Overview of Neck Arthritis (Cervical Spondylosis)

Neck arthritis (also known as neck osteoarthritis or cervical spondylosis) is the degeneration of the joints, bones, and discs of the cervical spine of the neck. Neck arthritis is a common condition, affecting more than 85% of people over the age of 60.

Neck arthritis can cause neck pain, stiffness, tingling, numbness, and headaches, as well as a clicking sound at the base of the skull. Arthritis neck pain can sometimes be severe and may lead to muscle spasms and shooting pains in the shoulders, back, legs, thighs, and buttocks.

If nerves are compressed by collapsing spinal bones, there can also be arm or leg weakness, lack of muscle coordination, or the loss of bladder or bowel control. Talk with your healthcare provider about symptoms that may require diagnosis.

Symptoms

Some people with neck arthritis have no symptoms at all, but most experience at least some level of discomfort—typically chronic pain and stiffness. As the condition progresses, other symptoms may develop, particularly if the spinal nerves become compressed ("pinched").

Symptoms of neck arthritis include:

• Neck pain or stiffness that worsens with activity or while standing
• A sound or feeling of your neck popping when you move
• Headaches that start in your neck
• Muscle spasms that affect movement or cause pain
• Fatigue, trouble sleeping, or irritability
• Numbness, tingling, and weakness in the arms, hands, fingers, legs, or feet
  

Neck arthritis also can affect the ability to work or perform normal daily activities. Severe cases can lead to complications that include a loss of bladder or bowel control, which requires medical care.

Causes

Neck arthritis is a form of osteoarthritis, also known as "wear-and-tear" arthritis. Symptoms develop when the cartilage discs between the bones of the cervical spine (called vertebrae) deteriorate or become damaged. With age, these gel-like discs can also dry out, causing them to flatten.

The loss of cartilage leads to narrowing of the space between vertebrae and nerve compression (known as radiculopathy). This leads to the onset of referred pain to different parts of the body depending on which spinal nerve is "pinched."

The progressive damage can stimulate the growth of bony projections called osteophytes (bone spurs). These bony growths can also cause complications.

Risk Factors

The main cause of neck arthritis is the simple wear-and-tear of the structures of the cervical spine that occurs over time.

Risk factors for neck arthritis include:

• Older age
• History of a neck injury
• Repetitive strain injuries
• Smoking
• Genetics
• Depression or anxiety
• Obesity
• Sedentary lifestyle and lack of activity
• History of severe arthritis

Diagnosis

To diagnose neck arthritis, your healthcare provider will start by taking a medical history and asking questions about your symptoms. A physical exam is used to assess the range of motion of your neck, check your reflexes and muscle function, and check your gait as you walk.

Imaging tests are commonly used to get information about the location and extent of damage to the cervical spine. Options include:

• Spinal X-ray: A common imaging test that involves a low dose of ionizing radiation
• Computed tomography (CT): A technology that combines multiple X-ray images to create three-dimensional "slices" of the spine
• Magnetic resonance imaging (MRI): An imaging technique that uses powerful magnetic and radio waves to visualize bones and soft tissues, such as cartilage
• Myelography: A technology that can show how bone spurs and intervertebral discs affect individual nerves
• Electromyography: A technology that assesses how well nerve signals are being transmitted to muscles

Other tests, such as a blood test to check for inflammatory arthritis, may be needed.

Treatment

The primary goal of treatment for neck arthritis is to relieve pain, prevent nerve compression, and restore function. There is no one-size-fits-all approach.

If you're diagnosed with neck arthritis, your treatment plan will be crafted to specifically target your symptoms, ensuring optimal results with minimal side effects and risks.

Non-Surgical Options

In most cases, neck arthritis is treated with the least invasive first-line measures. Rest and the use of cervical collar to limit motion can be used. Sleeping on your side may help you to protect the natural curve of your neck. Cold compresses or ice packs can help ease pain, while heating pads can help improve neck stiffness (particularly in the morning).

The following over-the-counter and prescription drugs may be used to help ease arthritis neck pain and stiffness:

• Topical pain relievers, including capsaicin patches and ointments like Icy Hot
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) or Celebrex (celecoxib)
• Tylenol (acetaminophen)
• Oral corticosteroids (steroids) like prednisone or dexamethasone
• Corticosteroid injections, delivered to the space between vertebrae
• Oral muscle relaxants, to help ease muscle spasms
• Opioid pain relievers, used for short-term pain relief
• Antidepressants, to help ease chronic nerve pain

Physical therapy, including cervical traction, hot or cold therapy, and massage therapy may also be recommended.

More aggressive or invasive therapies are used when there's no response to these options.

Surgery

Surgery is generally reserved for the most severe cases, in part because surgery doesn't always fully resolve the neck arthritis symptoms and may only provide minimal to moderate relief. There are also risks associated with any surgery.

Surgical options for neck arthritis include:

• Anterior cervical discectomy and fusion (ACDF): A surgery approached from the front of the throat to remove and replace the intervertebral discs while fusing adjacent vertebrae to limit neck movement
• Posterior cervical laminectomy: A surgery approached from the back of the neck to remove excess growth between vertebrae, widening the space and helping to decompress the spine

When to See a Healthcare Provider

Neck pain can occur for less serious reasons than cervical spondylosis, and symptoms can be temporary. But see your healthcare provider if you experience:

• Pain that doesn't improve with rest or OTC medications, or that becomes severe
• Muscle weakness or difficulty moving a part of your body
• Balance problems or you can't complete tasks that require coordination
• Bladder or bowel changes occur
• Symptoms that also include fever or unexplained weight loss
• Pain and/or numbness affecting an arm or back of shoulder

If your symptoms follow a fall, accident, or other trauma, it's important to have the problem diagnosed in order to rule out brain or spinal injury. Care provided by an orthopedist (bone and muscle specialist) may be recommended.

Summary

Neck arthritis, also known as neck osteoarthritis or cervical spondylosis, is caused by the progressive wear-and-tear damage of the cervical spine of the neck.

Symptoms include neck pain, stiffness, headache, arm or leg weakness, and referred pain to other parts of the body. Severe cases can affect a person's mobility and even lead to the loss of bowel or bladder function.

Neck arthritis is diagnosed with a physical exam and imaging tests. Treatment options include rest, neck immobilization, over-the-counter and prescription drugs, physical therapy, and neck exercises. Surgery may be considered if conservative therapies fail to provide relief.