Spinal Degeneration (Cervical)

Injuries > Neck & Head > Spinal Degeneration

(Also known as Cervical Degeneration, Neck Osteoarthritis, Neck Arthritis)

What is spinal degeneration?

Spinal degeneration of the neck is a relatively common condition characterized by wear and tear to the joints of the neck over time. It is usually seen in older patients (> 60 years of age) and may cause a variety of symptoms such as pain and stiffness in the neck.

The spine comprises of many bones known as vertebrae each of which has a large hole in its centre (figure 1). Because these bones are situated on top of each other, their holes line up, forming the spinal canal. This canal provides protection and space for the spinal cord and nerves to travel from the brain to the rest of the body. Each vertebra connects with the vertebra above and below via two types of joints: the facet joints on either side of the spine and the disc centrally (figure 2). There are also small holes on each side of the spine known as intervertebral foramen (IV foramen). These are located between adjacent vertebrae and allow nerves to exit the spinal canal (figure 2).

Over time, wear and tear to the discs, joints and bones can occur resulting in degenerative changes to the spine. These degenerative changes may include decreased disc height, loss of joint cartilage, bony spurring (osteophytes) and thickening of bone. This condition is known as spinal degeneration. As this condition progress the spinal canal and intervertebral foramen can begin to narrow and may eventually place pressure on the spinal cord and nerves resulting in a variety of symptoms.

Signs and symptoms of spinal degeneration

Many patients with minor spinal degeneration may experience little or no symptoms. As the condition progresses patients may experience pain and stiffness in the neck and a reduced available range or neck movement. In more severe cases involving spinal cord or nerve compression, pain, pins and needles, weakness or numbness may be experienced in the neck, upper back, arms or hands. Occasionally, headaches may also be present.

Patients with spinal degeneration generally experience an increase in symptoms during activities that repetitively or continuously straighten or extend the neck (figure 3). Symptoms may also increase during end of range neck movements (such as turning the neck to one side fully), during lifting or with prolonged slouching (particularly when sitting). Symptoms tend to ease when lying down (in good posture) or upon applying warmth to the neck (such as during a warm shower).

Diagnosis of spinal degeneration

A thorough assessment from a physiotherapist combined with appropriate investigations is usually required to diagnose spinal degeneration. An X-ray of the spine will typically demonstrate changes associated with spinal degeneration. Other investigations such as CT scans, bone scans or MRI's may also be indicated to assess the severity and to determine the exact structures that are affected.

Treatment for spinal degeneration

Patients with spinal degeneration are generally managed well with appropriate physiotherapy. Whilst little can be done to reverse the changes to the spine, patients can generally remain active by modifying their activities appropriately. The primary goal of treatment is to remain as active as possible without aggravating symptoms in order to maintain strength and mobility and to avoid deterioration. This can be achieved by having regular breaks from levels of activity that increase symptoms with positions of comfort. Activities should be balanced ideally to prevent any increase in symptoms. A gradual increase in activity and exercise can occur provided symptoms do not increase.

It is also important to maintain good posture (or as close to good posture as possible without increasing symptoms) to minimize stress on the neck (figure 4). Exercises placing minimal force through the neck should be performed to maintain fitness and mobility provided they do not increase symptoms. This may include regular walking, hydrotherapy exercises (designed by a physiotherapist) or gentle range of movement exercises as determined by the treating physiotherapist.

The use of a heat pack and massage can also be of benefit to relieve symptoms and assist with maintaining and improving neck range of movement.

Physiotherapy for spinal degeneration

Physiotherapy treatment for patients with spinal degeneration is important to assist with pain relief, improve flexibility and strength, and to ensure an optimal outcome. Treatment may comprise:

• soft tissue massage
• electrotherapy (e.g. ultrasound)
• mobilization
• traction
• dry needling
• postural correction
• use of a postural support
• heat treatment
• education
• activity modification advice
• clinical Pilates
• hydrotherapy
• exercises to improve flexibility, strength, posture and core stability

Other intervention for spinal degeneration

Despite appropriate physiotherapy management, some patients with spinal degeneration continue to deteriorate. When this occurs, other intervention may be required. This may include pharmaceutical intervention, investigations such as an X-ray, CT scan, bone scan or MRI, or assessment from a specialist. The treating physiotherapist can advise on appropriate management and can refer to the appropriate medical authority if it is warranted clinically. In more severe cases of spinal degeneration involving spinal canal stenosis or nerve compression, surgery may be required to relieve the pressure on the spinal cord or nerves.

Exercises for spinal degeneration

The following exercises are commonly prescribed to patients with spinal degeneration. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should be performed 3 times daily and only provided they do not cause or increase symptoms.

Chin Tucks

Begin sitting or standing tall with your back and neck straight, shoulders should be back slightly. Tuck your chin in until you feel a mild to moderate stretch pain-free (figure 5). Keep your eyes and nose facing forwards. Hold for 2 seconds and repeat 10 times.

Figure 5 – Chin Tucks

Neck Rotations

Begin sitting with your back and neck straight and your shoulders back slightly. Turn your head looking over one shoulder until you feel a mild to moderate stretch, or as far as you can go without pain (figure 6). Keep your neck straight and don't allow your head to poke forwards during the movement. Repeat 10 times to each side provided the exercise is pain free.

Figure 6 – Neck Rotations (right side)

Shoulder Blade Squeezes

Begin sitting or standing tall with your back straight (figure 7). Squeeze your shoulder blades together as hard and far as possible pain-free. Hold for 5 seconds and repeat 10 times provided the exercise is pain free.

Figure 7 – Shoulder Blade Squeezes

Physiotherapy products for spinal degeneration

Some of the most commonly recommended products by physiotherapists for patients with this condition include:

1. Heat Packs and Ice Packs
2. Therapeutic Pillows
3. Posture Supports
4. Lumbar Rolls for sitting

To purchase physiotherapy products for spinal degeneration visit the PhysioAdvisor Shop.

Other Exercises

View more neck flexibility exercises.

View more upper back flexibility exercises.

View basic Pilates exercises to improve core stability and posture.

Find a Physio for spinal degeneration

Find a physiotherapist in your local area who can treat spinal degeneration of the neck.

More Information

Read more about posture.

Read more about ergonomic computer set-up.

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