Arthritis means "inflamed joint," and there are two major types that affect the cervical spine: spondylosis or osteoarthritis (OA), which is the "wear and tear" type, and rheumatoid arthritis (RA) which is the more disfiguring and often more painful of the two. OA is often caused by trauma, poor posture, overuse or nutritional deficiencies. RA is more mysterious, but thought to be an autoimmune disorder. Both types progressively affect the neck and both cause stiffness, swelling, reduced range of motion and sometimes neuropathy as early symptoms, but there are some important differences that can be distinguished.
Stiffness
Stiffness is the primary early symptom of OA of the neck. Some disc degeneration and bone spur formation has to occur before stiffness is felt, however. The stiffness is felt first thing in the morning, disappearing fairly quickly (under an hour), or will be felt after too much movement later in the day. RA causes stiffness also, but frequently lasts longer in the morning (several hours) and can come and go spontaneously later in the day. The stiffness of early stage RA can also progress to pain during "flare ups."
Swelling
Swelling is the primary early symptom of RA and usually affects the joints of the hands before it spreads to the cervical spine. Both sides of the neck joints are affected equally, and sometimes there is a redness or warmth over the affected area. OA can create some swelling also, but not much during the early stages.
Reduced Range of Motion
As the discs degenerate and bone spurs form due to OA, reduced range of motion is typically noticed. Sometimes movement in one direction is restricted while the other is not. A mild grinding feeling with movement may also be noticed with early stage OA. With early stage RA, range of motion might be severely restricted in all directions during a "flare up," or might not be restricted at all.
Neuropathy
Although mild posterior headaches can be experienced with early stage OA, the nerve roots or spinal cord are not affected until more advanced stages, because OA is a degenerative form of arthritis. With early stage RA, due mainly to its inflammatory nature, the nerves of the cervical spine can be irritated during a flare up and produce tingling or shooting pain into the shoulders or down the arms. Headaches can also be experienced with early stage RA, but usually do not depend on movement or positioning of the neck, as is the case with OA.
Fatigue
Fatigue, malaise (flu-like feeling) and fever are early symptoms of RA in general, but not with any stage of OA.
References
- "Essentials of Skeletal Radiology"; Terry R. Yochum, D.C.; 2004
- The Mayo Clinic: Rheumatoid Arthritis
- Wheeless' Textbook of Orthopaedics: Online
