Spondylosis refers to the normal degenerative changes caused by aging and posture. That is the “wear and tear” that your doctor might have described when discussing your X-ray with you. It would be kinder to your neck to see these changes as graying hair or wrinkles, because that is in essence what it is. It is not always cause for panic and alarm, even if pain progressively creeps in.

However these changes in the joint surface can cause other problems that may cause pain and neck stiffness. Just like tires of are car get worn out with use, your moving parts gets worn out over time. Certain areas more than other due to the way you move, sit or use your body. The neck and lower back are the most common sites where we can see this process of regression.

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Neck joint degeneration, Neck joint pain, Painfull neck, Stiff neck joints

Why and how does this happen?

Degeneration of the neck joints start because of normal forces acting on the joint complex. The joint complex refers to the entire team who has to carry the load and allow pain free movement. This team includes two cervical vertebrae, the disc in between, the ligaments that aid in stability and the muscles that attach or pass over the joint to generate movement. All these components directly affect the neck joint’s movement, lets look at each individual component.

Discs

With age, discs lose their hydration the same way skin loses it’s elasticity. This will lessen the disc’s ability to absorb forces placed on the neck. The disc narrows from top to bottom because of the increase in forces . Loss of disc height is the reason elderly people seem to shrink as they age. The increase in load may lead to disc bulge/prolapse which results in the surrounding structures being pinched & compressed.

Ligaments

The ligaments also lose their elasticity, which cause traction spurs to develop on the bone. Osteophytes are bone spurs that form as the body’s attempt to help stabilize the joints. Osteophytes can form in the way of a nerve root, or may even become dislodged. The facet joints that is formed where the top vertebra slides onto the bottom one,  undergo changes where they become bigger in an attempt to stabilize the movement segment of the neck joint. This contributes to limited movements and the feeling of a “stiff neck”.

Nerve

All of these changes occupy space in an already tight fit area, even under normal circumstances. This can lead to stenosis, a narrowing of the canal through which the spinal cord passes. Because of this narrowing between the bones it will lead to compression of the nerves running to the shoulders and upper arm. This causes symptoms similar to that of a disc bulge/prolapse, but can be traced back to its origin from the neck joints.

Muscles

The surrounding muscles needs to work overtime to move against the in-congruent joint surfaces. Stability muscles are weaken, leaving you with a headache of a constant neck pain.

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Symptoms of neck joint degeneration

You may experience recurrent attacks of pain that come and go, which may differ in intensity and duration. It does not develop overnight, and slowly progressively gets worse, starting off as occasional stiff neck joint, and progressively becomes more frequently, longer periods, and eventually – constant.

The pain will be dull and deep on both sides of the neck, you may experience numbness and weakness of the arms and hands. This referred pain may be because of nerve compression or muscular referral. Pain will be worse on sudden movement, movement into end range or sustained positions e.g. sitting in front of a computer for hours, driving or texting.

Pain will be worse with activity and relieved by rest. Keeping the neck completely still will also cause the pain to get worse. Symptoms are worse in the mornings with stiffness in all directions, this takes about 30 minutes to ease. The longer it takes to ‘settle’ or ‘get moving’ the more progressed the neck degeneration has become. Your neck might even make sounds on movement, or feel dry and in need of some ‘oiling’ to just get moving again.

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Pinched nerve in Neck, Neck joint degeneration, Neck joint pain, Painfull neck, Stiff neck joints

Mild symptoms

  • Pain is bearable, but just a niggle
  • Painful when looking to one side
  • Muscle stiffness or ‘pull’ with movement
  • Stiff neck joints & limited range of movement
  • Stiffness when looking down
  • Dull ache or a sharp pain
  • Stiff to get out of a position as if staying there too long
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Moderate symptoms

  • Pain is more frequent & taking longer to dissipate
  • Pinching pain when looking to the side
  • Neck stuck or locked in one position
  • Headache
  • Numbness, pins and needles radiating into one arm
  • Pain when coughing or sneezing
  • Weakness in one hand

Dangerous symptoms

  • Pain with breathing
  • Numbness or pins and needles radiating into both arms
  • Left sided pain radiating into the little finger with difficulty breathing and chest pain
  • Difficulty with swallowing or speaking
  • Very stiff neck with flu-like symptoms and sensitivity to light
  • Weakness and sensation changes in both hands
  • Severe, constant pain not improved by any change in position, heat, medication
  • Severe pain at night
  • Unplanned/uncontrolled weight loss
  • Pins and needles/tingling of both hands at the same time

How is neck joint degeneration diagnosed?

The first and most frequently used tool are X-rays. The bony changes can be seen on X-ray. Your report may sound something like this:

“Early onset degeneration, loss of disc height, osteophyte formation, facet joint hypertrophy.”  The medical lingo is just a short version of the degeneration discussed above. A disc bulge or prolapse will not be visible on X ray. It may be necessary to have a MRI.

At our practice we try to get hold of old X-rays that shows us 2 points in time in order to determine the rate of degeneration and identify the neck joint levels that might be more at risk, and start there. X-rays from 10 or 15 years ago will be very helpful, even if its outdated, it this case it can serve a very useful purpose.

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When does cervical spondylosis happen?

Spondylosis diagnosis peaks between the ages of 50 – 59, with approximately 3 in every 1000 people diagnosed with cervical spondylosis. Men and women are equally affected, but men tend to be diagnosed younger. In South Africa rugby injuries are most likely to be blamed. The neck joint levels of C5/6/7 is the most commonly affected because of the position and change in curvature in the spine.

Your risk will be higher to develop neck joint degeneration after injury and trauma (car accidents, falls, rugby injuries), disc pathology (bulge or prolapse) or excessive strain – posture, work (computer/driving/surgeon/teacher), sport (cycling, swimming).

Other causes of stiff neck joints

Physiotherapy Treatment

Unfortunately we cannot reverse the degeneration, it is not as simple as that. We can relieve a great deal of your pain and assist you in some lifestyle adaptations that will help you minimize your neck pain. In doing things differently you can slow down the degeneration process.

Changing your pillow or posture can greatly change the amount of pain you are feeling. Improving your neck strength will aid in stability and the body would be less inclined to seek stability from osteophytes and muscle spasm. Muscle spasm is one of the main reasons why people eventually decide to come see us.

It is important to find a balance between enough movement to keep the muscles strong and the joints free, and too much movement that will cause a spike in inflammation and pain. We are able to guide you to find this balance.

Treatment will include myofascial work, dry needling, joint and nerve mobilisations, taping/strappping and exercises.

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