The most common type of arthritis that affects the cervical spine (C-spine) is osteoarthritis. This non-inflammatory condition is caused by trauma or "wear and tear," and is also called degenerative spondylosis or degenerative disc disease. The diagnosis of C-spine arthritis is usually made by X-ray or other imaging techniques, and the condition typically causes a certain pattern of associated symptoms.
Pain
According to Dennis Marchiori in his textbook "Clinical Imaging," spinal discs and joint cartilage do not have nerve endings. That means that the source of the pain of C-spine arthritis is not directly from the degenerated disc or cartilage. Proposed sources of pain include joint swelling, muscle tension or spasm, contracture of ligaments or pressure on underlying bone.
The pain of C-spine arthritis tends to be located more in the back of the neck than the front. The intensity of the pain is generally moderate (not unbearable), and tends to be posture/position sensitive. In other words, certain movements or positions make it worse; others make it better.
Stiffness
Mobility is affected as the discs and joint cartilages wear down. The cervical spine consists of many joints. Each of these joints, like links of a chain, contributes to the overall movement of the neck. Depending on the number of involved links and the severity of the degenerative changes, the quality and quantity of neck movement will be affected to some degree. This stiffness tends to be worse at rest and improves with activity. These changes in the joints occur most often in the segments of the lower neck, according to Yochum and Rowe in their book, "Essentials of Skeletal Radiology."
Crepitus
That crackly, crunchy gravelly sound your neck makes when you move it around is called joint crepitus, and it could be the result of C-spine arthritis. The discs and cartilages of the spine act like little shock absorbers. As these tissues start to wear, the joints lose some of their ability to glide smoothly. Because the joints of the C-spine are close to the ears, these little joint noises can be more noticeable.
Weakness
As a secondary effect of the pain of C-spine arthritis, there is a tendency to reduce activity. Reduced activity then results in gradual de-conditioning of the muscles in the involved region. Over time, there may be a noticeable decrease of strength in the muscles that support the head and neck.
"Red Flag" Symptoms
A chronic progression of C-spine arthritis can lead to considerable reduction in the spaces between the vertebrae. It can also lead to the formation of bone spurs around the margins of the bones adjacent to the joints. These combined factors can sometimes lead to compression of the spinal cord or of the delicate spinal nerve roots. In these cases, you may experience pain, numbness and weakness radiating into one or both arms. Sometimes it may also affect the legs. Any neck pain that progresses to involve the extremities should prompt an evaluation by a health care provider.
References
- "Clinical Imaging With Skeletal, Chest, and Abdomen Pattern Differentials;" Dennis M. Marchiori; 1999
- "Essentials of Skeletal Radiology;" Terry R. Yochum and Lindsay J. Rowe; 1987
