Cervical spondylosis - Diagnosing cervical spondylosis

Cervical spondylosis is usually suspected if there are typical symptoms of neck pain and stiffness. It will also be considered as a cause of radiating arm pain, problems with use of the hands or difficulty walking.

Various tests, described below, can be used to rule out other conditions and confirm the diagnosis.

Physical examination

Cervical spondylosis can limit the range of movement in your neck. You will be asked to rotate your head from side to side and tilt your head towards your shoulders.

Your GP may also test reflexes in your hands and feet, and check that you have full sensation in all your limbs. Problems with your reflexes or a lack of sensation could indicate nerve damage caused by narrowing of your spinal cord (cervical myelopathy).

You may be referred for an X-ray, which will show characteristic features of spondylosis, such as the presence of osteophytes (lumps of extra bone).

MRI and CT scans

Further testing may be required if cervical myelopathy is suspected, or your symptoms are severe and fail to respond to conventional treatments.

Details of some of the tests you may have are described below.

MRI scan

A magnetic resonance imaging (MRI) scan is a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.

An MRI scan can be useful in detecting underlying nerve damage.

CT scan

A computerised tomography (CT) scan involves taking a series of X-rays, which are then reassembled by a computer to produce a more detailed image.

CT scans can provide a much more detailed scan of your bones compared to an X-ray.

A CT scan is usually only performed if you are unable to have a MRI scan for medical reasons – for example, if you have a pacemaker.

Nerve conduction test and electromyography (EMG)

In some cases, a nerve conduction test and electromyography may help to diagnose cervical radiculopathy or cervical myelopathy.

A nerve conduction test measures the strength and speed of the signals transmitted through your peripheral nerves – the network that runs from your brain to other areas of your body, such as your limbs.

During a nerve conduction test, small metal discs called electrodes are placed on your skin. The electrodes release small electric shocks that stimulate your nerves. The speed and strength of the nerve signal is measured.

Electromyography involves having a small needle-shaped electrode inserted through your skin and into your muscle, using a local anaesthetic.

Both types of test are usually carried out at the same time to obtain a more detailed assessment of how well your nerves and muscles are functioning.