The wide variety of movements our skeleton is capable of performing rises from the intricate cooperation of bony anatomy, complex muscular contractions, stabilizing ligaments, navigated by the nervous system. The graceful movements of a dancer are very complex combination of forces placed upon our skeleton. These movements of the normal spine have still not been duplicated by any man made machine. However, there are disorders to the cervical (neck) spine that are unique to this region and are discussed here.
The term arthritis refers to the degenerative process that takes place in almost all human beings and is seen on X-rays as small bony projection called osteophytes. These Osteophystes are the result of our bodies attempt to stabilize the micro-instability that is found with the wear and tear in our spinal column. As the integrity of the discs in our spine deteriorates, our body attempts to correct this instability with ostephyte formation around the facet joints. The facet joints are the small joints found the back of our spine. These joints connect each level of the spine to allow motion within our spine. In most cases these small bony projections do not result in much dysfunction, however, if these osteophytes form in a location that places pressure on neural elements (like an exiting nerve) the pain will be felt by the patient along the route of that specific nerve. This condition is called Radiculopathy. However, if these bony projections place pressure on the spinal cord itself, other manifestations are observed and the condition is called Cervical (neck) Myelopathy.
Arthritic changes in the human spine are very common and may in fact be the normal progression of the aging process. Approximately 50 million people most patients that have arthritic changes seen on their X-ray are without any symptoms. However, a small subset of patients who have these changes on the X-ray will have complaints that range from neck pain, and stiffness, to sever debilitating pain with neurologic dysfunction. The severity of the symptoms can be the results of many different factors. These factors include the associated disc disease, instability of the spine, and involvement of neurologic dysfunction. Based on the severity of symptoms, your spine surgeon will decide on further diagnostic studies.
Neck pain alone could be the result of many different conditions. Arthritis of the neck however is a more specific disorder. In the absence of neurologic manifestations, the mainstay of treatment is medications and physical therapy. Medications in the anti-inflammatory class can generally reduce pain and stiffness to leave the patients comfortable with their daily living. Physical therapy modalities help restore function by decreasing stiffness, strengthening muscles, and improving stability in the structures of the neck. Physical therapist also provides modalities such as heat, message, electrical stimulation and other helpful options. Most patient find great relief from these modalities leading to eventual resolution of symptoms.
Arthritis of the neck could also be manifested as degenerative disc disease. At times when the neck pain and dysfunction does not resolve, your spinal specialist may elect to search for the origin of pain in the discs. A degenerated disc may cause severe enough pain that could be disabling. One test that could be performed is a discogram. Other test available to find the origin of pain is facet blocks.
In summary, cervical arthritis is a broad subject which basically means degenerative changes. Most symptoms arising from this condition resolve after a period of conservative modalities. For more specific answers and an evaluation you can see your spinal specialist.
