Neck Arthritis: Let’s Get That Stiff Neck Moving Again

Have you been noticing worsening pain and stiffness in the neck?…

Is your neck sounding more like rice krispies and popping when you turn the head?…

You very well may be developing arthritis of the neck, formally known as cervical spondylosis.

While neck pain related to arthritis may not sound so great, the good news is, there are many ways to manage it!

A Closer Look at the Cervical Spine

The neck is at the top of the spine and is made of 7 vertebrae bones.

The facet joints are the areas where the vertebrae come together to allow movement between two vertebrae. The facet joints are located on the back side of the vertebrae and are what allows movement to occur at the neck, which includes the following:

• Forward bending
• Back bending
• Side bending
• Rotation

The joint surfaces are covered with cartilage. Cartilage allows for smooth joint mobility and reduces friction in the joints. This allows for easy neck motion without pain.

Synovial fluid can be found within the joint space as well. This is a natural lubricant and nutrient source for the joints to keep them healthy and mobile.

The stacked vertebrae throughout the whole spine create a space called the spinal canal. The spinal canal is where the spinal cord can be found.

The spinal cord carries important nerve signals throughout the body. These nerve signals control your bodies movements, sensations, reflexes and different body functions, including breathing.

From the spinal cord comes nerves and nerve roots. At the neck specifically, there are 8 nerves that come from the spinal cord.

Spinal discs are situated between the vertebral joints. They provide shock absorption and support for the vertebrae and spinal cord.

Causes of Neck Arthritis

Now that we know a little more about the anatomy of the neck, what exactly can cause neck arthritis?

Arthritis itself creates inflammation or swelling within the joints, which also includes the joints in the neck. The exact cause of this inflammation can vary, but the most common cause of arthritis is normal wear and tear of the joints.

Other causes and risk factors include:

• Age
• Genetics
• Weight
• Medical history

Types of Arthritis

While arthritis is a general term to describe inflammation or swelling within the joints, there are many different types of arthritis that can be further described.

Let’s take a look at the most common forms of arthritis found in the body, including the neck.

Osteoarthritis

This is the most common type of arthritis in the body. Cervical osteoarthritis occurs from natural wear and tear in the joints.

With osteoarthritis, the cartilage between the joints begins to wear down, which can lead to less cushion between the bony layers. These creates increased stress to the joints.

Thinning and wearing down of the discs between the joints can also lead to cartilage destruction and bone on bone stress.

It’s not uncommon with losing the support between the bony joints to develop bone spurs. Bone spurs are bony growths created by the body to try to provide additional support to the joints if the discs and cartilage have become too worn down.

Unfortunately, these bone spurs can lead to narrowing of the space that the nerve roots and nerves pass through, creating a condition called spinal stenosis.

Degenerative osteoarthritis of the neck is also known as cervical spondylosis.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease and an inflammatory arthritis. This occurs when the body attacks itself, causing harm and damage to the synovial lining of the joints.

This type of damage can lead to pain, inflammation, and deformities within the joints.

While rheumatoid arthritis of the neck can occur, it’s more commonly found in hands, wrists and knees.

Spondyloarthritis

Spondyloarthritis is a group of inflammatory diseases, different from rheumatoid arthritis, that negatively affect the joints, ligaments and where the tendons attach to bone.

The following are common types of spondyloarthritis:

• Ankylosing spondylitis
• Psoriatic arthritis
• Reactive arthritis

Neck Arthritis Symptoms

As you can see, there are many different types of arthritis that can affect the body, including the neck. Seeing as osteoarthritis is the most common and is a large contributor to neck pain, this will be our primary focus for the rest of this article.

While cervical spine arthritis symptoms and limitations may vary, the following are the most common symptoms many tend to experience:

• Neck pain
• Neck stiffness
• Decreased range of motion moving the head (e.g., neck pain when turning the head)
• Muscle pain
• Grinding or popping in the cervical spine
• Possible headaches
• Cervical radiculopathy if there is nerve compression
• Neck muscle spasms

Diagnosing Neck Pain

If you’re experiencing ongoing neck pain, it’s recommended to see professional medical advice.

The type of medical doctor you may consider consulting with for neck pain would be your primary care physician, for example.

You may also consider consulting with a neurologist if you’re experiencing other symptoms that may involve a spinal nerve root, such as radiating pain, weakness or numbness and tingling.

Your doctor will perform an in-depth examination that will include going through your medical history and current neck pain symptoms, as well as a physical examination.

Physical Examination

The physical exam will normally include the following:

• Strength testing
• Sensation testing
• Range of motion testing
• Palpation, or manual pressure, around areas of tenderness
• Reflex testing
• Gait and balance assessment

Imaging for Neck Pain

It’s not uncommon for imaging studies to be ordered to further assess the cervical spine when you’re having neck pain. These will help determine the presence of cervical spondylosis or other potential causes of your neck pain.

An X-ray will provide a good look at the bones in the cervical spine. They will show if any bone spurs are present, abnormal alignment of the spinal column in the cervical region, and if any spaces in the cervical spine have narrowed, as is common with osteoarthritis.

A CT scan is more advanced than an X-ray. This type of imaging can provide a more in-depth look into the cervical spine, which may be more informative than a standard X-ray.

Magnetic resonance imaging, or an MRI, is one of the most advanced forms of imaging. An MRI will provide a more detailed look at the soft tissues surrounding the spine, including the nerves, muscles, discs, and the spinal cord.

The MRI will show if your symptoms may be related to a herniated disk, or in cases of more severe pain and symptoms, spinal cord compression, which can be considered an emergency situation depending on the associated symptoms.

Your doctor may also order blood tests to rule out inflammatory arthritic conditions and ensure there is no blood flow obstruction contributing to your symptoms. If you do have blood flow obstruction related to arthritis, sometimes this can cause dizziness.

Neck Arthritis Treatment

While neck arthritis itself cannot be cured, ongoing or chronic neck pain related to arthritis can absolutely be treated and well-controlled.

Medications

Your doctor may prescribe specific medications to relieve pain and swelling related to your neck pain.

Nonsteroidal anti inflammatory drugs, corticosteroids, and muscle relaxants are common prescriptions to help relieve pain. An over-the-counter pain medication may also be recommended.

Steroid Injections

If medications are not successful in providing pain relief, and you are continuing to have severe pain, an injection may be recommended.

While injections are not recommended to use frequently, they may help breakthrough the intense pain and limitations you’re experiencing.

The most common types of injections include a facet joint injection or an epidural steroid injection. The goal of these, similar to the above medications, are to reduce pain and reduce inflammation.

These pain management strategies may be necessary in order for you to be able to tolerate other treatments, such as physical therapy.

Physical therapy for neck arthritis

Physical therapy is commonly prescribed for those with neck pain related to arthritis of the neck.

Your physical therapist will perform their own examination, including review of your medical history, current symptoms, pain pattern, and physical examination.

Physical therapy treatment is aimed to address current physical limitations and improve overall spine health.

Common treatment strategies will include the following:

• Exercise
• Manual therapy (e.g., massage, joint mobilizations, manual cervical traction)
• Modalities:
  
  • Mechanical traction: If there are no contraindications, this can be helpful to relieve pressure from a painful joint and pinched nerve.
  • Electrical stimulation: If there are no contraindications, this can assist with decreasing pain signals, in order to improve functional movement and tolerance for therapy.
  • Heat or cold therapy for pain management.

Your physical therapist will also assess if there are any postural deviations and poor posture habits that may be increasing your pain. Among these corrections, they may look at your ergonomic set up at work and home, and your body mechanics or positioning with certain tasks or activities.

For example, sleeping position can have a huge impact on neck pain, especially if you’re not using the right kind of pillow.

While there is not one exact pillow appropriate for everyone with neck arthritis, it’s important to make sure the pillow you’re using provides the right kind of support and neutral alignment for the neck.

Recommended Exercises for Neck Arthritis

Your physical therapist will take you through exercises that focus on restoring normal motion not only in the cervical spine, but also surrounding regions that may be affected by your neck pain, including the arms and thoracic spine.

They will also include exercises to focus on postural, spinal and upper body strength. This is to ensure the arthritic joints are receiving the best support and stability possible.

Let’s take a look at a few common exercises recommended for neck pain due to arthritis.

1. Upper Trapezius Stretch

This stretch targets one of the primary muscles that typically experiences increased tension and stiffness from neck arthritis.

• You can perform this stretch in sitting or standing.
• If you’re intending to stretch the left side of the neck, bend your head to the right.
• Take the right hand and place it on the left side of the head.
• Gently pull the head to the right. You should feel a stretch directly on the left side of the neck.
• Hold anywhere from 30 seconds to 1 minute (don’t force the motion), and repeat on the other side.

2. Levator Scapulae Stretch

This is another neck stretch that targets a particular muscle normally involved in tension and stiffness related to neck arthritis. This stretch is similar to the upper trapezius stretch, but with a slightly different angle.

• You can perform this stretch in sitting or standing.
• If you’re intending to stretch the left side of the neck, bend your head to the right. Now, keep this position but also turn the head and look down to the right side.
• Take the right hand and place it on the left side of the head.
• Gently pull the head to the right, but on a downward angle. You should feel a stretch more towards the back of the neck on the left side.
• Hold anywhere from 30 seconds to 1 minute (don’t force the motion), and repeat on the other side.

3. Chin Tuck

This exercise is meant to assist in correcting a forward head posture.

• You can perform a chin tuck laying on your back, or in a sitting or standing position.
• Gently tuck the chin directly back, as if trying to make a double chin. Avoid nodding the head.
• Hold this position for 5 seconds, then slowly relax your muscles.
• Repeat 10-15 repetitions for 2-3 sets.

4. Open Book Stretch

This is a great stretch that targets the full spine.

• Begin laying on one side (can lay on your bed, couch or the floor). Make sure to have pillow support for a neutral neck position. The legs can be relaxed in whatever position is most comfortable.
• Reach the top arm forward, then slowly begin moving it towards the ceiling. Have the head follow this motion.
• Once the arm is pointing towards the ceiling, the rest of the spine should rotate and follow the arm as it continues to move and stretch behind you.
• Only rotate as far as the spine is comfortable with.
• Hold for 5 seconds, then return to your starting position.
• Repeat for 10 repetitions, then perform on the opposite side.

Surgery

Surgery is typically not needed for standard neck arthritis. However, more severe cases may call for surgical intervention.

If there is spinal nerve compression and is not successfully treated with conservative measures, surgery may be needed to decompress the nerve root. Symptoms related to nerve root compression may include, radiating symptoms down one or both arms, arm weakness, decreased grip strength, numbness and tingling.

If symptoms are not responding to conservative measures and stability in the cervical spine is a concern, a cervical fusion may be considered.

If there is proof of spinal cord compression, or cervical myelopathy, and you are showing red flag symptoms, emergency surgery may be necessary.

Some of these red flag symptoms may include sudden and significant muscle weakness, dropping objects, poor coordination, poor balance or falling, abnormal gait, increased reflexes in the arms, and dizziness.

Quick Steps to Fix a Forward Rounded Posture

If you have a forward rounded posture or rounded shoulders, or even if you’re just emailing on a computer all day long, it’s very easy to develop what is called “forward head posture”, which is when your chin just forward and your neck sticks out. Over time, this can become a real problem.

In this video I walk you through two simple exercises to help you with your forward rounded shoulder posture.

Key Points to Remember

While neck arthritis is a common part of aging, it’s important to remember how manageable it is!

You don’t have to automatically suffer with pain and stiffness forever just because arthritis has developed.

If you’re beginning to show early signs and symptoms of cervical arthritis, make sure to be proactive and consult with your medical professionals to get ahead of it.

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