How effective is physiotherapy for cervical spondylosis?

Cervical spondylosis describes wear-related changes in the bones, discs and joints of the neck. Some people have stiffness or local pain, while others develop irritation of a nerve or the spinal cord. Physiotherapy starts with an assessment of movement, strength, sensation and the activities that aggravate symptoms. Treatment may use gentle mobility work, postural guidance, shoulder and neck strengthening, and advice for sleep, driving or desk work. The goal is to make movement more comfortable and improve control around the neck; scans and symptoms do not always match closely.

Use the home programme at the frequency and intensity prescribed. Alternate prolonged sitting with brief movement, place screens where you do not need to keep the neck bent, and support the forearms during close work. Build strength gradually rather than testing the neck with sudden force. Tell the physiotherapist if an exercise causes arm symptoms, dizziness or a headache that persists. Medication, imaging or another specialist opinion may be needed when symptoms suggest nerve or spinal-cord involvement.

Seek urgent care for new or worsening weakness in an arm or leg, clumsy hands, problems with balance or walking, or changes in bladder or bowel control. Seek prompt assessment after significant neck injury, or when pain is accompanied by fever or unexplained illness. Arrange review if symptoms continue to restrict sleep or daily tasks despite following the plan.

Are my symptoms limited to neck joints, or is a nerve involved? Which activities are safe while stiffness is active? What signs would make you request imaging? How will we judge whether strengthening is helping?