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I have arthritis in my neck. What type of treatment can I expect?
Jul 27, 2011

The answer to your question about the type of treatment that you can expect with arthritis in the neck depends on the type of arthritis you have. There are numerous forms of arthritis, in total, there are probably more than 50 different types, but in practice the arthritis that this patient is most likely to have is Osteo or Degenerative Arthritis and is call Cervical Spondylosis. If one of the Inflammatory Arthritides affect the neck, the classical one being Rheumatoid Arthritis, the situation is much more serious, particularly in chronic Rheumatoid Arthritis, where in a certain percentage of patients, the upper part of the neck around area called the Atlanto axial joint is involved and this can sometimes have serious consequences. Spondylitis can also affect the neck and this may occur in either Ankylosing Spondylitis or some of the Sero Negative Spondyloarthropathies.

I shall assume that the most likely cause of the arthritis in this patient is Osteoarthritis or Cervical Spondylosis.

It is important to state that x-ray changes or Spondylosis are extremely common in patients over the age Of 50 years, possibly greater that 60% of the population. Many of these patients will have no symptoms other than possible occasional stiffness and restriction of movement of the neck. Treatment is usually very successful and the first aspect of this is that posture is extremely important. Any activity once the patient gets up in the morning to going to be at night that involves a lot of bending the neck can make the condition worse. Sleeping as flat as possible at night in order to prevent flexion is important. It is surprising to know that individuals turn in their sleep approximately every 11 minutes. Certain occupations, for example, individuals who spend all day at a computer, or other professions like Civil Servants, Bankers, Accountants, Draughtsmen who spend much of their time bending over a desk at work may be affected and in these situations, ergonomic advice should be given about trying to achieve optimum working posture.

Physiotherapy has an important role in the management of arthritis in the neck and techniques using various modalities of ultrasound, lasers, mobilization, cervical traction and gentle manipulation may give considerable help and improvement. Sometimes physiotherapy makes the situation more painful initially, but this post treatment pain usually disappears after a short period of time.

Drug treatment is very affective with non steroidal agents or analgesics. There are over 70-80 non steroidal agents available in this country. These drugs should be prescribed with care in females over the age of 50 years and the newer agents, which are said to be COX 2 specific, which means that they are less toxic to the gastrointestinal tract are often very effective.

Cervical collars for a short period may sometimes be indicated but in general the use of these can weaken the neck muscles if used over a long period.

Very rarely arthritis of the neck progresses with pain down the arms with neurological symptoms and in that situation if there is any compression, particularly of the spinal cord, the opinion of an experienced Surgeon who is used to operating on the neck should be sought.

In conclusion, most stiff and painful necks associated with arthritis get better within a few days or a couple of weeks, without the need of any special medical treatment. Only an extremely small percentage of those with severe and persistent problems are more detailed investigations like CT scans or MRI scans or possible surgery necessary. The long term prognosis for Osteoarthritis of the neck is usually excellent.

There is a booklet called 'Pain in the Neck' which gives all the relevant information and is available from the Arthritis Foundation of Ireland.

For more information on arthritis download a FREE copy of Caring for a Person with Arthritis.

This information has been provided by Arthritis Ireland, Ireland's only arthritis charity enabling people with arthritis to take their lives back.