If a cervical vertebra is fractured by trauma, such as in a car accident, a fall, a diving accident that jars the head, or any other significant cervical injury, the spinal cord can be damaged, possibly resulting in not only cervical pain but different types of impaired functioning depending on which cervical vertebra has been injured.
For example, a cervical injury to:
- C1, C2, or C3 (one of the first three cervical vertebrae) may result in functional loss of the diaphragm and necessitate the use of a ventilator to aid in breathing
- C4 (the fourth cervical vertebra, etc.) may prompt loss of functional control of the shoulders and biceps
- C5 may result in complete functional loss at the wrists and hands in addition to partial loss of the shoulders and biceps
- C6 may result in complete loss of hand function and limited use of the wrist
- C7 may result in decreased skillful use in the hands and fingers, and limited use of the arms.
A full review of cervical fractures is beyond the scope of this article.
It should be noted that trauma to cervical vertebrae occurs less often than cervical pain and other symptoms resulting from changes that occur with aging, such as the development of bone spurs in the neck and cervical osteoarthritis.
Cervical Degeneration: Bone Spurs and Cervical Osteoarthritis
A bone spur (medically known as an osteophyte) describes an enlargement of the facet joints, the small stabilizing joints that are located between and behind the adjacent cervical vertebrae. Bone spurs are smooth structures that can grow on the bones and tend to occur in adults over 60 years of age.
Patients with cervical bone spurs may or may not have symptoms, which could include neck pain and/or referred pain and weakness in the arms and the legs. For example, patients with cervical bone spurs may experience dull neck pain that occurs when standing. In some instances, the pain may be referred to the shoulders or prompt headaches.
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However, it must be emphasized that the presence of bone spurs in and of themselves does not necessarily mean this is what is generating a patient's pain. Most bones spurs are simply radiographic findings indicating a patient has degeneration in the neck.
Bone spurs may form as the result of cervical osteoarthritis, a condition marked by degeneration and breakdown of the cartilage between the facet joints in the cervical spine. With cervical osteoarthritis (also known as cervical arthritis), different symptoms may occur, such as pain that:
- Refers to the shoulder or between the shoulder blades
- Feels worse at certain times of the day (early in the morning, late at night)
- Calms with rest.
Rarely requiring surgery (such as when there is a vertebral fracture in the neck), cervical osteoarthritis is typically treated via rest, pain medications, chiropractic and/or traction.