Neck and shoulder pain (or painful numbness in the arms and arms) is a common problem in orthopedic clinics, especially nowadays, with the fast pace of our work life, many people need to face the computer for a long time, read books, sit in the office and work continuously with their heads down, drive, etc. All these contribute to the occurrence of “cervical spondylosis”. All these have contributed to the occurrence of “cervical spondylosis”, and not only has the incidence increased significantly, but the trend of youth is also very obvious. I will give you detailed answers to the most frequently encountered questions in the clinic. 1.What is cervical spondylosis? According to the current consensus at home and abroad, cervical spondylosis refers to degenerative changes of the cervical disc and a series of secondary changes that cause irritation or compression of adjacent tissues, such as the spinal cord, nerves and blood vessels in the neck, and cause various corresponding symptoms and signs, which is called cervical spondylosis. In other words, in order to diagnose cervical spondylosis, there must be structural changes (degenerative changes of cervical discs) and corresponding clinical manifestations (neck pain, dizziness, numbness of upper limbs and even difficulty in moving and walking, weakness, etc.), one of which is indispensable. Therefore, as a doctor, you cannot make a diagnosis of cervical spondylosis based on a film alone; or just put a “hat” of cervical spondylosis on some patients with very light performance, which is not only detrimental to treatment and rehabilitation, but also increases the psychological burden of patients. 2.How does cervical spondylosis develop? Cervical disc degeneration (commonly known as aging) is the main factor in the occurrence and development of cervical spondylosis. The spine (including the cervical spine, lumbar spine, etc.) at the back of our body is “built” by many vertebrae, and the intervertebral disc is the “cushion” between the upper and lower vertebrae, which can maintain the stability of the vertebrae. When the cervical intervertebral disc degenerates, its elasticity decreases and its volume shrinks, so it cannot maintain the height between the vertebrae and the stability of the cervical spine as effectively as before. With the aggravation of the disease, the patient will feel pain in the back of the occipital area, or “neck tightness”, “stiffness” and inability to move after waking up in the morning, etc. If the patient does not know what position to put the head in, this indicates early cervical spondylosis, which is also clinically known as cervical cervical spondylosis ( There are many types of cervical spondylosis, such as cervical type, nerve root type, spinal cord type, etc.). Usually these patients will have corresponding pressure points in the neck, and X-ray examination will reveal changes in the physiological curvature of the cervical spine (loss of physiological pronation, straightening, etc.), and the alignment of individual vertebrae is not neat enough. With further aggravation of disc degeneration, outward protrusion of disc tissue will compress the spinal cord and/or nerve roots, and intervertebral instability will form bone spurs around the vertebrae, increasing the compression of the spinal cord and nerve roots. The nerve roots in the neck innervate the motor and sensory functions of the upper limbs and part of the head and face. When it is compressed, patients not only have shoulder and neck pain, but also pain radiating to the upper limbs or the back of the head, accompanied by arm numbness, and in severe cases, weakness of the upper limbs, numbness of the fingers, decreased sensation of the skin of the limbs, and unconscious dropping of objects held in the hand. If the patient shows the above performance, it is highly suspected that the nerve root type cervical spondylosis is to blame. At this time, the doctor may recommend the patient to have a magnetic resonance imaging (MRI) examination in addition to the conventional X-ray examination in order to more clearly find out the lesions of the intervertebral discs, ligaments, nerves and other soft tissues. Because the spinal cord is the “pathway” through which the brain directs our actions, when the cervical spinal cord is compressed, patients will experience weakness in the limbs, unstable walking, walking like stepping on cotton, easy to kneel down or fall, accompanied by numbness in the corresponding limbs, decreased sensation, and even in a few patients, loss of control of urination and defecation, sexual dysfunction, tetraplegia, etc., especially in the neck. It is most common after trauma to the neck. This type of “spinal cord cervical spondylosis” usually requires surgery. When the protruding bone spur compresses the vertebral artery or the instability of the cervical spine pulls the vertebral artery and causes insufficient blood supply to the vertebral artery, the patient will experience symptoms such as vertigo, headache, change in vision, tinnitus and even mental disorder, which is called “vertebral artery cervical spondylosis”. Since the symptoms are atypical and can be easily confused with other diseases, cervical artery ultrasound or MRI angiography is required to provide diagnostic information. In addition, when there are different tissues damaged at the same time, the patient will have a mixture of one or more of the above symptoms, which is clinically called mixed cervical spondylosis. As can be seen, the manifestations of cervical spondylosis are complex and varied, and in practice, most patients have intricate symptom expressions that are not as typical as those mentioned above. Therefore, cervical spondylosis can only be diagnosed through a detailed examination by a specialist, so do not indiscriminately label yourself as “cervical spondylosis” to avoid unnecessary psychological burden and adverse consequences. Most often, patients come to the orthopedic clinic; after the orthopedic surgeon’s examination, if surgery is not required, you can see the rehabilitation department instead and be guided by a professional rehabilitation physician; after all, they have better knowledge of conservative treatment than most orthopedic surgeons. If conservative treatment is not effective, or if the condition continues to progress, it is best to get a cervical MRI and go back to the orthopedic surgeon for a second opinion. This is what makes the most sense.