Cervical arthritis is a condition that affects the part of the spine in the neck, or cervical spine. It is also known as cervical osteoarthritis or cervical spondylosis.
This condition can have many causes but is most often caused by age-related wear-and-tear that occurs in the spinal discs, bones (vertebrae), and joints of the neck.
Cervical arthritis is very common
and worsens with age. Degenerative changes in the cervical spine can occur in people as young as 30 years old, but many people don’t experience any symptoms from these changes.
In some cases, people may have pain or stiffness in the neck, or tingling, numbness, or weakness in the arms or legs. When symptoms do occur, non-surgical treatments are often effective. However, surgery may be needed for more severe cases.
The age-related changes to the spine that cause cervical arthritis include:
- Disc degeneration. Spinal discs provide cushioning for the vertebrae. As you age, the discs dry out and shrink, which can allow the vertebrae to rub against each other or lead to a herniated disc.
- Bone spurs. As the spinal discs wear down, the vertebrae may develop outgrowths on the edges of bone. These bone spurs can compress the spinal cord or the roots of the spinal nerves.
- Stiff ligaments. The strong cords of tissue that connect the vertebrae can stiffen with age, which can lead to a loss of flexibility in the neck.
Other causes of cervical arthritis include:
- Rheumatoid arthritis
- Psoriatic arthritis
- Trauma or injury to the neck
Dr. Christian DiPaola
, an orthopedic surgeon at UMass Memorial Medical Center, says cervical spondylosis happens in “just about all of us as we age,” but not everyone experiences symptoms.
When symptoms do occur, they often include pain or stiffness in the neck. “The pain could range from the base of your head all the way down to the base of your neck,” says DiPaola.
People with cervical arthritis may also have audible clicking or popping in their neck during motion. This noise is often noticeable because the cervical spine is so close to the auditory canal. However, this kind of clicking or popping is not usually a concern unless a person has other symptoms such as weakness or numbness in the arms or hands.
If bone spurs or other spine changes compress the spinal cord or spinal nerve roots, you might experience:
- Tingling, numbness, or weakness in the arms or hands
- Tingling, numbness, or weakness in the legs or feet
- Difficulty walking or lack of coordination
- Loss of bowel or bladder control
Risk factors for cervical arthritis include:
- Older age. An estimated 90 percent of men over 50 years old and 90 percent of women over 60 years old have degenerative changes in their cervical spine.
- Occupation. Jobs that involve awkward positions of the neck such as looking up or bending forward for long periods, or repetitive neck motions, can put extra strain on the neck.
- Neck injuries. Injury or trauma to the neck can lead to post-traumatic cervical arthritis.
- Genetic factors. People with close relatives who have cervical arthritis may have a higher risk of developing this condition themselves.
DiPaola says the number one risk factor is being human, because our lives require us to move our spine in different ways throughout the day, often repetitively.
“Our head and neck have to be positioned so we accomplish our day-to-day activities — whether that is driving, looking down while working, or looking up while changing a light bulb,” he says. Over time, this can contribute to age-related changes in the spine.
DiPaola says degeneration occurs most often in the cervical spine and the lumbar spine (lower back) because those parts of the spine have more mobility. The middle part of the spine (thoracic) is protected by the rib cage, so it is less mobile.
“Cervical spondylosis is a very broad category,” says DiPaola, so the goal of diagnosis is to narrow it down to a specific type and identify the causes and possible treatments. He says this includes looking at whether symptoms are made worse by certain activities, including work-related ones.
As part of the diagnosis, your doctor will ask you questions about your symptoms and medical history, and then do a physical exam that may involve:
- Checking how far you can move your neck comfortably in different directions (range of motion)
- Testing your muscle strength and reflexes to see if the spinal nerves that control those are affected
- Checking to see which parts of your arms and/or legs have numbness or tingling
- Watching you walk to see if a compressed spinal nerve may be affecting your gait
Your doctor may also order one of the following tests:
- Imaging test (X-ray, CT scan, MRI, or myelography) to look for abnormalities in the spine such as bone spurs, fractures, infections, or tumors. These can also identify areas where spinal nerves might be pinched.
- Nerve function tests (electromyography or nerve conduction study) to see how well the electrical signals are traveling along the nerves.
Treatment for cervical arthritis depends on many factors. This includes your age, the severity of your pain, the type of arthritis and your work or lifestyle goals.
Because damage to the joints caused by arthritis cannot be reversed, treatment usually involves preventing further damage and managing pain.
Your doctor may first recommend nonsurgical treatments such as:
- Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain. These include aspirin, ibuprofen and naproxen.
- Prescription medications that reduce swelling and pain, such as stronger NSAIDs or corticosteroids (pills or injections).
- Other medications that target the triggers or symptoms of inflammatory arthritis
- Physical therapy to strengthen the muscles that support the upper back and neck and safely improve the range of motion in the cervical spine. By doing this, “we can often change the pattern of pain,” says DiPaola.
- Lifestyle changes that reduce stress on the cervical spine and inflammation, such as changing your posture at home or work, quitting smoking, etc.
Surgery is rarely successful for neck pain that occurs with cervical arthritis. However, “if you have a problem where arthritis is causing nerve [or spinal cord] compression or you develop a deformity in your spine, those things may need to be treated with surgery,” says DiPaola. Your doctor may also recommend surgery if you have instability in the cervical spine.
Surgical treatments include:
- Relieving the pressure on the spinal cord or the spinal nerve roots caused by bone spurs or other tissues.
- Stabilizing the cervical spine by fusing together several segments, also known as spinal fusion.
DiPaola says unfortunately we don’t know yet how to prevent cervical arthritis. “So doctors tend to emphasize that people should stay active and maintain their mobility,” he says.
These healthy lifestyle activities include:
- Exercise regularly
- Eat a healthy diet
- Maintain good posture at work and home, including changing position frequently if you are standing or sitting for long periods
- Seek help early for injuries to the neck
The damage to the joints caused by cervical arthritis will not go away. However, many cases of cervical arthritis can be managed with non-surgical treatments such as over-the-counter medications and physical therapy. These can relieve symptoms and help keep arthritis from worsening.
With more severe cases, stronger medications may work. There are also surgical treatments that can relieve symptoms caused by compression on the spinal cord or spinal nerve roots, as well as stabilize the cervical spine.
Cervical arthritis, also known as cervical spondylosis, is a broad category that includes several different types of arthritis. The most common is due to age-related changes in the spine. It can also be caused by inflammatory conditions such as rheumatoid arthritis.
Symptoms can include pain or stiffness in the neck, or tingling, numbness, or weakness in the arms. Treatment depends on the type of cervical arthritis and how severe the symptoms are.
In many cases can be treated non-surgically with over-the-counter medications or physical therapy. Surgery may be needed in more severe cases.
Updated: July 26, 2021