling bladder
• Electric shock sensation down the spine when bending the neck (Lhermitte's sign)

Myelopathy requires urgent neurological evaluation. Unlike radiculopathy, myelopathy can progress irreversibly without treatment — sometimes requiring surgery.

Who Is Most at Risk?

• Adults over 40 — age is the most important risk factor
• IT professionals and desk workers — prolonged neck flexion (looking down at screen)
• Smartphone users — 'text neck' posture
• People with previous neck injuries or whiplash
• Those with a family history of cervical spine problems

Diagnosis at Sri Anand CNC

Dr. Anand Karnam performs:

1. Clinical examination: Reflexes, muscle strength, sensory testing, Spurling's test, and myelopathy signs
2. Nerve Conduction Study (NCS): Confirms nerve root damage and differentiates from peripheral neuropathy
3. MRI cervical spine: Arranged at a nearby imaging centre — shows disc prolapse, osteophytes, cord compression

Treatment — Most Cases Managed Without Surgery

Physiotherapy (Dr. Harisha, MPT):

• Cervical traction — manual or mechanical
• Neural mobilisation for radiculopathy
• Deep cervical flexor strengthening
• Postural retraining and ergonomics
• McKenzie method exercises

Medication (Dr. Anand Karnam):

• Pregabalin or duloxetine for nerve pain
• Muscle relaxants for acute spasm
• B-complex vitamins (B12, B6, B1) for nerve health

When Is Surgery Needed?
Surgery (ACDF — anterior cervical discectomy and fusion) is indicated for: progressive myelopathy, severe radiculopathy not responding to 12 weeks of proper conservative treatment, or cord compression threatening long-term function. Less than 15% of symptomatic patients require surgery.

The Most Important Lifestyle Change

Screen position: your monitor should be at eye level — not below. Every 10 degrees of neck flexion (looking down) adds approximately 10 kg of extra load on the cervical spine. At 60 degrees of neck flexion (typical smartphone posture), the effective load is 27 kg. This cumulative strain over years drives cervical disc degeneration in young adults.

For assessment, consultation, and physiotherapy: Sri Anand CNC, Chanda Nagar, Hyderabad. Call +91 90633 66983.