Arthritis of the cervical spine: why does my neck hurt and make noise?
Each day at least one patient states, “my neck pops and cracks and makes all this noise. Why is that?” The short answer is that the architecture of the joint structure in the cervical spine (neck) begins to break down as we age. As the architecture breaks down, friction develops in areas because of the uneven pressure on the joint surfaces. This is basically arthritic degeneration of the joint surfaces. The more advanced the degeneration, the more noise these surfaces will make as they move.
According to researchers at Penn Medicine, degeneration in the cervical spine (neck) can start as early as 30 years old. The degenerative process is also inevitable. The American Academy of Orthopedic Surgeons (AAOS) states that more than 85% of people over the age of 60 will experience degeneration of the cervical spine. That being said, age is the number one risk factor to get degenerative arthritic changes in the neck. It is a simple formula; the longer you live the more likely the parts will start to wear out. Like it or not, we are finite mechanical machines and therefore subject to wear and tear and eventual break down.
Age is not the only risk factor for degenerative changes. If you have a family history of spinal arthritis then you may have a genetic predilection for degenerative arthritis. While smoking has been linked to many degenerative processes in the body, there is a very clear link to both neck and back pain. If you have a job that requires either chronic repetitive head down postures or recurrent head up postures (extremes of either direction), you are at higher risk of neck pain due to degeneration. Several studies connect anxiety, depression, and psychosocial distress with neck and back pain. Lastly, if you have actually injured your neck or had a specific trauma (car accident, sports injury, fall, concussion, etc.) this will predispose you to degenerative changes of the cervical spine.
Most people that have degenerative arthritis of their neck don’t realize it. First of all, they have minimal to no pain. They may have lost some range of motion but it is either too minimal to notice and/or they have learned how to compensate for it so it is not noticeable. Once they start to experience symptoms it usually starts with stiffness or an acute sharp pain. An Xray is usually taken and reveals the preexisting arthritis. It is not unusual at this point for patients to connect the dots and realize the popping, cracking, or snapping they have been experiencing for several years was probably the early stages of the arthritic development. The discs or spacers that connect the vertebra (bones of the neck) will usually degenerate first. As these degenerate, the spine compresses and the joints on the back of the neck take more pressure and friction. The joints will degenerate faster in response to the pressure. As the joints and discs degenerate, spurs begin to grow usually narrowing the holes that serve as tunnels for the nerves coming out of the neck and supplying the muscles in the arms with a connection. If the nerves become compressed with arthritic spurs, you may experience numbness and tingling in the hands, pain down the arms, and/or weakness in the arms and hands. Not many people equate weakness in the legs or balance difficulty with neck problems but if the degeneration is severe it will also narrow the main spinal canal compressing the spinal cord. Compression of the spinal cord in the neck will affect everything from the shoulders down to the feet. Signs of spinal stenosis in the neck such as leg weakness and balance difficulty need to be evaluated by either a spinal specialist with advanced imaging such as an MRI and/or a CAT scan.
Treatment for patients with spinal related arthritis is generally focused on symptom control, improvements in range of motion and strengthening to stabilize the faulty architecture. The majority of sources recommend over-the-counter medications such as Ibuprofen, Naproxsyn, or Tylenol for pain. Nutritional supplements such as fish oils, glucosamine-chondroitin sulfate, and vitamin D are gaining more acceptance as a part of an anti-inflammatory based diet. Physical therapy, chiropractic, massage, and acupuncture are also viable treatments to reduce pain and improve range of motion. As part of a physical therapy and/or a chiropractic regimen, strengthening of the neck, shoulders, and upper back will help take stress off of the damaged joints in the neck.
Lastly, keep an eye on your posture. Avoid head down postures when using electronic devices such as your phone and tablet and bring the device up to eye level instead. Re-evaluate your pillow for proper support if your neck pain is worse in the morning. If your neck pain is lasting more than 14 days, see your doctor to assess the underlying cause and receive the necessary treatment.
Dr. Buchberger is a licensed chiropractor, physical therapist, certified strength and conditioning specialist and Diplomate of the American Chiropractic Board of Sports Physicians with 32 years of clinical sports injury experience. Dr. Buchberger can be contacted at 315-515-3117, www.activeptsolutions.com or www.shouldermadesimple.com