Cervical Osteoarthritis

April, 2020 Neck Pains

Vertebral surface erosion caused by aging is called vertebrae arthritis. It usually starts at the age of thirty. In osteoarthritis of the neck,small bony extensions (osteophytes) are created along the vertebrae, where the water of the adjacent disc nucleus collapses and the disc becomes narrower and loses its elasticity.

It should be noted that these degenerative changes can cause pain when the adjacent nerves or the muscles and ligaments are stimulated. Sequential injuries to the vertebrae as well as genetics, tobacco use, etc. increase the risk of osteoarthritis.

Signs and Symptoms of Neck Arthritis:

Neck pain can spread to the shoulders, which is exacerbated by the movement of the neck, from the top to the back of the head and hands to the fingers. The severity and quality of the pain increases or decreases, or any abnormal movement is exacerbated. However, pain attacks often occur for no apparent reason. Some patients suffer from persistent chronic pain. Arthritis-like pains usually occur in the morning after a night’s sleep. Osteoarthritis can cause pain along the shoulder route to the hands if the spinal nerves are stimulated, and require immediate intervention if accompanied by muscle weakness.

Diagnosis of neck osteoarthritis:

Physical examination and evaluation of muscle reflexes and gait are important.

Imaging Tests : Imaging tests provide the physician  complete information about the vertebral and spinal cord and osteoarthritis problems, including:

Cervical x-ray : Evaluate infection or bone mass.

Computed tomography : If problems are present in simple x-ray, CT scans can be used for more examination.

MRI : Used to examine soft tissues including discs, ligaments, spinal cord .

Nerve and muscle function test (EMG&NCV) : It is used to determine the      physiological function of the nerves and muscles.

Treatment of osteoarthritis of the neck

The basis of osteoarthritis treatment is noninvasive procedures and the most important principle is soft tissue strengthening around the cervical spine is as follows:

Rest:

Rest should only be relative.

Temporary closure of the brace or cervical collar only in the most advanced cases of arthritis associated with canal stenosis.Prolonged use may weaken the spine muscles.

Medicine:

Medications are used to relieve symptoms in the acute phase, as well as to restore muscle strength and relaxation, including muscle relaxants (peripheral and central), anti-inflammatory analgesics, and in severe cases usage  of opiate drugs. In the non-acute phase of arthritis, combined soy and avocado medications can also be used to prevent the progression and recovery of arthritic lesions.

Non-invasive  treatments :

  1. Physiotherapy : In physiotherapy, a combination of passive techniques and exercises is used to strengthen muscular structure and corrective movements. Passive therapeutic modalities such as ice / heat, ultrasound, and electrical stimulation relieve pain and spasm in a patient with cervical osteoarthritis .The patient with cervical osteoarthritis learns exercises to increase flexibility and range of motion by increasing his or her muscles strength.
  2. Massage and Manual Therapy : The basis of these techniques performed by hand also strengthens the muscular structure of the tissues around the vertebrae.
  3. High Power laser : The use of high-power pulse laser will increase cellular energy and repair damaged tissues and prevent the progression of arthritis.

 

Interventional  treatments:

Interventional procedures are performed by a pain specialist under the guidance of X-ray (fluoroscopy) or ultrasound in the operating room.

Diagnostic and therapeutic injections:

Injections into the spine such as combined steroids and topical anesthetics in the epidural space and injection into the intervertebral facet joints in a patient with cervical osteoarthritis can removes inflammation of the arthritic area.

Facet joints play an important role in the stability and movement of the neck. Radiofrequency in these areas can also be used for long-term pain relief. Other interventional methods may include ozone therapy, PRP injection, orthokine and … 

 

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