By Nicholas Yong

Product manager Andrew Ng, 25, thought his neck and shoulder pains were normal as he often spent many hours sitting at his work terminal.

Then one night, he went to bed with a stiff neck and woke up the next morning to find himself unable to turn his neck.

Mr Ng suffers from cervical spondylosis, or age-related degeneration of the cervical spine.

This condition occurs when wear and tear of the joints in the neck bones causes the formation of abnormal bony outgrowths, or bone spurs, around the margins of the joint.

The nearby muscles, ligaments and nerves may become irritated by these degenerative changes. Symptoms often develop slowly over time, but may start suddenly.

Age-related condition                                                                                                                         Some common symptoms include headaches, neck pain radiating to the shoulders or arms and numbness or weakness in the arms, elbows and/or fingertips.

In more severe cases, some patients lose bowel or bladder control when the spurs press on the spinal cord.

This condition usually occurs in those above 40 and progresses with age, but it can hit young people too.

Dr Lim Yeow Wai, a specialist in orthopaedic surgery at Raffles Hospital, estimates that he sees about 100 such patients a year.

Some of the more severe cases he has seen include those who have difficulty buttoning up their shirts or brushing their teeth, as they had lost dexterity in their hands.

Medical director for Singapore Sports Medicine Centre, Dr Benedict Tan, describes it as a 'cumulative problem' that results from overuse due to vigorous as well as sedentary lifestyles.

Those prone to this condition could be, for example, a swimmer who is constantly turning his neck or an office worker who slouches for hours at his terminal with his neck protracted forward to look at the screen.

Sports Solutions physiotherapist Gino Ng notes: 'It hits a lot of people who work for prolonged periods in strained or static positions, such as tailors or plumbers.'

Acute injuries such as whiplash can also accelerate the wear and tear and trigger the condition years later.

While neck and shoulder pains are common, Dr Lim advises that you should see a doctor if your pain recurs for more than six weeks.

Diagnosis begins with questioning about the patient's past history and a physical examination. An X-ray will also show any degenerative changes, while the doctor may also recommend an MRI (magnetic resonance imaging) scan for more severe cases.

The condition is usually treated with conservative therapy, such as lifestyle changes, physiotherapy and/or medication. Physiotherapy options include cervical traction, or pulling the neck along its length to relieve pressure, stretching and strengthening exercises for the neck and shoulder muscles and heat therapy.

If conservative treatment does not work, surgery to fuse degenerative joints or free up impinged nerves may be necessary.

After pain relief comes the need for lifestyle changes. As Mr Ng puts it: 'We teach our patients what to do, so they know how to help themselves.'

For example, Dr Lim advises office workers to take micro-breaks every 15 minutes, by doing stretching exercises or simply getting up and walking around.

Dr Tan also suggests that swimmers doing the freestyle rotate the entire body instead of just the neck. But he notes: 'The wear and tear is not reversible. You can't stop it from progressing, but you can slow the rate of progression.'

For Mr Andrew Ng, the changes in his lifestyle, such as paying attention to his sitting and walking postures, have certainly made a difference.

'Now, it's much better. The pain is manageable,' he says.

Prevention
You may not be able to prevent cervical spondylosis, but you may be able to reduce your risk by:

• Avoiding high-impact activities, such as running, if you have any neck pain.
• Doing exercises to maintain neck strength, flexibility and range of motion.         
• Taking breaks when driving, watching TV or working on the computer to keep from holding your head in the same position for long periods. 
• Practising good posture, with your neck aligned over your shoulders. 
• Protecting your neck from injury by putting on the seat belt when in a car.                                     

Source: Dr David Wong, specialist in orthopaedic surgery, Raffles Hospital.
This article was first published in The Straits Times.