What to Know About Rheumatoid Arthritis in the Neck

Rheumatoid arthritis causes neck pain and other symptoms (RA). Up to 80% of people in the highest risk group (male sex, positive rheumatoid factor, chronic and erosive joint illness) will have cervical spine joint involvement (vertebra in the neck).

An hyperactive immune system targets the joints, causing pain, edema, and stiffness in people with RA. The hands and feet's smaller joints are usually the first to be damaged. The disease normally takes many years to reach the neck, although one study found that nearly a fifth of people with RA experience neck pain when they were diagnosed.

Symptoms
Neck Pain
The most prevalent symptom of RA of the neck is neck pain. The severity of the condition varies from person to person. Dull or throbbing aching in the back of the neck and around the base of the skull is possible. It may be more difficult to move your head if your joints are stiff and swollen.

The neck discomfort associated with RA differs from that associated with a neck injury. You may have stiffness and soreness after an accident that improves over days and weeks. If you don't get proper therapy for your RA neck discomfort, it will get worse. Even if your symptoms improve, you should expect the inflammation, pain, edema, and stiffness to return.

Headaches
When RA affects your neck, you may also get headaches. Inflamed or irritated spinal nerves on each side of the vertebrae that supply feeling to the back of the scalp might cause pain.

A cervicogenic headache is a type of RA of the neck that causes pain in the head. Cervicogenic headaches are usually unilateral and worsen with movement of the neck and head. They may resemble other headache types, such as migraines and cluster headaches.

Causes
The synovial joints are damaged in RA due to chronic, long-term inflammation. The cervical spine can become unstable if RA affects the synovial joints in the neck. While the cervical spine has multiple synovial joints, RA favors the one between the atlas and the axis, the first and second bones of the spine. The atlas is in charge of sustaining the weight of the head, while the axis aids in neck movement.

Diagnosis
A physical examination is an initial step in identifying RA in the neck. Your doctor will examine your neck range of motion and search for signs of inflammation, misalignment, or joint instability. Checking for neurological symptoms, such as those caused by spinal cord compression, may be part of the physical exam.

They may also order blood tests to see how bad the inflammation is and imaging examinations to see if any of your neck joints are affected, and if so, which ones and to what extent. X-rays, magnetic resonance imaging (MRI), and/or ultrasound are all examples of imaging.

Treatment
Medication
The medications used to treat RA may assist with neck discomfort, but you may also want to look into neck-specific treatments.

In patients with RA, over-the-counter and prescription drugs may help reduce inflammation, and discomfort, and halt disease progression. Advil (ibuprofen) and Aleve (naproxen sodium), for example, are non-steroidal anti-inflammatory medicines (NSAIDs) that help relieve mild to moderate pain and inflammation.

If these meds don't work, your doctor may suggest a stronger anti-inflammatory or a corticosteroid.

Alternative Therapies
Because inactivity exacerbates RA joint pain, your doctor will likely recommend mild exercise like yoga to relieve stiffness and increase strength and flexibility. You might concentrate on neck exercises or workouts for the entire body.

Several other treatments specifically target the neck. Massage treatment or physical therapy, for example, may be recommended by your healthcare practitioner to relieve pain and stiffness in your neck joints, or physical therapy to enhance range of motion. While sleeping, therapeutic neck pillows can provide neck and head support.

Surgery
When you have significant, irreparable joint damage or evidence of nerve compression, your healthcare physician may recommend cervical spine surgery.

Re-stabilizing the first and second vertebrae and relieving pressure from spinal cord compression may be possible with surgery. Bony spurs (bony growths) in the neck, which are common in people with RA, can also be removed during surgery.