Treatment for arthritis in neck

Arthritis in Your Neck: Signs of Neck Arthritis, and What to Do About It

When you think of arthritis, you might think of creaky knees or painful, swollen fingers. But if your neck is feeling stiff or you have pain when you turn your head, this neck pain may be caused by arthritis too.

Like the rest of the body, the disks and joints in the neck degenerate due wear and tear. Osteoarthritis of the neck includes these changes that happen over time or because of an injury. Most people 60 years old and older will have a degenerative type of neck arthritis, says Rajat Bhatt, MD, a rheumatologist with Prime Rheumatology in Houston, Texas. Inflammatory types of arthritis that occur because of an overactive immune system can affect your neck as well.

Learn more about what causes neck arthritis and how arthritis of the neck is treated.

Symptoms of Arthritis in the Neck

While arthritis in the neck is common, symptoms of neck arthritis vary, says Neel P. Shah, MD, an orthopedic spine surgeon at Montefiore Medical Center in the Bronx, New York.

For most people, arthritis in the neck causes no symptoms. When neck arthritis symptoms do occur, it’s typically pain and stiffness in the neck that ranges from mild to severe. It may be worsened by looking up or down for a long time, or by activities where the neck is held in the same position for a long time like driving or reading a book. Neck pain usually subsides with rest or lying down.

Other symptoms of neck arthritis may include:

  • Headaches
  • Grinding or popping noise or sensation when you turn your neck
  • Muscle spasms in the neck and shoulders
  • Trouble walking
  • Weakness in the hands or legs
  • Loss of balance

Two other types of symptoms that are common in people with arthritis in the neck are radiculopathy and myelopathy.

Radiculopathy affects the spinal nerve root, the part of the nerve that branches off from the main spinal cord. Usually, some form of pressure on the spinal nerve root causes symptoms such as pain, weakness, numbness, and/or electrical sensations down an extremity.

Myelopathy is a disease process that affects the spinal cord that comes on slowly over time. Symptoms include compressed spinal nerve roots, radiculopathy, pain, weakness, numbness, and/or electrical sensations in an extremity.

“Neck arthritis can become debilitating, especially if there is compression of the spinal cord, which can lead to loss of strength, coordination, and balance,” says Dr. Shah.

Types of Arthritis that Affect the Neck

Neck pain can have numerous possible causes. Still, many people with sore, stiff necks that don’t improve over time are diagnosed with a type of arthritis.

Osteoarthritis in the Neck

Osteoarthritis in the neck is the degeneration of joints, vertebrae, and discs in the cervical portion of the spine. With less padding between them, vertebrae may rub against each other. That can cause tiny bone fragments to break off and float in the synovial fluid (a thick liquid that lubricates your joints and helps them move smoothly).

Sometimes this process stimulates the growth of bony projections along the edges called bone spurs, or osteophytes. Since the padding is now thinner, the vertebrae become closer to each other. That leaves less room for the spine nerves that stick out from the spinal cord.

Symptoms of neck osteoarthritis range from none to pain, stiffness, and inflammation. Osteoarthritis in the neck pain tends to worsen after activity. Complications such as loss of coordination can happen if the spinal cord becomes pinched.

Rheumatoid Arthritis in the Neck

Rheumatoid arthritis is a chronic inflammatory disease where the body’s immune system mistakenly attacks the lining of the joints. It often starts in the smaller joints of your hands and feet and can spread to other parts of the body like the neck as the disease progresses. This typically doesn’t happen until years after the onset of arthritis symptoms.

Neck pain is the primary symptom of rheumatoid arthritis in the neck, with the severity varying from person to person. You may feel a dull or throbbing ache in the back of your neck around the base of the skull. Joint swelling and stiffness can make it hard to move from side to side.

The difference between rheumatoid arthritis neck pain and a neck injury is that stiffness and pain from an injury can gradually improve over days or weeks. Rheumatoid arthritis in the neck may not get better; it can worsen if left untreated. Even if symptoms improve, inflammation, swelling, and stiffness can return with rheumatoid arthritis in the neck.

Spondyloarthritis in the Neck

Other types of neck arthritis include psoriatic arthritis and ankylosing spondylitis, which are both considered a type of arthritis called spondyloarthritis. It’s an umbrella term for inflammatory diseases that involve both the joints and entheses, the places where ligaments and tendons attach to the bones.

Psoriatic arthritis is a form of arthritis often accompanied by psoriasis, an inflammatory skin disease. For some people who have psoriatic arthritis, the condition involves the spine, which impacts the neck. Pain happens when inflammation strikes the joints between the vertebrae. This pain can occur on just one side of the body, the neck, and the lower and upper back. Read more about psoriatic arthritis symptoms.

Ankylosing spondylitis is a form of arthritis that strikes the bones in your spine and pelvis as well as peripheral joints. Early signs and symptoms might include pain and stiffness in your lower back and hips, especially in the morning and after inactivity. Fatigue and neck pain are common. AS symptoms might worsen, improve, or stop at irregular intervals.

How Neck Arthritis Is Diagnosed

Your doctor will start by taking a history and doing a physical exam. They’ll check the range of motion in your neck and test your strength, sensation, and reflexes to find out if there is pressure on your nerves or spinal cord. They’ll ask when your symptoms started, when the pain happens, and what makes the pain better and worse.

Your doctor may order an X-ray to assess alignment and look for arthritic changes, says Dr. Shah. If there is a concern of compression of spinal nerves or the spinal cord, you may need an MRI to look at the neutral structure and discs, says Dr. Shah.

A CT scan may be ordered to look at the bone more closely, especially to see if any bony outgrowths are causing compression. However, X-rays and MRIs are the tests that are usually ordered, says Dr. Shah. A CT scan with a myelogram (where dye is injected into the spinal canal to see the neural structures) may be used if an MRI can’t be done.

An electromyography, or EMG, may be ordered to assess for nerve compression, says Dr. Shah. An EMG tests the electrical conduction of the nerves in the arms. This test would be helpful if you have multiple nerves being compressed or compression of nerves at the neck and in the arm, he says.

Your doctor may order blood tests to see if you have any antibodies or systemic inflammation that would reveal inflammatory arthritis, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis.

Treatment for Arthritis in the Neck

In most cases, treatment for neck arthritis is nonsurgical. Nonsurgical treatment options are listed below.

Medication Options for Neck Arthritis

Analgesic and NSAID pain medication

Over-the-counter medications can be used to help address pain, inflammation, and swelling. NSAIDs like aspirin, naproxen, and ibuprofen can help relieve pain and reduce inflammation. Analgesics (such as acetaminophen) can help with mild to moderate pain. Your doctor can prescribe a stronger anti-inflammatory if OTC medications don’t provide relief.

Even though many commonly used NSAIDs are available over the counter, it’s important to talk to your doctor about side effects and drug interactions. NSAIDs can have significant side effects, including gastrointestinal complications, and are associated with an increased risk of heart disease.

Disease-modifying arthritis medication

Neck pain due to inflammatory arthritis is typically treated with a disease-modifying antirheumatic drug (DMARD), such as methotrexate for RA. Other conventional DMARDs include leflunomide, hydroxychloroquine, and sulfasalazine. Biologics are a newer type of DMARD that target specific immune system pathways. DMARDs help to reduce the immune system activity that is triggering inflammation and pain.

Steroid injections and nerve blocks

Steroid-based injections and nerve blocks can offer pain relief for arthritis in the neck. Both can be good for pain that radiates from the neck, says Carlo Milani, MD, an assistant attending physiatrist at Hospital for Special Surgery in the Department of Physiatry in and assistant professor of clinical rehabilitation medicine at Weill Cornell Medical College in New York City.

An epidural steroid injection is where doctors inject medicine directly into the epidural space of the spinal canal surrounding the nerve roots. The medicine is a combination of corticosteroids and a local anesthetic, which together reduce inflammation and relieve pain.

A facet joint injection is an injection of local anesthesia and corticosteroids that is placed directly into the affected joint. Facet joints connect the bones of the spine, allowing the spine to bend and twist.

The anesthesia offers temporary pain relief and the corticosteroids reduce inflammation in the joint.

A nerve block is the injection of a local anesthetic close to a targeted nerve or group of nerves to block pain. Different types are used depending on where you’re in pain. You may get relief from one injection or need several nerve block treatments.

Exercise for Arthritis in the Neck

Physical therapy

If you’re experiencing neck pain due to arthritis, your doctor may recommend physical therapy. Physical therapy for neck arthritis entails doing specific exercises to help strengthen and stretch weak or strained muscles. Physical therapy can improve range of motion. Sessions and programs vary in length and frequency and are tailored to your condition.

“The foundation of what we’re trying to do in physical therapy for the neck is often to help improve posture and the way people move,” says Dr. Milani. “Exercises in physical therapy tend to be focused on strengthening muscles of the back and neck, which puts less strain on structures of the cervical spine.”

You’ll do exercises during physical therapy and get instructions on ones to do at home.

Regular Physical Activity at Home

You may feel like you don’t want to move when your neck hurts. But being inactive may increase stiffness, which can cause you to lose even more mobility. “Aches and pains tend to respond better to continued movement than rest,” says Dr. Milani. “Exercise is often the foundation of treatment.”

Exercises that involve stretching, strengthening, and improving range of motion can help reduce pain and keep your neck limber. You want to move gently and smoothly when doing neck exercises, not jerk your neck or make sudden movements. You may feel discomfort at first. Stop if any exercise increases your neck pain.

Light exercise can help improve strength and flexibility. Walking, swimming, water aerobics, or biking fit the bill. Or go for yoga or Pilates. “Avoid overhead movement exercise or positions that exacerbate your symptoms,” says Dr. Milani. He says, for example, on a stationary bike, avoid a position that aggravates neck pain. Find a comfortable position while you are riding.

The military chin tuck helps with posture. Hold your chin to the neck for 10 to 20 seconds. Do this 10 times a day, says Dr. Shah.

Don’t forget about your shoulders. Exercising them will help strengthen the muscles that support your neck. Basic shoulder rolls will keep your shoulder and neck joints fluid.

Radiofrequency ablation

If medication, physical therapy, or other treatments don’t work, a procedure called radiofrequency ablation that numbs the joints of the neck might be indicated, says Dr. Milani. In the procedure, a heated needle tip heats up a small area of nerve tissue to stop it from sending pain signals. That can offer long-term, but usually not permanent, relief for six months to two years, he says.

Home Remedies for Arthritis in the Neck

While you can’t stop age-related joint degeneration from happening, you can try to slow its development or ease symptoms with simple lifestyle changes. Here are a few remedies you can try to manage neck arthritis pain.

Use ice

Apply a cold compress to the neck to help reduce inflammation, stiffness, and swelling.

Sleep right

Sleep with a pillow and bed that support your sleep preference, says Dr. Shah. If you like sleeping on your back, get a firm mattress and pillow. Side sleepers should get a medium mattress and pillow. Stomach sleepers should go for a soft mattress and pillow. Dr. Milani says you may find it helpful to sleep with a cylinder-like pillow that sits in the curve of your neck.

Stop smoking

Quit smoking if you’re a smoker. Smoking decreases the effectiveness of some drugs used to treat arthritis. And smoking can make it harder for you to do activities that relieve arthritis symptoms, like exercise. “It can worsen arthritis and also increase pain sensitivity,” says Dr. Bhatt.

Watch your computer stance

Support your back and neck while you sit at your computer. Keep your computer at eye level so you don’t have to change your neck position by looking up and down. “When using a computer and key board, have the monitor at eye level,” says Dr. Shah. “Use risers or an adjustable desk.” Your keyboard should be close to your body and your body should be close to your desk, says Dr. Milani. If your company offers it, an ergonomic assessment of your work station can help ensure that it’s set up properly, he says.

Use the phone correctly

When talking on the phone, use a headset. That will help prevent you from straining your neck. Smartphones have even launched the term “text neck,” which is a repetitive strain thanks to people hunching over their devices. This stance aggravates muscle pain in the neck. Instead of tilting your chin down to read your smartphone, put the device at eye level. That way your head isn’t constantly dropping and forced to strain.

Alter your posture

Changing your posture can help relieve neck pain from arthritis. Good posture, as it’s related to the neck, is when the ears are positioned directly above the shoulders with the chest open and shoulders back. Here, stress is minimized because the head’s weight is naturally balanced on the spine. “Correct posture is key,” says Dr. Shah. “With the use of computers and smartphones, we’re constantly being hunched forward. It’s demanding to the neck and applies harmful pressure to the structures of the neck.”

Surgery for Neck Arthritis

“Surgery is usually a last resort for neck arthritis,” says Dr. Milani. Your doctor may recommend it if you have severe pain that isn’t relieved with nonsurgical treatment or if you have signs of neurologic injury. “Surgery may be needed if the arthritis causes instability, or more importantly, impingement of nerves and/or the spinal cord,” says Dr. Shah.

Keep Reading

  • Can You Get Rheumatoid Arthritis in Your Neck?
  • Polymyalgia Rheumatica: These Are the Signs You Could Have It
  • Little Ways to Ease Arthritis Pain Without Leaving Your Bed

Just as years of walking and running take their toll on knees and hips, the cumulative stress of supporting the head — a weight roughly equal to that of a 10-pound bowling ball — wears on the disks and joints in our neck. As a result, nearly everyone ends up with arthritis of the neck, also known as cervical spondylosis.

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“What happens is the disks start to degenerate, the bones collapse on each other, and bone spurs occur,” explains Thomas Mroz, MD, Director of the Center for Spine Health.

Every human being will have disk degeneration. Unfortunately, disks aren’t built to last. By age 60, about 90 percent of people will show some evidence of cervical spine degeneration on X-ray.

What’s are the signs of neck arthritis?

Pain is the most obvious symptom of a disk problem in the neck, yet the degree of damage has little to do with how much it hurts.

“You can have 100 people with the same amount of degenerative changes in their cervical spine, and only a small percentage have neck pain,” says Dr. Mroz. Among those who do experience neck pain, the discomfort is usually short-lived, improving on its own within six to 12 weeks.

Sometimes, cervical arthritis narrows the space where nerve roots exit the spine, pinching the nerve. You can feel this as a radiating pain down your arm, or as numbness and weakness in your arm and hand. If a collapsed disk or a bone spur pushes into the spinal cord and causes compression, it can produce more serious symptoms (like loss of hand dexterity, loss of balance, difficulty walking or bladder and bowel control issues.)

Give yourself some time

If you have neck pain, modify your activities for a few weeks to avoid putting additional strain on your neck. To relieve more severe pain, you can take an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) or get a prescription from your doctor. The drug gabapentin (Neurontin®) may help with nerve-related neck pain.

If you don’t improve on these medications, your doctor might suggest an epidural steroid injection to decrease inflammation around and inside the nerve.

Once the pain subsides, Dr. Mroz recommends seeing a physical therapist or doing range-of-motion exercises to improve mobility in your neck and prevent stiffness. If you’re still having pain after six weeks, see a doctor.

When you should consider surgery

For most people with arthritis of the neck, time and nonsurgical measures will relieve the discomfort. But if you have a herniated disk that causes spinal nerve compression with symptoms like pain, weakness and numbness that don’t go away, it may be time to consider surgery.

One way to surgically correct a pinched nerve is with a diskectomy. The surgeon removes part of the damaged disk to relieve pressure on the nerve. Then the vertebrae may be fused — or welded — together to stabilize the spine. Another surgical option is a posterior foraminotomy, which widens the opening of the spine where the nerve passes through, and removes any bone spurs that are pressing on the nerve.

Compression of the spinal cord can be treated several ways surgically. They all create more space for the nerves. Anterior decompression and fusion surgery is similar to the treatment of a pinched nerve. Cord compression can also be addressed by removing a part of the vertebra called the lamina or a procedure called a laminoplasty.

The vast majority of people with a pinched nerve will improve following surgery. “People with spinal cord compression also improve, but the extent of improvement depends on the severity of neurological dysfunction before the surgery,” says Dr. Mroz.

This article originally appeared in Cleveland Clinic Arthritis Advisor.

Cervical Osteoarthritis Treatment

Treatment options for cervical osteoarthritis typically depend on the severity of symptoms and how often they disrupt daily life. Most often, nonsurgical treatment options will suffice for managing cervical osteoarthritis. In cases where pain worsens and various treatment methods have proven ineffective over a period of 6 to 12 weeks, surgery may be considered as a last resort.

See Treatment for Neck Pain

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Anterior cervical discectomy with fusion helps to alleviate nerve root pressure in the neck.
Watch: Anterior Cervical Discectomy and Fusion (ACDF) Video

Nonsurgical Treatment Options

If cervical osteoarthritis symptoms are mild, common treatments will include one or more of the following:

  • Rest when symptoms flare. Sometimes limiting neck movements for a short while, such as for an afternoon or a day, is enough to let the inflammation go back down and pain dissipate.
  • Cold and/or heat therapy. Some people prefer a cold pack, especially after an activity that results in pain, to minimize inflammation. Other patients prefer heat, such as a heating pad or heat wrap; or moist heat, such as a moist heat wrap for the neck or a warm bath or shower.
  • See Heat Therapy Cold Therapy

  • Over-the-counter medications. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g. Advil), naproxen (e.g. Aleve), or COX-2 inhibitors (e.g. Celebrex) may help relieve the pain from the inflammation that usually accompanies arthritis. Acetaminophen (e.g. Tylenol) is another over-the-counter pain reliever that could help.
  • See Medications for Back Pain and Neck Pain

  • Active lifestyle. Moderate exercise is good for the joints, including the neck’s facet joints. While rest is sometimes necessary during a painful flare-up, incorporating more movement into a daily routine oftentimes reduces long-term pain from cervical osteoarthritis. For example, committing to a walking regimen could be a good way to increase daily activity and naturally boost feel-good endorphins.
  • See Neck Exercises for Neck Pain

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If cervical osteoarthritis symptoms are more moderate and persistent, other treatment options could include:

  • Activity modification. Sometimes limiting or eliminating certain activities can prevent the worst of the flare-ups. For example, a person might find a specific swimming stroke twists the neck in a way that causes more pain than other swimming strokes. In that case, the problematic swimming stroke should be limited or completely avoided in the future. Everyone is different in terms of which activities might be more problematic for triggering cervical osteoarthritis symptoms.
  • Physical therapy. A physical therapist or other medical professional can create a program of exercise and stretching that targets the patient’s specific needs. When the neck muscles become stronger and more flexible, they are less likely to spasm and cause pain.
  • See Physical Therapy for Neck Pain Relief

  • Prescription medications. A doctor may prescribe opioids, also called narcotics, which block pain receptors in the brain. Another option could be prescription-strength muscle relaxants, which reduce painful muscle spasms in the neck and surrounding muscles. Prescription painkillers tend to be a short-term solution and are not recommended on an ongoing basis.
  • See Opioid Pain Medications

  • Radiofrequency ablation (RFA). A minimally-invasive RFA procedure delivers heat from a needle tip to create lesions on the small nerves that feed into the facet joint. This procedure prevents these nerves from sending pain signals to the brain. While RFA is capable of providing longer-lasting relief than a medial branch nerve block or facet joint injection, it is still a temporary solution because the nerves will likely regenerate in a year or two. RFA is typically not tried until a medial branch nerve block and/or facet joint injection has been successful for the patient and thus identified the facet joint as the likely cause of pain.
  • See Radiofrequency Ablation (RFA): Procedure and Recovery

This is not a complete list of treatment options. Many others exist, including manual manipulation and massage. Most people with cervical osteoarthritis will find relief and manage symptoms by combining multiple treatment types.

See Gentle Chiropractic Techniques for Neck Pain

In This Article:

  • Cervical Osteoarthritis (Neck Arthritis)
  • Cervical Osteoarthritis Symptoms
  • Diagnosing Cervical Osteoarthritis
  • Cervical Osteoarthritis Treatment
  • Cervical Facet Osteoarthritis Video

Surgical Treatment Options

While cervical osteoarthritis tends to be chronic, the symptoms rarely progress enough to require surgery. For patients with severe symptoms that are impeding their ability to function, such as numbness or weakness that goes down into the arm or hand, surgery may be an option.

See Surgery for Neck Pain

Two common surgical treatment options include:

  • Anterior cervical discectomy and fusion (ACDF). A surgeon approaches through the front of the neck and removes the disc at the vertebral level where degenerative changes are causing severe symptoms. The disc is then replaced with a spacer that maintains enough height for cervical nerve roots to pass unimpeded, and the vertebral level is fused so no further motion (nor degeneration) should occur.
  • See ACDF: Anterior Cervical Discectomy and Fusion

  • Posterior cervical laminectomy. A surgeon approaches the cervical spine from the back of the neck and removes the back part of the vertebra (lamina and spinous process) to give more room and decompress the spinal cord. If spine stability is a concern, the laminectomy can be combined with a spinal fusion.
  • See Posterior Cervical Laminectomy

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While neck surgery is in general a safe procedure, all surgeries carry risk. The patient and doctor will need to discuss the potential benefits and risks before making a final decision on surgery.

When Arthritis Causes Neck Pain

Cervical Spondylosis Diagnosis and Treatment

To diagnose cervical spondylosis, your doctor will ask you questions about your symptoms and perform a physical exam. You may also need to undergo imaging studies, such as X-rays or an MRI (magnetic resonance imaging), so that your doctor can view the vertebrae, disks, and ligaments of the neck and look for any abnormalities, such as bone spurs, that may be contributing to your symptoms.

Treatment options for cervical spondylosis include:

  • Limiting neck movement, which may mean wearing a cervical collar
  • Non-steroidal anti-inflammatory drugs (NSAIDs) or other pain medication to help relieve your pain and swelling
  • Physical therapy
  • Heat therapy
  • Ice therapy
  • Exercises to improve poor posture
  • Chiropractic manipulation
  • Neck exercise to strengthen and stretch the cervical spine
  • Neck steroid injections in some cases
  • In rare cases, surgery may be necessary to relieve pressure on the spinal cord from bone spurs or a herniated disk

Neck Pain and Rheumatoid Arthritis

Another type of arthritis that can cause neck pain is rheumatoid arthritis (RA), an inflammatory disease that can damage the joints. While rheumatoid arthritis typically affects the joints of the fingers and wrists, it can also affect other joints, including the neck.

Rheumatoid Arthritis Symptoms

The symptoms and signs of inflammation may include:

  • Warm, tender, swollen joints
  • Joint pain and stiffness in the morning lasting more than 30 minutes
  • Fatigue
  • Fever

Rheumatoid Arthritis Diagnosis and Treatment

A rheumatoid arthritis diagnosis begins with a physical exam and discussion of your symptoms. Your doctor may also order laboratory tests, such as blood tests and X-rays, to get a better understanding of your condition.

RA affects each person differently, and treatment will depend on your symptoms and how severe they are. Common treatments for rheumatoid arthritis include:

  • Medications to reduce inflammation and relieve pain
  • Medications to slow joint damage, such as disease-modifying anti-rheumatic drugs (DMARDs) and biologic response modifiers
  • Rest when you need it
  • Chiropractic treatment to alleviate neck pain through adjustments to your neck’s vertebrae.
  • Splints to support swollen, painful joints
  • Surgery when necessary; this may involve joint replacement (depending on the joint involved), reconstruction of tendons, or removal of inflamed tissue.

Ways to Treat Neck Pain at Home

In addition to medical treatments, consider:

  • Exercise. When your disease isn’t active, get moving — just don’t overdo it. In moderation, it can reduce your pain, help with movement, make you feel less tired, and it’s just a good thing to do for overall health. Your local chapter of the Arthritis Foundation may offer water exercise and other kinds of classes specifically for people with arthritis.
  • Ice packs. The next time you need to reduce swelling and pain, go to your freezer and grab a bag of frozen peas or corn — these aids conform easily to the neck area.
  • Not smoking. If you smoke, find a way to stop. The chance of complications from RA increases if you smoke, as do your odds of developing osteoporosis.
  • Warm baths. Besides helping with sleep, a warm bath can soothe achy joints and relax muscle tension.
  • Herbal remedies. If you’re looking for natural relief, turmeric, the common kitchen spice, is known to be an anti-inflammatory and may reduce neck pain caused by inflammation. Boswellia is another natural pain reliever with anti-inflammatory properties.
  • Yoga exercise. This ancient practice, which involves stretches, poses, and meditation, is not only a great exercise, but it also relieves stress and neck pain by reducing tension.
  • Massage. Have your partner or a professional gently massage your neck where it hurts, for temporary relief.

Neck Pain: Related Conditions

Neck pain is common among those who are 50 or older. “But I have children who come into my office with neck pain,” says Robin Lustig, DC, CCSP, of New Jersey Total Health in Lodi, N.J.

Other common causes of neck pain include:

Pinched nerve. This occurs when too much pressure is placed on a nerve by surrounding tissue. The pain from a pinched nerve in your neck can radiate into your shoulders, arms, or back. When you have a pinched nerve, you may also feel numbness or tingling in the area.

Injury or trauma such as a car accident or a fall. Injury or trauma to the neck can have long-lasting effects and cause arthritis years later, Dr. Lustig says.

A stiff neck. This is when it’s painful or difficult to move your neck from side to side. “A stiff neck can be caused by sleeping on your stomach in a funny position for a long time or from a muscle that went into spasm,” Lustig says.

Cervical myelopathy. This condition occurs when the spinal cord channel in the back of your neck narrows, putting pressure on the spinal cord, which can result in neck pain and numbness or weakness in your hands, arms, legs, and feet.

Shoulder arthritis. “People often develop shoulder arthritis where there is wear and tear or overuse,” Lustig says. The pain from shoulder arthritis can radiate into the neck.

Poor posture. If you sit hunched over your computer all day or hold the phone with your neck while you’re working at your computer, your neck can hurt at the end of the day.

Tumors. A tumor in the cervical region of the spine will cause neck pain and should be examined to determine the best course of treatment. As the tumor grows, it can cause pain as it compresses different nerves.

Meningitis. Neck pain and stiffness is a primary symptom of this infection, which can be life-threatening. If your neck pain and stiffness is accompanied by fever and vomiting, see your doctor immediately.

Lack of magnesium. Magnesium is a mineral that plays an important role in the way our bodies function. Many people lack magnesium in their diet. Researchers have linked a lack of magnesium to cramps, twitches, muscle tension, soreness, and back and neck pain.

New Research on Neck Pain

Arthritis cannot currently be cured, but researchers are working from many different angles to learn how this disease develops in order to find a cure.

Some of the new research on arthritis includes:

  • Focus on cells. Scientists are studying T-cells, a major player in immunity. They want to find out how inflammation starts so they can stop it.
  • Gene study. To find the genes responsible for rheumatoid arthritis, the National Institutes of Health (NIH) and the Arthritis Foundation are supporting the North American Rheumatoid Arthritis Consortium. At 10 research centers around the United States, scientists are gathering information and genetic samples from 1,000 families in which at least two siblings have the disease.
  • Other studies. Researchers are also looking at hormones, bacteria, and viruses in the hope of learning more about RA.
  • Clinical trials. As for research into cervical spondylosis, a recent look on the NIH clinical trials Web site turned up eight trials involving this disorder.

Neck Pain Prevention is Key

You can prevent some neck pain with these steps:

Learn stretching exercises. Consult a physical therapist if necessary. You should stretch every day especially before and after you exercise. If after exercising, your neck hurts, apply ice immediately.

Keep your back and neck supported. This is a must, especially sitting at your computer. If your computer is at eye level, it will keep you from having to look up and down and constantly change your neck position. Use a headset when talking on the telephone to avoid straining your neck.

Sleep with support. Use a firm mattress. If your neck is sore in the morning, you might want to buy a pillow that supports your neck as well.

Click it. Protect yourself from trauma by always using a seat belt when riding in a car.

Managing neck pain requires a consistent approach and carefully following the treatment plan outlined by your healthcare provider. You’re the one in charge of making sure you take the time to exercise, strengthen, and soothe muscles. At times you’ll feel challenged, but if you stay determined, you’ll have the best possible outcome.

Your doctor will make the decision as to whether to put you on an NSAID after weighing the benefits against the risks.

Narcotic painkillers. Because of their increased risks, opioids are not a first-line therapy for pain. Opioids such as codeine (contained in Tylenol with codeine), hydrocodone (contained in Vicodin and Lortab), and oxycodone (such as OxyContin, and contained in Percocet and Percodan) can provide significant relief when neck pain is particularly intense and other non-narcotic pain medications aren’t sufficient for pain relief. So can tramadol, a narcotic-like analgesic. Although opioids are effective for pain, they should be used with caution because they can lead to drowsiness, nausea, constipation, and depressed breathing. These prescription painkillers also have the potential for abuse and addiction. Narcotic painkillers are best used over the short term (one to two weeks) and under your doctor’s guidance.

Steroids. Steroids such as prednisone (Deltasone, Orasone, Sterapred) work by reducing inflammation. Although they can be taken orally, steroids given for neck pain are sometimes delivered directly to the spine via an injection to the area. Research shows that steroid injection does relieve neck pain over the short term, although its effectiveness for chronic pain is unclear. The most common side effects of short-term oral steroids are an increase in blood sugars, water retention and stomach ulcers. For the epidural, the risks are infection, headache, and bleeding. Side effects of oral steroids, which are not generally used, include weight gain, and, less often, high blood pressure and osteoporosis.

Muscle Relaxants. Baclofen and other muscle relaxants calm muscle tightness, and some research suggests they can relieve neck pain within the first few days of an acute injury. When using these drugs, watch out for side effects such as drowsiness, dependence, and urinary retention. These drugs are best used short term under a doctor’s guidance.

Anticonvulsants. Although they are approved by the FDA to treat seizures, anticonvulsant drugs such as gabapentin (Neurontin), carbamazepine (Tegretol), and pregabalin (Lyrica) may help with nerve-related neck pain. How exactly anticonvulsants work on neck pain is unknown, but they are believed to affect the way the brain perceives pain. Side effects include dizziness, sleepiness, vision problems, and vomiting. Patients who take these drugs may be at a greater risk of having thoughts or actions of suicide. The risk may be greater in people who have had these thoughts or actions in the past. Call the doctor right away if signs like low mood (depression), nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.

What You Need to Know about Neck Arthritis

When neck arthritis strikes, it can cause painful joint inflammation and stiffness. There are various types of neck arthritis, such as the following:

  • Cervical osteoarthritis involves the breakdown of the cartilage within the neck’s joints, which may occur due to wear-and-tear over time or may be accelerated by an injury.

    See Cervical Osteoarthritis (Neck Arthritis)

  • Rheumatoid arthritis is an autoimmune disease that can cause damage to joints. When rheumatoid arthritis occurs in the cervical spine, it is most likely to occur in the upper neck or base of the skull.1

    See Rheumatoid Arthritis in the Spine

  • Ankylosing spondylitis is a type of arthritis that causes enthesitis, which is inflammation where the ligaments and tendons attach to bone. While ankylosing spondylitis typically starts in the hips and lower back, it can eventually work its way up to the neck in severe cases.

    See Ankylosing Spondylitis

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Cervical osteoarthritis may also be referred to as degenerative joint disease.
Watch: Cervical Facet Osteoarthritis Video

The focus of this blog is cervical osteoarthritis, which is the most common form of neck arthritis that is discussed on this site.

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How cervical osteoarthritis develops

Pairs of small facet joints run down the back of your cervical spine. Each of your facet joints is lined with cartilage. This cartilage is surrounded by a capsule filled with synovial fluid, which lubricates your facet joints and enables smooth movements between adjacent vertebrae.

Watch Facet Joints Video

Cervical facet osteoarthritis develops when your cartilage begins to degenerate, or break down. As your cartilage thins and wears away, bone-on-bone friction occurs in your facet joints. This friction can create inflammation and bony overgrowths, called bone spurs (osteophytes).

See Cervical Osteophytes: Bone Spurs in the Neck

Symptoms of cervical osteoarthritis

Neck pain from cervical osteoarthritis typically starts gradually and progresses over time. The neck may feel particularly stiff and achy in the morning and then feel better as the day goes on.

Some common symptoms of cervical osteoarthritis can include one or more of the following:

  • Neck pain that typically feels dull but can also be sharp or burning
  • Referred pain up to the head or down into the upper back
  • Stiff neck or reduced range of motion
  • Neck tenderness when touched

On occasion, bone spurs may impinge on a nerve root in your neck. This impingement can cause radicular pain into the arm, which can feel electric shock-like. If nerve root inflammation results in neurological deficits, such as numbness or weakness in the arm or hand, it is called cervical radiculopathy.

Read more about Cervical Osteoarthritis Symptoms

Treatment options for cervical osteoarthritis

Cervical osteoarthritis can usually be successfully managed without surgery. Common treatments include:

  • Rest or activity modification. Going easy on the neck during a painful flare-up may ease pain. Also, you may need to modify some activities, such as using a different swim stroke if you enjoy swimming.
  • Physical therapy. A physiatrist, physical therapist, or other medical professional can customize a neck exercise program for you. A stronger and more flexible neck has improved function, which may reduce pain.
  • Over-the-counter medications. Non-steroidal anti-inflammatory drugs (NSAIDs) may help relieve inflammation from osteoarthritis. A few examples include ibuprofen (Advil) and naproxen (Aleve). Remember to carefully read the instructions before using any medication to reduce the risk for serious complications.

    See NSAIDs: Non-Steroidal Anti-Inflammatory Drugs

  • Heat and/or cold therapy. Applying ice can help reduce inflammation and numb the pain. Other people may prefer to apply heat therapy, which can increase blood flow and relax the muscles. When applying heat or cold therapy, applications should last about 15 minutes with about 2 hours of rest in between. Keep a layer between your skin and the heat/cold source.

    See Heat and/or cold therapy

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Other treatment options are available, including therapeutic injections. In rare cases for patients with severe cervical osteoarthritis that doesn’t respond to nonsurgical treatments, cervical spinal fusion surgery may be a treatment option.

Learn more:

Cervical Osteoarthritis Treatment

Facet Joint Osteoarthritis

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