An Overview of Neck Osteoarthritis

Also known as cervical spondylosis, this age-related condition is common

Neck Osteoarthritis

Getty Images Credit/Arman Zhenikeyev

Neck osteoarthritis (also known as neck arthritis, cervical arthritis, and cervical spondylosis) is exactly what it sounds like—degeneration of the joints, vertebrae, and discs in the cervical portion of the spine that can lead to pain, inflammation, and even impaired function. The condition typically affects people over 40 and worsens with age. According to the Mayo Clinic, more than 85 percent of people over 60 are affected by cervical spondylosis, and men tend to develop neck arthritis at a younger age than women.

Symptoms can range from none at all to pain and stiffness, and serious complications such as loss of coordination if the spinal cord becomes pinched can occur. Once neck osteoarthritis is diagnosed, most likely via a combination of physical exam and imaging test, a doctor can put together a treatment plan tailored to the location of the damage, the degree of degeneration, and the symptoms. This could mean medication, physical therapy, and/or surgery.

Cervical spondylosis literally may be a pain in the neck, but all in all, it's a condition that's common, well-understood, and can be successfully managed.

Causes

The cervical spine is made up of seven vertebrae (bones) 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 skill. Between each vertebra is an intervertebral disk—a pad of slippery cartilage that provides cushioning between each vertebra and also allows the surfaces of the bones to move smoothly. These structures make up the facet (zygapophysial) joints that allow the spine to move and flex. 

Osteoarthritis develops when the cartilage deteriorates or becomes damaged. With less padding between them, the vertebra may begin to rub against each other. This friction also can cause tiny fragments of bone to break off and float in the synovial fluid, causing pain and inflammation. Sometimes this stimulates the growth of bony projections along the edges called bone spurs (osteophytes). With thinner padding, the vertebrae also become closer to each other, leaving less room for the individual spinal nerves that extend out from the spinal cord.

The main cause of these changes is simple wear-and-tear to the structures of the cervical spine that takes place over time. With age, the discs begin to dry out due to natural dehydration throughout the body, causing them to flatten. Other factors that can play a role in neck osteoarthritis include injury, a job or hobby that requires lots of repetitive motion or heavy lifting that puts stress on the cervical spine and being overweight. There also may be a genetic component, and even smoking has been linked to increased neck pain, according to the Mayo Clinic.

Symptoms

Some people with cervical spondylosis have no symptoms at all, but most people experience at least some discomfort—typically chronic pain and stiffness. As the condition advances, other symptoms may develop, particularly if the spinal nerves or spinal cord become involved. These include:

  • Neck pain that worsens with activity performed when a person is upright
  • Neck pain that radiates to the arm or shoulder
  • Numbness, tingling, and weakness in the arms, hands, fingers, legs, or feet
  • Weakness in the legs, trouble walking, loss of balance
  • Loss of bladder or bowel control
  • A grinding sound in neck upon movement
  • Headaches

Neck osteoarthritis also can affect sleep and the ability to work or perform usual daily activities. And it can lead to certain debilitating and often permanent conditions. One of these is spinal stenosis, in which osteophytes that form inside the vertebrae cause narrowing of the passage they form for the spinal cord. Symptoms can include referred pain or shooting pains in the arms and legs (radiculopathy); an inability to walk at a brisk pace; and problems with fine motor skills. 

A related condition, foraminal stenosis, develops when the openings in the sides of each vertebra become narrow and pinch down on the spinal nerves that pass through them causing shooting pain down the arm. 

Diagnosis

In order to diagnosis neck osteoarthritis, a doctor will start by taking a medical history. He will ask questions about your symptoms, such as when they started, what can make the pain feel worse or better, and so on.

Next, the doctor will do a physical exam to assess the range of motion in your neck and to check your reflexes and muscle function in your arms and legs. He may watch you walk to see if there's anything off about your gait, which can indicate compression on your spinal cord.

Imaging tests will likely be necessary in order to get detailed information about the exact location and extent of damage to your cervical spine. These may include an X-ray of your neck (which can reveal bone spurs); a CT scan for a more detail picture of bone damage; magnetic resonance imaging (MRI) to home in on areas where nerves may be involved; and myelography, in which a dye is injected into the spinal canal to enhance an X-ray or CT image.

Treatment

The primary goal of treatment for cervical osteoarthritis is to relieve pain, prevent nerve compression, and restore function, but there's no one-size-fits-all approach. If you're diagnosed with neck osteoarthritis, your treatment plan will be crafted of components that will specifically target your symptoms and other individual factors.

That said, the treatment options include:

  • Rest and immobilizing the neck with a cervical collar
  • Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and non-narcotic analgesics or corticosteroid injections: For severe neck osteoarthritis, muscle relaxants or narcotic analgesics also may be prescribed. For some people, anti-seizure medications may dull nerve damage pain. Antidepressants may be helpful as well.
  • Physical therapy, including cervical traction, hot or cold therapy, and stretching and strengthening exercises for the neck and shoulders.
  • Massage therapy 
  • Surgery: Possible procedures may involve removal of bone, bone spurs, or disc tissue that may be compressing nerves of the spinal cord. Cervical fusion, or fusing the discs in the cervical region of the spine, may help stabilize the neck.

A Word From Verywell

Degeneration of the cervical spine is almost inevitable with age, but it doesn't have to stop you from being able to move freely or leave you with chronic pain and discomfort. At the first sign of neck problems, see your doctor for an exam and evaluation. The sooner you begin treatment, the sooner you'll feel better and regain function of your neck and upper back.

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