What Is Neck Arthritis? Signs You Have It and How to Treat It
Learn about neck arthritis and possible causes. Get tips to manage pain from neck arthritis and simple exercises from physical therapists to feel better.
Our Hinge Health Experts
Dr. Heather Broach, PT, DPT
Jonathan Lee, MD, MBA
Dylan Peterson, PT, DPT
Just as many people develop wrinkles on their skin or gray hair on their head, it’s common for structures in your body to change over time, including your joints. This is what happens in the case of cervical spondylosis, or changes in the structures of your neck. While neck arthritis doesn’t always cause symptoms, it can be a cause of persistent neck pain.
But it’s not the only cause of neck pain and many people can achieve pain-free living in spite of arthritis. Most of the time, neck arthritis responds well to conservative treatments like over-the-counter medications, heat, exercise, and physical therapy.
Neck Arthritis: The Hinge Health Perspective
Sometimes having a label like neck arthritis can make you feel stuck, “like you’re going to have pain no matter what, and there’s nothing you can do about it,” says Dylan Peterson, PT, DPT, a physical therapist at Hinge Health. “This couldn’t be further from the truth.”
You may not be able to control every issue involved in your neck pain, but you do have the power to change some important things. As our Hinge Health care team says, movement is medicine.
Here, learn more about neck arthritis and how to manage its symptoms — especially with exercises from Hinge Health physical therapists.
Intro to Neck Anatomy
Your neck and back are made up of 24 small bones, called vertebrae, that are stacked on top of one another to create a canal that protects your spinal cord. The top seven vertebrae, which begin at the base of your skull and travel down your neck, are called cervical vertebrae. Other important spinal structures include:
Your spinal cord is a long column of tissue that runs from your brain to your lower back and carries nerve signals.
Nerves in your neck send information between your brain and body. You can think of them as electrical cables that carry messages, helping you feel sensation and move your body.
Intervertebral discs sit between each vertebra in your spine. They act as shock absorbers and give your spine both flexibility and integrity.
These structures and more all work together to help you move and go about your daily activities. Sometimes, though, they can play a role in neck pain or arthritis.
What Is Neck Arthritis?
When you have cervical spondylosis, the small joints in the back of your spine can begin to change. This is very normal. In fact, many middle-aged and older people have signs of neck arthritis that don’t cause any symptoms, according to the American Academy of Orthopedic Surgeons.
A lot of factors can contribute to anatomical changes in your neck. The smooth, slippery cartilage that acts as a shock absorber between joints loses some volume with age, just as some people lose hair on their head. When this happens, the joints may rub against each other with increased friction. This can cause pain, but not always. If the cartilage in your neck wears away completely, your body may respond by “growing new bones” — known as bone spurs. These may contribute to narrowing of the spinal canal, called spinal stenosis, which can exacerbate pain.
You can also experience changes with your intervertebral discs. As they lose some of their cushioning and height, this can also put more pressure on your spinal joints.
All of these changes may sound alarming, but keep in mind that many people have neck arthritis without any symptoms or pain. This means that your anatomy alone isn’t always solely responsible for your pain. Other factors, like your stress, sleep, and daily movement, can play a role. And this is good news, because you can manage these factors and reduce your pain.
Signs Your Neck Pain Is Arthritis
There are many different contributors to neck pain and neck pain is relatively common. Up to 70% of people will experience it at some point in their lives. While neck pain can certainly be scary, it’s usually not necessary to get imaging (like X-rays or MRIs) to begin healing. Knowing the signs of arthritis can help you make informed decisions around care and treatment options. Common signs of neck arthritis include:
Neck pain and stiffness that gets worse with upright activity
Muscle spasms in your neck or shoulders
Numbness and weakness in your arms, hands, and fingers
Types of Arthritis
There are several different types of arthritis that can contribute to neck pain:
Osteoarthritis (OA). This is one of the most common forms of arthritis, affecting more than 32 million Americans. Some people call it “wear-and-tear” arthritis because it’s characterized by the gradual wearing away of cartilage in a joint. For some people, it can cause symptoms such as pain and stiffness that tend to worsen after activity.
Rheumatoid arthritis (RA). This is an autoimmune disease, meaning the immune system mistakes healthy cells in the body for foreign, invading cells and mounts an immune response against itself. In the case of RA, the immune system attacks the synovium (joint lining), causing inflammation and often stiffness and pain with movement.
Spondyloarthritis. This is a chronic form of arthritis that’s characterized by inflammation in certain joints and entheses — where tendons and ligaments attach to bones. It commonly affects the spine. There are several kinds, including ankylosing spondylitis and psoriatic arthritis. In the case of cervical (neck) spondyloarthritis, pain usually starts between your pelvis and spine, then may gradually affect your cervical spine. It tends to be worse at night and in the morning but eases with gentle movement.
A Moment of Truth
Let’s pause and acknowledge something: Living with pain is hard. It’s also personal. While certain medications, supplements, and steroids may work for your coworker or cousin, maybe they haven’t worked for you. There’s no one-size-fits-all approach when it comes to managing pain, but there are always ways you can improve joint health and manage arthritis-related symptoms. This is because your body has the amazing ability to adapt.
Think about a time you’ve eaten a huge meal. You’re stuffed and think there’s no way you can eat another bite. But if you’re offered a helping of your favorite dessert, your brain convinces your stomach that there’s still room for just a bit more food. This is one of many ways your body adapts because your brain tells it to. What’s another way? When your muscles act as a shock absorber for your joints when cartilage can’t (as in some cases of arthritis).
Arthritis, or the thought of developing arthritis, can be scary. Know this: There are many ways to help your body adapt and manage your symptoms. So let’s talk about them.
While there’s no one solution for arthritis that works for everyone, it is very manageable. Most cases of neck arthritis can be effectively managed with at-home, conservative treatments, such as the following recommendations from our Hinge Health physical therapists:
Heat. “Osteoarthritis responds really well to any sort of warmth, because it relaxes muscle tissue and brings blood to the area,” says Heather Broach, PT, DPT, a physical therapist at Hinge Health. Apply heat for 10 to 15 minutes at a time with a heat pack, hot water bottle, warm towel, or shower.
Medications. There are several over-the-counter medications you can use to relieve pain, including acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve). It’s important to make sure, based on your medical history, that you are safely able to take these medications. If you experience a severe flare, your doctor can prescribe a short course of oral corticosteroids, to help relieve pain by reducing inflammation, or muscle relaxants to prevent pain signals from reaching the brain.
Hydration. The discs in your cervical spine require fluid to stay healthy. Drink plenty of water to stay hydrated.
Massage. A 2014 study from the University of Florida found that people with neck arthritis who received regular massages experienced a reduction in pain and better range of motion.
Physical therapy. If you have chronic neck pain, a physical therapist can show you specific exercises to help you relieve pain and strengthen and stretch strained muscles. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.
Steroid injections. If your neck pain radiates down your arm, it may be due to a pinched nerve. Steroid injections to your spine contain an anti-inflammatory medication that can help reduce pain.
These tips can help many types of arthritis, but they are generally meant for osteoarthritis. If your neck pain is due to an inflammatory arthritis (e.g., rheumatoid arthritis, psoriatic arthritis, spondyloarthritis, lupus, etc.) your doctor may refer you to a rheumatologist for additional treatments and medications to address systemic inflammation. You can visit the American College of Rheumatology’s website for more information.
Your doctor may discuss surgery as an option if you have severe, persistent pain that has not improved with conservative measures like exercise and physical therapy. Not everyone is a good candidate for neck surgery, so it's important to discuss your options with your doctor.
Exercises for Neck Arthritis
One of the best ways to treat arthritis-related neck pain is through stretching and strengthening exercises. It’s normal to be a little wary of exercise in the face of arthritis. But exercise, even if it causes some discomfort at first, is good for your joints. “Our bones and ligaments are at the mercy of our muscles and tendons,” says Dr. Broach. “When we consistently use our muscles, that tone contributes to supporting the joints.” In other words, consistent exercise can relieve pain and stiffness.
Here are a few gentle exercises from Hinge Health that are commonly used to prevent and treat neck pain.
Thread the Needle
Thread the Needle
Thread the Needle
Thread the Needle
PT Tip: Don’t Weight Train Your Neck
It sounds weird, but it’s true: “I’ve seen people put weights around their head to try to strengthen their neck, and it can actually injure neck muscles,” says Dr. Broach. Ditto for cervical traction, which involves the use of weights to pull the spinal column into alignment. Research shows it doesn’t help treat neck pain. Instead, stick to therapeutic exercises, stretching, and movements and activities that you really enjoy.
Frequently Asked Questions
Are there certain movements that make arthritis worse?
You may notice that your neck arthritis worsens if you look up or down for a long time, or you perform an activity where your neck has to be in the same position for a while, like driving.
There is no such thing as “perfect” posture, but staying in the same position for a long time can put extra strain on your neck and cause some pain. How you hold yourself is not what’s important. What matters is how long you stay in one particular position.
That’s why Hinge Health likes to remind people that they’re almost always safe to move, even if pain is present.
How should you sleep if you have neck arthritis symptoms?
When it comes to choosing the right pillow for neck arthritis, less is more. “I find it’s better if people with neck arthritis use fewer pillows, and thinner ones,” says Dr. Broach. “If your pillow is too thick, it can make neck pain worse.” Look for one that keeps your head level with your body in a neutral position. As far as a sleep position, back or side is best, adds Dr. Broach. “Sleeping on your stomach is tough, because it forces your neck to the side,” she explains.
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