Just as in the lumbar spine, the facet joints in the cervical spine can degenerate and lead to arthritis in the neck. Many terms are used interchangeably to refer to cervical osteoarthritis, including cervical spondylosis, degenerative joint disease, or simply neck arthritis. On this site, it is called cervical osteoarthritis.
Cervical Osteoarthritis Symptoms
Neck osteoarthritis symptoms tend to be characterized as follows:
- Pain that radiates to the shoulder or between the shoulder blades
- Pain and stiffness that is worse first thing in the morning, and then improves after getting up and moving around
- Pain that gets worse again at the end of the day
- Feels better with rest
- May include headaches, especially headaches in the back of the head
Cervical bone spurs (osteophytes) are a common marker of cervical osteoarthritis, and cervical osteophytes may impinge on a nerve, producing the symptoms that radiate into the arms.
If the osteoarthritis impinges on the spinal cord it could lead to spinal cord dysfunction, and condition that is called cervical myelopathy.
In some instances, cervical spondylolisthesis (when one cervical vertebra slips forward over another) may be a secondary issue to the arthritis in the facet joints of the cervical spine, although spondylolisthesis is much more common in the lumbar spine (lower back).
Cervical Osteoarthritis Treatment
Treatments for cervical osteoarthritis are usually nonsurgical and may include one or a combination of the following:
- Rest when the pain is severe
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g. Advil), naproxen (e.g. Aleve), or COX-2 inhibitors (e.g. Celebrex) to relieve the pain from the inflammation that usually accompanies the arthritis
- Traction and/or chiropractic adjustments to help control chronic symptoms or provide relief for more severe episodes of pain from osteoarthritis
- Physical therapy and neck exercises to strengthen the neck, help maintain range of motion and prevent neck stiffness
- Cortisone injections, which are given with the goal of reducing inflammation, which contributes to the pain, by injecting steroids directly into the affected area
- Muscle relaxants to help reduce painful muscle spasms in the neck and surrounding muscles
- Heat or ice, which may be used to help alleviate localized pain. Some people prefer a cold pack or heat, especially after an activity that results in pain, to minimize swelling or inflammation. Other patients prefer heat, such as a heating pad or heat wrap (such as brand name ThermaCare), or moist heat, such as a moist heat wrap for the neck or a warm bath or shower.
- Activity modification, to reduce positions and activities the cause discomfort, including changing sleep habits to minimize pain and discomfort upon waking in the morning.
While cervical osteoarthritis tends to be chronic, the symptoms are rarely progressive and rarely require surgery. For patients with severe symptoms that are impeding their ability to function, surgery may be an option and a cervical laminectomy and/or cervical spinal fusion may be considered.