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Causes, Symptoms, and Treatment of Cervical (Neck) Osteoarthritis

With over two decades of experience in medicine, Melissa Flagg writes patient education articles, keeping you informed about your health.

An X-Ray of the Cervical Vertebrae

An X-Ray of the Cervical Vertebrae

What Is Osteoarthritis?

Osteoarthritis is the most common form of arthritis. It affects over 30 million Americans, and most of them are women. It is typically caused by wear and tear on the joints, which can be caused by trauma or injury, but is most commonly the result of the aging process.

The term osteoarthritis essentially means “bone and joint inflammation.” Osteo is Greek for “of the bone,” arth means joint, and –itis means inflammation. However, this term is actually misleading because osteoarthritis isn’t typically associated with inflammation until the later stages of the disease.

Cervical osteoarthritis can be extremely painful. It’s one of the most common forms of this type of arthritis and can affect anyone. It’s also a source of chronic pain and headaches for many people, including myself.

The Cervical Vertebrae

The vertebrae are not typical joints. They don’t have synovial fluid surrounding them, protecting them from friction and shock like the knees or elbows. Instead, they have a gel-like pad in between each vertebra known as the disc.

These discs are filled with a fluid that is comprised of degenerated collagen, proteoglycans and water. This gel-like center is called the nucleus pulpous, and it acts as the shock absorber for the vertebrae. It also keeps them spaced out.

There are seven cervical vertebrae and they are labeled C1, C2, C3 etc. C1 is the vertebra attached to the base of the skull and C2 allows the head to pivot. Because of this, these two vertebrae are under constant strain, and this predisposes them to osteoarthritis.

Anatomy of a Vertebra

Osteoarthritis in any part of the spine is known by several names including degenerative disc disease, which is exactly what you think: degeneration of the discs.

Essentially the nucleus pulpous becomes dehydrated, and this causes compression of the vertebrae. At the same time, osteophytes (also called bone spurs) begin to form and as the vertebrae compress these spurs can put pressure on spinal nerves, causing pain.

Eventually, the discs degenerate to the point of bulging into the spinal canal. Sometimes the degeneration is so bad that the gel-like contents herniate into the spinal column, which can also put pressure on spinal nerves (see diagram).

A Herniated Disc

Causes of Cervical Osteoarthritis

Our necks are constantly being used. From the time we get up to the time we go to sleep, our neck is in motion and supporting the weight of the brain and skull. Normal wear and tear on the vertebrae is a common cause of osteoarthritis of the spine, specifically the neck.

The Trapezius Muscle

There are a number of other things that can cause osteoarthritis to settle into the cervical vertebrae. It’s typically a result of the aging process, but it can occur in young people as well, and that’s usually the result of one of the following:

  • Whiplash caused by a blow to the head or a motor vehicle accident.
  • Poor posture.
  • Constant use of a smartphone that causes the head to tilt down putting pressure on C1 and C2.
  • Staying in the same position for long periods (surgeons typically have cervical osteoarthritis because of their head position during surgery).
  • Repetitive movement (such as “head banging”).
  • Trauma.
  • Sports injuries to the neck.
  • Compression caused by muscles in constant spasm (the trapezius muscle is the most common culprit).

Movement of the Neck

Symptoms of Cervical Osteoarthritis

Symptoms for all forms of osteoarthritis are very similar. However, cervical osteoarthritis has several characteristic symptoms that allow it to be easily distinguished from other forms of arthritis. These symptoms include:

  • Muscle pain (especially in the trapezius muscle)
  • Stiffness in the neck
  • Inability to turn the neck completely to either side
  • Pain in the neck
  • Ocular migraines
  • Headaches
  • Migraines
  • Pain that only subsides when laying down
  • Weakness, tingling or numbness in the arms
  • Psychological effects due to chronic pain
  • Problems performing routine tasks and hobbies
  • Sometimes complete and permanent disability

These are just a few of the symptoms. However, the headaches and migraines are the most disturbing to those who have been just diagnosed or are just developing the disease. The typical reaction is “But my neck doesn’t hurt.” It doesn’t have to.

Headaches can be caused from the compression that is the result of the discs degenerating and ultimately collapsing. Cervical osteoarthritis headaches are very distinctive, but are often misdiagnosed.

These headaches start at the very base of the skull and are usually unilateral (on one side of the neck). The pain then extends from the base of the skull up and over the top of the head and sometimes even to just behind the eye on the affected side.

However, both sides of the neck and head can be affected at the same time if the muscles are in spasm on both sides.

The compression can also cause any bone spurs to cut off the circulation of the cervical spinal fluid or put pressure on spinal nerves, most commonly the greater occipital spinal nerve.

This can trigger a migraine almost instantaneously along with all the symptoms that come with it including nausea, photophobia (light sensitivity), phonophobia (sensitivity to sound), vomiting and, of course, severe head pain.

Ibuprofen, Voltaren Gel and Ultram 50 mg

Ibuprofen, Voltaren Gel and Ultram 50 mg

Treatment of Cervical Osteoarthritis

Treatment typically involves management of the pain and other symptoms.

Pain medications can be very helpful in getting symptoms under control and allow the patient to resume some of their normal activities. Medications commonly used to alleviate pain from osteoarthritis include:

  • Voltaren gel
  • Ibuprofen
  • Tramadol (Brand name Ultram)
  • Naproxen sodium
  • Steroids (particularly prednisone)
  • Celecoxib (Brand name Celebrex)
  • Narcotic pain killers (Vicodin, vicoprofen)

Other treatments can include physical therapy, a change in lifestyle, the addition of exercise into the daily routine, and even a change in diet.

Treatment With Physical Therapy

Physical therapy helps to alleviate the stiffness that is caused by osteoarthritis. It can also help alleviate headaches. I know this from personal experience.

I have migraines due to compression of the cervical vertebrae C1, C2, and C3. This is the result of an injury sustained from a car accident many years ago. However, the injury caused osteoarthritis to develop along with bone spurs, which trigger migraines.

Anytime I went to my physical therapist and happened to have a migraine, the minute he started using manual traction on my neck to open the compression of the vertebrae, my headache magically disappeared, and the frequency of my headaches decreased considerably after several sessions.

Cardio and weight training exercise can work wonders for osteoarthritis. The movement prevents the stiffness so characteristic of osteoarthritis and the endorphins help to relax the muscles in the neck alleviating compression.

Weight training builds muscle, which also prevents compression because the muscles will help hold the vertebrae in place taking some of the pressure off of the discs.

However, weight training can exacerbate compression in muscles that are in constant spasm. It's important to speak with your doctor or physical therapist before starting any weight training program.

Making changes in your lifestyle such as alleviating a position that is known to exacerbate your arthritis (such as working on a computer, or driving) can do wonders for the prevention of further deterioration. While all positions can’t be avoided forever, it may be possible to change or correct your posture during these activities providing the same effect as avoiding them.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2012 Mel Flagg COA OSC


Bronwen Scott-Branagan from Victoria, Australia on November 01, 2018:

Thank you for a very interesting and informative article. The Rheumatology Specialist suggested Ibuprofen; I bought it, but then thought to look it up on the internet and found that it can cause big problems if one is allergic to Aspirin - which I am! Very! How glad I am that I did not take it, I'd rather put up with the pain! But this could be a warning to others, too.

MISTY PADILLA on October 31, 2018:

6 months post op. C3-'C6 tx. 2 1/2 inches of hardware in my neck! The worst exoerience ever. I feel worse then ever in fact more issues after surgery. They cut both posterior and anterior. EVERYDAY IS A STRUGGLE! From swallowing to sleeping, driving, anxiety you name it... WTF ! IM 44 YEARS OLD WITH A 4YR. SON 5YR. OLD GRANDAUGHTER. IS THERE HOPE FOR ME??????

Kitty Sloan on February 12, 2017:

Great information. CT demonstrated left occiput/C1 osteoarthritis, and multilevel enthesopathies. In PT which really helps. Didn't realize how the trapezius fits into all of this. Thank you for information.

Mel Flagg COA OSC (author) from Rural Central Florida on December 29, 2012:

@phoenix I love pinterest, but like you I was quite wary at first. Now that I've been using it more frequently it's kind of grown on me. They're really strict about spam as well. They even banned hubpages once because someone spammed users!

Zulma Burgos-Dudgeon from United Kingdom on December 29, 2012:

I've heard about Pinterest but wasn't sure about it. But if you're alright with it, I'm going to give it a go.

I had a good feeling the rent issue would work out. Excellent news.

Mel Flagg COA OSC (author) from Rural Central Florida on December 28, 2012:

@phoenix I've been doing something similar to let the universe know I'm serious about the changes I want. I actually created a secret pinboard on pinterest - kind of like a vision board. So far, things are changing, so I know it will work out for you as well.

I was really worried about the rent too, but it seems we're always saved at the last minute... :D and I am ever so grateful for that!

Zulma Burgos-Dudgeon from United Kingdom on December 26, 2012:

Hello again. :D

No, nothing yet. The closing date was 21 December and what with the holidays I don't imagine I'll hear anything till the New Year. In the meantime, I'll just keep looking. I have cleaned out my locker at work. The only things left in there belongs to the company; nametags, handbooks and such. It's my way of letting the universe know I'm serious about finding a new situation.

I was a little concerned about your rent situation, but I felt that things would turn out. I'm relieved to hear this.

Yule was lovely; hope yours was too. Call it what you will, all I know is I've had a fun year getting to know you.

Mel Flagg COA OSC (author) from Rural Central Florida on December 26, 2012:

@phoenix, I've been so horrible at replying to my comments lately, so I'm sorry! Have you heard anything about the position yet? Office work experience is like riding a bike, you never forget it and I'm sure your experience will show through during an interview. I wish you the best of luck on that!! :D

I have yet to get that email written, so much has happened and I've actually been swamped with work over the holidays (not a complaint though!). Suffice to say, however, we did get the rent paid!

I hope you had a wonderful Yule, and I think our meeting was fate, or destiny, or whatever you want to call it. You've been so helpful and supportive and I'm so grateful for that!! :D

Zulma Burgos-Dudgeon from United Kingdom on December 20, 2012:

Thanks, DOM. I'm sending off the application today. It's for an administrative assistant to the Medical Secretary of a pediatrics and OB unit. I'm a little nervous. It's been years since I've done office work. I know I can handle it. I've had years of experience. What I don't have is a piece of paper that tells HR that. Oh well, if it's meant to be...

You do sound more optimistic. I'll keep an eye out for your email. My daughter and I are doing last minute Christmas shopping today and I'm dreading it. Crowds make me very anxious. In fact, she had to promise to treat me to a coffee and fresh, hot cinnamon pretzel before I would agree. lol

Happy Yule to you too, DOM. I'm so glad to have made your acquaintance.

Mel Flagg COA OSC (author) from Rural Central Florida on December 19, 2012:

@phoenix, those chewables are so gross, I don't know how my daughter eats them. But they are the only way I can get extra vitamin C in her.

I hope you find a new job that actually appreciates you for 2013. You really shouldn't have to put up with that kind of crap just to make a pittance.

Things have gotten better, I'll email you with the details. I've been so busy trying to salvage what's left of the holidays for Sam, I really haven't had much time for anything else. o if I don't get a chance to email you before it, Happy Yule! Since this one is really special, I think we might do something to mark the occasion. Not sure what yet though.

Zulma Burgos-Dudgeon from United Kingdom on December 14, 2012:

Hey, DOM.

I couldn't abide these chewables anymore (yechh) so I flushed them.

As far was work is concerned, I've told them enough times about safety hazards in the warehouse and on the shop floor and frankly I'm tired of listening to my own voice. He only looks after his favourites anyway and I am most definitely not part of the 'inner circle.' lol Never mind. I'm polishing up my resume and looking for a new job. I don't get paid enough to put up with them.

Once again, I'm sorry I couldn't have been more help to you. Let us know how things are going.

Mel Flagg COA OSC (author) from Rural Central Florida on December 13, 2012:

@Phoenix I hope your feeling better. Warm water bottles are perfect for the neck and really do wonders for loosening up the neck muscles. So do muscle relaxants but they tend to put me to sleep. lol As for the chewable vitamin C, if you haven't noticed them helping it's because they are made entirely of sugar and vitamin C and glucose have almost exact chemical structures, which means glucose gets priority and the vitamin C just gets washed out. Plus they taste horribly!! ick!!

Tell the bosses if they had a safer work environment, you wouldn't be injured! I don't get why companies don't take care of their employees. It's not as expensive as they think it is, or as expensive as having them out for weeks at a time!

Feel free to rant, you've listened to my crap enough, I'm honored to return the favor!! :D

Zulma Burgos-Dudgeon from United Kingdom on December 11, 2012:

Hi, DOM.

I'm as well as can be expected. Although I got hit on my left side, it's affected the right side as well. I thought this might happen. My neck muscles are pretty stiff but the lower back is recovering nicely.

My husband got me a hot water bottle to put on my neck to loosen the muscles up so I could stretch more easily. It was so lovely and cosy warm I ended up falling asleep. lol. It did help though.

As far as the Vit C, I desperately need my regular tablets. I ran out so my husband brought back the only thing he could find: orange-flavoured chewable Vit C. They are positively vile.

I'm off work at the moment. The bosses aren't happy about that. I don't care. If they had kept the warehouse tidy, this probably wouldn't have happened. The delivery guy was so busy watching out for junk on his left only that he never saw me. (I was on the right side.) By the time I turned around to check if the way was clear it was too late. Time to find a new situation I think.

Thanks for the advice, DOM, and sorry for the rant. It's the frustration talking.

By the way, I also need to use a certain type of pillow that allows me to sleep with as straight neck as possible.

Mel Flagg COA OSC (author) from Rural Central Florida on December 10, 2012:

@Glenn, I wholeheartedly agree. Too many people think their doctors are "gods" and trust them implicitly, but they are human just like us and can easily make mistakes. I have to have a thin pillow, interestingly. It can't be over 6" thick or I wake up with a raging migraine. I'm so sensitive to the thickness of my pillow that when my hubby occasionally (and accidentally) switches my pillow with his when he changes the pillow cases, I have a migraine the next day, and until I figure out that I have the wrong one. My hubby is like you and has to have two pillows.

Mel Flagg COA OSC (author) from Rural Central Florida on December 10, 2012:

@Phoenix OMG!!! Are you ok?? Never a dull moment with us huh? I hope you feel better soon, gentle stretching exercises may help loosen you up a bit, I'm sure you're pretty stiff, but take it easy for awhile! You may want to increase your vitamin C a bit to help with the healing and keep that collagen flowing. I'll be thinking of you!!

Glenn Stok from Long Island, NY on December 09, 2012:

Daughter Of Maat, Yes I have found relief by propping my head up on two pillows when I sleep. The numbness only occurs when I let my head hang back. Thanks for the confirmation that this type of misdiagnoses is common. This goes to show that people need to do their own due diligence and not always trust their doctors.

Zulma Burgos-Dudgeon from United Kingdom on December 08, 2012:

Thanks for the vote of confidence, DOM. Unfortunately I just had an accident at work that has set me back for at least 2 weeks. I've hurt the muscles on the left side of my neck and my lower back after getting hit by a delivery cage loaded with groceries. I not happy right now. :(

Mel Flagg COA OSC (author) from Rural Central Florida on December 08, 2012:

@Glenn Thank you!! Unfortunately, what you've been through is all too common. Problems in the cervical spine are often misdiagnosed as carpel tunnel because of the pain and/or numbness and tingling in the arms and hands. I had a friend of mine who broke his neck falling off of a roof and although he healed, he had permanent damage that caused tingling and numbness in his pinky and ring finger on his left hand and all because of compression and a herniated disc.

I hope you have since found some relief despite the unnecessary surgery!

Mel Flagg COA OSC (author) from Rural Central Florida on December 08, 2012:

@phoenix it is difficult in the beginning. I've been off my routine for so long now that I've lost a lot of the strength I built up, and I can really tell. It takes time, and you may only get to half a sit-up by the weekend, but you'll get there! :D

Glenn Stok from Long Island, NY on December 05, 2012:

I found your hub very interesting and informative. I had three herniated discs in my cervical spine. There is another side effect that was disovered by having an MRI. I had misdiagnosed carpel tunnel. The numbness in my hand was actually caused by the herniated discs in my neck. Unfortunately this was discovered after I already had carpel tunnel surgery, which really never needed to be done.

I'm sorry to hear what you are going through, and I hope you're feeling better. The physical therapy does wonders.

I understand a lot more now about the neck after reading your hub. Voted up and useful.

Zulma Burgos-Dudgeon from United Kingdom on December 05, 2012:

I'm going to have to go slow. I didn't realize how weak I've become since the surgeries. I need to try to rebuild my core strength. It's been challenging but I hope to do one sit-up by the weekend. lol

Good luck with yours, DOM.

Mel Flagg COA OSC (author) from Rural Central Florida on December 04, 2012:

How did it go?? I really need to get back to mine. I've been so busy writing, I haven't had the time.

Zulma Burgos-Dudgeon from United Kingdom on December 03, 2012:

Thanks, DOM. I try to put a little programme together today.

Mel Flagg COA OSC (author) from Rural Central Florida on December 02, 2012:

@BlossomSB, Thank you! This is one of those problems that doctors tend to sweep under the carpet it seems. But it's a very real problem. I thoroughly enjoyed writing this hub and hopefully other people who are suffering as I do will find some relief from it.

Mel Flagg COA OSC (author) from Rural Central Florida on December 02, 2012:

@phoenix, any type of cardio will do, although I've found that boxing helps me the most mainly because it works the upper body, specifically that damn trapezius muscle. All the punching seems to help loosen up the neck muscles as well as the upper back.

Weight training should be focused on the upper body. The stronger the muscles in the upper back and neck, the easier it is for the vertebrae to stay in place. I do lots of bicep, tricep and shoulder work. The tricep and shoulder exercises really help with loosening the trapezius. Although initially, the neck muscles tighten so it's important to get plenty of stretching in. Yoga helps tremendously with that!

Bronwen Scott-Branagan from Victoria, Australia on December 02, 2012:

Thank you for this helpful information. You explain the problem clearly and the images endorse what you have written. Voted up.

Zulma Burgos-Dudgeon from United Kingdom on December 01, 2012:

Good info. I didn't know cardio and weight training could be so helpful. Is there any particular type that is most useful?