Cervical Osteoarthritis
Information on the symptoms, treatment, and prognosis of cartilage degeneration in the vertebrae of the neck.
Symptoms and causes
Cervical osteoarthritis, or cervicoarthrosis, is a degenerative condition characterized by the wear of cartilage in the cervical vertebrae (neck area). As a result of abnormal friction between bones, more severe pathologies can develop in addition to causing intense pain.
Cervical tissues degrade over time, and there are four grades of osteoarthritis depending on the extent of involvement:
- Grade 1 or mild cervical osteoarthritis: Cartilage is minimally damaged, so symptoms are almost absent.
- Grade 2 or moderate cervical osteoarthritis: Cartilage begins to degrade, and soft tissues show minor damage. Pain usually occurs with physical activity.
- Grade 3 or advanced cervical osteoarthritis: Cartilage damage is significant, bones begin to be affected, and deformities may appear. Daily movements provoke pain.
- Grade 4 or severe cervical osteoarthritis: Cartilage is almost completely destroyed, leaving no space between vertebrae. Pain is intense due to bone inflammation.
The prognosis of cervical osteoarthritis varies for each patient. However, since its progression is slow and treatments aim to delay symptom onset, it is generally favorable and not life-threatening.
Symptoms
Symptoms vary depending on the osteoarthritis grade and the degree of tissue involvement within the joint. The most common manifestations are:
- Axial neck pain: persistent, often worse at rest and relieved by movement.
- Vertebral pain radiating to the shoulders and nape.
- Neck stiffness.
- Bone inflammation.
- Muscle spasms/contractures.
Causes
Although the causes are not fully understood, all studies indicate that cervical osteoarthritis is caused by progressive degeneration of articular cartilage due to aging. In some cases, it may result from trauma or poor postural habits.
Risk Factors
Factors that increase the risk of developing cervical osteoarthritis include:
- Age: cartilage degenerates progressively, typically appearing after 50 years.
- Sex: the disease affects women more frequently.
- Previous cervical trauma or injury.
- Excessive cervical vertebral movement or sustained postures due to occupational or sports activities.
- Family history.
- Diabetes.
Complications
Complications arise when cartilage is completely destroyed and can include:
- Intense pain.
- Development of osteophytes (bone spurs).
- Reduced mobility.
- Difficulty performing daily tasks.
- Cervical radiculopathy: nerve compression causing tingling and weakness extending into the arms.
- Cervical myelopathy: spinal canal narrowing compresses the spinal cord, resulting in weakness, lack of coordination, and sensory changes.
- Cervical vertigo: causes dizziness and instability.
- Sleep disturbances.
- Depression due to chronic pain.
Prevention
Cervical osteoarthritis cannot be prevented, but its progression can be slowed with certain habits:
- Strengthening neck muscles.
- Maintaining proper posture when using a computer or lifting heavy objects.
- Performing gentle stretches regularly if maintaining the same posture for long periods.
- Staying adequately hydrated.
- Avoiding smoking.
- Avoiding alcohol.
- Maintaining a healthy weight.
- Practicing low-impact exercise such as swimming, yoga, or walking.
Which Specialist Treats Cervical Osteoarthritis?
Cervical osteoarthritis is managed by specialists in rheumatology and traumatology and orthopedic surgery.
Diagnosis
Diagnosing cervical osteoarthritis is not always straightforward, as symptoms may take time to appear. Typically, evaluating the patient’s medical history, analyzing symptoms, and performing a physical examination to assess pain severity and range of motion are sufficient.
Imaging studies are used to assess vertebral condition or the presence of complications, including X-ray, magnetic resonance imaging (MRI), or computed tomography (CT).
Treatment
Treatment of cervical osteoarthritis focuses on slowing disease progression and alleviating symptoms. In most cases, a conservative approach is preferred:
- Analgesics for pain relief.
- Anti-inflammatory medications to reduce swelling.
- Muscle relaxants.
- Corticosteroid or hyaluronic acid injections to protect vertebral bones.
- Physiotherapy to relax and strengthen muscles and promote mobility. Patients are also instructed on proper daily posture.
When osteoarthritis is advanced or does not respond to less invasive treatments, surgery may be indicated:
- Cervical arthrodesis: fusion of two or more vertebrae to prevent instability. Pain is relieved, and the risk of complications is reduced, but mobility is lost.
- Cervical arthroplasty: removal of the intervertebral disc and replacement with an artificial prosthesis to restore joint function and relieve pain.
