Cervical Spondylosis (Arthritis of the Neck)

Cervical spondylosis, sometimes called cervical arthritis or arthritis of the neck, refers to changes due to wear-and-tear arthritis (osteoarthritis) that occur over time and affect the bones, disks, and joints of the neck. This condition affects over 85% of people over age 65.

The most common symptoms of cervical spondylosis are neck pain and stiffness. It is also possible to have cervical spondylosis and not have any symptoms. Most people respond well to treatment, which includes medication and physical therapy.

This article covers the symptoms and causes of cervical spondylosis, diagnosis, and treatment of this arthritic condition.  

Cervical Arthritis Symptoms  

The terms "cervical spondylosis" and "osteoarthritis of the neck" refer to progressive degenerative neck changes. Neck pain and headaches at the back of the head are generally the first symptoms of cervical spondylosis. The neck might also feel stiff, with symptoms being worse in the morning and improving as the day progresses.

Cervical spondylosis symptoms can range from mild discomfort to severe pain that disrupts daily life. For people who experience symptoms of cervical spondylosis, pain starts gradually and worsens with time.

As cervical spondylosis progresses, you might experience:  

• Pain that is at its worst at the end of the day
• Symptoms that subside with rest
• Pain that radiates to the shoulders or shoulder blades
• Pain and symptoms that disrupt sleep, sometimes waking you up in the middle of the night
• Tenderness with pressure on the neck
• The inability to turn the head or bend the neck
• A clicking or grinding noise when turning the neck

More severe symptoms of cervical spondylosis are:  

• Cervical bone spurs (osteophytes): Some people with cervical spondylosis will have bony growths that can impinge on spinal nerves (putting pressure on the nerve, sometimes called a pinched nerve). Compression of spinal nerve roots produces cervical radiculopathy, leading to pain, tingling, and weakness that radiates into the shoulders, arms, and hands.
• Cervical myelopathy refers to spinal impingement that leads to spinal cord dysfunction. Symptoms include pain, tingling, numbness, muscle spasms, and weakness in areas beneath the neck. Spinal cord dysfunction can affect mobility, hand use, and bladder or bowel function control. 
  

Causes

Where degenerative changes are commonly associated with cervical spondylosis, other conditions and factors might lead to it.

Additional causes of cervical spondylosis include:

• Autoimmune diseases: Rheumatoid arthritis and psoriatic arthritis are among those that can cause chronic inflammation in the cervical spine.
• Trauma to the neck, including injury and repetitive stress on the neck: Cervical spondylosis is commonly seen in occupations in which people perform activities that stress the neck, such as sports.
• Wearing of spinal disks (the cartilage disk between the vertebrae)
• Age: The likelihood of developing cervical spondylosis increases with age, especially after 40 years old.
• Genetics: Genetic components have been identified in connection with cervical spondylosis, meaning that some types of arthritis that lead to spinal damage are hereditary.

Diagnosis 

A diagnosis of cervical spondylosis starts with a discussion of symptoms and medical history with a healthcare provider. They will ask what symptoms you have experienced, their causes, and what improves them.  

The next step is a physical examination of the neck, back, and shoulders. Your healthcare provider will feel the back of the neck for tenderness, weakness, and reduced range of motion (how far you can move your neck). Your provider will also check your reflexes, muscle strength, and gait (how you walk) to determine if there is pressure on the spinal cord or spinal nerves.

Imaging can offer more information and better confirm a diagnosis of cervical spondylosis. A neck X-ray can detect changes to the cervical spine, including bone spurs, and rule out other causes of your neck symptoms, such as neck cancer, infections, or fractures.

Magnetic resonance imaging (MRI) can produce more detailed images that pinpoint pinched nerves. A computed tomography (CT) scan can provide more detailed images of the spinal cord and nerve roots.  

Nerve function tests can help your healthcare provider determine if nerve signals travel correctly to the muscles. For example, electromyography can measure electrical activity in the nerves as they transmit messages to the muscles. A nerve conduction study uses small shocks passed through the nerves to measure the strength and speed of nerve signals.

Treatment 

Treatment for cervical spondylosis tends to be conservative—using methods to preserve function and avoid surgery. The treatment method your healthcare provider chooses will depend on how severe your cervical spondylosis is and other factors like your age, how much pain you are in, the cause of your cervical spondylosis, and your personal health goals.

The main objectives of treating cervical spondylosis are to relieve pain, prevent long-term damage to the spinal cord and spinal nerves, and help you keep doing daily activities.

Nonsurgical treatments for cervical spondylosis are medications, physical therapy, lifestyle and at-home remedies, and alternative medicine.

Medicines  

Medicines used to treat cervical spondylosis include:  

• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, including Advil (ibuprofen) and Aleve (naproxen sodium), are available without a prescription to relieve pain and inflammation. Your healthcare provider can prescribe a more potent NSAID to help manage severe symptoms.
• Corticosteroids: A corticosteroid injection or a short course of an oral corticosteroid like prednisone can ease pain and bring down inflammation.
• Muscle relaxants: If cervical spondylosis causes muscle spasms, your healthcare provider can prescribe a muscle relaxant, such as Amrix (cyclobenzaprine), to manage symptoms.
• Antidepressants: Some types of antidepressants can ease neck pain from cervical spondylosis.
• Anti-seizure drugs: Some anti-seizure drugs can down nerve pain resulting from damaged nerves.

Physical Therapy  

A physical therapist can teach you exercises to stretch and strengthen neck and shoulder muscles. Physical therapy also is helpful for managing pain and stiffness.  

Lifestyle and At-Home Therapies

Lifestyle and at-home remedies can help relieve pain, stiffness, and swelling.  

Some lifestyle changes can reduce inflammation and stress on the neck, including changing posture. Quitting smoking can also reduce inflammation. At-home therapies might help bring about relief. For example, cold treatment can bring down swelling, and heat might relieve pain.  

You might also consider resting your neck and limiting neck movement to reduce inflammation and pain. A neck brace can help limit movement but should only be used for short periods to avoid muscle weakness and neck stiffness. 

Alternative Medicine  

Alternative medicines refer to therapies outside of traditional medicine. Chiropractic adjustments and massage therapy are alternative treatments that might help manage cervical spondylosis.  

Chiropractic adjustments might relieve neck pain and stiffness. A chiropractor can manipulate your cervical spine in a way that helps to relieve symptoms. X-rays should be done before chiropractic adjustment to ensure it is safe for a chiropractor to treat you.

Acupuncture, in which thin needles are inserted into the skin at specific points, may also be beneficial in reducing neck pain.

Massage therapy might also help relieve neck pain and stiffness. Talk to your healthcare provider before you start treating so they can advise you on whether neck massages are safe for you.   

Surgery

Your healthcare provider might refer you for surgical treatment of cervical spondylosis when all other treatments have failed. Surgery might also be recommended if neurological symptoms are severe or if neck arthritis causes extreme pain or disability.  

Surgery to treat cervical spondylosis might involve removing bone spurs, part of the cervical vertebra, or a herniated disk. The removed parts of the cervical spine are fused with hardware and bone grafts.

Summary

Cervical spondylosis refers to the wearing down of neck bones, disks, tendons, ligaments, and joints. The main symptoms are neck pain and stiffness.

Treatment for neck arthritis tends to be conservative and includes over-the-counter and prescription medicines, physical therapy, lifestyle therapies, at-home remedies, and alternative medicines. More severe cases of cervical spondylosis are treated with surgery to repair damaged parts of the cervical spine.  

A Word From Verywell

Most people will respond well to treatment for for cervical spondylosis and see complete or near-complete symptom relief within a few weeks. Even if you experience pain and symptom relief for months or years, it is possible to have a recurrence of symptoms later down the road or have long-term neck pain.

Keeping up with physical therapy exercises and stretching can help prevent recurrences of neck pain. You should also reach out to a healthcare provider as soon as neck symptoms return or if you find you have severe neck pain, numbness, tingling, muscle spasms, or problems walking or using your hands.