Arthritis in the Neck

Overview of Cervical Spondylosis and Arthritis of the Neck

Xray image of arthritic spine.
Arthritis is one cause of cervical radiculopathy. CNRI/Science Photo Library/Getty Images

Cervical spondylosis is caused by degenerative changes in the bones and intervertebral discs of the neck. A less technical name for this condition is osteoarthritis of the neck, or degenerative disc disease of the neck.

Typically, arthritis in the neck starts at about 40 years of age, and as you get older it will likely continue to progress. Men tend to develop cervical spondylosis at a younger age than women. Cervical spondylosis can lead to myelopathy. In fact, it is the most common condition of the neck that can affect the spinal cord.

Arthritis - The Neck and Its Changes

With age, osteophytes - aka bone spurs - form on vertebral bodies. Bone spurs are the body’s response to wear and tear.  In the spine, bone spurs may to help stabilize joints on increase joint surface area, but they may also cause pain as they put pressure on spinal nerves, and/or the spinal cord. This pressure can also cause numbness, weakness and even often incontinence of either the bowels or the bladder.

See above for an image of neck arthritis, and below, as well as the pages that follow, for more detailed information on symptoms and treatments.

Risk Factors for Cervical Spondylosis

A senior couple is shown in close up.
Taking Advil or ibuprofen raises your risk for a stroke. Westend61/Getty Images

The Amercian Academy of Orthopaedic Surgerons says the most common risk factors for cervical spondylosis are, first and foremost, age.  Starting in middle-age and continuing on from there, they say, neck arthritis (cervical spondylosis) is very common.

After age, comes genetics. Neck arthritis (like some other types of spine problems), may run in families.  If your spinal canal and/or intervertebral foramen are naturally small in diameter, your risk for complications of degenerative arthritis may be higher. With a narrow spinal canal, the spinal cord -- a very sensitive structure that relays feelings to the brain and movement commands from the brain to the muscles -- has less space to fit inside the column of bone it occupies.  Contact between the cord and the column could irritate the column and cause symptoms.

Smoking contributes to degenerative disk disease, and is therefore a risk factor.

Related: Smoking and Back Pain

Other risk factors include, potentially, your occupation.  The AAOS says that if your job involves a lot of repetitive neck motion and/or overhead work, your risk may be higher.  Depression and/or anxiety are psycological risk factors.

Related: Chronic Pain, Depression and Anxiety

And finally, trauma, especially repeated trauma puts you at a higher risk, although for many people, cervical spondylosis is not preceded by an identifiable cause or event.


AAOS. Cervical Spondylosis (Arthritis of the Neck.) OrthInfo. American Academy of Orthopaedic Surgeons website. August 2015.

Cervical Arthritis Symptoms

A man attempts to treat his own neck.
A man attempts to treat his own neck. Shelby Ross/The Image Bank/Getty Images

According to Rana,  et. al. in the August 2015 Medscape article titled, "Diagnosis and Management of Cervical Spondylosis Clinical Presentation,"  the source of neck arthritis pain, when it does occur, is not well understood by the scientific community.  Sometimes this condition has symptoms and sometimes it does not.

Intermittent neck pain (cervicalgia) are the most common symptoms, Rana et. al. say. The pain is often accompanied by stiffness.

In fact, about 1/3 of people with cervical spondylosis also have headaches, usually in that lower skull (called sub-occiptial) area.  Sometimes these headaches are the most dominant symptom patients report to their doctors, Rana, et. al. say.

Radiuclopathy is another syndrome that often accompanies cervical spondylosis.  The symptoms of cervical radiculopathy include pins and needles, pain and weakness in the arms and hands. Radiculopathy occurs when a spinal nerve root become irritated.

Myelopathy, caused by irritation of your spinal cord tissue, is another source of cervical spondylosis symptoms.  Unlike to radiculopathy, it tends to come on slowly over time, and is the a common cause of pins and needles.  If the symptoms are coming from higher up in your neck (C-3 through 5), you may experience a syndrome called “numb, clumsy hands," where writing and similar activities become problematic.  Your legs may be affected, as well.


Rana, S., M.D., et. al. Diagnosis and Management of Cervical Spondylosis Clinical Presentation. Medscape website. Last Updated: Aug 2015.

Diagnosing Cervical Spondylosis with Flexibility Tests and X-Rays

Neck x-ray for diagnosing arthritis or other conditions.
Neck x-ray for diagnosing arthritis or other conditions. plepraisaeng

As with most neck and back diagnostic processes, your doctor will gather information about your condition by taking a history and doing a physical exam.

When it comes to imaging (i.e., x-rays, MRI, CT scans and the like) the gold standard is MRI. This is especially true if you have nerve symptoms such as pain, pins and needles, numbness or weakness going down one arm.

An MRI may help your doctor to see not only your bones, but your soft tissues and nerves as well.  It may help her to accurately estimate how much unimpeded space is left in your spinal canal and intervertebral foramen. 

Rana, et. al. say that in addition to an MRI, x-ray can help her see how your spinal alignment, including any spondylolisthesis, contributes to central canal stenosis. 

If you don’t have nerve symptoms, you may only need an x-ray.  The strength of an x-ray is its ability to show what’s going on with bones, so having one may alert your doctor to things like narrowing in your disc space, bone spurs, loss of neck curve, facet joint hypertrophy, and any decrease in your spinal canal diameter.  It can also help her classify cervical spondylosis in elderly people as mild, moderate or severe.

Another diagnostic imaging test commonly given to people with cervical spondylosis is the CT scan (CAT scan.)  A CT scan is like an x-ray except that it takes multiple images of the inside of the body, and shows a cross section of the area.  The quality of the image is better than x-rays, which may enable your doctor to better study your spinal canal, neural foramen, as well as changes in your bones.

Myelography is used to visualize your nerve roots, where the spinal cord branches out to become spinal nerves.  There’s also CT myelography which some practitioners prefer because it is thought to have lower false-positive results (compared to myelography.) CT myelography is most often used when surgery is involved, as opposed to first time or asymptomatic diagnosis.

Another type of test that doctors use to diagnose (or confirm a diagnosis of) radiculopathy is a nerve conduction study.


Rana, S., M.D., et. al. Diagnosis and Management of Cervical Spondylosis Clinical Presentation. Medscape website. Last Updated: Aug 2015.

Arthritis in the Neck - Treatment

Pain relievers
Pain relievers. Peter Dazeley/Photographer's Choice/Getty Images

Your primary care doctor or general internist may be able to provide treatment for your cervical spondylosis.  That said, many a referral to a specialist is made for this condition. Referrals to rheumatologists (who treat arthritis,) neurologists, and orthopaedic or neuro-surgeons are common.  

Referrals to physical therapists are made for conservative care that is tailored to your symptoms and condition.

If your symptoms are mild or moderate, and if you do not have progressive nerve problems, you may only need conservative care.  This may involve one or more of the following:

  • Nonsteroidal anti–inflammatory drugs (NSAIDs) including aspirin, naproxen or ibuprofen to help reduce inflammation and relieve pain.
  • Analgesics, such as acetaminophen (Tylenol) for pain relief only.
  • Corticosteroid injections to treat radiating pain and to reduce inflammation.
  • Nerve blocks for temporary pain relief.
  • Restricting but not eliminating physical activity.
  • Cervical collar for support and stabilization during the healing period.
  • Exercise and, as mentioned above physical therapy.

Surgery is much less common for neck arthritis.  Signs you may need surgery include pain that's difficult or impossible to control and/or nerve problems (such as pins and needles or other electrical sensations, numbness and/or weakness down one arm) that over time continue to worsen.

Generally, a laminectomy, also known as decompression surgery, is performed for cervical spondylosis.  That said, Rana, et. al. reports that surgery "has not been proven to help neck pain and/or suboccipital pain." 



Rana, S., M.D., et. al. Diagnosis and Management of Cervical Spondylosis Clinical Presentation. Medscape website. Last Updated: Aug 2015.

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