Cervical Arthritis

Written by DynoMed.com, Indianapolis, IN

Cervical arthritis is a type of arthritis that affects the upper spine causing pain in the neck. Over time the pain may spread to the arms. Age, injury and poor posture play a role in who develops this disease.

The cervical spine consists of seven distinct vertebral bodies that are separated by intervertebral discs. These discs support the neck while giving it flexibility. Cervical arthritis is caused when the cervical vertebrae in the neck deteriorate accompanied by the deterioration of the cartilage that provides shock absorption. These changes gradually constrict the space in the vertebra, which causes extreme neck pain.

Nearly everyone over the age of 50 will experience some wear and tear in the spine, but not everyone develops cervical arthritis. People usually develop symptoms of cervical arthritis when they are between 40 and 50 years of age. Men are more likely than women to develop this type of arthritis. However, postmenopausal women have a higher incidence of this disease.

Causes of Cervical Arthritis

Injury or repeated trauma to the neck or back from recreational or work activities is the most common cause of cervical arthritis. For example, an old football injury experienced years before may be one reason why cervical arthritis has appeared now. Often, signs of the disease begin when a person is in their 20s, but symptoms do not show up for many years. Later, once the cervical vertebrae and their discs begin to degenerate, a minor injury to the spine may provoke the symptoms.

Experts have shown that other types of arthritis such as rheumatoid arthritis and ankylosing spondylitis predispose some people to cervical arthritis. The symptoms between the diseases are also very similar. Often, it is difficult at first to diagnose because of the similarities between diseases.

Symptoms of Cervical Arthritis

Chronic neck pain is the most common symptom. This neck pain is caused by nerve or spinal cord compression. Bony ridges, called osteophytes, often develop on the vertebrae as a result of arthritic change, reducing space for the spinal cord and limiting movement of the neck.
Other symptoms of cervical arthritis may include:

• Muscle weakness, with numbness in the neck and arms, perhaps also the hands and fingers
• Tenderness to the touch at the neck itself
• Stiffness which limits movement of the neck particularly noticeable in backing up a car
• Headaches
• Loss of Balance

About 5 to 10 percent of patients who have cervical arthritis develop myelopathy, or compression of the long tracts of the spinal cord. This is called spinal stenosis. It may produce symptoms of weakness, incontinence and may result in the loss of sensation. Long standing stenosis leads to permanent symptoms.

Treatment of Cervical Arthritis
In order to diagnose your chronic neck pain, your doctor may use a number of different tests to determine if your condition is cervical arthritis. He or she may order an X-ray to see if your vertebrae have deteriorated.  A myelogram with CT (computer tomography) scan will provide a picture of your spine’s bone structure. A MRI (magnetic resonance imaging) scan is used to get a clearer picture of soft tissues in the spine. After examining the results, an orthopedic surgeon may be called in if your particular case is severe.

Most cases of cervical arthritis respond to a mixture of rest, drug therapy and exercise. Learning how to rest your neck area is essential to a successful treatment plan. You may need to consider the kinds of pillows you sleep with and your general posture. A physical therapist may be able to guide you in performing gentle neck exercises, and will have advice about improving your posture in order to minimize the effects of cervical arthritis.

Non-steroidal anti-inflammatory medications (NSAIDs) such as aspirin, acetaminophen or ibuprofen may be recommended to decrease swelling and relieve pain. Patients who have a severe episode of cervical arthritis may benefit from a single treatment of a steroid epidural, injected directly into the affected part of the neck. This form of treatment can often relieve the situation to such a degree that other treatment measures can then be put into place.

Other non-operative measures may include:

• Cold compresses
• Massaging the muscles
• Avoiding stressful conditions
• Ultrasound or whirlpool treatments

Surgery may be necessary in severe cases of cervical arthritis that do not respond to conservative treatment.  For example, if the compression of the nerve or spinal cord cannot be relieved and the pain is unremitting, surgery may be necessary to relieve the pain. An orthopedic surgeon should be consulted to discuss the various types of procedures and the likelihood of success in your particular case.