Spondylosis happens when the discs and the facet joints in the spine age. It's caused by everyday use over many years and is quite normal as you get older.
The discs between the bones become thinner and the spaces between the bones narrower. Spurs of bone called osteophytes sometimes form at the edges of the bones and the facet joints. These changes can be seen in x-rays and are very similar to osteoarthritis, but in the neck they’re known as cervical spondylosis. These changes are part of a repair process where the body adapts to the wear that occurs as we age.
Spondylosis doesn't always cause pain, but it may increase the risk of having spells of neck pain. Because neck pain tends to come and go, it's not usually possible to identify spondylosis as a driect cause.
Occasionally when people have spondylosis:
- the nerve roots may be irritated or pinched, either by bulging discs or osteophytes, sometimes causing pain or numbness
- if the vertebral artery is pinched it can affect the blood supply to the brain, causing dizziness or blackouts.
Spondylosis shouldn't be confused with ankylosing spondylitis, where inflammation in the spine can causes pain and stiffness.
Whiplash is caused by your body being carried forward, causing your head to flip back. As your body stops, your head is thrown forwards. This happens most commonly in car accidents and sports injuries. It’s thought that the pain is caused by the capsule around the facet joints and the ligaments stretching, along with muscle spasm as your body tries to splint the injury. There's often a delay before you feel any pain or stiffness from whiplash.
Although whiplash can badly strain your neck, seat belts and properly adjusted headrests in cars help greatly to prevent serious injuries. Most whiplash improves within a few weeks or months. Gentle exercises to keep your neck moving will help to prevent longer-term problems and get you back to normal as soon as possible.
Most muscles relax completely when they’re not being used, but some (known as anti-gravity muscles) have to work all the time in order to keep your body upright. Muscles at the back of your neck must always be tensed, otherwise your head would fall forwards when you're sitting or standing. When we’re worried or stressed we often tighten these muscles even more, which can cause neck pain and tension headaches. Tension headaches are very common and are often wrongly called migraines.
A slipped or bulging disc in your neck can cause neck pain which is usually associated with pain radiating down one arm, numbness, pins and needles, or weakness. This will often settle by itself or following physiotherapy, but occasionally you may need further treatment.
Stenosis and myelopathy
Rarely, disc bulges and osteophytes can cause narrowing of the spinal cord (stenosis) which can affect the spinal cord and cause weakness in arms and legs (myelopathy).