Arthritis in the neck (cervical spondylosis): what helps
'Wear and tear', 'arthritis in the neck' and 'cervical spondylosis' all describe the same thing: age-related changes in the discs and joints of the neck. They're found in most adults, and they aren't a sentence to a lifetime of neck pain.
What is cervical spondylosis?
It's the collective term for changes in the neck with age: discs lose height and may bulge, and the small joints at the back of the neck develop bony thickening. These changes are visible on X-ray and MRI.
How common is it?
Extremely. In an MRI study of 1,211 people with no neck symptoms, 87.6% had disc bulging, including about three-quarters of those in their twenties. More significant findings, such as compression of the spinal cord, were uncommon (5.3%) and increased after 50 (Nakashima et al., Spine, 2015). So changes on a neck scan are the rule, not the exception.
Does neck arthritis cause pain?
It can contribute, but many people with these changes have no pain. Neck pain is usually influenced by several things at once: how sensitive the joints and muscles are, strength and endurance, sleep, stress and how long you hold positions.
What does it feel like?
Typically stiffness and aching in the neck, often worse in the morning or after holding one position, with reduced turning, for example when reversing the car. There may be grinding or clicking noises with movement, which are harmless. Headaches at the base of the skull and aching into the shoulders are common.
What helps arthritis in the neck?
Regular movement and strengthening. A Cochrane review found strengthening and endurance exercises for the neck, shoulders and shoulder blade muscles may reduce pain and improve function in chronic neck pain, while stretching alone wasn't expected to help much (Gross et al., Cochrane, 2015). Hands-on treatment can ease pain and stiffness as part of a plan that includes exercise.
What exercises are good for neck arthritis?
Gentle range-of-motion exercises, turning, tilting and nodding, done daily. Chin nods to build the deep neck muscles. Shoulder blade strengthening such as rows and band pull-aparts. Upper back mobility. Start gently and build up; some discomfort is acceptable if it settles quickly.
Is the grinding noise in my neck a problem?
Noises with movement are very common, with or without arthritis, and aren't a sign of damage. If they aren't painful, they can be ignored.
Should I avoid moving my neck?
No. Keeping the neck still tends to make it stiffer and more sensitive. Avoid holding any one position for long periods, and keep it moving through the day.
What about pillows and sleeping?
Choose a pillow that keeps your neck level with your spine. Sleeping on your back or side is usually more comfortable than on your stomach.
See our post on waking with a stiff neck.
Can neck arthritis pinch a nerve?
Sometimes. Bony changes can narrow the openings where nerves leave the spine, causing pain, tingling or numbness in the arm. This often settles with time and conservative care.
See our post on pinched nerves in the neck.
Is neck manipulation safe if I have arthritis?
We choose techniques based on your age, scan findings, bone health and preferences. For many people with neck arthritis, gentle mobilisation, soft tissue work and exercise are more appropriate than manipulation, and work well.
Will it get worse?
The changes on a scan progress slowly with age, but symptoms tend to fluctuate rather than steadily worsen. Many people have flare-ups followed by long comfortable periods, particularly if they stay active and strong.
Do I need a scan?
Not usually. Because these changes are so common in people without pain, a scan rarely changes treatment for ordinary neck pain. Imaging is useful when there are signs of nerve or spinal cord involvement, after trauma, or when symptoms aren't following the expected course.
Does heat help a stiff, arthritic neck?
Many people find heat, such as a warm shower or heat pack, eases morning stiffness and makes it easier to get moving. Follow it with a few gentle range-of-motion exercises.
How can an osteopath help?
We assess your neck, upper back and nerves, treat hands-on to ease stiffness and pain, and give you a simple exercise routine. We'll also look at driving, desk and sleep positions that may be contributing.
When is it serious?
See a doctor promptly for clumsiness in the hands, difficulty with fine tasks such as buttons, unsteady walking, weakness in the arms or legs, or changes in bladder or bowel control, as these can indicate pressure on the spinal cord. Also see your GP for neck pain with fever, unexplained weight loss, or pain after a fall. Call 000 for sudden severe neck pain with headache, dizziness, or difficulty speaking or swallowing.
See our neck pain treatment in Berwick page. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
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Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
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