How Can Rheumatoid Arthritis Affect The Cervical Spine
Rheumatoid arthritis is a chronic, systemic, autoimmune disease in which the immune system, which is designed to attack foreign bodies like bacteria and viruses, mistakenly attacks other healthy areas of the body, including the spines facet joints and even organ systems. Untreated, attacked joints can become deformed and lose their mobility.
When it comes to spine pain, a rheumatoid arthritis diagnosis is limited to the cervical spine. People can have problems, such as facet joint arthritis, further down the spine, but this is likely not due to RA. It is possible to have both osteoarthritis and rheumatoid arthritis at the same time.
If you have RA, you are part of a group of 1.3 million other Americans who have the disease.1 The disease causes morning joint stiffness that can last one to two hours or the whole day. It generally improves with movement of the joints. Other signs and symptoms include loss of energy, low fevers, loss of appetite, and lumps in the elbows and hands, called rheumatoid nodules. About 75% of RA patients are women, but cervical spine involvement is more common in male patients and those with a positive rheumatoid factor.
When rheumatoid arthritis loosens ligaments, erodes bone or causes thickened tissue around the atlantoaxial joint, it can compress the spinal cord and brain stem, which can lead to paralysis or even death if the neck is moved in certain positions. Fortunately, there are many treatments to avoid these outcomes.
How Is Cervical Spondylosis Diagnosed
The doctor will generally begin by asking you about symptoms and taking a medical history. This will be followed by a physical exam of the body, with a focus on the neck, back, and shoulders. The doctor is also likely to test reflexes and the strength of hands and arms, check for loss of sensation, and watch you walk.
Other tests that might be done include imaging exams such as X-rays, computed tomography , and magnetic resonance imaging . MRI scans use large magnets, radio waves, and a computer to produce the best images of the body. You might also be referred to a neurologist.
Spinal Arthritis: What You Need To Know
Osteoarthritis is the most common type of arthritis to affect the spine.
Arthritis can occur anywhere along the spine, but is more frequent in the lower back and neck.
Pain and stiffness are the most common symptoms of spinal arthritis.
Causes of spinal arthritis are still largely unknown except for osteoarthritis, which is typically a result of wear and tear.
Spinal arthritis treatment may include pain medications, steroid injections, physical therapy and surgery in severe cases.
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Spinal Arthritis Causes And Risk Factors
The causes of arthritis in the back or neck vary depending on the type of arthritis you have. Besides normal wear and tear and autoimmune triggers, in many cases the exact cause remains unknown. Genetic components have been identified in connection with some forms of spinal arthritis, meaning that it may be hereditary.
Other spinal arthritis risk factors include:
Presence of certain conditions such as diabetes, gout, psoriasis, tuberculosis, irritable bowel syndrome and Lyme disease
Exercises For Neck And Shoulder Pain
Here are the best exercises for neck and shoulder pain. These neck pain exercises can help strengthen the muscles around your neck and cervical spine and take pressure off your discs:
- Water exercise or aerobics
- Resistance Training Perform joint friendly non-impact Exercises for Arthritis to strengthen the muscles surrounding the joints , taking pressure off of them and begin true healing.
- Posture Training The Alexander Technique is really great for this. Proper Posture is very important in getting arthritis pain relief and this can help you relieve neck, back and shoulder pain!
- Ergonomics Proper Ergonomic Posture reduces stress on your back and joints.
- Lose Your Neck Pain This guide gives you all the exercises, diet choices for arthritis relief that has been proven to work from the healthy back institute!
Do whatever you can do that doesnt add additional stress on your neck and spinal column to relieve the pressure on your neck and spine. Then add the following natural treatments below to restore pain free mobility for the long term.
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When To See A Doctor For Cervical Osteoarthritis
Some conditions can feel similar to cervical osteoarthritis, so it is imperative to see a doctor for an accurate diagnosis and effective treatment plan. A cervical selective nerve root block can be used to determine the source of neck pain. In order to diagnose the cause of a patients neck pain, the doctor will likely start with the following:
How Is The Neck Structured
Your neck and back are made up of small bones called vertebrae. These are stacked on top of each other to form the spinal column.
The spinal column supports your head and protects the spinal cord. This is the main structure which links the network of nerves throughout your body. Messages travel along this network sending sensations, such as pain, to your brain.
The top seven bones in the spinal column form your neck, and these are called the cervical vertebrae. The bones are linked together by facet joints. These are small joints between your vertebrae that, together with your neck muscles, allow you to move your head in any direction.
Between the vertebrae are discs of cartilage. The discs act as shock absorbers and give the spine its flexibility. A slipped disc occurs when one of these discs slips slightly out of its natural position in the spine.
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Osteoarthritis Of The Spine
Osteoarthritis is the most common form of spinal arthritis. It usually affects the lower back and develops through wear and tear. As the cartilage between the joints slowly breaks down, it leads to inflammation and pain. Because the pain is from mechanical damage, it is typically more noticeable when you bend or twist your back. Past back injuries may also contribute to the development of degenerative arthritis of the spine.
Osteoarthritis of the spine usually affects the facet joints between the vertebrae. It is also known as facet joint arthritis, facet joint syndrome and facet disease. In some cases, degeneration of the spinal discs may contribute to facet joint arthritis. As discs between the vertebrae become thinner, more pressure is transferred to the facet joints. This leads to more friction and more damage to the cartilage.
When these degenerative changes occur in the neck, this condition is called cervical spondylosis. Arthritis in the neck doesnt always cause pain, and many people have no noticeable symptoms.
What Are The Treatments For Cervical Spondylosis
In most cases, cervical spondylosis treatments are conservative. They include:
- Use of nonsteroidal anti-inflammatory drugs or other non-narcotic products to relieve pain from inflammation
- Chiropractic manipulation that can help to control episodes of more severe pain
- Wearing a cervical collar to limit movement and provide support
- Other forms of physical therapy, including the application of heat and cold therapy, traction, or exercise
- Injecting drugs into the joints of the spine or the area surrounding the spine, known as epidural steroid injection or cervical facet joint injection
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Recognizing The Signs Of Neck Arthritis
Neck arthritis develops in the same way as arthritis in other joints. The cartilage in the cervical discs that cushion your vertebrae begin deteriorating with age. Vertebrae begin grinding against each other or pressing on nerves within your spinal column.
You could have cervical spondylosis if you regularly experience:
- Neck pain
- Grinding sensation when turning your neck
Pain is the most common symptom of neck arthritis, but stiffness can be severe. In some cases, neck stiffness can keep you from fully turning your head, which can interfere with your ability to drive safely.
Not everyone with cervical spondylosis has noticeable symptoms. If you do experience symptoms, they may be worse in the early morning and at night. Some people find that symptoms improve with rest.
Neck pain caused by cervical spondylosis is often chronic, but its rarely so severe that it stops you from carrying out your normal daily activities. Still, that doesnt mean you have to settle for a life of pain and discomfort.
Give Yourself Some Time
If you have neck pain, modify your activities for a few weeks to avoid putting additional strain on your neck. To relieve more severe pain, you can take an over-the-counter nonsteroidal anti-inflammatory drug or get a prescription from your doctor. The drug gabapentin may help with nerve-related neck pain.
If you dont improve on these medications, your doctor might suggest an epidural steroid injection to decrease inflammation around and inside the nerve.
Once the pain subsides, Dr. Mroz recommends seeing a physical therapist or doing range-of-motion exercises to improve mobility in your neck and prevent stiffness. If youre still having pain after six weeks, see a doctor.
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What Is Neck Arthritis
When you consider the fact your neck is made up of 7 small vertebrae, and yet it holds your 8-to-10-pound head up every day, is it any wonder that many people end up with arthritis and pain?
Also known as cervical spondylosis, arthritis of the neck ultimately affects almost everyone. In fact, degeneration becomes visible on an X-ray in about90% of people by 60 years of age. It results from wear-and-tear that causes changes to the spine.
Spinal disks can begin to bulge, as well as dry out and weaken, which in turn may cause the disk spaces to collapse. You may feel increased pressure in your joints as they degenerate and the protective smooth cartilage wears away. In cases where the cartilage is totally gone, bone may rub on bone and cause bone spurs to develop.
Using Heat And Ice Packs
Applying a heat pack to your neck can help to ease pain. You can use a microwavable wheat bag, a hot-water bottle or a reusable heat pad which you can buy from chemists and sports shops. An ice pack, or even a bag of frozen peas, can also be helpful.
Make sure you wrap heat or ice packs in a towel and dont put them directly onto your neck to avoid burning or irritating your skin. You might want to consider applying a heat pack to your neck before and after exercise to help soothe the muscles.
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How To Avoid Neck Strain During Sex And Sleep
The natural pain-killing powers of an endorphin rush during sex can actually help your RA. But while youre temporarily feeling less pain, you might push your body past its boundaries. To prevent hyperextending your neck during sex, try to resist the tendency to throw your head forward or back during orgasm. You’ll also want to invest in a good pillow. The right type of pillowask your physical or occupational therapist for a recommendationcan also prevent morning neck stiffness after a good nights rest.
Why Neck Inflammation Can Be Dangerous
When RA inflammation affects a joint, it can cause bone erosions and slackness in ligaments. In the neck, this can lead to instability between the first and second vertebrae as well as alignment problems when you tilt your head forward or back. If it progresses, the nerves may get impinged, which can lead to weakness and numbness in extremities, says Rajat Bhatt, M.D., a rheumatologist at Memorial Hermann Katy Hospital in Richmond, TX. Severe instability can also lead to compression of the spinal cord, which can be fatal. Fortunately, surgery to fuse the joint can eliminate the risk .
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Neck Arthritis Physical Therapy Will Pt Help
Youve come here looking for help with your neck arthritis, and by now you probably want to know if physical therapy can help.
The answer is yes, physical therapy can help with neck arthritis.
When you first visit a physical therapist, youll complete an evaluation or consultation.
During this evaluation, your therapist will see how well you can move your neck, ask what symptoms you have, and assess joint function in your neck and back.
After the initial assessment, your physical therapist will work with you to create a plan to alleviate neck arthritis symptoms.
Rheumatoid Arthritis Medication Treatment Goals
Pinpointing how to subdue an overactive immune system has stumped doctors for decades. Seventy-five years ago, one of the only rheumatoid arthritis treatments for patients was a weekly injection of gold into the gluteal muscle. Today, there are a plethora of treatment options.
Current treatments give most patients good or excellent relief of symptoms and let them keep functioning at or near normal levels, reports the website of the American College of Rheumatology.2
Since there is no cure for the disease, the aim of treatment is to reduce pain and halt joint breakdown. The goal is to not only control symptoms, but to prevent further damage and deformities, Dr. Chi said.
Many rheumatoid arthritis treatment drugs fall into a bucket labeled disease modifying antirheumatic drugs . While most patients receive some form of a DMARD, no single drug is a guaranteed solution as patients react to the drugs differently. Scientists designed some of the drugs to fight against certain immune cells, while other drugs reduce immune mediators or block immune cell functions. Patients may be treated with a DMARD in combination with nonsteroidal anti-inflammatory drugs or low-dose corticosteroids, which reduce swelling and pain.
Common first line DMARDs include methotrexate, leflunomide, hydroxychloroquine and sulfasalazine.
If first line medications dont work, rheumatologists can pull out a list of second line medications called or biologics.
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Other Rheumatoid Arthritis Treatment Options
Patients can also relieve joint stiffness with like swimming, walking or cycling, Dr. Chi said. I generally prefer low impact, Dr. Chi stated. The more force you apply to the joints, the more damage you could do to the cartilage.
Spinal surgery may be a treatment as well. The most important indications for when rheumatoid arthritis is involved are resistant pain, neurologic deficits and/or a need to stabilize the upper cervical spine to prevent spinal cord damage.
References1. Freeman J. RA Facts: What are the Latest Statistics on Rheumatoid Arthritis? Rheumatoid Arthritis Support Network. October 27, 2018. https://www.rheumatoidarthritis.org/ra/facts-and-statistics/. Accessed June 27, 2019.
2. Duarie-Garcia A. Rheumatoid Arthritis. How is rheumatoid arthritis treated? Updated March 2019. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Rheumatoid-Arthritis. Accessed June 25, 2019.
Scher JU, Malik F, Manasson J. Using the Microbiome to Aid Psoriatic & Rheumatoid Arthritis Diagnostics & Therapeutics. Rheumatology 2018 Year in Review. https://nyulangone.org/news/using-microbiome-aid-psoriatic-rheumatoid-arthritis-diagnostics-therapeutics. Accessed June 27, 2019.
What Are The Long
Middle or lower back pain is most often a mechanical issue, and does not occur because of RA. However, in some cases the disease can indirectly cause pain in the mid or low back. For example, severe pain in other joints could alter the mechanics of your gait, which could result in back pain over time.
My neck has been affected the most by my RA, but my lower back also hurts, and I think thats caused by the pain in my hips and knees, says CreakyJoints member Mary Eldreth Pearson. If I have to stand for longer than 30 minutes my lower back hurts more.
RA may also indirectly affect the back because it increases a persons risk of developing osteoporosis, Dr. Bolster says. While osteoporosis itself isnt painful, it can result in insufficiency fractures of the vertebral bodies in the thoracic and lumbar spine.
If someone with RA came to me with sudden onset of back pain, that could indicate a compression fracture of the spine, which occurs in people with osteoporosis, she explains.
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What Will Happen To Me
For most people neck pain settles down fairly quickly. This usually takes several weeks but can vary between people. Some people still have problems with their neck even after the original problem has settled down. This is often because a lack of activity has caused stiffness and weakness of the neck muscles.
Spondyloarthritis In The Neck
Other types of neck arthritis include psoriatic arthritis and ankylosing spondylitis, which are both considered a type of arthritis called spondyloarthritis. Its an umbrella term for inflammatory diseases that involve both the joints and entheses, the places where ligaments and tendons attach to the bones.
Psoriatic arthritis is a form of arthritis often accompanied by psoriasis, an inflammatory skin disease. For some people who have psoriatic arthritis, the condition involves the spine, which impacts the neck. Pain happens when inflammation strikes the joints between the vertebrae. This pain can occur on just one side of the body, the neck, and the lower and upper back. Read more about psoriatic arthritis symptoms.
Ankylosing spondylitis is a form of arthritis that strikes the bones in your spine and pelvis as well as peripheral joints. Early signs and symptoms might include pain and stiffness in your lower back and hips, especially in the morning and after inactivity. Fatigue and neck pain are common. AS symptoms might worsen, improve, or stop at irregular intervals.
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Overview Of The Temporomandibular Joint
The TMJ can both open like a hinge and glide, which is a major reason for its uniqueness and complexity. Unknown by many, there are two TMJs in the body located in front of each ear. The joints attach the mandible to the skull. Also, they are essential for talking, eating, yawning, and making facial expressions.
A medical term for problems with the jaw joint is temporomandibular joint dysfunction , or simply temporomandibular joint disorder. TMJ disorders do not only affect the jaw, but they may also have an impact on the ears, cheeks, and the rest of the face.