Cervical Arthritis Symptoms
Cervical arthritis, also known as cervical spondylosis, is an osteoarthritic condition
affecting the upper spine. Osteoarthritis is a form of arthritis where the cartilage in
joints begins to wear away because of an accident or because of the natural aging process.
In cervical spine arthritis, the vertebrae in the neck, known anatomically as the cervical
vertebrae, begin to degenerate, accompanied by degeneration in the flexible disks of
shock-absorbing cartilage that fit between them. These changes gradually narrow the space
in the vertebra called the foramen. This narrowing causes compression on the nerves
leading from the spinal cord in the neck. The nerves become inflamed, producing neck pain
that may radiate to the arms.
Cervical arthritis tends to begin between the ages of 30 and 50 as part of the normal
aging process; like all arthritic conditions, it may grow worse over time. Nearly everyone
over the age of 50 experiences some wear and tear in the cervical spine, but not everyone
develops symptoms of cervical spine arthritis. Once the cervical vertebrae and their disks
begin to degenerate, a minor injury to the spine (such as that caused by a fall or sudden
twist) may provoke symptoms. Cervical arthritis may also begin earlier in life, perhaps as
the result of a back injury, such as those experienced while playing football or falling
from a horse.
While cervical arthritis tends to affect men more often than women, its symptoms may be
similar to those produced by two conditions seen more frequently in women: rheumatoid
arthritis (a systemic disorder affecting the synovial fluid in the joints), and
osteoporosis (a condition in which many of the bones in the skeleton are weakened and
become brittle).
Cervical Arthritis Symptoms
Symptoms may include:
- Chronic neck pain, particularly with motion
- 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
- Headaches
- Loss of balance
Degeneration of the cervical vertebrae can produce several different
conditions affecting the spinal cord and nerve roots. 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. The facets of the vertebrae (those portions
that interlock with each other, forming joints in the structure of the spine) may also
show wear and tear.
Occasionally one of the soft disks cushioning the vertebrae may rupture, resulting in a
herniated disk. When this happens, there is usually pressure against the spinal cord or
nerve roots also. A herniated disk is a distinct problem, however, usually occurring as a
single instance, whereas cervical spine arthritis is a progressive, chronic process that
waxes and wanes over time. Cervical disc hernias usually result in prominent arm and hand
pain rather than neck pain.
About 5-10% of patients who have symptomatic cervical arthritis develop myelopathy, or
compression of the long tracts of the spinal cord. This may produce symptoms of weakness,
a loss of sensation or of one’s sense of position in space, and incontinence. As
strange as it may seem, neck and radiating nerve pain is unusual in these cases.
Diagnosis of Cervical Arthritis Symptoms
If you experience chronic neck pain, your doctor may use a number of different tests to
determine whether your condition is cervical arthritis. X-rays show any abnormalities in
the bones of the spine, and help determine the amount of degeneration in the vertebrae and
their facets. A myelogram with CT (computer tomography) scan provides the best detail of
the bone structure of the spine. MRI (magnetic resonance imaging) scans are sometimes done
to get a clearer picture of other structures in the spine besides bone.
If x-rays or other imaging tests show that your particular case is severe (as in the
case of numbness resulting from a disk pressing onto the nerves), your doctor may refer
you to an orthopaedic surgeon for further evaluation.
Cervical Arthritis Symptoms, Treatments and Options
In most cases patients respond to conservative cervical arthritis treatments that are
carefully thought out for each individual. Rest of the neck area is essential. To
accomplish this, it may be necessary to consider your general posture, the kinds of
pillows you use in bed, and the features of your occupation that affect the condition of
your neck.
Non-steroidal anti-inflammatory medications (NSAIDs) such as aspirin, acetaminophen or
ibuprofen may be recommended as a cervical arthritis treatment to decrease swelling and
relieve pain. Sometimes time-released medication is most effective. While other
painkillers may be prescribed, narcotic pain medication is generally avoided. 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
cervical arthritis 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 to relieve acute pain.
Massaging the muscles is also helpful. Avoiding stressful conditions may also help. Your
physician may recommend ultrasound or whirlpool treatments. 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.
Positioning of the neck may improve or worsen neck pain. When arthritis is the primary
cause of the pain, the neck might be made to feel better in a flexed position. If, on the
other hand, this is the result of a motor vehicle injury or a blow, then putting the neck
in extension may relieve the pain. Traction is also helpful. A simple method of performing
traction is to use the weight of your head as a traction device. If your pain is eased in
extension, lying on a bed with your head off the end of the bed will provide eight pounds
of traction. Pillows can be placed underneath the knees to avoid stretching and
hyperextension of the low back. If arthritis is the problem and the pain is relieved more
with flexion, lying on your stomach with a pillow under the pelvis and the ankles with the
head dangling off of the bed may be helpful. This provides eight pounds of traction in
flexion. Remember however, as this may relieve pain, be careful that you do not fall
asleep in this position.
Surgery
Surgery is generally recommended only in more severe cases of cervical arthritis, when
the condition appears unresponsive to other forms of treatment. Patients should discuss
the possibility of surgery with an experienced orthopaedic surgeon, weighing the
likelihood of success in their particular case. Surgical procedures are tailored to the
severity of the condition. Sometimes the surgeon can remove a portion of bone, relieving
pressure on the spinal cord. Surgery may also be used to fuse some of the cervical
vertebrae, remove a damaged disk, or enlarge the spinal cord space by clearing it of bony
spurs. Sometimes bone graft procedures are used. |
