Overview of Neck Osteoarthritis

Neck osteoarthritis (also known as neck arthritis or cervical spondylosis) is the degeneration of the joints, bones, and discs of the cervical spine of the neck. Neck arthritis mainly affects people over 50 and tends to worsen with age.

Neck arthritis can cause neck pain, stiffness, tingling, numbness, and headaches as well as neck clicking 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.

The article describes the symptoms, causes, and diagnosis of neck arthritis. It also explores the various treatments used to provide arthritis neck pain relief, including medications, physical therapies, neck exercises, and surgery.

Neck Arthritis 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 that worsens with activity or while standing
• Neck pain that radiates to the arm or shoulder
• Numbness, tingling, and weakness in the arms, hands, fingers, legs, or feet
• A grinding sound in the neck
• Headaches
• Weakness in the legs, trouble walking, and loss of balance
• Loss of bladder or bowel control
  

Neck arthritis also can affect sleep and the ability to perform normal daily activities. Severe cases can lead to complications that are debilitating and possibly irreversible.

One of these is spinal stenosis in which the space within the spinal bones grows smaller, crowding and compressing nerves. The compression of spinal nerves can cause referred pain (meaning pain felt in other parts of the body). It can also affect the ability to walk at a brisk pace and cause problems with fine motor skills.

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 progressive damage can stimulate the growth of bony projections called osteophytes (bone spurs), triggering the onset of spinal stenosis.

On top of this, the loss of cartilage "cushioning" causes the space between vertebrae to get narrower, leading to 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."

Anatomy

The cervical spine is made up of seven vertebrae that are stacked one on top of the other like the rings on a ring toss game; the top ring is located at the base of the skull.

Starting with the second vertebra (C2), there is a pad of soft cartilage called an intervertebral disc that cushions between each vertebra and allows for smooth movement of the neck. Facet joints between each vertebra (called zygapophysial joints) provide added stability and flexibility. 

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, particularly in people over 50
• A neck injury, such as can occur with contact sports or car accidents
• Repetitive stress injuries, such as can occur with jobs that involve heavy lifting or overhead work
• Smoking, which appears to promote spinal stenosis
• A family history of neck arthritis, which suggests that genetics plays a role

Diagnosis

To diagnose neck arthritis, your healthcare provider will start by taking a medical history. They will ask questions about your symptoms, such as when they started and what makes the pain better or worse.

Next, they will do a physical exam to assess the range of motion of your neck, check your reflexes, and see how well the muscles of your arms and legs are functioning. They may also ask you to walk to see if there are any abnormalities in your gait that indicate radiculopathy.

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 are affecting individual nerves
• Electromyography: A technology that assesses how well nerve signals are being transmitted to muscles

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

Neck arthritis is treated conservatively in most cases, reserving more aggressive or invasive therapies for cases that are intractable (meaning resistant to treatment).

The treatment of neck arthritis typically starts with rest and immobilizing the neck with a cervical collar. 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.

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

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.

A Word From Verywell

Degeneration of the cervical spine is almost inevitable with age, but it doesn't mean you have to suffer chronic pain or be faced with significant physical limitations. In short, neck arthritis isn't "one of those things" you have to live with if you get it.

At the first sign of neck arthritis, see your healthcare provider for a physical exam and comprehensive evaluation. The sooner you start treatment, the better able you will be to preserve the function of your neck and spine and minimize pain.