Conditions

Neck Osteoarthritis

Osteoarthritis is a common condition that affects the joints. In the neck, it develops gradually over time as the joints and surrounding tissues change with age. These changes are a normal part of getting older and do not always cause pain.

Many people think osteoarthritis is simply "wear and tear". We now know this is not accurate. Joints are living tissues that continually repair themselves throughout life.

neckpain

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Arthritis UK describes osteoarthritis as "tear, flare and repair". This means that joints naturally go through cycles of change and repair. Sometimes they become irritated ("flare"), causing pain and stiffness, before settling again. Osteoarthritis is more common as we age. This is more common over the age of 45.

The main symptoms are:

Neck pain
Neck stiffness
Pain that may spread to the shoulder or shoulder blade
Morning stiffness that usually improves within about 10 minutes

An osteoarthritis joint can “flare”. This can occur after an injury however it can also happen without a clear cause. Most flares improve over several weeks, although some can take longer. Below are some treatment options which may help manage your symptoms.

Steps to take to recovery

Self-Management

Activity Modification

If symptoms have recently worsened it may be worth reducing or changing activities that make your symptoms worse. Trying to get a balance between rest and activity can help your pain to settle down. Regular positional changes may make things more manageable. Try to keep the neck moving but avoid prolonged static positions. You may be sore at first, however, start slowly and gradually increase the amount you do.

Pain Relief

Over-the-counter medicines: Over-the-counter pain relief may help you stay active. Always follow the advice provided with the medicine.

Topical creams: Some people find topical creams or gels helpful for short-term relief of pain and stiffness.

It is important to check whether you can take these medicines. If you are unsure whether you can take these medicines, speak to a pharmacist or another healthcare professional.

Heat therapy

A hot water bottle or wheat bag applied to the neck for 10–15 minutes may help reduce pain and muscle tension. Wrap ice or heat packs in a towel and do not place them directly onto your skin to avoid ice or heat burns.

Exercises

Consider light aerobic exercise at first such as walking, swimming, or cycling. Neck exercises on Arthritis UK may help.

You might not always feel like exercising if you have arthritis. And you might be worried that exercising will make your pain or your condition worse. However, we now know that exercise can help pain and reduce stiffness. Try performing some simple range of movement exercises to help maintain your movement and allow things to settle down.

Further Treatment

Physiotherapy

If your symptoms aren't improving or you feel you need more help, then please refer yourself to physiotherapy. We will assess your symptoms and work with you to develop a treatment plan. You can have one-to-one physiotherapy and have access to our gym classes. We can also refer you to other services to access other treatments listed below if appropriate.

Corticosteroid Injection

These are occasionally completed for severe flare-ups that aren’t settling. Physiotherapy and pain relief are recommended before considering an injection. Injections may reduce severe inflammation and pain for a period. The physiotherapy service can refer people to the pain team for possible injections. It is not an appropriate option for everyone.

Surgery

Surgery is only recommended for a small number of people. This is not an appropriate option for most. Your physiotherapist would discuss your referral options with you if required.

When to seek further advice

Most neck pain, arm pain, numbness or weakness is not caused by a serious problem. However, new or worsening symptoms affecting your nerves or spinal cord require urgent medical assessment.

Please contact your GP urgently if you develop any of the following:

Changes to your hands or arms

New or worsening weakness in your hands or arms
Difficulty with tasks that require hand coordination, such as fastening buttons, using cutlery or writing
Increased clumsiness or dropping objects

Changes to your walking or balance

New problems with balance or walking
Feeling unsteady on your feet
New difficulty controlling your legs

Changes to bladder or bowel function

New difficulty controlling your bladder or bowel
New changes in your ability to pass urine or open your bowels

Other concerning changes

Numbness or altered sensation that is getting worse or spreading
Symptoms that are progressively worsening over time

These symptoms can sometimes be a sign of degenerative cervical myelopathy (DCM), where the spinal cord in the neck becomes compressed. Although uncommon, early assessment is important as treatment can help prevent further deterioration.

Seek medical advice if:

The symptoms described in the "When to seek further advice" box can be a sign of a condition called cervical myelopathy. Although uncommon, it needs urgent medical assessment because early treatment is important. If untreated it can lead to permanent leg, arm, bladder, bowel and/or sexual dysfunction. You can find more information about degenerative cervical myelopathy on NHS inform.

There are many causes of neck pain. Although the symptoms can be distressing, most do improve with time. There are circumstances where a medical opinion is appropriate. If you are experiencing any of the following, please contact 111 or your GP for advice.

Neck pain with severe dizziness, fainting, double vision, difficulty speaking or difficulty swallowing.
A severe new headache with neck pain, especially if you also have a fever or feel very unwell.
Severe pain that is getting worse, especially at night and not relieved by changing position.
Neck pain and new arm or leg weakness or lack of co-ordination
Pain that started after a serious accident, such as after a car accident
Neck pain and a history of previous cancer
Neck pain with a diagnosis of osteoporosis

Do I need further investigations?

Many people ask whether they need a scan. It is natural to think an MRI scan would be helpful to guide management and provide a diagnosis. In most circumstances it usually does not change treatment. An MRI scan shows detailed images of the neck, however a scan is not usually needed to diagnose neck osteoarthritis.

There are circumstances where further investigations are necessary. For example, suspected cervical myelopathy, significant new muscle weakness, a serious underlying condition, or persistent cervical radiculopathy symptoms. A health care professional would recommend further investigation in these contexts.

The information below is reproduced from NHS England's BestMSK patient advice to help explain what an MRI scan can and cannot tell us, and when an MRI may be appropriate.

Some important things you need to know about what an MRI scan can tell us and when it is appropriate

MRIs provide a picture of the anatomy of the spine.
MRIs cannot tell how someone feels and are not a diagnosis.
MRIs can be used to plan treatment with you and rule out serious conditions such as cancer or fractures.
MRIs are rarely needed for people with back or neck pain.
MRIs should be requested after assessment by a specialist.

Some important things you need to know about your MRI scan report

Some of the medical words used in MRI reports can be complex and may sound scary.
For example, eight out of ten people aged 50 or over with NO pain have something called ‘degeneration of discs’ noted in their MRI report. However, findings such as this are more common as we become older and can be signs of a naturally maturing spine.

If you have any questions about having an MRI scan or need clarification on the report of an MRI scan, please discuss these with the clinician who sent you for the MRI.

Lifestyle factors that influence health

Osteoarthritis is common and is influenced by our overall health. Age, weight, smoking, long-term conditions such as diabetes and even long-term stress can all influence osteoarthritis symptoms. Improving general health, staying active, and addressing lifestyle factors can help improve symptoms. Further information on health and lifestyle factors can be found on our Your Musculoskeletal Health webpage.