Arthritis can be thought of as a disease causing painful inflammation and stiffness of the joints. The most common arthritis is osteoarthritis, which is typically described as a natural degenerative process.
Other types of arthritis, for example Rheumatoid arthritis, are rarer and are caused by pathological processes such as autoimmune disease or secondary to infection.
The focus of this blog is cervical (neck) osteoarthritis, which is the most common form of arthritis we see. Cervical osteoarthritis may also be referred to as cervical spondylosis or degenerative changes.
How does cervical osteoarthritis develop?
Pairs of small joints, called facets, run down the back of your cervical spine. Each of your facet joints is lined with cartilage. This cartilage is surrounded by a joint capsule filled with lubricating synovial fluid, enabling smooth movements between adjacent vertebrae.
Cervical facet osteoarthritis develops when your cartilage begins to degenerate, or break down, due to injury, repetitive strain or inactivity. Most of the time the joints become inflamed and flare up, the body then does it’s best to settle the inflammation and repair itself. The repair process leads to some of the symptoms associated with arthritis including tightness of the joint and a reduction in how far it can move.
In extreme cases we can see this process lead to bone spurs (osteophytes) and eventually bone-on-bone friction between the joints.
Symptoms of cervical osteoarthritis
Neck pain from cervical osteoarthritis typically starts gradually and progresses over time. The neck may feel particularly stiff and achy within the first 30 minutes of the morning then feel better as the day goes on.
- Neck and shoulder/shoulder blade pain – that comes and goes
- Problems getting comfortable in bed at night with discomfort or pain usually described as a dull ache
- Morning stiffness which takes around 10-30 minutes to ‘get going’
- Some people have headaches – often starting at the back of the neck
- Difficulty doing tasks for long periods such as gardening or hobbies
In severe cases, bone spurs may impinge or irritate a nerve root, causing pain or numbness down the arm and potentially weakness in the arm and/or hand. This is referred to as a cervical radiculopathy.
To confirm osteoarthritis is the cause of your stiffness and pain, imaging may be advised by your chiropractor.
Treatment options for cervical osteoarthritis
Cervical osteoarthritis can usually be successfully managed without surgery. Common treatments include:
- Load management or activity modification. Going easy on the neck during a painful flare-up may ease pain, though it is usually preferable to remain active at a reduced load or with modifications.
- Rehabilitation. A chiropractor, or other medical professional can customize a neck exercise program for you. A stronger and more mobile neck has improved function, which may reduce pain.
- Manual therapy. Your chiropractor, or other medical professional can help relieve symptoms and increase mobility with the use of manual therapies. These could include Spinal manipulation, Trigger point therapy or Dry needling
- Heat and/or cold therapy. Applying ice can help reduce inflammation and pain. Other people may prefer to apply heat therapy, which can increase blood flow and relax the muscles. When applying heat or cold therapy, applications should last about 15 minutes at a time.
Other treatment options are available, including therapeutic injections. In rare cases for patients with severe cervical osteoarthritis that doesn’t respond to nonsurgical treatments, cervical spinal fusion surgery may be a treatment option.