Definition

Cervical syndrome is a collection of disorders caused by changes in the cervical spine and surrounding soft tissues. These structures include the spinal discs, joints, muscles, and ligaments. The condition is commonly associated with pain as its main symptom.

Causes

The most frequent cause of cervical syndrome is the decline in cervical spine function. Degenerative changes occur in the spinal joints, the joints between the spine and ribs, and the spinal discs.

Besides degenerative processes, cervical syndrome can result from several causes, including injuries (fractures, bruises, ligament tears), inflammation (rheumatism and infections), metabolic changes, and tumors.

Some examples of cervical spine disorders include:

• Cervical spondylosis: Aging process of the cartilage and cervical spine.
• Cervical disc herniation: Protrusion or rupture of the intervertebral discs.
• Degenerative disc disease: Damage and decline in disc function.
• Cervical spinal stenosis: Narrowing of the spinal canal in the neck.
• Cervical myelopathy: Damage to the cervical spinal cord due to canal narrowing or function decline.
• Cervical radiculopathy: Compression or pinching of the spinal nerves.
• Infection.
• Tumor.

Risk factor

Factors that increase the risk of cervical syndrome include:

• Prolonged sitting with incorrect posture. Excessive and improper spinal load leads to poor posture. Poor workplace posture stresses the cervical spine and neck and shoulder muscles. A study reported an increased risk of neck pain in workers who sit for over 95% of their work time compared to those who sit less.
• Gender. Women report more neck pain than men.
• Age, particularly between 35 and 49 years.
• Stress.
• Smoking.

Symptoms

The main symptom of cervical syndrome is pain, which can range from mild to very severe. Cervical pain can radiate to the head, jaw, shoulders, one or both arms, back, and even legs. The pain sensation includes:

• Increased tension in the back of the neck muscles.
• Neck stiffness.
• Reduced neck movement.
• Head region disturbances, including ringing in the ears, blurred vision, headaches, dizziness.
• Upper limb disturbances.
• Fatigue.
• Other rarer symptoms include coordination or balance problems, difficulty breathing, loss of bowel and bladder control.

These symptoms can progress from acute to chronic stages. In the acute phase, pain can last from several days to weeks. If pain persists for more than a few weeks, it is considered chronic cervical syndrome.

Diagnosis

To diagnose cervical syndrome, doctors will first take a medical history and ask about symptoms and medications. Then, physical and additional examinations will follow.

Some additional tests for cervical syndrome include:

• CT scan: Shows the shape and size of the spinal canal, its contents, and surrounding bones. Helps diagnose degenerative spine diseases, inflammation, and bone damage from infections or tumors.
• MRI: Identifies problems in the cervical spinal cord and exiting nerves, degenerative spine diseases, disc herniation, infections, and tumors.
• X-ray: Uses low radiation to show bones and surrounding soft tissues. Reveals fractures, disc problems, spinal curvature disorders, and joint inflammation.
• Electrodiagnostic tests: Include electromyography (EMG) and nerve conduction studies using electrical currents and electrodes to assess nerve and muscle function and damage.

Management

Treatment options for cervical syndrome include:

• Nerve or electrical stimulation: Uses low voltage electricity to stop pain signals. Examples include transcutaneous electrical nerve stimulation (TENS), where electrodes are placed on the skin at nerve endings and spinal nerve stimulation with electrodes placed under the skin.
• Spinal procedures: Radiology techniques deliver steroids and medications directly to the pain source, reducing pain and inflammation. This is often combined with physical therapy.
• Ultrasound-guided injections: Ultrasound helps doctors see nerves, bones, tendons, and muscles, allowing precise medication delivery to pain points. Steroid and platelet-rich plasma injections are commonly used.
• Radiofrequency ablation: Uses radio wave heat to damage nerve tissue, disrupting pain signal transmission.
• Stiffness management: Relaxes tight and stiff muscles with medications. This includes Botox injections for specific muscles and baclofen injections into the spinal fluid.

Physical therapy for cervical syndrome has proven benefits. Proper physical therapy can help neck pain sufferers resume daily activities, improve quality of life, and reduce work absences.

Complications

Cervical syndrome affects physical and psychological function, negatively impacting daily activities. Those with cervical syndrome may have limited mobility, leading to increased work absences and reduced quality of life.

Prevention

While you cannot fully prevent cervical syndrome, you can reduce the risk by:

• Staying physically active.
• Maintaining good sitting posture.
• Avoiding neck injuries by using proper equipment during sports.

When to see a doctor?

If you experience neck pain or other symptoms of cervical syndrome, consult a doctor. The doctor can help identify the problem, allowing you to restore daily function.

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