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Cervical Osteoarthritis

What is Osteoarthritis of the Neck?

Osteoarthritis (OA) of the neck, also called cervical spondylosis, are age-related changes of the spine. In OA, the cartilage between the vertebrae degenerates. Since cartilage is essentially a cushion between the vertebrae, the breakdown of the cushion will cause joint damage over time.

The cartilage cushions between the vertebrae are the discs in the front of the spine and the facet joints in the back of the spine.

OA of the neck can take many different forms, such as disc degeneration, facet joint degeneration, a change in the curvature of the neck (straightening of the cervical lordosis), or bone spurs.

While spine specialists may use the term “Arthritis”, they usually classify the problem by a specific condition such as disc degeneration or facet joint degeneration, rather than just calling it Arthritis.

What is the difference between Osteoarthritis of the Spine and other Arthritis forms of the spine?

Osteoarthritis is generally related to aging, rather than a specific disease of the body. Rheumatoid arthritis is a condition which is part of a disease process where the body believes that the joint lining (synovium) is foreign material and attacks it.

Is Osteoarthritis of the Spine inherited?

Osteoarthritis of the spine does not have to be inherited. It is often related to aging and wear and tear, rather than just genetics.

How common is Osteoarthritis of the Cervical Spine?

This condition is often present in patients over the age of 50. By the age of 60, most people will have signs of OA of the cervical spine on X-Rays. Over the age of 60, 85% of the population has signs of OA on a spine image. However, most patients have either no symptoms or mild symptoms. The presence of Osteoarthritis changes on an X-Ray does not mean that pain has to be present.

Which parts of the spine are affected by Osteoarthritis?

 Osteoarthritis can affect any part of the spine. It is most often seen as degeneration of the spinal discs, facet joints, and ligaments. The disease can also affect the spinal nerves or spinal cord depending on the degree of degeneration. Examples of that are when bone spurs form or discs herniate into the spinal canal, compressing the spinal cord.

What are some of the specific spine conditions seen in patients with Osteoarthritis of the Cervical Spine?

Spinal Osteoarthritis is usually classified by specific conditions of the cervical spine. Here are some of the most common ones:

  1. Cervical Degenerative Disc Disease
  2. Cervical Facet Joint Degeneration
  3. Cervical Foraminal Stenosis
  4. Cervical Radiculopathy
  5. Cervical Spinal Stenosis

What are some risk factors for Spinal Osteoarthritis?

Here are some risk factors for getting OA:

  1. Being Overweight
  2. Lack of Exercise
  3. Being exposed to frequent heavy lifting, twisting and bending
  4. Prior neck injuries
  5. History of disc disease
  6. Prior cervical spine surgery

What are the symptoms from Spinal Osteoarthritis?

Here are some common symptoms of OA in the spine:

  1. Stiffness of the spine
  2. Spine pain that is worse after standing or sitting
  3. Pain in the neck which spreads to the shoulder or arms
  4. Pain or weakness in the arms or legs
  5. Difficulty with gait
  6. Headaches

How is Osteoarthritis of the spine diagnosed?

Spine specialists use information from the patient history, physical examination and special tests to diagnose this condition.

  1. History

A history of spine stiffness and aching which has progressed slowly over the years and is relieved by rest is often suggestive of Osteoarthritis of the spine.

      2. Physical Examination

Here are some tests done by doctors to assess for OA:

  1. Neck mobility (range of motion)
  2. Tenderness to touch and pressure (palpation) over the spine
  3. Muscle strength testing
  4. Sensation testing
  5.  Gait testing
  6. Reflex testing

3. Imaging

                a. X-Rays

Basic spine X-Rays are often used to look for OA. They can usually show the presence of the disease and the severity. The height of the disc, presence of bone spurs, facet joint degeneration and the spinal curvature can be evaluated.

               b. CT Scans

A CT scan can show the wear on spinal bones and joints in more detail than X-Rays. It can be useful to assess the degree of OA, but is not commonly used to find out if a   patient has OA due to the high radiation exposure.

               c. MRI scans

                MRI is usually not needed to make the diagnosis of OA. However, patients who have severe symptoms or show signs of nerve involvement often need an MRI to assess the discs, spinal nerves and spinal cord in detail.                            

What is the treatment of Osteoarthritis of the Spine?

Here are some of the Non-Surgical and Surgical treatments of the cervical spine (neck) for this condition:

  1. Non-Surgical Care

Having a diagnosis of OA of the spine does not mean a patient has to have pain. The treatments below are for periods of time which are painful, or if the pain becomes persistent.

A. Alternative Health Care

Massage Therapy, Acupuncture, Meditation, Herbal Remedies and Aromatherapy are some examples of Alternative Medicine options for this condition.

B. Chiropractic Care

Chiropractic care such as spine manipulation techniques can offer relief from OA of the spine.

C. Spine Exercises

Spine exercises are an important way to maintain muscle tone and mobility for OA patients. Range of motion exercises can help alleviate the stiffness which is common in more advanced cases of OA.

D. Physical Therapy (PT)

Physical Therapy techniques such as spinal exercises, aquatic therapy, ultrasound, and manual therapy are some examples of what PT can offer for Spinal Osteoarthritis.

E. Self Help Devices

Neck Braces, Neck Pillows and Back Mattresses are just some examples of Self Help Devices which can help with the symptoms of OA.

F. Medications

Here are some of the available medications which are used to control the pain and stiffness from OA:

  1. Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
  2. Muscle Relaxants
  3. Pain Killers
  4. Nerve Pain Medications

G. Injections

Depending on the exact spine condition which is causing pain from Spinal Osteoarthritis, a specific spine injection can offer significant help.

  1. Cervical Interlaminar Epidural Steroid Injection
  2. Cervical Transforaminal Epidural Steroid Injection
  3. Cervical Nerve Root Block
  4. Cervical Facet Joint Injection
  5. Cervical Facet Joint Radiofrequency Rhizotomy
  6. Cervical Trigger Point Injection

 

2. Surgical Care

Surgical treatment is typically reserved for patients with severe cases of OA of the spine. These patients often have a poor quality of life due to pain or loss of nerve function.

Here are some potential surgical options:

  1. Anterior Cervical Decompression and Fusion (ACDF)
  2. Posterior Cervical Fusion
  3. Cervical Artificial Disc Replacement