Cervical osteoarthritis

If you're reading this, you're probably familiar with that neck stiffness. The kind that prevents you from turning your head. That morning pain that takes time to fade. Or that worry after reading a report mentioning "osteoarthritis." As physiotherapists, we see patients every day who fear their neck is worn out for good.

You are not alone. 98% of adults between 21 and 83 years old show signs of cervical osteoarthritis on an MRI.¹ Even at 21 years old. However, not 98% of people experience neck pain.

Good news: Cervical osteoarthritis is a normal part of aging. It is not a serious disease. Physiotherapy can completely eliminate symptoms in most cases, even if the osteoarthritis is still present. What the science shows:

• The presence of osteoarthritis doesn't always mean pain: 98% show signs on MRI, but most feel no pain.¹
• Wear and tear affects the entire joint: Cartilage, bones, ligaments, discs, and muscles can all be affected.³
• Movement is the best treatment: Your joints are nourished and strengthened through movement.
• Symptoms are treatable: Even with visible osteoarthritis, you can achieve a pain-free neck.

This guide will help you understand your condition and get back to your activities. For an overview, consult our complete guide to neck pain.

What is cervical osteoarthritis?

Cervical osteoarthritis is the normal wear and tear of the neck's vertebral joints. It affects cartilage, bone, ligaments, discs, and muscles. It's a natural aging process, not a serious disease.

We often talk about cartilage wear between the vertebrae. Cartilage acts like a cushion between the surfaces of your vertebrae. It allows your vertebrae to glide and move smoothly.

Over time, this cartilage wears down. All the structures of the joint can be affected.

Cervical osteoarthritis affects the entire joint, not just the cartilage.

Key takeaway: 98% of adults between 21 and 83 years old show signs of cervical osteoarthritis on an MRI.¹ This process begins even at age 21. It's normal and part of natural aging.

Let's look at the symptoms cervical osteoarthritis can cause.

What are the symptoms of cervical osteoarthritis?

Main symptoms include neck pain, morning stiffness, reduced flexibility, and creaking or cracking sounds with movement. However, cervical osteoarthritis doesn't always cause symptoms.

Many people live with osteoarthritis without experiencing any symptoms. Surprising? It's actually quite common.

Reassuring reminder: 98% of adults show signs of osteoarthritis on an MRI. This does not mean 98% have neck pain. Osteoarthritis visible on an image does not automatically mean symptoms.

If you experience headaches along with your neck pain, read our article on cervicogenic headaches.

We frequently treat this issue in physiotherapy. Let's look at what causes cervical osteoarthritis.

What are the causes and risk factors?

Aging is the main cause of cervical osteoarthritis. By age 50, almost everyone has it. Risk factors include past neck injuries, being female, obesity, a sedentary lifestyle, and jobs requiring prolonged static postures.

Osteoarthritis doesn't develop overnight. It's a gradual process that unfolds over several years, which is normal and natural.

Osteoarthritis can sometimes cause cervical stenosis, which is a narrowing of the spinal canal. This is rare. Consult a professional if your symptoms change or worsen.

Let's look at how cervical osteoarthritis is diagnosed.

How is cervical osteoarthritis diagnosed?

Diagnosis relies on your symptom history and a clinical examination. An X-ray can confirm osteoarthritis, but it's not always necessary. Imaging results don't always correspond to the symptoms you experience.

What an X-ray or MRI shows isn't always relevant to your symptoms.

Reminder: 98% of adults between 21 and 83 years old show signs of cervical osteoarthritis on an MRI.¹ Even at age 21. Yet, 98% do not have neck pain.

Your symptoms and the clinical examination often matter more than the imaging results. Don't be alarmed if a report mentions osteoarthritis; it's expected and normal.

Let's look at when to consult a physiotherapist.

When should you see a physical therapist?

Consult a physiotherapist when pain or stiffness prevents you from doing your daily activities. For example, if you have difficulty checking your blind spots while driving or bending over. You don't need to see a doctor beforehand.

Practical examples:

• Difficulty checking your blind spots while driving
• Difficulty bending over
• Stiffness limiting your daily movements
• Pain lasting several weeks

You don't need to see a doctor before consulting a physiotherapist. If necessary, the physiotherapist will refer you to one.

Let's look at the treatments offered.

What are the physiotherapy treatments?

Movement is the best treatment for cervical osteoarthritis. The physiotherapist assesses your mobility, nerve glide, postural habits, movement quality, and strength. This assessment allows them to create a personalized treatment plan.

For more details, consult our guide on physiotherapy for neck pain.

Services offered:

• Joint mobilization: Reduces pain and improves movement
• Home exercises: Address the cause, not just the symptoms
• Guidance on activity levels: Adjusts your activities to optimize healing
• Postural advice: Prevents recurrence

Physiotherapy doesn't cure osteoarthritis; wear and tear cannot be reversed. However, treatment can completely eliminate symptoms, even if the osteoarthritis remains present.

You can regain a pain-free neck even if osteoarthritis is visible on imaging.

Let's look at what you can do at home.

What to do at home?

Stay active. If you have a sedentary lifestyle, start with walks and neck mobility exercises. If you're already active, continue your activities while listening to your body.

If sedentary:

• Regular walks
• Neck and shoulder mobility exercises
• Respect your pain (a little is okay, not too much)

If already active:

• Continue activities that don't cause too much pain
• Listen to your body

Practical tips:

• Painful movements: Stop temporarily, resume gradually
• Static positions: Avoid staying in the same position for more than an hour. Move your neck and shoulders regularly.
• Pillow: Choose a pillow that supports the curve of your neck
• Sleeping position: Avoid sleeping on your stomach if you experience morning stiffness

Let's look at how to prevent or slow down osteoarthritis.

How to prevent or slow down cervical osteoarthritis?

Regular physical activity prevents and slows down cervical osteoarthritis. Your joints are nourished by movement. Aim for 150 minutes of cardio activity per week, strength training twice a week, and maintain a healthy weight.

Your joints get stronger through movement. It's like caring for a plant: regular attention makes all the difference.

Other tips:

• Healthy weight: Varies by individual
• Avoid repeated injuries: Sprains, fractures, and surgeries accelerate wear and tear
• Healthy eating: Consult a nutritionist or the Canadian Food Guide

These tips can help you no matter your age. Regular activity reduces your chances of experiencing symptoms, even if you already have osteoarthritis.

Need professional advice?

If your neck pain persists, our physiotherapists can help. Contact Physioactif for a personalized assessment.

Visit our neck pain page to book an appointment.

To learn more:

Listen to the podcast "Parle-moi de santé" by Alexis Gougeon, a physiotherapist at Physioactif. Episode #15 discusses osteoarthritis in an easy-to-understand way.

Available on Spotify, Apple Podcast, and Google Podcasts.

References

1. Okada E, Matsumoto M, Fujiwara H, Toyama Y. Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation: comparison study with asymptomatic volunteers. Eur Spine J. 2011;20(4):585-91.

1. Musumeci G, Aiello FC, Szychlinska MA, Di Rosa M, Castrogiovanni P, Mobasheri A. Osteoarthritis in the XXIst century: risk factors and behaviours that influence disease onset and progression. Int J Mol Sci. 2015;16(3):6093-112.

1. Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013;9(4):216-24.

1. Canadian Society for Exercise Physiology. Canadian 24-Hour Movement Guidelines for Adults ages 18-64 years. 2021. Available from: https://csepguidelines.ca/adults-18-64/