What is the Best Treatment for Arthritic Neck Pain?

Neck arthritis can cause pain, stiffness, and other symptoms. It can also make it hard to move. Your doctor may suggest a treatment plan to relieve your neck pain and improve your mobility.

Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen may help relieve pain and swelling. They might also recommend a soft cervical collar.

Nonsurgical Treatments

Most people with neck arthritis can manage their symptoms with nonsurgical treatments, which include resting the neck, preventing overuse, and using heat and cold to ease pain. Medications, such as over-the-counter acetaminophen, can help relieve mild pain. A doctor can also prescribe stronger anti-inflammatory medications.

Over time, the neck’s spinal joints (cervical spine) can degenerate, or break down, due to normal wear and tear or because of a condition that causes inflammation in joint tissue, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis. This can cause a stiff, painful neck, a “grinding” or “cracking” sound when the neck is moved, weakness and/or numbness in the arms or hands and inability to move the head easily from side to side.

A physical examination is usually the first step in diagnosing neck arthritis. The doctor will ask questions about when the neck pain began and its severity. The patient may be asked to walk to check for signs of a spinal cord compression (myelopathy).

The most common treatment is an injection of a mixture of steroid and local anesthesia into a facet joint, which connect the bones of the spine. The local anesthesia blocks pain, and the steroid reduces inflammation. A cervical epidural block is another type of injection, which involves injecting anesthetic medicine into the space around the covering of the spinal cord (epidural space). This relieves neck and arm pain that may be caused by a herniated disc in the neck.

Medications

Your neck’s 24 different-sized bones (vertebrae) form a canal to protect your spinal cord. Between the vertebrae are flexible intervertebral disks that act as cushioning. As you age, your discs can shrink and the bones may rub together, causing pain and stiffness. This is called cervical spondylosis.

A few days of rest and simple self-help treatments, such as taking a hot bath or using a heating pad, often relieve arthritis pain and stiffness. Your doctor may also prescribe painkillers, such as paracetamol, and drugs that relax the muscles in the neck. However, muscle relaxants aren’t usually prescribed for long-term use because they can have serious side effects. In rare cases, your doctor may suggest drugs to reduce nerve irritation, such as gabapentin and pregabalin.

You may also try a TENS machine, which is small battery-operated device that puts low-voltage electrical stimulation on the painful area and produces a pleasant tingling sensation. It is believed to interfere with pain signals from the brain, and some people find it helpful. If your symptoms are severe, your doctor may do other tests, such as an MRI scan, to help identify the cause of your neck arthritis. He or she may also do a nerve conduction study to test how well your spinal nerves are functioning. This can detect compression of a spinal nerve, a condition called radiculopathy, or narrowing of the spinal canal, a condition called myelopathy.

Physical Therapy

The neck supports the head, and it’s made up of 7 bones (vertebrae) stacked one on top of each other, with 2 facet joints between each vertebra and muscles that help move and support the bones. Spinal discs cushion and allow the spine to move, but they can degenerate over time, causing pain. Bone spurs can form as a response to degeneration, and these can pinch the spinal nerves or the spinal cord. These conditions are called cervical spondylosis, a common cause of neck pain.

The best treatment for neck arthritis is usually physical therapy, and your doctor will probably prescribe a program of exercises that stretch, strengthen and improve your range of motion. Your doctor may also recommend heat or ice packs for pain relief. Heat soothes muscle tissue and increases blood flow, and can be used as often as needed. You can use a heat pack, hot water bottle or warm towel, or take a warm shower or bath.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, or the painkiller acetaminophen, can help relieve inflammation in the neck. However, these medications won’t treat the underlying cause of your pain. Your doctor may also prescribe a muscle relaxant to help with neck stiffness, but this is rarely used for long-term use because it can make your symptoms worse.

Surgery

Just like wrinkles on your skin or gray hair on your head, normal wear and tear can change structures in your neck over time. These changes are called cervical spondylosis, and they can cause pain and stiffness.

Over time, the cartilage that cushions joints in the spine can break down, and bones rub together more easily. This causes the space between spinal discs to shrink, and it can allow herniated disk material to push through. Spinal nerves in the neck send signals that help control movement and feeling, so when they’re pinched by slipped discs or compressed spinal cord tissue, it can cause weakness, tingling, or numbness.

If over-the-counter painkillers and a day or two of rest don’t ease your symptoms, talk to your doctor. If the problem is neck arthritis, a healthcare professional can recommend treatments and exercises that will usually relieve your symptoms.

Minor surgery is often recommended, because it doesn’t open a large part of your body and can be done in a hospital or doctor’s office. Depending on the procedure, you may need to stay overnight or be monitored by nurses at home until your anesthesia wears off.

If neck arthritis is severe, or if spinal cord compression is involved, surgery may be required. During this procedure, the doctor can remove bone spurs and any other debris that’s causing your problems. He or she can also relieve pressure on spinal nerves by using a technique that involves heating the nerves with radiofrequency ablation.