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Neck Osteoarthritis (Cervical Spondylosis)

Definition of Neck Osteoarthritis

My mother has suffered neck osteoarthritis for years. Symptoms became problematic in her mid-50's and now at 81 years of age her pain is at times unbearable. Having already suffered knee replacement surgery, she refused surgery as an option for relief from her neck pain. She does have some strategies that she uses to relieve the pain. Physiotherapy, massage and regular walking along with a soft neck brace are her tools in battling her affliction. Pain medication she only uses as a last option.

Neck osteoarthritis is also known as cervical spondylosis. It describes age-related wear and tear of the spinal disks of the neck. Facet joints of the cervical spine can degenerate with age or injury resulting in arthritis of the neck. This chronic condition may also be seen referred to as degenerative joint disease or neck arthritis.It appears to affect men and women over 40 years and continues to worsen with age. Although both men and women appear to be equally affected, men seem, on average, to develop this condition earlier than women.

Causes of Neck Osteoarthritis

One or more nerve roots can be compressed by the degeneration of cervical spine discs. The compressed nerves can cause:

  • neck pain
  • arm pain
  • arm weakness
  • arm numbness
  • arm tingling

Aging is the major risk factor or cause of neck arthritis. However, neck injury can contribute to the arthritis many years later The wear and tear due to aging results in the following possible changes:

  1. Dehydrated disks resulting in shrinkage allowing bone-on-bone contact between vertebrate. Disk dehydration begins around age 40.
  2. Herniated disks are caused by age-related cracks in the disks resulting in bulges pressing on the spinal chord or nerves.
  3. Bone spurs result from the extra amount of bone produced by the disks in response to degeneration. These spurs can also pinch the spinal chord or nerves.
  4. Stiff ligaments make the neck less flexible. Ligaments are tissue cords that connect bone to bone and they stiffen and calcify with increasing age.

Symptoms of Neck Arthritis

Neck arthritis, especially in the early stages, tends to be symptom free. However, when symptoms do appear the neck is the primary center of pain. Neck osteoarthritis may also show show the following symptoms:

  1. Radiating pain to the shoulders or between the shoulder blades.
  2. Early morning stiffness and pain that gets better when moving around.
  3. Pain that worsens again at the end of the day.
  4. Upright activity that increases the neck pain.
  5. Neck pain that moves down to the arm and shoulder.
  6. Numbness and weakness that affects arms, hands, and fingers.
  7. Movement of the neck produces a grinding sound.
  8. Pain and discomfort that is relieved with rest.
  9. Pain that manifests itself as headaches, particularly in the back of the head,

Risk Factors for Neck Osteoarthritis

There are a number of risk factors for neck osteoarthritis. They include:

  1. Age
  2. Occupations such as those requiring repetitive neck movements, overhead work or awkward positioning which place more stress on the neck.
  3. Neck injuries
  4. Genetic factors

Diagnosing Cervical Spondylosis

A number of factors are examined and tests both physical and diagnositic are utilized to determine if arthritis is the source of the symptoms experienced.

1. Medical history: a patient's history is examined to determine if any of the risk factors associated with cervical spondylosis are present.

2. Physical examination: this is conducted by a physician to make observations regarding level of pain, the range of motion present in the neck, state of muscle reflexes and general nerve and muscle function in the patient's arms and legs.

3. Imaging studies and other diagnostic tests: finally, if the medical history and physical examination warrants further investigation, a number of more definitive tests are conducted.

  • X-rays which will show bone spurs but are also used to rule out tumors, infections and fractures.
  • CT-scan which is a special type of X-ray technology which provides a cross-sectional view of the cervical area providing finer details of the bones.
  • MRI which uses magnetic field and radio waves providing a more detailed images not only of bones but also of soft tissue which makes it a very advantageous tool for finding pinched nerves.
  • Myelogram which requires the injection of a dye into the spinal canal after which X-rays or CT scans generate much clearer pictures of the spinal canal.
  • EMG which measures the electrical activity of the patient's nerves assessing whether they are properly transmitting messages to the muscles at rest and when contracting.
  • Nerve conduction study which requires the attachment of electrodes to the patient's skin above the nerve suspected of causing cervical issues. The small shock passed through the nerve measures the strength and speed of its signals.
Diagram of preconditions for Anterior cervical discectomy and fusion.

Diagram of preconditions for Anterior cervical discectomy and fusion.

Possible Treatments Of Neck Osteoarthritis

A number of medicinal, physical and surgical treatments are available for neck arthritis depending on the level of pain, discomfort and type of degeneration present.

1. Medications both over the counter (for milder symptoms) and prescribed (for more chronic pain) are available.

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  • Non-steroidal anti-inflammatory drugs (NSAIDS),
  • Non-narcotic analgesics,
  • Corticosteroid injections,
  • Muscle relaxants, including cyclobenzaprine (Flexeril, Amrix) and methocarbamol (Robaxin) may be required for more severe pain management.
  • Narcotic analgesics, such as hydrocodone (Vicodin, Lortab) or oxycodone (Percoset, Roxicet) are also prescribed for more severe pain.
  • Anti-seizure drugs including some types of epilepsy drugs such as gabapentin (Neurontin, Gralise) and pregabalin (Lyrica) will relieve the pain caused by damaged nerves.

2. Therapy both with a therapist and at home can strengthen muscles relieving neck pain and providing increased mobility.

  • A therapist can teach a patient exercises designed to strengthen and stretch neck and shoulder muscles.
  • Traction is of benefit to some patients suffering from pinched nerves as this therapy can provide more room between disks relieving the pinched nerve.
  • Regular massage is helpful for pain management and regaining mobility.
  • Regular exercise at home can maintain muscle strength relieving pain.
  • Heating or icing the neck can relieve stiff muscles and reduce pain and inflammation.
  • A soft neck brace will allow neck muscles to rest and provide some relief but it should only be a short-term solution as it can weaken muscles over time.

3. Surgery is a last resort option when none of the above options provide adequate pain and mobility relief. It is used in order to provide more room for the spinal chord and nerve roots thus relieving pinching and compression of the nerves. Surgery always comes with inherent risks so it is used as a last resort option.

  • A herniated disk or bone spurs may be removed.
  • Part of a vetebra may be removed.

Age invariably brings with it degeneration of bodily systems including bone. Arthritis is a common ailment of the elderly and in rarer cases with the very young. Maintaining an active lifestyle, focusing on proper posture and eating a healthy well-balanced diet is key to reducing and slowing the ravages of the aging process. It is inevitable that our bodies will wear with age but how fast and to what degree can be controlled to some degree by maintaining a healthy lifestyle.

Resources Used

Eustice, Carol. Neck Osteoarthritis - What You Need to Know. October 12, 2007.

Mayo Clinic Staff. Cervical Spondylosis. June 12, 2012.

Ullrich, Peter F. Jr., MD. Spine Cervical Osteoarthritis (Neck Arthritis). March 30, 2011


Sally on January 06, 2017:

Thank you for this article on neck pain.

Floris Wood from Toledo, Ohio on June 15, 2014:

My wife, who has cerebral palsy(CP) had a laminectomy at Cleveland Clinic (CC) in 2003. We talked to several doctors in our hometown of Toledo, Ohio and they all said the same, that having CP made no difference to them. They would do the same operation that they did on everyone.

My wife worked as an advocate for people with disabilities and has seen many people with CP who had a laminectomy. A high percentage of these operations on people with CP fail because the doctor is too aggressive and removes too much bone tissue. Six months after the operation the patient cannot lift his head up and lives the rest of their life looking at the world with their head cocked to the side, chin resting on his chest.

At CC they studied my wife's neck carefully to see where they could remove tissue and do the least damage. The operation was successful in the sense that it slowed down the loss of function and paralysis she was increasingly experiencing . In some areas where she had lost function she got a little bit of function back.

The doctors at CC told her that if she lived long enough she would eventually need a fusion of the cervical spine, because there was not enough good bone there to work with for another laminectomy. Last year, ten years after the laminectomy, she returned to CC to evaluate her neck. She was suffering some loss of function. The good news was that some of her neck had self fused in a beneficial way. But other parts showed deterioration and some impingement on the spinal cord.

They gave her a choice to delay a fusion hoping more beneficial fusion would take place; or, have a fusion done with all the risks that go along with it. One of those risks for a person with CP is that her nervous system would react violently to the mechanisms of the fusion and cause such violent spasm that it would wreck the fusion, with disastrous results for her life. During recovery from the laminectomy her CP nearly wrecked that operation just in response to the hard collar she was supposed to wear for a few weeks.

They ended up leaving the collar off and controlling the pain and spasms with pain killers. That, of course, raises the risk of an addiction problems, which, fortunately did not happen.

She has chosen to wait. She is very fortunate to live close the two world class medical facilities, CC and the University of Michigan Medical Center in Ann Arbor.

The moral of the story is to read up on the latest medical studies and discuss these with you doctor. If he dismisses them with no more reason than, "they have been found not to work" or "They are highly experimental" he probably just wants your insurance companies money and to get back to the golf course.

He Should be able to discuss the advantages and disadvantages of each method with you and to answer your questions without taking offense that you are asking them.

My wife's neck is doing very well so far. We have to be very careful when driving because we know that her neck is fragile and a small whiplash could result in total paralysis or death. With luck she will not need a fusion before she dies on her appointed day.

Thank you, Teresa, for this well researched and well written article.

Teresa Coppens (author) from Ontario, Canada on June 15, 2014:

Thanks lyricwriter. I appreciate the kudos. Surgery is always a last option. Scary for sure.

Richard Ricky Hale from West Virginia on June 14, 2014:

Excellent article Teresa. Well researched and written. I have an aunt with the same condition and it caused her a lot of pain for years. Surgery always has risk. This high up, I would say it is a high risk.

Teresa Coppens (author) from Ontario, Canada on January 08, 2014:

golda11, I agree. Permanent treatments I believe are rare for most osteo related issues. But even some relief from the constant pain would be beneficial depending on the risks involved.

golda11 on January 07, 2014:

It is terrible to bear neck osteoarthritis even for short time. Patients can have surgery and medication as treatment but these are not permanent treatments.

Teresa Coppens (author) from Ontario, Canada on May 12, 2013:

My mom has had therapy for hers and has received some relief. Heat applied to the area has also helped but I would check with your doctor before proceeding with that. Anything that strengthens the muscles in your shoulders and neck area should provide relief. Your therapist will talk to you about your specific needs before proceeding I would assume. I am sure you would appreciate any relief from the pain. I know my mom suffers a lot from it. Good luck and I hope you find some combination of therapies that work.

Melody Collins from United States on May 09, 2013:

I am only 33 and I terrible neck pain. I have a hard bump on my spine at c2 c3. I am patiently waiting for my referral to the neurosurgeon. In the mean time my doctor wants me to do physical therapy. Does physical therapy help with osteoarthritis?

Teresa Coppens (author) from Ontario, Canada on November 24, 2012:

Floris, thank you so much for the wonderful compliment. I am so very happy your wife found a clinic that would work compassionately with her particular needs. I am so very happy to hear that she found a clinic that provided a less invasive but successful procedure that gave her relief and also gave back her working life! I wish her and you all the best!

Floris Wood from Toledo, Ohio on November 24, 2012:

Great article. My wife has severe cerebral palsy. She, generally, avoids surgery because she has seen how her friends with CP have been butchered by surgeons who seem to think the more aggressive they are in their lamenectomy the better the results will be. One year after surgery the patient's chin is permanently rest on their chest because the muscles never healed from the operation. When her employer would no longer let my wife work because of the pain and paralysis she had in her arms, we went to the Cleveland Clinic and met a doctor who described the operation her would do. It was the least invasive he could that could be done and still have some benefit. Nine years after the operation she is still a very active and productive human being (she heads an organization that gives out two million dollars worth of grants for projects that benefit people with disabilities every five years.) She has little pain but she has lost quite a bit of arm function. You are a wonderful writer. Thanks.

Teresa Coppens (author) from Ontario, Canada on September 02, 2012:

I should get you and my mom talking. I'm sure you'd have a lot of notes to compare. Good luck with your pain management stayingalivemoma and thanks for your interest.

Valerie Washington from Tempe, Arizona on September 01, 2012:

Really good informational hub. I have cervical spondylosis, so I know all too well the pain your mother goes through. At times, it can be unbearable. I usually take pain pills, but most of the time I just complain, complain, complain about it! :)

Pinned to Pinterest!

Teresa Coppens (author) from Ontario, Canada on August 31, 2012:

Thanks Jerry. Is Omniflex available at naturopath stores? I'd like to get my mum to give it a try. Thanks for the advice, much appreciated!

Gerald A Bruno from Wyckoff, New Jersey on August 31, 2012:

I had severe knee OA about 6 yrs ago, and have had moderate neck OA for several decades. I've been traeting my knee OA with a multiple ingredient natural product called Omniflex that has essentially eliminated my knee pain and has had the added benefit of helping my neck OA. My neck range of motion still isn't normal, but I have very little neck pain and no longer hear the grinding when I turn my head.

Might be worth a try.

Teresa Coppens (author) from Ontario, Canada on August 26, 2012:

Rebecca, I hope you never have to learn to deal with this affliction. It pains me to see my mother suffering so with little to help her. Thanks for the compliment - glad you enjoyed the hub.

Teresa Coppens (author) from Ontario, Canada on August 26, 2012:

Thanks Daisy, glad you learned something new. I hope your cervical sprain does generate problems for you in the future. My mum suffers immensely from this condition and it is definitely no fun at all.

Teresa Coppens (author) from Ontario, Canada on August 26, 2012:

Thank you dinkan53 for the compliment. Glad you found the article useful. And yes, reducing stress and sleeping well would be two useful symptom relievers to add to my hub.

Rebecca Mealey from Northeastern Georgia, USA on August 26, 2012:

I have never heard of this infliction, but I will surely nowhere to live if I ever need to. Your Hub is very attractively done and packed full of information with great illustrations.

Daisy Mariposa from Orange County (Southern California) on August 26, 2012:


I especially enjoy reading Hubs in which I learn something new. Thanks for publishing this very informative article.

Speaking as someone who had a cervical sprain a number of years ago, neck pain is no fun at all.

dinkan53 from India on August 26, 2012:

Eating well, sleeping well, reducing stress, and proper medications needed are very important in managing neck osteoarthritis. Thanks for sharing this informative article. Rated as useful one.

Teresa Coppens (author) from Ontario, Canada on August 26, 2012:

Thanks for your quick response. Glad you found it useful.

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