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Clinical Features :
The symptoms are in the neck or in the upper limb, or both.
Neck symptoms consist chiefly of aching pain in the back of neck or in the
trapezius area,
- a feeling of stiffness and
- grating on movement.
There us a Liability to
periodic exacerbation’s, probably from unremembered stains or repetitive
movements.
Occipital headache may be a feature it the upper half of the cervical spine
is affected.
In the upper limb there
may be an ill-defined and ill-localized “referred” pain spreading over the
shoulder region, or there may be more serious symptoms from interference
with one or more cervical nerves in their foramina. The main features of
nerve root irritation is radiating pain along the course of the affected
nerves, often reaching the digits.
There may also be a
parenthesize in the hand, in the form of tingling or ‘pins and needles’.
Noticeable muscle weakness is uncommon.
The cervical cord itself may be compressed by a central disc protrusion or
from osteophytes arising from the posterior aspects of the vertebral bodies,
giving rise to long tact signs and disturbances of gait.
Vertebral artery
involvement by osteophytic growth may cause drop attacks, precipitated by
extension of the neck. Osteophytes arising from the anterior vertebral
margins may sometimes by their size give rise to dysphasia.
On Examination :
-the neck may show slight kyphosis.
-The posterior cervical muscles may be somewhat tender but they are not in
spasm.
— Movements are not limited or restricted markedly except during acute
exacerbations or when the degenerative changes are very advanced.
— Audible crepitation on movement is common — In the upper limb objective
findings are usually slight or absent, for nerve pressure is seldom great
enough to produce well-defined objective neurological signs and so
demonstrable muscle weakness or sensory impairment is exceptional.
Depression of one or more of the tendon reflexes is, however, fairly common. |
