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Cervical Arthritis

What Is It, Treatment, and More

Author: Corinne Tarantino, MPH

Editors: Ahaana Singh, Ian Mannarino, MD, MBA

Illustrator: Abbey Richard

Copyeditor: Joy Mapes


What is cervical arthritis?

Cervical arthritis refers to arthritis of the neck, which results from swelling around joints in an area of the neck called the cervical spine. The cervical spine consists of the top seven bony vertebrae of the spinal column (i.e., backbone), along with the flexible intervertebral discs that are between each vertebrae, absorb shock, and allow movement. Arthritis of the cervical joints can limit movement and rotation of the neck and cause significant neck pain, among other symptoms.

If left untreated, cervical arthritis can lead to several conditions affecting the spine, including spinal stenosis, radiculopathy, and myelopathy. Spinal stenosis occurs when the space between two vertebrae becomes narrowed. Cervical arthritis can cause spinal stenosis due to the development of small, bony outgrowths called bone spurs, which grow when the body tries to fix bone damage from the arthritis. Complications of cervical arthritis may eventually pinch the nerves that branch off from the spinal cord, producing a condition called cervical radiculopathy, which often causes pain, numbness, tingling, and other associated symptoms in the neck, shoulders, and arms. Finally, myelopathy, severe pressure on the spinal cord, may occur with cervical arthritis and can cause significant pain.

What causes cervical arthritis?

Cervical arthritis can develop due to many factors and conditions. The most common type of cervical arthritis is known as cervical spondylosis, or osteoarthritis, which usually results from age-related wear and tear of the joints and intervertebral discs. Degenerative disc disease, the gradual wearing and weakening of an intervertebral disc, can result in pain and an increased risk of developing a herniated disk, when the soft inside of the intervertebral disc pushes out into the spinal canal. Cervical osteoarthritis can also develop as a result of trauma or disease, such as joint disorders or osteoporosis, a disease in which decreased bone density can lead to frequent fractures and breaks.

Inflammatory arthritis, which occurs when the immune system causes inflammation around the joints, is another potential trigger for cervical arthritis. Ankylosing spondylitis is the most common type of inflammatory arthritis that impacts the spinal column. Research strongly associates ankylosing spondylitis with genetic factors. Less commonly, rheumatoid arthritis, psoriatic arthritis, reactive arthritis, and enteropathic arthritis can also lead to cervical arthritis.

There are many other risk factors for cervical arthritis. People who are older, have a history of neck pain in their family, carry more weight, or have already experienced joint problems due to disease or injury are more likely to develop cervical arthritis. 

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What are the symptoms of cervical arthritis?

Cervical arthritis is characterized by progressively worsening pain along the neck that may travel to the head, shoulders, and arms. The pain tends to decrease during rest and increase during physical activity. Depending on the underlying cause of an individual’s cervical arthritis, a variety of additional symptoms may present. If inflammatory arthritis is the root source, the case of cervical arthritis will often be accompanied by arthritis along the limbs of one side of the body or along other parts of the spine. Regardless, the most commonly associated symptoms include limited range of motion of the neck, stiffness, and headaches. Individuals may also experience swelling of the fingers due to inflammation, called dactylitis.

How is cervical arthritis diagnosed?

Diagnosis of cervical arthritis begins with a clinical evaluation, including a review of symptoms, consideration of medical history, and a physical examination. A clinician may ask the individual to move their neck in different directions to discover the extent of their range of motion. Depending on the potential causes, additional testing may be required to make a diagnosis. Most of the time, imaging studies -- like X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI), or ultrasounds -- are important. X-rays will show changes to the bones themselves, while the other images can show problems with the intervertebral discs or fluids in the joints. Blood tests may be considered to determine if an inflammatory condition is a factor. Occasionally, a spinal tap will be advised to analyze the fluid in the joints (i.e., synovial fluid) for diagnosis.

How is cervical arthritis treated?

Treatment of cervical arthritis often focuses on pain relief and mobility improvement. For people with mild symptoms, an initial approach may include lifestyle changes aimed at minimizing activities that cause pain. In some cases, wearing a splint or brace to support or realign the most painful joints may be suggested. Occupational or physical therapy may also be recommended for improving joint mobilization and strengthening surrounding muscles. For individuals whose weight contributes to their arthritis, weight loss through regular exercise and a nutritious diet may decrease the stress on their joints. 

When people have more severe symptoms, medications may be needed to relieve pain. First, oral or topical nonsteroidal anti inflammatory drugs (NSAIDS), such as ibuprofen and aspirin, may be recommended. If pain persists, glucocorticoid injections can be administered at the location of the pain. Individuals with long-term, severe pain may be prescribed stronger medications, such as duloxetine or opioids.

If symptoms do not resolve with all other treatment options, surgery may be considered. Surgical options can include the removal of herniated disks, bone spurs, or part of a vertebra, as well as fusing some vertebrae together. 

What are the most important facts to know about cervical arthritis?

Cervical arthritis is a condition characterized by swelling around the neck joints in the cervical spine. Usually caused by wear and tear of the joints due to aging, cervical arthritis can also develop from preexisting medical conditions, such as inflammatory arthritis. Cervical arthritis often presents with chronic, worsening pain and stiffness in the neck. Diagnosis begins with a clinical examination, typically followed by imaging, and occasionally, blood tests to assess for inflammatory causes. Treatment for cervical arthritis varies depending on severity but generally focuses on pain relief and increased range of motion. Treatment of mild cases may involve lifestyle modifications and physical therapy, while more severe cases may require medication and, if other treatment options are not effective, surgery.

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Related links

Osteoarthritis
Seronegative arthritis: Clinical practice
Rheumatoid arthritis and osteoarthritis: Pathology review
Bones of the neck

Resources for research and reference

Della-Giustina, D., & Dubin, J. (2020). Neck and back pain. In J. Tintinalli, O. J. Ma, D. Yealy, G. Meckler, J. S. Stapczynski, D. Cline D., & S. Thomas (Eds.), Tintinalli's emergency medicine: A comprehensive study guide (9th ed.). McGraw-Hill. 

Park, D. (n.d.). Cervical spondylosis (arthritis of the neck). In OthroInfo: Diseases & conditions. Retrieved April 20, 2021, from https://orthoinfo.aaos.org/en/diseases--conditions/cervical-spondylosis-arthritis-of-the-neck/ 

Sen, R., & Hurley, J. (2020, March 30). Osteoarthritis. In StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482326/ 

Smith, H., Smith, E., & Smith, B. (2012). Duloxetine in the management of chronic musculoskeletal pain. Therapeutics and Clinical Risk Management, 8: 267-277. DOI: 10.2147/TCRM.S17428

Suneja, M, Szot, J., LeBlond, R., & Brown, D. (2020). DeGowin’s diagnostic examination (11th ed.). McGraw-Hill.