Cervical arthritis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Cervical arthritis, also known as cervical spondylosis, is osteoarthritis involving the cervical spine.

Osteoarthritis is a form of arthritis where the cartilage in joints begins to wear away. In cervical arthritis, the facet joints in the rear of the neck vertebrae begin to degenerate. In addition, the intervertebral discs that function as cushions between the vertebrae lose their water content and flatten out. These changes gradually narrow the neural foramina- the openings that nerve roots use to exit the spinal cord. This narrowing causes irritation of the nerve roots, producing neck pain that may radiate into the shoulders and arms.

Cervical arthritis begins between the ages of 30 and 50 but may also begin earlier, as a result of trauma.

Other forms of arthritis that cause cervical arthritis are rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Reiter’s disease, gout, pseudogout, and diffuse idiopathic skeletal hyperostosis (DISH). With these types of arthritis, inflammation plays a larger role in the damage that occurs in the cervical spine.

Symptoms may include:

• Chronic neck pain, particularly with motion
• Muscle weakness, with numbness in the neck and arms, perhaps also the hands and fingers
• Stiffness which limits movement of the neck
• Headaches
• Balance problems

Bony spurs, called osteophytes, often develop on the vertebrae as a result of arthritic change, reducing room for the spinal cord and limiting movement of the neck.

Occasionally one of the soft disks cushioning the vertebrae may rupture, resulting in a herniated disk.

About 5-10% of patients who have symptomatic cervical arthritis develop myelopathy, or compression of the spinal cord. This may produce symptoms of leg weakness, as well as bladder and bowel incontinence.

X-rays will show abnormalities in the vertebrae. A myelogram with CT (computer tomography) scan provides the best detail of the bone structure of the spine. MRI (magnetic resonance imaging) scans also are useful particularly for viewing soft tissue structures within the spine.

In most cases patients respond to conservative treatment. Rest is essential. It may be necessary to evaluate posture, types of pillows used, occupational stressers, and any other activity that could be an aggravating factor.

Non-steroidal anti-inflammatory medications (NSAIDs) may be recommended as an early treatment modality.

Patients who have a severe episode of cervical arthritis may benefit from a single steroid epidural injection. If the facet joints are inflamed, facet injections may also be employed.

Other non-operative measures may include ice, moist heat, massage, ultrasound, electrical stimulation, exercises, traction, and postural training.

Surgery is generally recommended only in more severe cases of cervical arthritis, when the condition appears unresponsive to other forms of treatment.

Get more information about cervical arthritis and related conditions as well as...

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