Arthritis of the Neck
Arthritis is the swelling and tenderness of one or more of your joints. We spoke to Dr. Michael Gordon, orthopedic spine and neck surgeon with HOI, to get his expertise on arthritis of the neck.
What causes arthritis of the neck?
Arthritis of the neck, or Cervical Spondylosis as it is known orthopedically, is a condition of wear and tear in the neck that occurs in almost all humans. Beginning in the cervical spine by the early 30s, it presents as a gradual loss of disk space height, formation of spurs on the edges of the vertebrae, and degenerative spurring of the facet joints in the neck. It is mostly an age-related condition and is largely genetically based. Some people develop x-ray changes in their late 20s while others have fairly pristine x-rays well into their late 60s. Cigarette smoking has been shown to accelerate these changes, as has obesity and trauma. Early arthritis in the neck can cluster in families.
What are the symptoms?
The presenting symptoms of arthritis in the neck may be no symptoms at all. Many patients with even severe arthritic change at one or two levels in the spine are asymptomatic. They might notice only a slight loss of neck range of motion. In other patients, particularly if the arthritic changes affect the more mobile segments of the neck, will note marked limitation in range of motion, and be unable to look over their shoulders or lose the ability to look up at the ceiling or down at their toes. Navel gazers beware!
Pain, when it does occur from arthritis, presents as midline aching, activity-related and is usually worse early in the morning or after strenuous activity. Bending, stooping and lifting, especially if overhead, causes increased pain and occasionally numbness.
Large spurs in the cervical spine can cause spinal cord or nerve compression and are known as spinal or foraminal stenosis. This is the most common cause of neurologic symptoms in adults, and presents as arm tingling, numbness or weakness.
How is it diagnosed?
X-rays, Cat scans and MRI scans are the diagnostic imaging procedures of choice. Occasionally a nerve test, called an Electro-myogram is used to differentiate between nerve compression caused by arthritic change in the neck vs. nerve abnormalities in the extremity such as carpal tunnel syndrome.
How is it treated?
It must be emphasized that fewer than 1 in 100 patients with cervical arthritis require surgery. Most people respond to simple treatments: heat and ice, changing pillows, adjusting reading or desk positions, decreasing screen time at work, taking over the counter medicine such as Tylenol or Advil, stretching and physical therapy, and decreasing exposure to high vibration environments. Occasionally, more invasive treatments such as cortisone injections or radiofrequency ablations of painful nerve roots may be beneficial. Surgery is relegated to those with severe pain, deformity or progression of numbness tingling or weakness. Severe spinal cord compression may occur in a small percentage of patients. When necessary, surgery of the cervical spine is extremely safe and reliably improves function.
