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:
- Dehydrated disks resulting in shrinkage allowing bone-on-bone contact between vertebrate. Disk dehydration begins around age 40.
- Herniated disks are caused by age-related cracks in the disks resulting in bulges pressing on the spinal chord or nerves.
- 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.
- 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:
- Radiating pain to the shoulders or between the shoulder blades.
- Early morning stiffness and pain that gets better when moving around.
- Pain that worsens again at the end of the day.
- Upright activity that increases the neck pain.
- Neck pain that moves down to the arm and shoulder.
- Numbness and weakness that affects arms, hands, and fingers.
- Movement of the neck produces a grinding sound.
- Pain and discomfort that is relieved with rest.
- 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:
- Occupations such as those requiring repetitive neck movements, overhead work or awkward positioning which place more stress on the neck.
- Neck injuries
- 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.
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.
- 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.
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