BMJ  2007;334:527-531 (10 March), doi:10.1136/bmj.39127.608299.80

Clinical Review

Cervical spondylosis and neck pain

Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, Hertfordshire SG1 4AB

The first 150 words of the full text of this article appear below.

Most patients who present with neck pain have "non-specific (simple) neck pain," where symptoms have a postural or mechanical basis. Aetiological factors are poorly understood^w1 and are usually multifactorial, including poor posture, anxiety, depression, neck strain, and sporting or occupational activities.^w2 Neck pain after whiplash injury also fits into this category, provided no bony injury or neurological deficit is present.^w3 When mechanical factors are prominent, the condition is often referred to as "cervical spondylosis," although the term is often applied to all non-specific neck pain. Mechanical and degenerative factors are more likely to be present in chronic neck pain.

In cervical spondylosis, degenerative changes start in the intervertebral discs with osteophyte formation and involvement of adjacent soft tissue structures. Many people over 30 show similar abnormalities on plain radiographs of the cervical spine, however, so the boundary between normal ageing and disease is difficult to define.^w4 Even severe degenerative changes . . . [Full text of this article]

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